Italian nurses' COVID-19 experiences from mass media interviews: a qualitative study

Introduction: The COVID-19 pandemic is heavily hitting healthcare systems around the world, and nurses are battling in the front line. Previous studies have reported nurses’ responses to catastrophic situations, but also interviews released by Italian nurses to the main mass media channels could bear important messages for policy makers and stakeholders.This study describes Italian front-line nurses’ experiences during the COVID-19 pandemic through television interviews. Methods: This is a descriptive qualitative study. Data were collected through purposive sampling from Italian front-line nurses’ interviews during the COVID-19 pandemic. Publicly available interviews between 7th and 29th March 2020 were collected from the websites of national and regional television stations. Thematic content analysis was used to describe, summarize, and classify data into macro themes. The study is compliant with Standards for Reporting Qualitative Research.  Results: A total of 21 television interviews were collected from front-line clinical nurses, nursing managers, nursing trade union representatives and representatives of the Nursing Regulator. Thematic analysis yielded four macro-themes: psycho-social effects of the COVID-19 pandemic on health professionals; altered patient relationships; personal safety; recognition and promotion of the profession. Conclusions: The COVID-19 pandemic has exacerbated some problems already present, such as the shortage of nurses, but has also turned the spotlight on the nursing profession. Highly involved and affected by the pandemic, nurses have become better known by the public and often also protagonists of public discussions. It is important that nurses’ value as allies of the public emerges stronger from this dramatic situation

Italian nurses' COVID-19 experiences from mass media interviews: a qualitative study

Introduction. The COVID-19 pandemic is heavily hitting healthcare systems around the world, and nurses are battling in the front line. Previous studies have reported nurses\u2019 responses to catastrophic situations, but also interviews released by Italian nurses to the main mass media channels could bear important messages for policy makers and stakeholders. This study describes Italian front-line nurses\u2019 experiences during the COVID-19 pandemic through television interviews. Methods. This is a descriptive qualitative study. Data were collected through purposive sampling from Italian front-line nurses\u2019 interviews during the COVID-19 pandemic. Publicly available interviews between 7th and 29th March 2020 were collected from the websites of national and regional television stations. Thematic content analysis was used to describe, summarize, and classify data into macro themes. The study is compliant with Standards for Reporting Qualitative Research. Results. A total of 21 television interviews were collected from front-line clinical nurses, nursing managers, nursing trade union representatives and representatives of the Nursing Regulator. Thematic analysis yielded four macro-themes: psycho-social effects of the COVID-19 pandemic on health professionals; altered patient relationships; personal safety; recognition and promotion of the profession. Conclusions. The COVID-19 pandemic has exacerbated some problems already present, such as the shortage of nurses, but has also turned the spotlight on the nursing profession. Highly involved and affected by the pandemic, nurses have become better known by the public and often also protagonists of public discussions. It is important that nurses\u2019 value as allies of the public emerges stronger from this dramatic situation

Title: A cross sectional multisite exploration of Italian paediatric nurses' reported burnout and its relationship to perceptions of clinical safety and adverse events using the RN4CAST@IT-Ped

AimTo explore Italian paediatric nurses’ reported burnout and its relationship to their perceptions of safety and adverse events.DesignA cross‐sectional study using the RN4CAST@IT‐Ped database with a web‐based survey design.MethodsThe RN4CAST@IT‐Ped questionnaire was used to collect data in 2017. This comprised three main components: three dimensions (22 items) of the Maslach Burnout Inventory including emotional exhaustion, depersonalization and personal accomplishment. Participants also scored an overall grade of patient safety and estimated the occurrence of adverse clinical events.ResultsNurses (N = 2,243) reported high levels of burnout. Most rated clinical safety as high. The risk of adverse events ranged from 1.3–12.4%. The degree of burnout appeared to influence the perception of safety and adverse events.ConclusionThe association between nurses’ burnout and perceptions of higher rates of adverse events and reduced safety in clinical practice is an important finding. However, it is unclear whether this was influenced by a negative state of mind, and whether reduced safety and increased adverse events negatively influenced nurses’ well‐being, thus leading to burnout. Regardless, the association between nurses’ burnout and these quality concepts needs further exploration to examine the effect, if any, on burnout and safety, and identify supportive mechanisms for nurses.ImpactThe association between reported burnout and perception of safety and risk of adverse events in Italian paediatric nurses has been reported for the first time. Nurses reporting burnout are at greater risk of intensely negative perceptions of clinical safety and adverse events. This is an important finding as perceptions can influence practice and behaviours. Quality measures in children's clinical environments need to go beyond obvious indicators to examine nurses’ well‐being as this also influences quality and safety

