A Comparative Study of Data Collection Methods in the Process of Nursing: Detection of Chemotherapy Side Effects Using a Self-Reporting Questionnaire

Ocular vestibular evoked myogenic potentials (oVEMP) and cervical VEMP (cVEMP) are newer diagnostic methods, which allow an insight into the otolith senses. Our aim was to determine changes in certain parameters of the VEMP wave complex after successfully performed repositioning procedure, as an indicator of the state of recovery in patients with benign paroxysmal positional vertigo (BPPV). This may confirm the theory of otolith returning into the area of otolithic senses. The study included 48 patients with unilateral posterior semicircular canal BPPV. On their first arrival, otoneurological examinations, oVEMP and cVEMP tests were performed. The same were included in follow up check-ups scheduled at seven days and six months after successful implementation of Epley maneuvers. The initial measurement revealed a significantly reduced amplitude of oVEMP on the affected side. On the 7-day measurement, the amplitude increase was observed on the affected side, with significant reduction in the amplitude ratio (p=0.693), which reached statistical significance on the last measurement at 6 months (p=0.006). These findings confirmed the hypothesis of the return of otoconia into the utricular area

Not only a problem of fatigue and sleepiness: Changes in psychomotor performance in Italian nurses across 8-h rapidly rotating shifts

Although many studies have detailed the consequences of shift work in nurses concerning health, fatigue, sleepiness, or medical errors, no study has been carried out trying to disentangle the contribution of sleepiness and fatigue associated to shift work from the attentional performance. The aim of this pilot study is (A) to investigate the effects of an 8-h rapidly rotating shift on fatigue and sleepiness among staff nurses and (B) how these factors affect their psychomotor performance. Fourteen nurses were selected for a within-subject cross-sectional study according to this sequence of shifts: morning–afternoon–night, which were compared as function of tiredness, sleepiness, and performance at the Psychomotor Vigilance Task (PVT). Subsequently, a within-subject Analysis of Covariance (ANCOVA) evaluated if the observed differences between shifts persist when the contribution of sleepiness is controlled. Our results clearly indicate that night shifts are associated with significant greater sleepiness and tiredness, and worsened performance at the PVT. As hypothesized, ANCOVA showed that these differences disappear when the contribution of sleepiness is controlled. Results point to a lower psychomotor performance in night compared to day shifts that depends on sleepiness. Hence, interventions to minimize the consequences of the night shift should consider a reduction of sleepiness

Usporedbeno istraživanje metoda prikupljanja podataka u procesu sestrinske njege: otkrivanje nuspojava kemoterapije pomoću upitnika za samoprocjenu

