Assistenza Infermieristica E Ricerca最新文献

. The consequences of visiting restrictions in long term care facilities: a narrative review of the literature.

Introduction: To prevent the spread of Covid-19, residential health care facilities banned access to informal caregivers.

Aim: To describe the consequences of visiting restrictions in residential facilities during the pandemic and to identify the strategies adopted to lessen their effects.

Methods: A narrative review of the literature was carried out by searching PubMed and CINAHL database between October 2022 and March 2023. The research included primary, qualitative and quantitative studies written in English/Italian language, and in which data collection was performed after 2020.

Results: Twenty-eight studies were included: 14 qualitative, 7 mixed-method and 7 quantitative. Residents and family members experienced anxiety, sadness, loneliness, apathy, anger and frustration. Technology tried to ensure contact, but with limitations due to residents' cognitive-sensory impairments, technological expertise, and staff's available time. Attempts to allow visitors again were welcomed with gratitude, but access was not always granted, causing discontent. Health care professionals experienced the restrictions with ambivalence, torn between the need to prevent contagion and concerns for residents' quali-ty of life.

Conclusions: Visiting restrictions had negative consequences for residents, family members and health care professionals. The sense of abandonment experienced pointed out the lack of strategies able to balance safety and quality of life.

. Measuring missed nursing care during the Covid-19 pandemic: methodological reflections. Missed care phenomenon has demonstrated an increasingly interest of the researchers over the years. Even during the pandemic period, many studies have been published with the aim of describing missed care during this healthcare emergency. The comparative studies (Covid-19 versus non-Covid-19) were innovative; however, no important differences have emerged. On the other hand, many studies have been published with a descriptive intent, also in this case without highlighting substantial differences as compared to the pre-pandemic period. These findings bring out a series of methodological reflections, which should be considered to advance research in this field.

. Identifying population needs: methods of analysis and stratification. In this article, examples of population stratification models used at the national level to identify different levels of needs and interventions are reported. Most models are based primarily on health data, diseases, clinical complexity, use of health services, hospitalizations, emergency room access, pharmaceutical prescriptions, and exemption codes. The limitations of these models relate to the availability and integration of data, as well as generalizability in different contexts. Moreover, to address the difficulty of implementing effective local interventions, the co-production or integration of social and health services is strongly suggested. Some survey techniques are presented to detect the needs, expectations, and resources of specific communities or populations.

. Preparedness for emergencies: strategies to increase the supply of beds and advanced intensive skills.

Introduction: The recent pandemic has highlighted the importance of emergency preparedness plans. In addition to technological and structural resources, it is essential to have professionals with skills that allow them to safely work in intensive care areas.

Aim: The aim of the contribution is to propose an intervention model to develop the skills of nurses of operatory theatres or intensive care to enable them to work safely in critical care settings.

Methods: A plan was devised, involving a multiprofessional group to increase the number of beds in the intensive and semi-intensive care areas, as well as to train staff, hypothesising the activities to be reduced by moving staff to different areas.

Results: The proposed organisational model could be implemented in other hospitals; it guarantees emergency preparedness and the expansion of the skills of the staff involved.

Conclusions: Nursing staff with advanced skills should be readily available to safely guarantee the expansion of intensive care beds. The current division between intensive and semi-intensive settings could be revised in favour of a single critical care area.

. Transitioning Italian nursing education in the post-pandemic period: priorities in the light of lessons learnt.

Introduction: Once back to normalcy, many nursing education activities have been restored without an in-depth analysis of which transformations enacted in the pandemic period should be maintained and valued.

Aim: To identify priorities to effectively transitioning nursing education in the post-pandemic period.

Method: Descriptive qualitative design. A network of nine universities involved 37 faculty members, 28 clinical nurse educators and 65 students/new graduates. Data were collected through semi-structured interviews; the main priorities reported in each university were combined to gain a global view.

Results: Nine priorities emerged, including the need to: 1. reflect on distance learning to promote its complementary role to face-to-face teaching; 2. rethinking the rotations of clinical practical training by refocusing their aims, duration, and preferred settings; 3. understanding how to integrate the virtual and the in-presence learning spaces into the educational pathway; 4. continuing with inclusive and sustainable strategies. Considering that nursing education is essential, it is a priority to develop a pandemic education plan capable of guaranteeing its continuity in all circumstances.

Conclusions: Nine priorities have emerged all considering the importance of digitalization; the lessons learnt, however, indicate the need to enact an intermediate phase capable of guiding towards the complete transition of the education in the post-pandemic era.

. Methodological challenges for proactive post-Covid care strategies. In the present global-national scenarios of healthcare systems obliged to recognise their profound failure in the management of the Covid pandemic, the uncertainties on what could possibly be done to reverse the causes of the failures are the dominant terms of reference. The urgent needs of substantially increasing the investments on the scarce human resources and on the structural inequalities in the access to care are, in fact, in profound contrast with policies obedient mainly to economic sustainability and further exclusion from health rights. An epidemiological agenda explicitly centred on the lives of communities as producers of knowledge (not based on administrative and artificially standardised data), and as real bottom-up partners of the classical top-down actors is illustrated. The above perspective is discussed as a provocative and at the same time realistic opportunity for an innovative promotion of an autonomous role of the nursing professions and research.

. Haemopoietic stem cells transpantation: a narrative review. Haematopoietic stem cell transplantation (HSCT) is an effective treatment for many haematological malignancies and its employment is growing thanks to the increased possibility of finding suitable donors and the discovery of therapies to treat major complications. The fourth contribution on emergencies in the oncology setting proposes a narrative literature review to describe the transplant pathway, the types of HSCT, the conditioning regimen, the stem cells reinfusion, the aplasia phase, the major complications and the follow-up. The review included secondary studies published from 2020 to 2022, on adult transplanted patients and written in English; 30 studies were included. In addition, 28 primary studies describing key issues and 11 textbooks were added. Both autologous and allogeneic HSCT expose patients to infectious or drug therapy-related complications, such as mucositis and bleedings. The allogeneic HSCT is at higher risk of major complications such as the graft-versus-host disease and the venous-occlusive disease. The update proposed is accompanied by two cases with multiple choice questions, in patients who underwent autologous stem cells hematopoietic transplantation: case 1 (published in this issue of the AIR journal) on septic shock and case 2 (which will be published in the next issue of the AIR journal) on a massive hemothorax.

. The nurses' strike in the United Kingdom: an overview of the reasons, debate and implications.

Introduction: In the UK, where the National Health Service (NHS) was founded, one of the most important and long-lasting strikes in nursing is taking place.

Aim: To understand the historical, professional, political/social reasons for the UK nurse's strike.

Method: Historical, scientific literature and data from key informant interviews have been analysed. Data has been summarized narratively.

Results: On 15th December 2022, more than 100,000 NHS nurses went on strike in England, Northern Ireland, and Wales asking for an increased salary; on the 6th and 7th of February and 1st of March the protest has continued. By improving pay, nurses believe the attractiveness of the profession can increase and counteract the loss of nurses who are leaving the public for the private sector, and the lack of attractiveness of the profession towards young people. The strike is organized by the Royal College of Nursing in a structured form which gives nurses precise information on how it should be explained to patients: according to a survey, 79% of the population supports the nurses' strike. However, not all agree with this strike action.

Discussion: The media, social media and professional debate is passionate with some polarization between who is in favor and who is against. Nurses strike not only for better wages but also to increase patient safety. What we see in the UK today is the result of years of austerity, lack of investment and health priorities: a similar situation experienced in several countries as well.