Unmet nursing care needs on medical and surgical wards : a scoping review of patients’ perspectives

© 2019 John Wiley & Sons Ltd Aims and objectives: To review and synthesise research studies on surgical and medical inpatients’ perceptions on unmet nursing care needs. Background: Missed nursing care is a growing phenomenon that has been shown to adversely affect care outcomes—mainly in adult medical and surgical care settings. However, to date the aggregated and synthesised evidence of missed care comes from research that measures perceptions on missed care in surgical and medical settings from nurses, but not from the patients. Design: Scoping review. Methods: In September 2018, three databases were searched: MEDLINE/PubMed, CINAHL and SCOPUS and papers were selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were as follows: primary studies; published in peer-reviewed journals; in English or Italian; and regarding routine care provided to adult inpatients. Quality appraisal and a thematic analysis were conducted. Results: Of the 1541 abstracts initially identified, 44 papers were included. Five themes emerged: “communication,” “self-management, autonomy and education,” “personal sphere,” “essential physical care” and “emotional and psychological care.” The majority of the unmet needs were related to the “personal sphere” and “emotional and psychological care.” These unmet needs were not identified in previous literature on nurses’ perspectives of missed care. Also, physical care deficits like oral hygiene were identified. Conclusion: It is important to take into account patients’ perspectives. The themes focusing on patients’ personal sphere, and emotional and psychological care, underline how patients need nurses to pay more attention to their cultural background, consider the person as a whole and for nursing care to be holistic and respectful of patients’ dignity. Relevance to Clinical Practice: This study intends to raise awareness amongst nurses and policymakers about the importance of addressing missed nursing care and unmet patients’ needs in adult medical or surgical inpatient settings to ensure high-quality care and patient satisfaction

The contribution of nursing doctoral schools to the development of evidence 10 years after their establishment in Italy: An exploratory descriptive survey of former and current doctoral students’ publications

AimTo analyse through an exploratory descriptive survey how former and current doctoral students’ publications have contributed to the development of evidence between the establishment of the doctoral schools of nursing between 2006 - 2015.Design An exploratory descriptive survey.Methods We analysed the papers published in peer-reviewed journals by the four Italian PhD Schools of Nursing between 2006 - 2015. Additional missing information was retrieved from Web of Science.Results We identified 478 scientific papers. The papers increased from 12 in 2006 to 110 in 2015. Most are published in 29 journals, of which 15 have an impact factor ranging between 0.236-3.755. These results show the increasingly significant contribution of nursing doctoral programs to the production of evidence, which can be used to improve the quality of nursing and inform health policies. Nursing doctoral schools deserve a greater recognition, especially by Italian funding agencies and political institutions

Experiences of older people following an acute exacerbation of chronic obstructive pulmonary disease: A phenomenological study

Aims and objectivesTo explore the experience of patients affected by COPD following hospitalization due to an acute exacerbation event.BackgroundChronic Obstructive Pulmonary Disease (COPD) is a progressively debilitating disease, often with very burdensome symptoms such as acute and chronic breathlessness and fatigue. Acute exacerbation often creates a life threatening event. Exacerbation can also have substantial psychological effects including anxiety and depression although this aspect is less well researched – especially amongst people with COPD recovering from an acute event and facing a return home.DesignA descriptive phenomenological study.MethodsIn depth interviews were conducted with twelve COPD patients recently recovering from an acute exacerbation of their COPD. Data were analysed using Colaizzi's phenomenological framework.ResultsFour themes were identified from the data: a sense of loss and frustration, hopelessness, uncertainty about the future and fear of becoming a burden. Participants expressed quite negative views including a loss of hope, uncertainty about their future care and the burden they may become on their families. They appeared stressed and anxious as a result of the acute event they had experienced.ConclusionsThis study shows that an acute episode of illness can generate a sense of hopelessness and uncertainty about their future care in people with COPD. This occurs as they recover physically and think about the future, often in quite negative terms.Relevance to clinical practiceFor healthcare professionals it is important to take into account the potential feelings of loss, hopelessness and uncertainty that people can experience following an acute exacerbation of their COPD and ensure that psychological care is available as physical recovery takes place. Such care to include good discharge planning, giving patients time to express concerns and referral to counselling services if appropriate

