Moving forward the Italian nursing education into the post-pandemic era: findings from a national qualitative research study

Background: During the CoronaVIrus-19 (COVID-19) pandemic, nursing education has been dramatically transformed and shaped according to the restrictions imposed by national rules. Restoring educational activities as delivered in the pre-pandemic era without making a critical evaluation of the transformations implemented, may sacrifice the extraordinary learning opportunity that this event has offered. The aim of this study was to identify a set of recommendations that can guide the Italian nursing education to move forward in the post-pandemic era. Methods: A qualitative descriptive design was undertaken in 2022–2023 and reported here according to the COnsolidated criteria for REporting Qualitative research guidelines. A network was established of nine Italian universities offering a bachelor’s degree in nursing for a total of 6135 students. A purposeful sample of 37 Faculty Members, 28 Clinical Nurse Educators and 65 Students/new graduates were involved. A data collection was conducted with a form including open-ended questions concerning which transformations in nursing education had been implemented during the pandemic, which of these should be maintained and valued, and what recommendations should address the transition of nursing education in the post-pandemic era. Results: Nine main recommendations embodying 18 specific recommendations have emerged, all transversally influenced by the role of the digital transformation, as a complementary and strengthening strategy for face-to-face teaching. The findings also suggest the need to rethink clinical rotations and their supervision models, to refocus the clinical learning aims, to pay attention towards the student community and its social needs, and to define a pandemic educational plan to be ready for unexpected, but possible, future events. Conclusions: A multidimensional set of recommendations emerged, shaping a strategic map of action, where the main message is the need to rethink the whole nursing education, where digitalization is embodied. Preparing and moving nursing education forward by following the emerged recommendations may promote common standards of education and create the basis on for how to deal with future pandemic/catastrophic events by making ready and prepared the educational systems

Variation of the occurrence of physical restraint use in the long-term care: A scoping review

Physical restraints in the long-term care setting are still commonly used in several countries with a prevalence ranging from 6% to 85%. Trying to have a broad and extensive overlook on the physical restraints use in long-term care is important to design interventions to prevent and/or reduce their use. Therefore, the aim of this scoping review was to analyze the range of occurrence of physical restraint in nursing homes, long-term care facilities, and psychogeriatric units. Pubmed, CINAHL, Ovid PsycINFO-databases were searched for studies with concepts about physical restraint use in the European long-term care setting published between 2009 and 2019, along with a hand search of the bibliographies of the included studies. Data on study design, data sources, clinical setting and sample characteristics were extracted. A total of 24 studies were included. The median occurrence of physical restraint in the European long-term care setting was still high (26.5%; IQR 16.5% to 38.5%) with a significant variability across the studies. The heterogeneity of data varied according to study design, data sources, clinical setting, physical restraint’s definition, and patient characteristics, such as ADLs dependence, presence of dementia and psychoactive drugs prescription

Securing of naso-gastric tubes in adult patients: A Review

OBJECTIVES: To establish the most effective securing devices and techniques for preventing nasogastric tube displacement or inadvertent extubation, mucosa and skin lesions, discomfort, and complications (ab ingestis pneumonia, reduced caloric intake, mortality) in adult patients. DESIGN: Systematic review of published and unpublished reports in any language, identified by searching 5 electronic databases, websites, reference lists, and existing systematic reviews and papers identified by experts in the field. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Systematic reviews, randomised controlled trials, and comparative studies that compared 652 techniques or devices to secure nasogastric tubes in patients 18 years old or older. RESULTS: Five studies (of which two were randomised controlled trials) were included. Four studies reported on bridle versus the tape technique (unbridled). The studies' population was comprised of mostly Intensive Care Unit patients. Four studies measured unintentional dislodgement or removal and found a statistically significant advantage in favour of the bridle. Three studies measured time until failure: two studies compared the bridle versus tape technique whereas the other compared different types of tape. One study did not find any significant difference between the two groups of patients whereas the second demonstrated a significantly longer time until failure in the bridled patients. Three studies comparing bridled and unbridled patients measured adverse events such as external nasal ulceration, epistaxis and sinusitis, and there was no agreement between their results. One study measured caloric intake and found that bridled patients received a higher percentage of their caloric goal than unbridled patients. Only one study analysed the cost-effectiveness of the bridle versus the tape technique and found a cost saving by implementing routine bridling of nasoenteric feeding tubes. Discomfort was not measured in the included studies. CONCLUSIONS: Despite the large number of patients receiving this intervention, there is insufficient evidence to suggest one securing technique or device over another. Data are lacking on the beneficial effects of the various methods or systems. There is little or no statistically significant evidence regarding bridling of nasogastric tubes but more research is needed. There is a need for more well-designed studies conducted in various clinical settings

