Assistenza Infermieristica E Ricerca最新文献

. Family nurses in Italy: an explorative survey.

Introduction: The Family and Community Nurses (FCN) are unevenly distributed throughout Italy.

Aim: to describe the numbers, functions and work situation of FCNs in Italy.

Methods: A questionnaire with 24 multiple-choice questions was sent to 60 Nursing and health professions District managers, to explore numerical standards of reference, recruitment methods, training, work environments and methods, hierarchical and functional dependencies, functions performed and level of autonomy.

Results: 38 (63%) managers from 14 regions responded. In 26 (68%) districts, FCNs are employed with numbers ranging from 2 to 350 per district (median FCN/inhabitants ratio of approximately 1/16.000 inhabitants (IQR 10.000-40.000). Nurses with at least 2 years of work experience (in home or medical care) were selected, and all have attended or are currently attending a training course (university, regional - 40% of the districts - or internal courses). In almost all Districts FCNs hierarchically depend on the Nurse Manager while functionally from the District Nurse or Medical Director. FCNs mostly work in multidisciplinary teams and in most Districts (21, 80%) perceive good levels of autonomy.

Conclusions: Although a limited number of managers responded, these data provide a cross-section of the variability of numbers and organization at district level.

. The complexity of the nursing research in the primary health care: methodological challenges and suggestions.

Introduction: Research in primary care nursing has grown in the last decades addressing the national and international call aimed at increasing the primary health care services.

Method: A of the main possible challenges that researchers might encounter in primary care research is proposed, as well as suggestions aimed at implementing strong research methodologies.

Results: The study designs feasible in this setting such as that observational, randomized cluster and/or pragmatic trials, stepped wedge designs, and mixed-method studies are discussed; as well as strategies to involve the population, e.g., with participatory research; how to describe the interventions and the possible outcomes sensitive to the family/community nurses care to consider.

Conclusions: National and international guidelines promote the implementation of the family/community nurses. Many Italian regions are implementing the model tailored to the context: these initiatives should be accompanied studies capable to document their outcomes.

. Family and Community Nursing(FCN): guidelines of the network of Master for FCN of Italian Universities. Developing new and more advanced roles for nurses could improve access to care, quality of care and contain costs. The joint document elaborated by the network of the University Masters for FCN aims to provide a guideline to standardize the postgraduate courses for the training of FCNs and to promote the development of core competencies, which are essential, also in the perspective of a possible future passage towards the second level Master degree. The skills and the core contents to be developed, are proposed together with indications are given for workshops to develop technical skills and the organization of practical training.

. Pandemic affected mental health of doctors and nurses. Depression, burnout, and insomnia: after three pandemic waves, the health care personnel and in particular the female component, is grappling with a new emergency. In Piedmont, 44.5% have experienced symptoms of psychological malaise. This phenomenon was reported both in professional and in the lay press, to highligt the attenttion on a problem that, if not managed correctly, risks to impact on the health of health care personnel.

. Nurses and the new reform: is there space and resources for nursing care?

Introduction: The National reform for recovery and resilience (PNRR) may represent a unique opportunity for the development of the nursing profession.

Objective: A group of colleagues was asked to comment on the positive and critical aspects of the PNRR.

Methods: Questions or points for reflection were proposed: if and how the nurses'role is recognised and promoted in the redesigned National Healthcare System; the real attention to the continuum of care and to the actual fragmentation of social and health services in community care; if Mission 6: Health devotes sufficient attention and funding to the needed increase in the number of health professionals in the health care services and to the development of new skills. Everyone was free to choose which question to answer or could send free reflections.

Results: In addition to the positive aspects, a number of critical points and areas to be better defined were highlighted, for example, the need for more nurses requires investment in training; greater clarity is needed regarding the chain of coordination of home care and district services (who, how, whether public or private).

Conclusions: It is important to continue paying attention, monitoring and speaking out to ensure that European funding enhances district, and public, care. And a key point to reach this aim is also the strengthening of the nursing care networks.

. The complications of enteral nutrition in medical wards.

Introduction: The effects of Enteral Nutrition (EN) in patients unable to feed themselves have been widely explored although studies in low-/mean- intensity words are lacking.

Aim: To measure the prevalence of EN side effects in medical wards and to explore their risk factors. Metodi. Observational, retrospective study on matched patients. All patients in the medical departments of the Azienda Ospedaliero-Universitaria Senese were enrolled (81 cases and 162 controls) from 1 August 2018 to 1 September 2019, aged over 50 years and hospitalized for longer than 4 days. The NE side effects such as diarrhea, vomiting, gastric stagnation and abdominal pain were collected from clinical records The presence of EN, age of patients, mobilization and use of antibiotics during hospitalization were considered risk factors.

Results: The prevalence of diarrhea, vomiting, gastric and abdominal pain ranged from 4.9% to 11.1%. The EN was not a significant risk factor for the onset of gastrointestinal disorders, and these complications were always lower than in the controls. Vomiting, diarrhea and abdominal pain were more frequently, though not significantly, associated to antibiotic treatments; the age of subjects significantly predicted the diarrhea, showing a protective effect with the age increase.

Conclusions: The study shows a low prevalence of diarrhoea, vomiting and abdominal pain compared to the literature. These symptoms were not significantly associated to the EN, that cannot be considered a risk factor.

. Cultural meta-analysis 2: the after Covid-19. Against the background of the promises-expectations of an ethically and ecologically renewed and resilient world (declared needed to compensate and to avoid the repetition of the pandemic tragedy), the same methodology proposed in the heart of the Covid scenario has been applied: a cultural metanalysis - transversal through and comprehensive of the various points of view which have had ( and seem to have) an important role for a period defined as 'some light at the end of the tunnel'. After the mandatory priority of a focus on the most qualified health literature, the survey provides essential elements of information and analysis on scenarios which more closely coincide with the challenges to be faced if and when the imaginary of a 'different-better' world should be translated into reality, specifically in the model area of health. With the obvious limitation of an exercise of methodology (which cannot pretend to a completeness of coverage), both world famous and 'significant' authors are included, as well as Italian voices. The take-home - not easy - message is clear. The pandemic has not been an 'health-disease' event. Its 'syndemic' nature (i.e. its interaction with structural, permanent, economic, social, cultural pandemics) imposes the acceptance and the long-term pursuit of new civilisation paradigms. Health care is definitely one of the areas where this cultural challenge must be met.