Assessment and choice of the device for vascular access

The accurate vascular monitoring by nurses both at the beginning and during infusion treatment, in addition to the selection of the best device for each patient, can increase patient satisfaction, reduce complications, preserve peripheral veins, reduce or eliminate time used to find unlikely vein access, reduce hospital stay length and reduce the costs associated with infusion treatment. Aims of study are to ascertain the presence of a procedure for choosing the most suitable venous device for each patient, to identify nurses' criteria to make a vascular assessment, and to describe when nurses make a vascular assessment. A descriptive study with convenience sample of 290 nurses. The data collection instrument is an anonymous questionnaire. The questionnaires administered, returned, and considered valid were 227. 14% of the sample states that within their ward there is a a procedure to evaluate the most suitable device, while 70% states the opposite and 16% of the sample states that "they do not know". The results show fairly clearly that in the wards considered there is no procedure currently in use in order to choose the most suitable device for each patient, that nurses do not have clear criteria to make a vascular assessment, that they carry out vascular assessment at different times of the infusion's process

Accertamento e scelta dei dispositivi ad accesso venoso

RIASSUNTO L'esecuzione da parte degli infermieri di un accurato accertamento vascolare all'inizio e per tutta la durata della terapia infusiva, insieme all'individuazione del dispositivo più adatto al paziente, può aumentare la soddisfazione del paziente, diminuire le complicanze, preservare le vene periferiche, diminuire o eliminare il tempo impiegato dagli infermieri a reperire accessi venosi improbabili, ridurre i costi associati alla terapia infusiva. Gli obiettivi sono stati di indagare la presenza di una procedura per la scelta del dispositivo venoso più adeguato al paziente, descrivere i criteri utilizzati per la valutazione del letto vascolare, identificare il momento in cui gli infermieri eseguono la valutazione del letto vascolare. E' stato svolto uno studio descrittivo con campione di convenienza composto da 290 infermieri. Lo strumento di raccolta dati utilizzato è un questionario anonimo. I questionari somministrati, restituiti e ritenuti validi sono stati 227. Il 14% del campione afferma che è in uso una procedura per valutare il dispositivo venoso più adatto per ogni paziente mentre, il 70% dichiara che non è in uso e il 16% che non sa se c'è una procedura. I risultati dello studio mostrano che nelle unití  operative appartenenti al campione (1) non è in uso una procedura per la scelta del dispositivo più adeguato al paziente, (2) che gli infermieri non hanno chiari i criteri per effettuare la valutazione del letto vascolare, (3) che essi effettuano la valutazione del letto vascolare in momenti differenti del processo infusivo.Parole Chiave: accertamento vascolare, selezione dispositivo venoso, accesso vascolare, terapia infusiva, linee guida praticheThe accurate vascular monitoring by nurses both at the beginning and during infusion treatment, in addition to the selection of the best device for each patient, can increase patient satisfaction, reduce complications, preserve peripheral veins, reduce or eliminate time used to find unlikely vein access, reduce hospital stay length and reduce the costs associated with infusion treatment. Aims of study are to ascertain the presence of a procedure for choosing the most suitable venous device for each patient, to identify nurses' criteria to make a vascular assessment, and to describe when nurses make a vascular assessment. A descriptive study with convenience sample of 290 nurses. The data collection instrument is an anonymous questionnaire. The questionnaires administered, returned, and considered valid were 227. 14% of the sample states that within their ward there is a a procedure to evaluate the most suitable device, while 70% states the opposite and 16% of the sample states that "they do not know". The results show fairly clearly that in the wards considered there is no procedure currently in use in order to choose the most suitable device for each patient, that nurses do not have clear criteria to make a vascular assessment, that they carry out vascular assessment at different times of the infusion's process. Key words: vascular assessment, venous device selection, vascular access, infusion therapy, practice guideline

Regenerative potential of human dental pulp stem cells in the treatment of stress urinary incontinence: In vitro and in vivo study

OBJECTIVES: To evaluate the regenerative potential of human dental pulp stem cells (hDPSCs) in an animal model of stress urinary incontinence (SUI). SUI, an involuntary leakage of urine, is due to physical stress involving an increase in bladder pressure and a damage of external urethral sphincter affecting muscles and nerves. Conventional therapies can only relieve the symptoms. Human DPSCs are characterized by peculiar stemness and immunomodulatory properties and might provide an alternative tool for SUI therapy. MATERIALS AND METHODS: In vitro phase: hDPSCs were induced towards the myogenic commitment following a 24 hours pre-conditioning with 5-aza-2'-deoxycytidine (5-Aza), then differentiation was evaluated. In vivo phase: pudendal nerve was transected in female rats to induce stress urinary incontinence; then, pre-differentiated hDPSCs were injected in the striated urethral sphincter. Four weeks later, urethral sphincter regeneration was assayed through histological, functional and immunohistochemical analyses. RESULTS: Human DPSCs were able to commit towards myogenic lineage in vitro and, four weeks after cell injection, hDPSCs engrafted in the external urethral sphincter whose thickness was almost recovered, committed towards myogenic lineage in vivo, promoted vascularization and an appreciable recovery of the continence. Moreover, hDPSCs were detected within the nerve, suggesting their participation in repair of transected nerve. CONCLUSIONS: These promising data and further investigations on immunomodulatory abilities of hDPSCs would allow to make them a potential tool for alternative therapies of SUI

La pratica infermieristica basata sui modelli teorici: uno studio qualitativo sulla percezione degli Infermieri

RIASSUNTO Molti studiosi sostengono che teoria e teorizzazione sono strettamente correlate alla pratica clinica e che il sapere disciplinare non procede solo dall'applicazione dei principi generali di grandi teorie ai casi particolari, ma si sviluppa, in maniera più pertinente, a partire dallo specifico contesto assistenziale nel quale si realizza. Ogni infermiere, infatti, possiede un modello mentale del quale può o meno essere consapevole, che motiva e sostanzia ogni azione e scelta professionale. Il presente studio descrive il modello teorico infermieristico che orienta l'agire professionale, il modello mentale e le conoscenze tacite ad esso sottese. Identifica nel modello teorico esplicito del gruppo professionale che gli infermieri partecipanti rappresentano, aspetti di continuití  con il modello teorico proposto da questo Corso di Laurea in Infermieristica, Sono stati realizzati 4 focus group ai quali hanno partecipato complessivamente 22 Infermieri, rappresentanti di quasi tutte le unití  operativa dell'Arcispedale Santa Maria Nuova di Reggio Emilia. E' possibile sostenere che il modello teorico infermieristico di ciascun gruppo professionale è il risultato di conoscenze tacite, che contribuiscono a definire il modello mentale di ciascun professionista e di un modello teorico esplicito cui sono sottesi contenuti teorici appresi applicati consapevolmente e riadattati alla/dalla pratica assistenziale. Ragionare sull'uso della teoria nella pratica ha permesso di dare visibilití  a un modello teorico esplicito autenticamente infermieristico orientato ai bisogni della persona, nella sua complessití  in specifici contesti.Parole chiave: modelli teorici dell'infermieristica, conoscenze tacite, sapere esplicito, pratica clinica, Focus Group. Nursing practice based on theoretical models: a qualitative study of nurses' perceptionABSTRACTMany faculty argue that theory and theorizing are closely related to the clinical practice, that the disciplinary knowledge grows, more relevantly, from the specific care context in which it takes place and, moreover, that knowledge does not proceed only by the application of general principles of the grand theories to specific cases. Every nurse, in fact, have a mental model, of what may or may not be aware, that motivate and substantiate every action and choice of career. The study describes what the nursing theoretical model is; the mental model and the tacit knowledge underlying it. It identifies the explicit theoretical model of the professional group that rapresents nursing partecipants, aspects of continuity with the theoretical model proposed by this degree course in Nursing.. Methods Four focus groups were made which were attended by a total of 22 nurses, rapresentatives of almost every Unit of Reggio Emilia Hospital's. We argue that the theoretical nursing model of each professional group is the result of tacit knowledge, which help to define the personal mental model, and the theoretical model, which explicitly underlying theoretical content learned applied consciously and reverted to / from nursing practice. Reasoning on the use of theory in practice has allowed us to give visibility to a theoretical model explicitly nursing authentically oriented to the needs of the person, in all its complexity in specific contexts.Key Words: nursing theories, tacit knowledge, explicit knowledge, clinical practice, focus group roups