Securing of Naso-gastric Tubes in Adults Patients:A Review

Objectives: To establish the most effective securing devices and techniques for preventing nasogastric tube displacement or inadvertent extubation, mucosa and skin lesions, discomfort, and complications (ab ingestis pneumonia, reduced caloric intake, mortality) in adult patients. Design: Systematic review of published and unpublished reports in any language, identified by searching 5 electronic databases, websites, reference lists, and existing systematic reviews and papers identified by experts in the field. Eligibility criteria for selecting studies: Systematic reviews, randomised controlled trials, and comparative studies that compared 2 techniques or devices to secure nasogastric tubes in patients 18 years old or older. Results: Five studies (of which two were randomised controlled trials) were included. Four studies reported on bridle versus the tape technique (unbridled). The studies\u2019 population was comprised of mostly Intensive Care Unit patients. Four studies measured unintentional dislodgement or removal and found a statistically significant advantage in favour of the bridle. Three studies measured time until failure: two studies compared the bridle versus tape technique whereas the other compared different types of tape. One study did not find any significant difference between the two groups of patients whereas the second demonstrated a significantly longer time until failure in the bridled patients. Three studies comparing bridled and unbridled patients measured adverse events such as external nasal ulceration, epistaxis and sinusitis, and there was no agreement between their results. One study measured caloric intake and found that bridled patients received a higher percentage of their caloric goal than unbridled patients. Only one study analysed the cost-effectiveness of the bridle versus the tape technique and found a cost saving by implementing routine bridling of nasoenteric feeding tubes. Discomfort was not measured in the included studies. Conclusions: Despite the large number of patients receiving this intervention, there is insufficient evidence to suggest one securing technique or device over another. Data are lacking on the beneficial effects of the various methods or systems. There is little or no statistically significant evidence regarding bridling of nasogastric tubes but more research is needed. There is a need for more well-designed studies conducted in various clinical settings

Visible and Invisible Caring in Nursing from the Perspectives of Patients and Nurses in the Gerontological Context

Aim: Just as in many countries all over the world, the number of older people in Italy has increased rapidly. Consequently, an increasing number of nurses are engaged in the care of older patients. However, due to a lack of understanding of how nurses and patients perceive caring, nursing care may be compromised. The aim of this study is to explore, describe and compare the perceptions of gerontological nurses and patients related to the dimensions of caring in nursing in an Italian hospital setting. Methods: In this qualitative descriptive study, a variety of analytic techniques were used to analyse semi-structured interview data from a purposeful sample of 20 nurses and 20 patients from geriatric units in two different Italian hospitals. Findings: Although both nurses and patients gave rich descriptions of caring experiences, patients described features of caring in nursing that were visible (including nurses\u2019 caring gestures, giving attention and being competent) while nurses predominantly emphasised aspects of caring that were relatively invisible (such as reflecting on the patient\u2019s past needs, evaluating the nursing care rendered, planning for more appropriate future nursing care, taking multiple complex contextual factors into account to protect the patient and being competent). Conclusion: Our data revealed more nuanced insight into the meaning of invisible and visible caring in nursing within the gerontological context than has been previously reported in the literature. This has implications for nursing education and practice because it may help nurses meet the actual needs of older patients in hospital settings

The effect of early oral postoperative feeding on the recovery of intestinal motility after gastrointestinal surgery: Protocol for a systematic review and meta-analysis