RN4CAST@IT-Ped: Nurse staffing and children's safety

Some authors argue that it is not longer ethically correct to expose hospitalized patients to death risks associated with understaffing (Nickitas, 2014). Also the Care Quality Commission (CQC, an independent regulator of all health and social care services in England) has included staffing levels as one of the auditing quality standards when inspecting hospitals and health centres. The Royal College of Nursing, in its document Mandatory Nurse Staffing Levels (RCN, 2012), clearly defined which nurse staffing levels should be adopted by policy makers to ensure the provision of safe care. However, even in the UK where such pressure exists there are no legally defined nurse staffing levels

Predicting needlestick and sharps injuries in nursing students: Development of the SNNIP scale

© 2020 The Authors. Nursing Open published by John Wiley & Sons Ltd. Aim: To develop an instrument to investigate knowledge and predictive factors of needlestick and sharps injuries (NSIs) in nursing students during clinical placements. Design: Instrument development and cross-sectional study for psychometric testing. Methods: A self-administered instrument including demographic data, injury epidemiology and predictive factors of NSIs was developed between October 2018–January 2019. Content validity was assessed by a panel of experts. The instrument's factor structure and discriminant validity were explored using principal components analysis. The STROBE guidelines were followed. Results: Evidence of content validity was found (S-CVI 0.75; I-CVI 0.50–1.00). A three-factor structure was shown by exploratory factor analysis. Of the 238 participants, 39% had been injured at least once, of which 67.3% in the second year. Higher perceptions of “personal exposure” (4.06, SD 3.78) were reported by third-year students. Higher scores for “perceived benefits” of preventive behaviours (13.6, SD 1.46) were reported by second-year students

L\u2019esperienza di ricovero dei caregivers familiari in ambito pediatrico e le relazioni con l\u2019assistenza infermieristica: uno studio osservazionale multicentrico