Toxicity of chemotherapy is a factor that most negatively affects the quality of life of cancer patients. Monitoring of side effects and adverse effects may be subject to errors due to various factors such as the lack of privacy during data collection, shame on the part of the patient to talk about some issues, lack of recognition of symptoms and/or unawareness of side effects of treatments, and/or inappropriate reference model of data collection. In order to assist caregivers in proper data collection, a ‘self-reporting questionnaire’ was designed. The questionnaire was developed using validated scales such as the Common Terminology Criteria for Adverse Event, Edmonton Symptom Assessment Scale and Douleur Neuropathique en 4 Questions. The survey involved the population of patients scheduled for chemotherapy in Day Hospital at the Campus Bio-Medico University Hospital, Rome, between June and July 2015. During the period of observation, 367 patients were admitted to Day Hospital, 57.5% of women and 38.4% of men, average age 64 years, for a total of 622 accesses; of these, only 173 were interviewed by the nursing staff in relation to side effects and toxicity. During the trial, 381 patients were involved, of which 60.1% of women (p=0.8) and 38.3% of men (p=0.9), average age 63 years (p=0.9), for a total of 611 accesses and 498 self-reporting questionnaires administered. At the end of the trial period, in order to evaluate usability, an evaluation questionnaire was given to medical personnel, including five doctors and six nurses, to consider possible amendments to the instrument and its perceived effectiveness. Comparative analysis of data collected during the observation period and the trial showed how the use of the self-reporting questionnaire allowed for detection of side effects of chemotherapy earlier and in a more detailed way than relying only on medical examination and unstructured interview by nursing staff. It also enabled reaching a larger number of users. In conclusion, the use of self-reporting systems, together with the work and clinical judgment of the expert, can contribute to improvement in the patient quality of life, corroborating nurse interviews through a precise and systematic data collection process that reduces the amount of interpretation of symptoms by the patient and the caregiver, while providing them with precise instructions on what to report and how to report it. The significant and rapid spread of computers, tablets and smartphones allows for speculating on further use and implementation of this system through its computerized application.Toksičnost kemoterapije je čimbenik koji ima najteži učinak na kvalitetu života u bolesnka s karcinomom. Praćenje nuspojava i štetnih učinaka može biti podložno greškama zbog raznih čimbenika kao što je nedostatna zaštita povjerljivosti ­tijekom prikupljanja podataka, nevoljkosti bolesnika da govori o nekim problemima, neprepoznavanje simptoma i/ili ­nepoznavanje nuspojava liječenja i/ili neodgovarajući referentni model prikupljanja podataka. Zato smo izradili upitnik za samoprocjenu kako bismo pomogli u ispravnom prikupljanju podataka onima koji pružaju skrb ovim bolesnicima. Upitnik je izrađen uz pomoć provjerenih ljestvica kao što su Common Terminology Criteria for Adverse Event, Edmonton Symptom ­Assessment Scale i Douleur Neuropathique en 4 Questions. Istraživanje je obuhvatilo bolesnike naručene za kemoterapiju u Dnevnoj bolnici Sveučilišne bolnice Campus Bio-Medico u Rimu u lipnju i srpnju 2015. godine. U tom razdoblju u Dnevnu bolnicu je primljeno 367 bolesnika, 57,5% žena i 38,4% muškaraca prosječne dobi od 64 godine, za ukupno 622 pristupa. Od svih tih bolesnika sestrinsko osoblje je samo njih 173 ispitalo o nuspojavama i toksičnosti. Za vrijeme istraživanja bio je uključen 381 bolesnik, od toga 60,1% žena (p=0,8) i 38,3% muškaraca (p=0,9) prosječne dobi od 63 godine (p=0,9), za ­ukupno 611 pristupa i 498 izdanih upitnika za samoprocjenu. Kako bismo procijenili primjenjivost ovoga upitnika, na kraju istraživanja upitnik za njegovu procjenu je podijeljen medicinskom osoblju uključujući pet liječnika i šest medicinskih sestara kako bi razmotrili moguće potrebne dopune ovoga instrumenta te njegovu učinkovitost. Usporedbena analiza podataka prikupljenih tijekom istraživanja pokazala je da je primjena upitnika za samoprocjenu omogućila otkrivanje nuspojava kemoterapije ranije i podrobnije nego kad se to oslanjalo samo na medicinski pregled i nestrukturirani razgovor sestrinskog osoblja s bolesnicima. Uz to, ovom metodom je obuhvaćen veći broj korisnika. U zaključku, primjena sustava za samoprocjenu zajedno sa stručnim radom i kliničkom prosudbom može doprinijeti poboljšanju bolesnikove kvalitete života, pružiti potporu razgovoru sestrinskog osoblja s bolesnikom kroz proces preciznog i sustavnog prikupljanja podataka, čime se znatno smanjuje tumačenje simptoma od strane bolesnika i osoba koje ih njeguju, ali im pruža točne upute o čemu trebaju izvijestiti i kako. Zahvaljujući značajnom i brzom širenju računala, tableta i ‘pametnih telefona’ može se promišljati o daljnjoj primjeni ovoga sustava kroz njegovu računalnu aplikaciju

La metafisica del dolore

Il dolore pone le sue radici nella notte dei tempi. Da sempre è stato oggetto d’interesse per il genere umano, suscitando timore e superstizione nell’antichità, studio e analisi nei tempi successivi. Ricerche accurate effettuate nei secoli sull’argomento hanno consentito solo oggi di poterlo comprendere e controllare nel migliore dei modi. Per anni, la difficoltà maggiore è stata quella di voler descrivere, in poche parole, una condizione che aveva risvolti psicologici, fisiopatologici, emotivi ed affettivi. C'è una disciplina che studia l'essere in quanto essere e le proprietà che gli sono inerenti per la sua stessa natura e non si identifica con nessuna delle cosiddette scienze particolari, giacché nessuna delle altre ha come suo oggetto d'indagine universale l'essere in quanto essere. Ciascuna di esse, infatti, ritaglia per proprio conto una qualche parte dell'essere e ne studia gli attributi, come fanno, ad esempio, le scienze matematiche. Solo la metafisica può farlo, visto che si tratta di una branca della Filosofia. La maggior parte di coloro che per primi filosofarono, pensarono che principi di tutte le cose fossero solo quelli materiali. Non a caso, essi affermano che ciò di cui tutti gli esseri sono costituiti (ciò da cui derivano originariamente e in cui si risolvono da ultimo) è elemento ed è principio degli esseri, in quanto è una realtà che permane identica pur nel trasmutarsi delle sue affezioni

Knowledge, attitudes, behaviour and training needs of ICU nurses on medication errors in the use of IV drugs: a pilot study

