Nursing students' interprofessional educational experiences in the clinical context: findings from an Italian cross-sectional study

To explore nursing students' interprofessional educational (IPE) experiences during their most recent clinical rotation and to explore the factors supporting IPE experiences

Nursing students' involvement in shift-to-shift handovers: Findings from a national study

Background Effective performance of clinical handovers should be one of the priorities of nursing education to promote efficient communication skills and ensure patient safety. However, to date, no studies have explored to what extent nursing students are involved in handovers. Objective To explore nursing students' handover involvement during their clinical rotations and associated factors. Method This was a secondary analysis of a large national cross-sectional study that involved 9607 undergraduate nursing students in 27 universities across 95 three-year Italian baccalaureate nursing programs. The involvement in the clinical handovers was the end point (from 0, never, to 3, always). A path analysis was performed to identify variables directly and indirectly affecting students' handover involvement. Results Handover involvement was reported as \u2018only a little\u2019, \u2018to some extent\u2019, and \u2018always\u2019 by 1739 (18.1%), 2939 (30.6%), and 4180 (43.5%) students, respectively; only 749 (7.8%) of students reported never being involved. At the path analysis explaining the 19.1% of variance of nursing students' involvement, some variables emerged that directly increased the likelihood of being involved in handovers. These were being female (\u3b2\u202f=\u202f0.115, p\u202f<\u202f0.001); having children (\u3b2\u202f=\u202f0.107, p\u202f=\u202f0.011); being a 3rd-year student (\u3b2\u202f=\u202f0.142, p\u202f<\u202f0.001) and being a 2nd-year student as compared to a 1st-year student (\u3b2\u202f=\u202f0.050, p\u202f=\u202f0.036); and having a longer clinical rotation (\u3b2\u202f=\u202f0.015, p\u202f<\u202f0.001) in units with high \u2018quality of the learning environment\u2019 (\u3b2\u202f=\u202f0.279, p\u202f<\u202f0.001). Moreover, students who were supervised by the nurse teacher (\u3b2\u202f=\u202f 120.279, p\u202f<\u202f0.001), or by a nurse on a daily basis (\u3b2\u202f=\u202f 120.253, p\u202f=\u202f0.004), or by the staff (\u3b2\u202f=\u202f 120.190, p\u202f<\u202f0.001) reported being less involved in handovers as compared to those students supervised by a clinical nurse. Variables with indirect effects also emerged (model of student's supervision adopted at the unit level, and number of previous clinical rotations attended by students). Moreover, handover involvement explained 11.5% of students self-reported degree of competences learned during the clinical experience. Conclusions Limiting students' opportunity to be involved in handover can prevent the development of communication skills and the professional socialization processes. Strategies at different levels are needed to promote handover among undergraduate nursing students

Nursing students' interprofessional educational experiences in the clinical context: findings from an Italian cross-sectional study

To explore nursing students' interprofessional educational (IPE) experiences during their most recent clinical rotation and to explore the factors supporting IPE experiences

Evoluzione della carenza infermieristica e strategie adottate per affrontarla: studio longitudinale in undici aziende sanitarie

Descrivere l’evoluzione della carenza infermieristica così come è stata percepita dal 2000 al 2009 dai dirigenti infermieristici e le strategie attivate per affrontarla. Metodi. Sono stati coinvolti i dirigenti infermieristici di 11 aziende sanitarie ed ospedaliere del Friuli Venezia Giulia, Trentino Alto Adige e Veneto che hanno partecipato a tre interviste strutturate: la prima nel 2000, la seconda nel 2004 e la terza nel 2009. Risultati. Nella prima rilevazione lo scostamento medio tra dotazioni organiche teoriche (infermieri necessari all’azienda) e reali era del - 5.4%; nella seconda del -9.2%, mentre nella terza del -3.3%. La carenza si è trasformata nel tempo da stagionale a annuale, e sembra diffusa tra i reparti. Mentre nel 2000 e nel 2004, ogni azienda aveva attivato in media 5 strategie, nel 2009 ne sono state attivate in media 7, ma poche di sistema: l’unica è l’accorpamento transitorio dei reparti, nei periodi estivi per assicurare le ferie. Secondo i dirigenti, si stanno già registrando effetti della carenza su pazienti ed infermieri. Conclusioni. La carenza di infermieri ha continuato ad impegnare nell’ultimo decennio le direzioni infermieristiche ed aziendali. Ha cambiato le sue cause ma le strategie di gestione sono rimaste sostanzialmente le stesse

Opportunity to discuss ethical issues during clinical learning experience

Undergraduate nursing students have been documented to experience ethical distress during their clinical training and felt poorly supported in discussing the ethical issues they encountered. Research aims: This study was aimed at exploring nursing students' perceived opportunity to discuss ethical issues that emerged during their clinical learning experience and associated factors

Multi-level analysis of national nursing students' disclosure of patient safety concerns

Error reporting is considered one of the most important mediating factors for patient safety (PS). However, reporting errors can be challenging for health care students

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys