L’utilizzo della Classificazione Internazionale per la Pratica Infermieristica (ICNP®) in ambito pediatrico e neonatale: revisione della letteratura

Introduction: Literature reports that the use of Standardized Nursing Terminology contributes to a better implementation of nursing care and patients’ safety and to do research. ICNP® is an international and combinatorial standard terminology proposal by ICN, adaptable to different settings, among which paediatric and neonatal. Methods: A literature review on different databases (Medline/Pubmed, CINAHL, Embase, Web of Science and Scopus) was conducted to investigate the use of ICNP® in professional practice in paediatric and neonatal settings. Results: 44 papers were included in the review; 33 of which focused on the paediatric setting while 11 on the neonatal setting. It is evident ICNP® is usable in both settings, permitting to describe nursing care to different age groups, in-hospital, out-of-hospital and in specific clinical situations. Discussion: ICNP® is up to the task of describing nursing care, implementing nursing care plans, analysing types of nursing care for management aims, studying concepts or specific pediatric or neonatal situations. ICNP® is adaptable to different nursing frameworks and models. Few studies analyses ICNP® implementation or effectiveness in clinical settings. Additional research is needed to verify ICNP® effectiveness in paediatric and neonatal settings and to implement contextual catalogues. Key words: Standardized Nursing Terminology, ICNP, Paediatric Nursing, Neonatal Nursing.Introduzione: La letteratura indica che un utilizzo di terminologie infermieristiche standardizzate porti a un miglioramento della qualità dell’assistenza e della sicurezza dei pazienti, oltre che a un implemento della possibilità di svolgere ricerca. ICNP® è una terminologia infermieristica standardizzata proposta da ICN di tipo combinatorio, adattabile a diversi contesti professionali, tra cui quello pediatrico e neonatale. Metodo: E’ stata svolta una revisione della letteratura allo scopo di indagare l’utilizzo del linguaggio ICNP® nella pratica professionale in area pediatrica e neonatale attraverso le banche dati Medline/Pubmed, CINAHL, Embase, Web of Science e Scopus. Risultati: Sono state incluse nella revisione 44 pubblicazioni, 33 riguardanti l’ambito pediatrico e 11 riguardanti quello neonatale. E’ emerso che ICNP® è utilizzabile in entrambi gli ambiti, permette di descrivere l’assistenza erogata in diverse fasce d’età, in contesti ospedalieri o extraospedalieri e in casi di situazioni cliniche specifiche. Discussione: ICNP® risulta in grado di descrivere l’assistenza, implementare piani di assistenza infermieristica, approfondire il tipo di assistenza erogata a fini manageriali, studiare alcuni concetti o situazioni specifiche di area pediatrica e neonatale. ICNP® è adattabile a diversi modelli concettuali dell’assistenza infermieristica. Pochi studi interessano l’effettiva implementazione del linguaggio in un contesto clinico o l’analisi di efficacia del suo utilizzo in questo ambito. Servono ulteriori ricerche per verificare l’efficacia di utilizzo di ICNP® in contesti clinici neonatali e pediatrici e per sviluppare Cataloghi di contesto. Parole chiave: Terminologia Infermieristica Standardizzata, ICNP, Infermieristica Pediatrica, Infermieristica Neonatale

Revisione della letteratura sugli strumenti che misurano le conoscenze, atteggiamenti e percezioni dei professionisti sanitari rispetto ai programmi di antimicrobial stewardship

Introduction: The establishment of multi-disciplinary antimicrobial stewardship programmes means that there is a need to study how well healthcare personnel are able to deal with the problem on a daily basis. This study therefore aimed to identify and critically examine existing tools to measure knowledge, attitudes and practices with respect to antimicrobial stewardship among physicians and nurses. Method: After a literature review of biomedical databases such as PUBMED, EMBASE, SCOPUS, CINAHL, a total of 14 instruments were identified between May and November 2021, the purpose, theoretical framework and statistical validity of which were analysed and described. Results: The theoretical framework and validation process vary widely between instruments and are not described in all of them. The pilot study was not always conducted or well detailed. The questionnaires varied in length and were mostly answered on a 5-7 point Likert scale. The work of Baraka et al 2019 together with that of Ashiru-Oredope et al 2021 appear to be the best from the point of view of statistical validity. Baraka has the high number of questions. Discussion and conclusions: The literature review and the use of already existing instruments, even by the same author, are the basis of all the identified studies even if the explanation with respect to the reason for this choice is missing. The validation process was not described for all instruments. When selecting and adapting instruments, attention should be paid to the domains within the scale, the number of items and the theoretical-cultural fit.Introduzione: L’istituzione di programmi di antimicrobial stewardship multidisciplinari comporta la necessità di studiare quanto il personale sanitario sia in grado di affrontare il problema quotidianamente. Con questo studio si è voluto, pertanto, andare ad identificare ed esaminare criticamente gli strumenti esistenti per misurare le conoscenze, gli atteggiamenti e le pratiche rispetto all’antimicrobial stewardship fra i medici e gli infermieri. Metodo: Dopo una revisione della letteratura su database biomedici come PUBMED, EMBASE, SCOPUS, CINAHL, tra maggio e novembre 2021, sono stati identificati un totale di 14 strumenti di cui sono stati analizzati e descritti scopo, quadro teorico e validità statistica. Risultati: Il quadro teorico e il processo di validazione variano molto fra gli strumenti e non in tutti sono descritti. Lo studio pilota non sempre è stato condotto o ben dettagliato. I questionari, di lunghezza variabile, prevedevano per lo più risposte su scala Likert a 5-7 punti. Il Lavoro di Baraka et al 2019 insieme a quello Ashiru-Oredope et al. 2021 risultano essere i migliori dal punto di vista della validità statistica. Baraka ha il maggior numero di domande. Discussione e conclusioni: La revisione della letteratura e l’utilizzo di strumenti già esistenti, anche dello stesso autore, sono la base di tutti gli studi individuati anche se manca la spiegazione rispetto al motivo di tale scelta. Il processo di validazione non è stato descritto per tutti gli strumenti. Quando si selezionano e si adattano gli strumenti, si dovrebbe prestare attenzione ai domini all'interno della scala, al numero di item e all'adattamento teorico-culturale.&nbsp

Risk of skin tears associated with nursing interventions: A systematic review

Background: Skin tears are a significant problem for patients and healthcare professionals. They can cause pain, impact quality of life, and become chronic and infected. The risk of skin tears is associated with dependence in daily life activities and with nursing interventions. Objectives: To examine which nursing interventions increase the risk of skin tears. Design: Systematic review. Data sources: The MEDLINE, CINAHL, Scopus, and Cochrane Library databases were searched in March 2022. Publication years: Publications included were from 2012 to 2022. Results: Seventeen articles were included in the final analysis reporting nursing interventions associated with the risk of skin tears. Hygiene with cold water and soap, not applying leave-on products to moisten/protect dehydrated skin, and wearing short sleeves were found to be associated with skin tears. Transferring patients into and out of bed in a rough manner and wearing jewelry or long nails can increase the risk of skin tears. Removal of adhesive dressings or bandages can also cause skin tears. Conclusion: Nursing staff need to know which interventions put their patients at risk of skin tears and which interventions are recommended to prevent skin tears. Nursing care can affect the health of the patient's skin

Il ruolo dell’infermiere nel processo di deprescribing: revisione della letteratura

INTRODUCTION: The elderly, frail, chronic and polytherapy population often experiences drug-related reactions or adverse effects. Deprescribing is a systematic process of identifying and discontinuing drugs at times when the potential or existing harms outweigh the potential benefits. Deprescribing is a multidisciplinary process, in which the role of the nurse needs to be deepened. METHOD: A literature review was conducted starting from the databases: PubMed, Cinahl, Scopus and Cochrane Library. RESULTS: Fourteen articles were included that discussed the nursing role in the deprescribing process. The nurses administer the therapy and evaluate the positive and negative effects of the drugs, discussing with the doctor for possible suspensions or reductions of the therapy. They discuss therapy with patients, understanding the patient's beliefs about drugs and highlighting the "burden" of polypharmacy. They educate and involve patients in the depre-scribing process, interacting with them and with family members and caregivers. To have better results from deprescribing, multidisciplinary collaboration and discussion within the team is necessary. Nurses are aware that they have a role in the deprescribing process, but they would like to receive more evidence-based training. CONCLUSIONS: Nurses have an important role in implementing the deprescribing process. Deprescribing training must be encouraged, for a more informed and responsible professional action. None of the reviewed articles referred to the Italian context, therefore the results may not be fully applicable. Studies relating to deprescribing in the Italian context should be carried out.  INTRODUZIONE: La popolazione anziana, fragile, affetta da cronicità e in politerapia, spesso vive esperienze di reazioni o effetti avversi farmaco-correlati. Il deprescribing è un processo sistematico di identificazione e di interruzione di farmaci nei momenti in cui i danni potenziali o esistenti superano i benefici potenziali. Il deprescribing è un processo multidisciplinare, in cui il ruolo dell’infermiere necessita di essere approfondito.  METODO: è stata condotta una revisione della letteratura partendo dalle banche dati: PubMed, Cinahl, Scopus e Cochrane Library.  RISULTATI: sono stati inclusi quattordici articoli che hanno discusso il ruolo infermieristico nel processo di deprescribing. L’infermiere somministra la terapia e valuta gli effetti positivie negativi dei farmaci, si confronta col medico per eventuali sospensioni o riduzioni della terapia. Discute con l’assistito della terapia, comprendendo le convinzioni dell’assistito rispetto ai farmaci ed evidenziando il “burden” della politerapia. Educa e coinvolge l’assistito nel processo di deprescribing, confrontandosi con esso e con i famigliari e il caregiver. Per avere migliori esiti dal deprescribing è necessaria la collaborazione multidisciplinare e il confronto all’interno dell’equipe. Gli infermieri sono consapevoli di avere un ruolo nel processo dei deprescribing, ma chiedono maggiore formazione evidence based. CONCLUSIONI: l’infermiere ha un ruolo importante nell’implementare il processo di depre-scribing. La formazione al deprescribing deve essere incentivata, per un agire professionale più consapevole e responsabile. Nessuno degli articoli revisionati si riferiva al contesto italiano, i risultati pertanto potrebbero non essere del tutto applicabili. Andrebbero effettuati studi rela-tivi al deprescribing nel contesto italiano. PAROLE CHIAVE: de-prescrizione, poli-terapia, popolazione anziana, ruolo infermieristic