Attitudes and Beliefs of Portuguese and American Nursing Students about Patients’ Sexuality

Nursing school graduates must be prepared to interact comfortably and effectively with patients about their sexual health. This study analyses the attitudes and beliefs about patient sexuality held by Portuguese and American nursing students. Objective: In Portuguese and American nursing students, (1) we analyzed students’ attitudes and beliefs towards sexuality using the Sexuality Attitudes and Beliefs Survey (SABS); (2) we identified nationality, socio-demographic information, and affective-sexual beliefs and attitudes. Method: Quantitative, cross-sectional study; convenience sample of 296 students (63.2% Portuguese; 36.8% American); mean age: 21.9 years (SD = 3.12); two-way ANOVA and multiple correspondence analyses were performed. Results: Attitudes and eliefs toward sexuality: Portuguese women are more liberal than men, contrary to American students. Among both nationalities, participants with multiple sexual partners held more conservative attitudes. Sexual orientation: bisexual American students and homosexual Portuguese students are conservative. Multiple correspondence analysis revealed two profiles: (1) Portuguese students: liberal-tolerant in attitudes towards patient sexuality, live with family/roommate, 18 to 21 years old, no or one sexual partner; (2) US students: traditionalist attitudes towards patient sexuality, share house, 22 and 23 years old, multiple partners. Conclusion: Human sexuality must be addressed in nursing education curricula

Providing a teaching and learning open and innovative toolkit for evidence-based practice to nursing European curriculum (EBP e-Toolkit): Project rationale and design

©2020. This manuscript version is made available under the CC-BY-NC 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Published, version of a Published Work that appeared in final form in Population Medicine. To access the final edited and published work see https://doi.org/10.18332/popmed/128272Evidence-based practice (EBP) is an instrument of great utility in making clinical decisions in nursing care, improving the quality of nursing care and patients’ health outcomes. There is no European framework for EBP competency, and no guidelines for EBP teaching. The general concept of the project ‘Providing a Teaching and Learning Open and Innovative Toolkit for Evidence-based Practice to Nursing European Curriculum: (EBP e-Toolkit)’ is to fill this gap in Nursing education across Europe and to foster and harmonize the teaching and learning of EBP in the European nursing curricula and to produce the acquisition of EBP competence earlier in professional life. The project is organized along four major outputs, and a dissemination and sustainability plan has been set up. A mixed method research constitutes the main methodological approach applied in the project. This methodology requires the active participation of all research groups, partners, steering committee, nursing students, and educators, in the project. The use of the EBP e-Toolkit will increase nurses’ and nursing students’ level of EBP competence by formulating specific guidelines to be implemented in EBP teaching

Teaching evidence-based practice (EBP) in nursing curricula in six European countries—A descriptive study

©2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Accepted version of a Published Work that appeared in final form in Nurse Education Today. To access the final edited and published work see https://doi.org/10.1016/j.nedt.2020.104561Background: Teaching evidence-based practice (EBP) in nursing education varies among nurse educators and universities. Lack of nurses' knowledge and skills are among the barriers commonly associated with the limited use of EBP in practice. Objectives: To describe the presence, characteristics and content of courses of EBP in nursing bachelor's, master's, and PhD programs in six European countries. Design: A descriptive study design was employed. Settings: The study was implemented as part of the EBP e-Toolkit Project as a strategic partnership of six European higher education institutions from six countries in the framework of the Erasmus+ Programme. Participants: Census sampling (N = 225) was used. A total of 162 (72%) faculties responded from the following countries: Spain (79), Italy (44), the Czech Republic (15), Poland (12), Greece (7), and Slovenia (5). Methods: Three structured instruments were developed by using the consensus development panel. The research was conducted from December 2018 to March 2019. For names of subjects, a manual narrative Template Analysis was used with open descriptive coding. Results: Subjects in “EBP in Nursing or Health Care” are included in 45 (29.2%) bachelor's programs, mostly worth 180 European Credit Transfer System (ECTS) credits, 30 (28%) master's, and 6 (40%) PhD programs. In bachelor's programs, an average of 134 h are spent teaching EBP steps, followed by 127 h in master's programs and 52 h in PhD programs. EBP subjects have different focuses: clear topics in EBP, development of research knowledge, awareness of the need for evidence-based clinical work, and understanding the needs of the profession. Conclusions: Teaching EBP is not yet sufficiently integrated into nursing curricula. For more efficient integration, guidelines on the standardization of teaching approaches and content have to be developed in all three cycles of higher education. Further research is needed on the implementation of teaching at master's and PhD levels of nursing curricul