Given the ever-shorter length of hospital stay after surgical procedures, nowadays it is more important than ever to study interventions that may have an impact on surgical patients' wellbeing. According to the ERAS (Enhanced Recovery After Surgery protocols) program, early feeding must be considered one of the key components to facilitate early recovery while improving outcomes and patients' overall experiences. To date, the international literature has reported that early postoperative feeding compared with traditional (or late) timing is safe; nevertheless, small clinical outcomes effects has been reported, also for recovery of gastrointestinal function. Therefore, the effectiveness of early postoperative feeding to reduce postoperative ileus duration remains still debated

Evoluzione della funzione di coordinamento delle attivit\ue0 formative professionalizzanti dei Corsi di Laurea delle Professioni sanitarie. Indagine nazionale

Since the transition of the healthcare professions education from the Regional Schools to University, the role of Coordinator of the clinical learning activities has been reinforced and has became increasingly important in the governance of the degree programs. However, to date, the professionals holding this function have expressed disappointment for their position within the organization and the instability of their role. Aiming at developing a stabilization policy of this role, a National survey was conducted to describe the functions, recruitment criteria, term of office and development of Coordinators of the clinical learning activities of the 22 Healthcare Professions Degree Programs\u2019 campuses. Two hundred and twenty nine Directors/Coordinators out of 425 eligible (53.8%) participated in the study; they represented 16 out of the 22 Healthcare Professions. The 41.9% of the respondents were named as Coordinators and the 42.4% as Directors. More than 85% of the interviewees were \u2c3 41 years old, had a Master degree and a three-years renewable contract; the 70% worked for the National Health Service, the 23.6% for the University and the remaining 6% were freelance professionals. Two third of them had a full time position. All the respondents worked as Coordinator for at least three years and the 36.7% of them for more than 11 years; the 50% of them had a salary equal to a Charge Nurse. More than 90% of the respondents perceived themselves autonomous in the organization and evaluation of the students\u2019 clinical placements, while they reported a reduced autonomy in the supervision of Courses schedules and in the Tutors\u2019selection. Starting from these results, the CPCLPS may hypothesize possible developments for the coming years

L\u2019emergenza covid-19 nelle parole degli infermieri [The COVID-19 emergency in the words of the nurses]

This special issue of AIR is dedicated to the direct professional experiences and personal testimonies of a sample of the nursing personnel during the most dramatic phase of the covid-19 pandemia in the most severely affected regions of Northern Italy (Lombardy, Piedmont, Veneto, Friuli, Trentino, Emilia Romagna Regions). The decision to adopt a research strategy aimed to give visibility and voice to colleagues re-presenting some of the key hospitals of the regions obliged to a radical reorganisation of their structures and organisation of care, was adopted to catch from inside the crisis scenarios the expected mix of intense emotions (from anxiety, to fatigue, to personal and professional uncertainty, to the burden of impotence), and of needed technical creativity and efficiency which were requested to face a totally unexpected situation where guidelines could hardly be of help. The interview/diaries/focus groups were carefully planned not so much in terms of the contents, but with attention to the acceptance of the interviewed to enter in a free dialogue, with no Q&A, to be recorded, and to last for the time felt to be by both sides appropriate. The texts which are reported in this dossier are fragments of the recordings (overall more then 30 hours), without adjustments. It has been agreed that while all the names of the participants are provided as \u2018authors\u2019, the individual contributions are anonymous (not out of privacy consideration!) as they are part of a collective narrative, which reflects the great variability of the languages and of the perceived-ex-pressed experiences and memories. The material has been organised in sections which are conceived as \u2018verbal snapshots\u2019 taken from the networks of care settings, but at the same time of the places and houses where the colleagues were lite-rally full-time living, to assure unaccountable overtime working hours, and the requested \u2018safety distances\u2019 and lockdowns. The titles of the 8 sections coincide somehow with the principal components of the chain of activities and challenges which had to be faced: The changes in everyday\u2019s care, How to be prepared to the emergency, The teamwork, The loneliness and the isolation of the patients, The loneliness of the nurses, The difficult choices, The organization of the work and of the wards, change after covid-19. The core of the dossier is framed by boxes which provide also a minimum background of the administrative and epidemiological data on the pandemia in the regions of interest (it is interesting to remind that the central-southern areas of Italy have been far less affected), and a brief concluding reflection on reflection on the post-pandemia from the nursing point of view