Development and validation of two versions of the nurse–patient mutuality in chronic illness scale

Aims The aim of the study was to develop and psychometrically test the Nurse–Patient Mutuality in Chronic Illness (NPM-CI) scale in two versions, one for nurses and one for patients. Method A multiphase methodological study was conducted. In the first phase, a qualitative investigation was conducted through interviews and an analysis of the content; inductively, the items of two instruments were generated, one for nurses and one for patients. In the second phase, the content and face validity were assessed through the expert consensus method. In the third phase, exploratory factor analysis (EFA), Cronbach's alpha test, intraclass correlation and Pearson correlation coefficients were conducted to estimate construct, criterion validity and instrument reliability. For each phase, the sample included nurses and patients recruited from a large hospital in Northern Italy. Data collection was conducted between June and September 2021. Results Nurse and patient versions of the NPM-CI scale were developed. Two rounds of consensus reduced the items from 39 to 20; content validity index ranged between 0.78 and 1, content validity ratio was 0.94. Face validity indicated clarity and comprehensibility of the items. EFA identified three latent factors for both the scales. Internal consistency was satisfactory, with Cronbach's alphas ranging between .80 and .90. Test–retest stability was suggested, with an intraclass correlation coefficient of .96 (nurse scale) and .97 (patient scale). Predictive validity was established, with a Pearson correlation coefficient of .43 (nurse scale) and 0.55 (patient scale) between the mutuality scales and satisfaction in providing and receiving care. Conclusion The results suggest that the NPM-CI scales are sufficiently valid and reliable for the clinical practice among chronic illness patients and the nurses caring for them. A more in-depth exploration of this construct in the context of nursing and patient outcomes is warranted. Patient or Public Contribution Patients were involved in all study phases. Impact Mutuality is fundamental in the relationship between nurse and patient, based on trust, equality, reciprocity, and mutual respect. The NPM-CI scale was developed and psychometric estimated through a multiphase study in both nurse and patient versions. The NPM-CI scale measures the factors of ‘developing and going beyond’, ‘being the point of reference’ and ‘deciding and sharing care’. The NPM-CI scale allows us to measure mutuality in clinical practice and research. Expected outcomes and influencing factors for patients and nurses could be associated

Additional file 1 of Electronic patient-reported outcomes (e-PROMs) in palliative cancer care: a scoping review

Additional file 1. Complete search strategy for the Medline, Embase, Web of Science, SCOPUS, PsycINFO and CINAHL databases and gray literature. It has been realized in collaboration with a librarian with expertise in systematic searches in medical research databases

Association between greenspace and lung function in Italian children-adolescents.

Background: Few studies have examined the impact of urban greenspace exposure on lung function in children-adolescents, and the available evidence is still inconsistent. The aim of the current study was to verify the hypothesis that the effects of greenspace exposure vary with differing levels of lung function of children-adolescents. Methods: Between November 2005 and May 2006, 2150 children-adolescents (age-range: 10-15 years) living in the city of Palermo were enrolled in a cross-sectional survey. Parents were interviewed through a modified version of the Italian Studies on Respiratory Disorders in Children and the Environment (SIDRIA) questionnaire. All children-adolescents performed spirometry and were tested for allergic sensitization. Exposures to greenspace and grey space at the home addresses were measured using the CORINE land-cover classes. Parametric quantile regression models were applied for assessing the association between greenspace exposure and spirometry parameters, accounting for possible confounders and effect modifiers. A p-value lower than 0.05 was considered statistically significant. Results: From the 1st to the 21st percentile, children-adolescents living within greenspace had higher FEV1 than those living within grey space. In particular, the estimated effects were: 1st (β = 0.238 L, p = 0.01), 5th (β = 0.140 L, p = 0.01), 10th (β = 0.097 L, p = 0.015), and 15th (β = 0.073 L, p = 0.025). Similarly, from the 1st to the 29th percentile, children-adolescents living within greenspace had higher FVC than those living within grey space. In particular, the estimated effects were: 1st (β = 0.367 L, p = 0.0003), 5th (β = 0.215 L, p = 0.0003), 10th (β = 0.150 L, p = 0.0004), and 15th (β = 0.112 L, p = 0.001). No significant associations were found for FEV1/FVC, FEF25-75 and FEF25-75/FVC. Conclusion: Quantile regression techniques may provide new insights into the evaluation of the association between greenspace exposure and lung function in children-adolescents, showing substantially heterogeneous effects from lower to higher quantiles of spirometry parameters. These results may help implementing policies for planning sustainable housing and surrounding greenspace