Professioni infermieristiche最新文献

Introduction: Accurate pain assessment and management in critically ill patients withcognitive alterations who are unable to communicate constitute a major challenge for themedical and nursing staff of Intensive Care Units (ICUs). This study want assess the impact of Critical Care Pain Observation Tool (CCPOT) scale in ICU practice and evaluate the effects on pain assessment and management in brain-injured critically ill adult patients.

Methods: This before-and-after study was carried out in an Italian ICU, where data were collected before (T0) and after (T1) implementation of the CCPOT in brain-injured critically ill adults.

Results: The study population consisted of 81 patients (35 before and 46 after intervention). The use of propofol fell significantly and at the same time the use of morphine increase significantly (morphine: t(80) = 1.51, p =.02) after intervention.Analysis of the data with respect to pain relief and prevention during some nursing care activities revealed a significant increase in the use of fentanyl citrate and paracetamol. Pain management was in line with the protocol, which envisaged administration of pain medications to patients with CCPOT scores less than 3 in 76.8% of cases.

Conclusion: The present findings strongly support the value of the CCPOT scale in managing ICU patient pain in conjunction with medical and nursing staff training. However, further studies of larger patient samples should be performed.

The Emergency Medical Service team are often the first to arrive in situations that later turned out to be crime scenes. Therefore, multiple responsibilities derive from their actions, as there is the burden of assisting the parties involved by maintaining the integrity of forensic evidence while, at the same time, mitigating further harm or risks. The aforementioned, however, often lack any forensic training with the consequent risk of alteration of the area and loss of fundamental information for the purpose of further investigation. The purpose of this study, born from the interdisciplinary collaboration between nursing and forensic sciences, is aimed to guarantee the correct approach by emergency professionals at the Crime Scene; in the light of the data currently available regarding intervention strategies, a Data Collection Sheet was drawn up, whose non-immediate compilation would inevitably lead to the loss of important informations. This is a tool not intended for medical examiners, already trained in this field and equipped with elaborate survey cards, but rather an easy-to-use tool that is the prerogative of "laymen" that can prevent emergency healthcare professionals from losing crucial elements that will then be provided to the investigative bodies and consequently to the consultants or experts. The working method involved the research in Literature of already existing operational tools and a bibliographic review of texts, articles and protocols relating to the topic, as well as surveys carried out at national level via email with EMS Operations Centres about the use of a Crime Scene Report Card.

The constant evolution of the health care system has led to a thorough reorganization of the system itself and an improvement in terms of the quality of treatment provided. Many articles in the literature confirm that the answer to increased quality of standards and efficient levels of organization are undoubtedly due to true and efficient team work, without any of the professionals involved having to change their area of expertise. This rapid evolution of the treatment process has required the improvement and definement of technical-specialist skills on the part of the nursing staff; personnel who have proved to be the real link in the technical-communicative processes. In relation to this important aspect, it has become essential to design, at present based on more than ten-years of experience, a profile of "job description" skills for the nursing staff engaged in the world of donations and transplants, in order to give companies objective and measurable elements on the skills profile that can be identified for this specific area and a clear recognition of the profession itself.

Background: Presenteeism represents the need to "get to work although we feel sick"; thus, affecting the quality of work, leading to errors or omissions, reducing productivity and increasing costs. Nurses are among the job categories with the highest degree of Presenteeism, which may negatively affect work quality.

Aims and objectives: To assess the prevalence of Presenteeism among Italian nurses.

Methods: A cross-sectional, multicentric study was carried out from January to December 2015 in a sample of Italian nurses. A total of 652 nurses completed the questionnaire. The mean Stanford Presenteeism Scale (SPS-6) total score was 21.6 (±4.0). Nurses showed high Presenteeism levels when considering the "Avoiding distractions" and "Completing work" sections of the Scale.

Results: Male nurses showed a lower degree of Presenteeism than women, which also tended to be less severe with increasing age. The presence of ≥1 self-reported health problem was associated with an increase in the score.

