[How the bed rest period and the posture assumed by the patient post lumbar puncture caninfluence the onset of complications: a rapid evidence assessment]. / Come il tempo di allettamento e la postura assunta dal paziente dopo rachicentesi possono condizionare l'insorgenza di complicanze: un'analisi delle evidenze.

AIM: To identify how the bed rest period and the posture assumed by the patient after lumbar puncture can influence the onset of complications, and which nursing interventions to adopt in order to reduce the complications. METHOD: A rapid assessment review was performed and the electronic databases PubMed, CINAHL, and the Cochrane Central Register of Controlled Trials were searched between 2001 and 2015. RESULTS: Initially, 407 studies were retrieved, and 5 of these publications were considered to be eligible for the purpose of the study,4 comparing different periods of bed rest and 1 comparing patients position. Headache, nausea, vomiting and other symptoms, do not seem to reduce with a 24 hours longer bed rest. There is a lack of evidence on the effectiveness of early mobilization, as well as on the effects of different postures after the procedure performed to reduce the incidence of complications. Only a statistically significant gender difference in the onset of the headache was found: women seem to be more at risk. The selected studies showed a medium-low methodological quality and a high heterogeneity in the systems used to measure the symptoms, in the features and dimensions of the investigated populations. CONCLUSIONS: Currently available data do not permit to identify care interventions related to effective bed rest period based on scientific evidences in order to prevent post rachicentesis complications. It is therefore considered necessary to conduct further experimental and observational studies, with a high methodological rigor in order to maximize the effectiveness of nursing care.

Does participative leadership reduce the onset of mobbing risk among nurse working teams?

AIMS: To evaluate the advancement of knowledge on the impact of an empowering leadership style on the risk of mobbing behaviour among nurse working teams. The secondary aim was to evaluate, along with leadership style, the contribution of other organisational- and individual-related mobbing predictors. BACKGROUND: The style of leadership in reducing the onset of mobbing risk in nurse working teams still remains a matter of discussion. Nurse working teams are particularly affected by mobbing and studies exploring individual and organisational inhibiting/modulating factors are needed. METHODS: An empirical study involving 175 nurses of various public hospital corporations in northern Italy. Data were collected via structured and anonymous questionnaires and analysed through a logistic regression. RESULTS: Organisational, individual and participative leadership variables explained 33.5% (P < 0.01) of variance in the onset of mobbing. Two predictive factors emerged: a participative leadership enacted by nursing managers and the nursing shortage as perceived by clinical nurses. Results confirmed that the contribution made by a participative leadership style in attenuating the onset of mobbing risk in working teams was significant. CONCLUSIONS AND IMPLICATIONS FOR NURSING MANAGEMENT: A participative leadership style adopted by the nurse manager allows for the reduction of tensions in nurse working teams. However, mobbing remains a multifaceted phenomenon that is difficult to capture in its entirety and the leadership style cannot be considered as a panacea for resolving this problem in nurse working teams.

[The leadership style as a mitigator of the insurgence of mobbing risk. Results from an empirical research on Italian nurses]. / Stile di leadership e rischio di mobbing: risultati di una ricerca empirica in ambito infermieristico.

BACKGROUND: The influence of the organizational factors in mobbing onset, is supported by several studies. The leadership style is considered as one of its main antecedents. OBJECTIVES: To investigate the relation between the leadership style adopted by the Nurse Coordinator and the diffusion of "negative actions", main indicator and antecedent of mobbing onset. METHODS: Empirical study that involved 175 nurses and obstetricians of a Public Hospital Corporation in North Italy. Data has been collected via a semi-structured and anonymous questionnaire. RESULTS: The results confirm the hypothesis that the adoption of a non-collaborative leadership style goes with a greater diffusion of "negative actions" among the nurses. CONCLUSIONS: To intervene on organizational variables, such as the leadership style, allows to reduce the working unease and, therefore, the factors which are linked to it and which bear on the provided relief quality. The results of this study underline the Nurse Coordinator role in preventing and thwarting the onset of "negative actions", which are a potential source for mobbing onset.

Chief Nurse Executives involuntary turnover in times of health care reforms: Findings from an interpretative phenomenology study.

In recent years, due to several health care system reforms in different countries, an increased involuntary turnover rate of Chief Nurse Executives has been reported around the World. However, no data on their perceived experience of their dismissal have been documented up to now in the European context. Describing the experience of involuntarily dismissed Chief Nurse Executives was the main aim of this interpretative phenomenological study. Data were collected through face-to-face audiotaped interviews performed by involving a purposeful sample of 13 Chief Nurse Executives; data analysis was performed by using the QSR NVIVO 11 software. The Chief Nurse Executives' experience of Being fired is characterized by three main themes: (1) "Health Care Institutions are places influenced by political turbulences"; (2) "My competence and presence in the arena is despised by a range of strategies"; and (3) "Transiting from darkness to light". According to their experience, the reason for dismissal was due to changes in the political climate and the introduction of a new chief executive officer; moreover, Being fired caused a deep pain similar to that experienced during bereavement. In some socio-political contexts, the political climate can influence the role of a Chief Nurse Executive: political membership, whether implicit or explicit, is considered of great value. In other contexts, the Chief Nurse Executives' value is based on professional competences and achieved outcomes. At times of changes in the political climate, the peculiarities of the specific socio-political context should be evaluated as to whether one should anticipate his/her resignation or not.

[The admission to Nursing Homes and Home care services of elderly patients: analysis of the trend from 2008 to 2011 in a North Italian district]. / Il ricorso alle case di riposo e all'assistenza domiciliare per gli anziani: analisi di trend dal 2008 al 2011 in un distretto del nord Italia.

INTRODUCTION: The effects of the economic crisis impact on several aspects, included the use of health and social services. AIM: To analyze the effects of the economic recession on the request of in-home and long run social-health services. METHODS: Retrospective research. The databases of a In-home Nursing Service, the Social Services and the Welfare area of a Social-Health Local Service in North of Italy have been consulted, with reference to the period between 31st December 2008 to 31st December 2011. RESULTS: From 2008 to 2011 the users supported by the In-Home Nursing Service increased by 30.3% while a decrease in the waiting lists for public and private nursing homes was observed. The users of In-Home Assistance Service decreased by 11%, as well as recipients of In-Home Meal Service (33%). Since 2008, the number of regional economic allowance beneficiaries dramatically increased; these allowances are dispensed as a support to In-Home Nursing Service and to social frailty. CONCLUSIONS: Profound changes of the offer and use of long term care services is evident. The endurance of this trend could impair the In-Home Nursing Services ability to answer to health needs of citizens. Health care professionals should strengthen the educational interventions to improve the level of patients'self care.