Core evidence-based practice competencies and learning outcomes for European nurses: consensus statements.

©2021. This manuscript version is made available under the CC-BY-NC 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Accepted, version of a Published Work that appeared in final form in Evidence-Based Nursing (EBN). To access the final edited and published work see https://doi.org/10.1111/wvn.12506Background: Consensus on evidence-based practice (EBP) competencies and associated learning outcomes for registered nurses has not yet been achieved in the European context. Aims: To establish a set of core EBP competencies for nurses and the most important EBP learning outcomes encompassing attitudes, knowledge, and skills dimensions for implementation into nursing education in European countries. Methods: A multi-phase modified Delphi survey was conducted: Phase 1, a literature review; Phase 2, a two-round consensus of experts; and Phase 3, a Delphi survey. Experts from six European countries participated. Results: In Phase 1, 88 records were selected and 835 statements extracted, which were grouped according to the seven steps of EBP. After removing 157 duplicates, the remaining competencies (n = 678) were evaluated in Phase 2. Then, a two-round expert consensus was reached, with 24 competencies and 120 learning outcomes identified and divided into affective, cognitive, and skills domains. In Phase 3, based on a Delphi survey expert consensus, all evaluated statements were included in a final set of competencies and learning outcomes. Only two learning outcomes were recommended for allocation to a different domain, and four were reformulated as suggested, with no further changes to the others. Linking Evidence to Action: The set of EBP competencies and learning outcomes can guide nurse educators, managers, and EBP stakeholders in the development of content that incorporates EBP knowledge, skills, and attitudes into educational programs. Prioritizing the EBP competencies and learning outcomes that are most necessary and adapting them to every context will provide healthcare organizations with guidelines for enhancing the continuing education of nurses. These results could facilitate the development of effective tools for assessing nursing students’ and nurses’ perception of competencies required for EBP processes

Educational interventions for teaching evidence-based practice to undergraduate nursing students: a scoping review

©2020. This manuscript version is made available under the CC-BY 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Published, version of a Published Work that appeared in final form in International Journal of Environmental Research and Public Health. To access the final edited and published work see https://doi.org/10.3390/ijerph17176351Background: Evidence-based practice (EBP) is the appropriate approach to guide healthcare personnel in their clinical practice. Despite the importance of EBP, undergraduate nursing students are not very much engaged and have a lack of knowledge and skills. Aim: The aim of this study was to gather, assess and synthesize evidence on educational interventions promoting evidence-based practice competencies in traditional undergraduate nursing students. Methods: This is a scoping review on sixteen English and non-English databases. A data extraction form was established including authors, year of publication, country, types of participant, specific objectives, study design, educational intervention, comparison if existed, and outcomes of significance. Results: The search strategy retrieved 8901 records in total. After screening for duplicates and eligibility, 20 articles were included in the qualitative synthesis. Improvement in EBP domains such as knowledge, skills, attitudes/behaviours, EBP beliefs, use, practice, level of evidence, critical thinking and future use of EBP were mentioned and assessed in different studies. Conclusions: EBP training can improve nursing students’ capacity in healthcare provision. Teaching EBP competencies along undergraduate nursing curricula should be a high priority at nursing programmes. The use of innovative approaches seems to be more effective than traditional ways. Education of EBP increases its future use and critical thinking and EBP programs improve self-efficacy and the level of evidence utilization