Assistenza Infermieristica E Ricerca最新文献

. What is a statistical genocide? Memo for an active nursing management of the new reform of the national health system. A recent editorial note in a journal which is certainly culturally and not only scientifically relevant as The Lancet, underlines how statistics, a discipline and methodology expected to be highly reliable and needed to produce critical evidences for programming and evaluating health issues and interventions, has become in various scenarios a misleading tool, by its capacity of using data to manipulate epidemiological information which coincides with the specific cancellation of situations of violation of human and health rights. As we live in a time and in contexts where data are becoming the protagonists of the decision-making processes from the digitalisation of all information, to the uncontrollable dependence from algorithms in deciding priorities and 'personalised' care the alarm raised deserves attention: not exclusively to avoid misled behaviour, but more importantly to assure better and truly innovative practices. In the present challenging situation, which sees the nursing profession planned to acquire more substantial autonomy in the production of knowledge, the alarm could and should be interpreted as a 'sentinel provocation' (and concrete model scenarios are proposed) to manage and utilise data which focus and made better targeted populations more exposed to conditions of fragility and marginalisation: the dominance of administrative data directed mainly to monitor economic sustainability, must be integrated and re-directed to a care where the human rights to health are the indicators and the measure of outcomes.

. "Open" Covid-19 ICU and the emotional impact on nurses: a qualitative study.

Introduction: The Covid-19 pandemic has led hospitals to introduce restrictions on family visits at all levels of care. Intensive care units have suffered an increase in bed space and workload, closing to family visits. Health care personal, especially nurses, have experienced significant psycho-physical stress during the Covid-19 pandemic waves.

Aim: To describe and investigate the experiences and the emotional impact of nurses who have experienced the Covid-19 ICU open to family visits.

Methods: Phenomenological qualitative study through the use of semi-structured interviews.

Results: From the interviews made to ten nurses, five themes emerged: reactions to the admission of family members, the active role of the family member, the effect of the visits on hospitalized patients, the return to normality, and the admission of family members as a therapeutic act. After an initial concern about the spread of infection, the nurses have welcomed with satisfaction the opening of ICU Covid-19 to visits. The entry of family members into the Covid-19 ICU was perceived as a facilitating factor for the patient's course and care.

Conclusions: The humanization of care is a delicate process: in our study a strong emotional impact has emerged on the nursing staff, which produced joy, satisfaction and contentment, and even more on the impulse and the strength to continue doing their work. This organizational model has restored a kind of normality to patients, their families and health workers, despite the ongoing pandemic.

. Video calls between patients and families: a narrative review.

Introduction: Many services have introduced video calls between patients and family members during the pandemic.

Aim: To synthesize the literature on the use of video calls between patients and family members when "in presence" visits are limited or banned.

Methods: A narrative review of the literature was conducted by searching PubMed and Cumulative Index to Nursing and Allied Health Literature databases using the keywords video call, covid, relative and similar terms. Articles on video calls between family members and patients referring to the 2020-2022 pandemic period have been included.

Results: Eighteen studies were included: six descriptive qualitative, four case reports, three cross-sectional, three observational, a quasi-experimental and a commentary; most of them were from Italy and based in intensive care and long-term facilities. The most used term was video call. Studies investigated how to properly plan and conduct the video call, prepare the patient and his/her family, accounting for the technical aspects and devices. Video calls may generate positive effects on satisfaction, anxiety, depressive symptoms, and distress of patients and families; however, negative effects have been also documented.

Discussion: The use of video calls in acute care and end-of-life settings implies a different complexity from nursing homes or long-term care facilities. The video call must be planned and evaluated as all other nursing interventions; it cannot be spontaneous and without a preliminary assessment of the potential benefits and risks; health care professionals should be properly trained.

. Patient isolation during Sars-CoV-2 pandemic: the caregivers' experience in a neuro-rehabilitation unit.

Introduction: During the Covid-19 pandemic, caregiver visits were suspended in many health care facilities and, even today, limitations remain. These restrictions have impacted not only the patients but also caregivers.

Aim: To explore the life experience of caregivers of hospitalized patients, during the pandemic and the impact of visit limitations in a rehabilitation unit.

Method: An exploratory qualitative study was conducted, following the COREQ guidelines. Caregivers of inpatients were purposefully sampled and interviewed, until data saturation. A qualitative thematic analysis with an inductive approach was performed.

Results: Fifteen caregivers were interviewed. The themes emerged were: 1. perception of the illness as a sudden change; 2. concerns for their loved one (i.e. the loneliness or the suffering); 3. critical (difficult to organize and perceived too short) and positive aspects of the visits; 4. barriers to communication (for example, masks when in presence; or the difficult use of technologies by elders); 5. patient's protection and support (thinking that the relative's presence may improve the rehabilitation); 6. emotions (from discouragement when visits were not allowed, to joy when meeting their loved one).

Conclusions: Caregivers experienced uncertainty, worry, anxiety, fear, and lack of understanding of their loved one's clinical situation. Alternatives to the visits or the visits with physical barriers were helpful but not always effective.

This is the second contribution of a series of updates on some of the oncological emergencies. The updates are published in the form of a case, with multiple-choice questions to assess knowledge, a brief discussion of the answer, and reference literature, to further explore the topic presented. This case involves the management of malignant bowel obstruction from an ovarian cancer.

. How nurses spend their time-shift and the strategies adopted to maximize it: a scoping review.

Introduction: Investigating how nurses spend their time during the shifts has become important mainly recently, due to the nursing shortage.

Aim: The aims of the study were to map and summarise, (a) how nurses use their time-shift in different care settings, and (b) the time-shift management strategies implemented.

Method: A scoping review according to the Arksey and O'Malley framework, integrated by Levac and colleagues and the Preferred Reporting Items for Systematic review and Meta-analysis extension-Scoping reviews guideline was conducted in 2021.

Results: Thirty-one studies were included (30 primary studies, one secondary), published from 1987 to 2021, mainly conducted in USA, UK and Sweden. Most of them were based on quantitative designs (23/30). In critical and psychiatric settings, the nursing time is dedicated almost equally in direct and indirect care; in the medical, surgical, and oncological units, the direct care activities occupy around the 30% of the nursing time-shift, whereas the indirect care activities increase. In long-term settings the indirect care reaches the 60% of nursing time while in home care around one third of time is spent in direct care. Nurses enact different time-management strategies during the shift.

Conclusion: Nurses spend limited time at the bedside, as perceived also in the Italian nursing practice; making more visible to patients and their caregivers the value of the indirect care performed by nurses is necessary.

. 'One for all, all for one': an example of community networks integration and coordination.

Introduction: In order to build networks and activate more support services at home, it is essential to have information about the availlable resources.

Aims: To describe the experience of creating an informative brochure on territorial services for people at home.

Methods: The brochure was developed by collecting both from the web and from health care professionals data on services supplied by non-profit organizations.

Results: The brochure is divided into sections, each corresponding to a type of service and presenting the questions that users may ask or the most frequent situations (e.g. "I can't grocery shopping any more"), the availlable services and contact information.

Conclusions: A brochure providing information on the service providers available in the region is a useful tool for both patients and caregivers.