Conclusions: In line with previous studies performed outside Italy, Presenteeism appear to be a widespread condition also among Italian nurses, requiring appropriate treatment and recognition by healthcare providers. The results of this survey might be used as a minimum, most likely underestimated basis for targeted public health policies.

Background: The use of simulation in the training of nurses has increased in the last decades, allowing the acquisition and development of several competencies.

Objective: Understand the experiences of nursing students who used the aged simulation suit.

Methodology: Qualitative study of a phenomenological nature. The participants were nursing students, who used the aged simulation suit. Data collection was made through the interview, and the data analysis was performed following the Giorgi phenomenological method.

Results: Three themes reflect the essence of the experience: Wear the skin of the elderly; Confrontation with their own ageing process; Skills development.

Conclusion: If, on the one hand, the students who used the aged simulation suit experienced sensory and motor impairment and consequent confrontation with their own ageing process, on the other hand, they experienced the development of scientific, relational and citizenship skills. It is expected that the results of this work will foster the use of the aged simulation suit as a complementary methodology, with potential impact on the quality of care and health gains.

Introduction: Hospitalisation represents a significant risk factor for the decline in the general conditions of the elderly. Loss of autonomy in elderly inpatients, together with immobilisation, has been defined as 'Hospital-Acquired Disability' and affects 65% of this class of patients. Less than half of them will regain independent mobilisation. Included among the negative effects are: falls, increased percentage of admission to nursing homes, longer hospital admissions, increased mortality and morbitity. Despite these facts, elderly patients remain in bed for 83-95% of their hospital stay; they rarely walk or are mobilised. Only on an international level has this issue been analysed OBJECTIVES: To analyse active mobilisation in inpatients.

Methods: Prospective analytical and descriptive study performed from December 2018 - May 2019 in the Clinical Medicine department of the AUSL of Reggio Emilia. Descriptive analysis of the data has been performed.

Results: A total of 1725 patients were screened for the study. After applying the inclusion criteria, 295 patients were enrolled in the study, 9 of which were then excluded for failure to be mobilised. 66.4% of these patients were mobilized the morning during hygiene-rounds. According to the nurse, they appeared in a stable state, alert and oriented (88.1%) and used a variety of aids (from 1 to 3) (57.3%). The frequency of mobilisations were: 44.4% once a day, 31.2% twice, 24.4% three times or more.

Discussion: This study highlighted that mobilisation is strictly correlated to first assistance, frequently relying on health care assistants, and is mostly applied to oriented patients who only need one assistant. Further studies are required to investigate connections between patient's features and mobilisation.

Background: Music listening represents a gold standard in the evidence-based holistic nursing practice. However, music listening is seldom involved in orthopedic postoperative settings, and only a few related studies can be retrieved in literature.

Purpose: The aim was to assess the effects of music during the orthopedic postoperative period, when patients frequently report pain and anxiety.

Method: A randomized controlled trial on 56 patients, equally divided in an experimental group treated with music and a control group in standard care, was conducted during their first-day of recovery from orthopedic surgery. The primary outcome was the pain level assessed with the VAS scale and the Short Form-McGill Pain Questionnaire. Secondary outcomes assessed were anxiety level, blood pressure, heart and respiratory rates and oxygen saturation. Following surgery, when clinically stabilized and soon after their return to their ward room, patients listened to music from a personal programmed playlist using their smartphones for 30 minutes.

Results: In music group, the Short Form-McGill Pain Questionnaire score significantly improved in the sensorial dimension (p=0.006) and in the affective dimension (p=0.02). Patients showed a pleasant experience in listening to music (90%), found it useful in coping with pain (64%) and improving mood (86%).

Conclusions: Music in the orthopedic post-surgical period induced significant improvement in pain relief, representing a useful complementary intervention to drug treatment. Music listening could be a safe treatment, inexpensive and simple to manage by nurses in orthopedic postoperative settings.