ABSTRACT Background: la soddisfazione dell\u2019utenza in merito all\u2019assistenza ricevuta in ambito sanitario \ue8 un aspetto che negli anni ha assunto sempre maggiore rilevanza, non solo in ambito infermieristico, in quanto viene annoverato tra i nursing sensitive outcomes, ma anche a livello economico e politico. In ambito pediatrico, la filosofia maggiormente abbracciata nel mondo occidentale \ue8 la Family Centered Care, che prevede la centralit\ue0 del bambino e del suo nucleo familiare nell\u2019intero processo di cura. Pochi sono gli studi che hanno valutato le relazioni tra l\u2019esperienza dei caregivers familiari in merito all\u2019assistenza ricevuta e gli aspetti pi\uf9 organizzativi dell\u2019assistenza infermieristica. Obiettivi: Esaminare l\u2019esperienza dei caregivers familiari relativamente al ricovero ospedaliero che hanno vissuto con il loro bambino e valutare le relazioni con l\u2019assistenza infermieristica ricevuta e il setting di cura. Metodi: Studio osservazionale trasversale, con raccolta dati a tre livelli (amministrativo, infermiere e caregivers) tramite campionamento di convenienza. La partecipazione \ue8 sempre stata preceduta da accettazione alla partecipazione allo studio in seguito alla lettura del consenso informato. per queste analisi \ue8 stato estrapolato un sotto-campione paragonabile con gli studi presenti in letteratura. Nella raccolta dati a livello caregivers sono state coinvolte 9 Aziende ospedaliere affiliate all\u2019Associazione Ospedali Pediatrici Italiani situate in diverse regioni italiane. I dati sono stati raccolti attraverso una web survey, a livello infermiere, e attraverso il Child HCAHPS, appositamente adattato e validato per il contesto italiano (S-CVI 0.91; ICC 0.90; Alpha di Cronbach 0.90). I dati sono stati analizzati a livello di unit\ue0 operativa attraverso analisi di statistica descrittiva, per descrivere il campione e le variabili oggetto di indagine con indici di tendenza centrale, frequenze e percentuali; in seguito \ue8 stato costruito un modello di regressione lineare per studiare le relazioni tra gli esiti estrapolati dai dati della survey caregivers e le variabili infermieristiche (workload) e di setting (ospedale pediatrico VS ospedale generale). Per quanto riguarda i dati relativi alla survey caregiver \ue8 stato applicato l\u2019approccio Top Box come indicato dalla letteratura, \ue8 stata quindi calcolata la percentuale di risposte date alle singole domande tenendo in considerazione la scelta qualitativamente migliore (es. \u201cSi, assolutamente\u201d, \u201csempre, o \u201cvoto 9-10\u201d) Tutte le analisi sono state condotte tramite il software statistico IBM SPSS, versione 22. Risultati: Sono state coinvolte 96 unit\ue0 operative, 1472 infermieri e 635 caregivers. Gli ambiti in cui sono stati raggiunti valori percentuali pi\uf9 alti sono stati quelli relativi al dolore e alla comunicazione con medici e infermieri. I valori pi\uf9 bassi, invece, erano relativi alla sicurezza, alla preparazione alla dimissione e il comfort. Complessivamente le risposte date dai caregivers riferite agli ospedali pediatrici erano migliori rispetto a quelle riferite agli ospedali generici. Dal modello di regressione lineare \ue8 emerso che all\u2019aumentare di un punto nel punteggio di workload diminuisce di 2.12 punti l\u2019overall rating dell\u2019ospedale; aggiungendo al modello la tipologia di ospedale \ue8 risultato che l\u2019essere in un ospedale pediatrico aumenta di 0.28 punti l\u2019overall rating dell\u2019ospedale. Conclusioni: questo \ue8 il primo studio condotto in Europa che indaga l\u2019esperienza dei caregiver in ambito pediatrico attraverso lo strumento gold standard per la valutazione della Family Centered Care, ed \ue8 anche il primo a mettere in relazione questi esiti con le caratteristiche dell\u2019organico infermieristico. Questi dati confermano ancora una volta come l\u2019assistenza infermieristica possa influenzare l\u2019esperienza di ricovero impattando sulla qualit\ue0 e le cure erogate. Inoltre, questi dati possono essere molto utili nell\u2019individuare interventi migliorativi per rendere l\u2019assistenza infermieristica pediatrica sempre pi\uf9 centrata sulla famiglia ed efficace.ENGLISH ABSTRACT Background: patients\u2019 satisfaction for nursing care in the healthcare is an aspect that has become increasingly important over the years, not only for the nursing -as it is counted among nursing sensitive outcomes- but also at in economic and political issues. In Pediatrics, the philosophy most embraced in the Western world is Family Centered Care, which envisages the centrality of the child and his or her family unit in the entire care process. Few studies have evaluated the relationships between the experience of family caregivers regarding the care received and the organizational aspects of nursing care. Objectives: To examine the experience of family caregivers in relation to the hospitalization they have lived with their child and evaluate the relationship with the nursing care received and the care setting Methods: Cross-sectional study; multi-level data (administrative, nurses and caregivers) through convenience sampling. Participation has always been preceded by acceptance to participate in the study following the reading of the informed consent. For these analyses a sub-sample comparable with the studies in the literature was extrapolated. Nine hospitals affiliated with the Italian Pediatric Hospitals Association, located in different Italian regions, were involved in the data collection at the caregivers level. The data were collected through a web survey, at the nurse level, and through the Child HCAHPS, specially adapted and validated for the Italian context (S-CVI 0.91; ICC 0.90; Cronbach's Alpha 0.90). The data were analysed at the unit level through descriptive statistical analysis, to describe the sample and the variables of interest with central trend indices, frequencies and percentages; then, a linear regression model has been built to study the relationships between caregivers\u2019 outcomes and the nursing (workload) and setting (pediatric hospital vs general hospital) variables. Data from to the caregivers\u2019 survey, the Top Box approach was applied as indicated in the literature: each item was recoded as an indicator variable of whether respondents selected the most positive response option (eg "Yes, absolutely", \u201cAlways, or \u201crate 9-10\u201d). All analyses were conducted using IBM SPSS statistical software, version 22. Results: Ninety-six units, 1472 nurses and 635 caregivers were involved in the study. The areas in which the highest percentage values \u200b\u200bwere achieved were those relating to pain and communication with doctors and nurses. The lowest values, on were related to safety, preparation for discharge and comfort. Overall, the responses given by caregivers in pediatric hospitals were better than those reported by caregivers in general hospitals. The linear regression model showed that increasing the workload score by one point decreases the hospital's overall rating by 2.12 points; adding the type of hospital to the model, it was found that being in a pediatric hospital increases the hospital's overall rating by 0.28 points. Conclusions: this is the first study conducted in Europe that investigates the experience of caregivers in the Pediatrics through the gold standard tool for evaluating Family Centered Care, and is also the first to relate these outcomes with the characteristics of the nursing staff. These data confirm once again how nursing care can influence the hospitalization experience by impacting on the quality and care provided. In addition, these data can be very useful in identifying improvements to make pediatric nursing care increasingly family-centered and effective