Assistenza Infermieristica E Ricerca最新文献

. Insulin: a story 100 years long. Part of the November 13 issue of the Lancet was devoted to insulin, which this year celebrates 100 years since its discovery. In this issue, we report a of the main contributions both to illustrate the history, but also to highlight the emblematic path-not only for insulin-of drug pricing, which severely limits its accessibility to those who need it most.

. The family and community nurse-led proactive management of COPD patients: experience of an Italian health district.

Introduction: Integrated care management for COPD may reduce healthcare utilisation, improving cost-efficiency.

Aim: To assess the primary outcomes of a family and community nurse-led proactive management of COPD patients of an Italian health district.

Methods: Target population comprised men and women >60 years, resident in the municipalities of Collegno and Grugliasco (metropolitan area of Turin). Administrative databases (hospital discharge records, drug prescriptions, legal exemptions) were first used to identify patients with diagnosis of COPD; the cases were validated by the General Practitioners (GPs). The 335 patients were enrolled from July 1, 2015 to November 30, 2016. Family and community nurses were responsible for anamnesis, spirometry, assessment of adherence to therapy, counselling and healthy lifestyles education. GPs were responsible for the clinical staging and revision of therapy. Patients were followed-up to 12 months.

Results: Improvements were observed in smoking cessation (prevalence of smokers from 23.9% to 20%), BMI normalization (in 13.4% of patients out of standard), physical activity (from 32.5% to 64.5% of patients), and pneumococcal vaccinations (from 14.9% to 58%). The last two outcomes were statistically significant. Patients showed high levels of satisfaction; 12-months compliance was 62.1%.

Conclusion: A family and community nurse-led proactive management of COPD patients in primary care is feasible and effective. Interventions should be structured, personalised and multi-component, oriented at motivating, engaging and supporting the patients. Positive results led to continue and extend the programme.

. Project for an Health Centre. For an interpretation of the post-pandemic as a time of experimentation. The problems in health care, highlighted by the pandemic that so severely affected the Bergamo area, led to the activation of a multidisciplinary group, that started a path of reflection and proposals, to move the health care from the hospitals to the districts. The consultations and meetings involved not only institutional representatives of health and social care but also schools, municipalities and voluntary associations, and started several projects (some are already ongoing) that promote the contacts with the community, in the idea that health can be achieved only through the involvement and participation of and with the citizens. A model has been proposed to build a district clinic, and several initiatives have been planned: to identify, orient and support adolescents with mental distress; to map existing social and voluntary services and to promote reciprocal knowledge of professionals involved; to improve peer support among students and the self-esteem in students with a troubled background. All initiatives are characterized by a broad involvement of all stakeholders and a down-top approach of strategies and interventions. The experience presented is a blueprint of involvement, participation, and mutual engagement of professionals, lay citizens and communities.

. Family and Community nursing: overview of practice in Europe. In this contribution, an overview of the role and functions of the family nurse in some European countries is presented. The role of family and community nursing varies with respect to contexts and changes according to the needs of the population, focusing particularly on frail conditions, or maternal and child support, or the prevention and management of chronic diseases. Family and community nurses have specialized postgraduate training, except in Finland, to gain skills to help individuals and families prevent disease conditions or cope with chronic disability. They work primarily in community centers, in patients' homes, and with families; advocate for lifestyle modification and behavioral risk factors; and care for families on wide-ranging health issues.

. Conclusions and reflections for planning not based on average numbers. Planning for the number of Family and community nurses (FCNs) needed cannot be based on average estimates issued at the national level. In fact, organizing a service requires in-depth knowledge not only of patients, but also of the local area, health, social, and volunteer services. This information is available, however not always easy to use and combine with other useful data stored in databases not connected to each other. While waiting to have enough FCNs, priorities for those available should be set at local level. The choice of priority target groups of population depends on local data but also on a careful assessment of the services already available in the area, in order to identify the populations most at risk or with limited access of services of the national health and social systems.

. The implementation of Family Nursing in a municipality of the Provence of Bolzano. In the Province of Bolzano, 45 Family and Community Nurses have been trained to date with a 1250-hour course of which 400 hours of practical training. The working model adopted is the Calgary Assessment model, based on ithe relationship with families. The experience of the District of Bassa Atesina, which includes ten municipalities and about 40,000 inhabitants, is described, and in particular the assignment of three family nurses to a mountain municipality with a population of 1700 inhabitants, located with a considerable territorial dispersion. The FCNs cared for 48 families with tailored care plans. The model will be extended to other Districts.

. Looking for stolen time: two years that worth four. The pandemic had a considerable impact on the mental health of health care personnel, as documented by a study, conducted on 550 employees of different profiles of a university hospital in Milan. Workers report war-like experiences. The initial gratitude of the population was followed by an attitude of rejection, as health workers were considered carriers of contagion. Financial recognition went only to the managers. The one against Covid was a war, and the nurses the combatants. Strategies can be activated to recognize the commitment and sacrifice of those who were (and remained) on the front lines.

. What family nursing really means? The Family and Community Nurse (IFeC) was introduced in 1998 by the World Health Organization, with the aim of extending the care of nurses to the family, which represent the center of people's lives and care, and to shift the focus of care and interventions (particularly those of prevention) from the individual, to the family, and also to the community to which they belong. Investment in prevention requires strategies and foresight on the part of decision-makers, and does not guarantee immediate returns. IFeCs, if empowered to care for the community, can make a major contribution to population health.