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ABSTRACT: Closure of wards (units) during the summer is a management practice introduced in some Italian hospitals to deal with the national nursing shortage and seasonal staffing patterns. The authors discuss a cross-sectional comparative study that they conducted to assess the effects of this management practice on patient outcomes.
The Journal of nursing administration 10/2010; 40(10):448-53. · 1.15 Impact Factor
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The Journal of infection 10/2008; 57(5):420-2. · 4.13 Impact Factor
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Clinical Nurse Specialist 02/2008; 22(2):102. · 0.81 Impact Factor
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ABSTRACT: Italian Nursing Faculties use a range of tutorial strategies (laboratory sessions, intensive clinical tutoring, weekly tutoring) aimed to enhance nursing students' diagnostic reasoning: these strategies have different impacts on promoting student critical thinking. By using critical thinking methods, students develop abilities to check, monitor and constantly evaluate the accuracy of the diagnostic reasoning process. However, there is little evidence to show how effective tutorial strategies are on the accuracy of diagnostic reasoning. There is also very little known about the complexity of tutorial strategies because these are made up of several components (e.g. tutor questioning abilities, the value of the setting, the impact of the environment, the expertise of the tutor and the impact of the Faculty's philosophy of learning), tutorial strategies cannot be standardised and depend on multiple factors which are difficult to control.
The objective was to establish a relationship between tutorial strategies orientated to enhance critical thinking and the accuracy of diagnostic reasoning (i.e. the number of correct answers given by students on simulated cases in two different nursing education contexts). It was hypothesised that students who had had one laboratory session using intensive tutorial strategies had less probability of making reasoning errors in diagnosing a simulated case than a control group that had weekly tutorials or routine tutoring.
A double pragmatic experimental study was adopted involving two Italian Nursing Faculties at universities in Verona and Udine.
A total of 144 students in the first year of their Nursing Science Degree course were involved; in Verona, two random groups of 41 students were taken (an intervention group and a control group). Random selections of 39 students for the intervention group and 29 students for a control group were made from the second campus in Udine. Data analysis was conducted comparing student outcomes in the same faculty (intra-trial analysis) and between the two campuses involved (inter-trial analysis).
The students doing laboratory sessions and intensive clinical tutorials demonstrated fewer errors compared to the control group [OR 3.75; IC 95% 1.77-7.88], although the students who receive routine tutoring, demonstrated higher risk of mistaking the problems of the patient [OR 0.22; IC 0.95% 0.07-0.65].
From intra- and inter-trial analysis of the results, it can be concluded within limits, that those students who had had intensive tutorial strategies aimed developing critical thinking abilities, formulated fewer wrong hypotheses in the first list they made when confronted with a new nursing case. Faculties should consider these outcomes and develop strategies including intensive tutorial strategies for improving the accuracy of nursing students' clinical reasoning.
International Journal of Nursing Studies 12/2007; 45(9):1285-98. · 2.18 Impact Factor
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ABSTRACT: Surveillance activities have been considered of paramount importance for effective infection control programs in health care organizations.
Our objective was to design a capture system able to assure surveillance of hospital-acquired infections (HAI) in acute hospitals with few resources devoted to infection control.
We performed 4 biweekly repeated prevalence studies to identify major HAI (urinary tract infections, surgical site infections, lower respiratory tract infection, bloodstream infections) as defined by the Centers for Disease Control and Prevention (CDC) criteria in 3 large hospitals in northeastern Italy (6 internal medicine departments, 5 general surgery departments, 3 intensive care units, and 1 bone marrow transplant unit).
One thousand five hundred fifty-four patients were screened (63.9% in medical wards, 27.5% in surgical wards, and 8.5% in intensive care units and bone transplant unit). The overall prevalence of infection was 4.9% (77/1,554); 4.5% (70/1,554) of patients were infected. A capture system based on the presence of fever >or=38 degrees C, antibiotic use, and presence of devices guarantees 100% sensitivity in detecting HAI but requires an assessment of 62% of the population. Using the presence of fever and devices as criteria guarantees a sensitivity of 98%, requiring an assessment of 41.4% of patients, whereas presence of fever and antibiotic use has the same sensitivity but requires an assessment of 50% of patients. Using nursing records, physician records, and direct patient examination as sources of documentation guarantees that all necessary data are collected while requiring a mean of 4 minutes and 42 seconds per patient (standard deviation, 1 minute and 30 seconds).
A capture system based on biweekly repeated prevalence studies that select patients for the presence of fever, antibiotics, and medical devices ensures the detection of all HAI in a resource-limited environment.
American Journal of Infection Control 08/2006; 34(6):362-6. · 2.40 Impact Factor
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ABSTRACT: The management of pain sensations is useful to enhance technical quality within hospitals: this study provides an overview of pain management in a highly specialized health center. In 69.6% of cases the patients answers matched with those of health staff: the most interesting factor is the health staff's willingness to attend training courses aimed at treating the patients pain.
Igiene e sanita pubblica 59(4):239-52.
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ABSTRACT: To compare the standards of nursing personnel involved in direct care in surgical and orthopedical wards, with those of the studies of Aiken et al.
A convenience snow ball sampling technique allowed to include 65 centres. Data were collected in an index day, in the middle of the week, in hospitals with a surgical and ortopedical ward on the following variables: number of nurses, number of nurses aids, average time of nursing care per patient over the 24 hours.
Sixty-five surgical and 43 ortopedical wards for overall 2286 beds were included. A nurse, on average, cares for 8.9 patients (7.2 in the morning; 9.2 in the afternoon and 13.6 during the night). Over the 24 hours patients receive 70 minutes of care from nursing personnel and 96 from nurses aids.
The number of patients cared for by Italian nurses is higher compared to that observed in Aikens' papers, although health care systems and organization are not strictly comparable. To reach the American standards 997 extra nurses would be necessary. The situation described stresses a critical problem and the need to define national standards on the number of nurses and health care personnel to guarantee to hospitalized patients.
Assistenza infermieristica e ricerca: AIR 25(4):206-13. · 0.35 Impact Factor
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ABSTRACT: The purpose of the study was to evaluate the incidence of incontinence pad use among patients admitted to medical wards, the reasons why nurses decide to use an incontinence pad, the extent to which the use of pads is avoidable, and the outcome of inappropriate pad use after discharge from the hospital.
A prospective cohort study was conducted; patients admitted to medical wards were observed during hospitalization and a 7-day follow-up period after discharge.
The study was conducted in 2 acute-care units in Northern Italy. All new patients admitted to the units were recruited.
At the time of admission to the hospital, in addition to the 120 patients who already used incontinence pads, there was a 34% incidence of new cases (98/286). The most frequent reason why nurses decided to use this aid was incontinence caused by space-time disorientation, followed by limited mobility, incontinence, patient request, nursing shortage, and involuntary urine leakage not perceived by patient. Seventy patients out of 208 used incontinence pads unnecessarily for a total of 544 days.
Decisions about the use of the incontinence pads are not always consistent with research-based or literature-based suggestions. Nurses should develop clinical guidelines or protocols for the appropriate use of incontinence pads.
Journal of WOCN 34(6):649-54. · 1.14 Impact Factor
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ABSTRACT: In the last decade, the public use of complementary and alternative therapies for the solution of various health problems has increased dramatically. Listening to music can be considered a support to the traditional medical practice for the reduction of anxiety and stress related to chemotherapy.
Holistic nursing practice 23(4):238-42. · 0.52 Impact Factor