Background. Prior studies have shown that lack of knowledge and training, incorrect behaviours and attitudes put Intensive care unit (ICU) patients at risk. The aim of this study was to assess knowledge, attitudes and professional behaviour of Italian nurses towards preparation and administration of intravenous medications in ICUs. Reliability and validity of the questionnaire were assessed as well. Methods. A survey was conducted on a sample of Italian nurses in 2015 through a self-administered questionnaire. Reliability was tested and content validity was evaluated using Cronbach’s alpha. Multiple logistic regression models were built to identify predictors of knowledge, attitudes and behaviours. Results. In total, 123 nurses completed the questionnaire. For the variable ‘adequate knowledge’ nurses were divided in those who had correctly answered 7 of 8 questions on knowledge and everyone else, while for ‘attitudes and professional behaviour’ responders were grouped into those who showed a positive attitude and appropriate behaviour and everyone else. Results of the multiple logistic regression analyses show some association, although not statistically significant, between correct behaviour, positive attitudes and the years of work experience. It is interesting to note that appropriate knowledge weighs negatively on correct behaviour (OR 0.06, 95% CI 0.04-0.42). Moreover, graduate nurses have more appropriate knowledge than those who are not. A high level of interest for specific training was reported by almost all responders. Cronbach’s alpha for all three sections together resulted in a value of 0.49. Conclusions.This pilot study demonstrated the need to amend the questionnaire, especially the knowledge and behaviour sections, in which the Cronbach’s alpha was less than 0.7. Targeted educational programs are needed to improve the expertise of nurses to reduce medication errors during preparation and administration of IV medications in the ICU

Nursing students’ experience of risk assessment, prevention and management: a systematic review

Introduction:  As a fundamental dimension of quality, the patient safety and healthcare workers safety in the healthcare environment depend on the ability of each healthcare workers (whether administrators or technicians) to reduce the probability of error. This review focused on nursing students. The aim was to assess level and determinants of knowledge about risk assessment, risk prevention and risk management of nursing students. Methods: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Two reviewers searched the bibliographic databases Pubmed, Scopus and Cinahl to collect all the available articles in English and Italian issued between 2015 and August 2019. To obtain an exhaustive string search, the following keywords were combined through Boolean operators AND and OR: Clinical Risk Assessment, Nursing Education, Nursing Student*, Patient Safety. The authors assessed the quality of the evidence by using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method.  Results: Twelve papers are included. Although the literature on the nursing student's error is limited, their frequencies are worrying. Some authors have created a model of prevention of clinical error based on three level. However, the majority of nursing students don’t felt confident with a patient safety. Many authors shown that patient safety education was delivery by lecture, laboratory or simulation sessions. Conclusions: This review underlines the need to revise the nursing curriculum on patient safety and the need to think what educational methodology is the better for the student to create a safe care. &nbsp

Reliability and use of Copenhagen Burnout Inventory in italian sample of university professors

Academics often have to face with burnout syndrome at work. This cross-sectional study evaluates the reliability of the Italian version of the Copenhagen Burnout Inventory (CBI) in a sample of Academics of Sapienza University of Faculty of Medicine and Pharmacy, through an online questionnaire composed of the CBI, SF12 Health Survey, and Positivity Scale. Univariate, bivariate, multivariate analyses, and Cronbach α coefficients of CBI were performed. Ninety-five participants completed the questionnaire (response rate 85%). Cronbach’s α of the three domains were high (0.892, 0.868, and 0.836). Women, younger and part time professors reported higher score in personal (p = 0.025; 0.060) and work burnout. In multivariate analysis decreasing age (β = −0.263; p = 0.001); being a professor in environmental technicians (β = −0.120; p = 0.098); and low mental (β = −0.263; p = 0.020), physical (β = −0.319; p ≤ 0.001) and positivity scores (β = −0.237; p = 0.031) predict significantly higher personal burnout. Low physical (β = −0.346; p < 0.001) and mental (β = − 0.249; p = 0.013) positivity (β = −0.345; p = 0.001) scores; fewer years of work (β = −0.269; p ≤ 0.001); and being a medical or nursing professor (β = 0.169; p = 0.016) predicts high work burnout. Low MCS predicts a high level of student burnout. Results suggest that the Italian version of the CBI is a reliable instrument. Further research should focus on the prevalence of burnout in academics

Morphology of planktonic zoeal stages of Palicus caronii (Decapoda, Brachyura), identified by DNA barcoding, provides novelties to Palicoidea larval systematics

The zoeal development of the brachyuran crab, Palicus caronii, comprises two zoeal stages and the morphology is described and illustrated in detail. The zoeae were collected in plankton samples from the Southern Ligurian Sea (Western Mediterranean). Although the morphology of the larval stages of this species was unknown, a combination of characters allowed the zoeae to initially be assigned to the Palicidae, based on the previous unique known first zoeal description of one species of this family. Later, the identification of the larvae as Palicus caronii was confirmed through molecular analysis. The morphological features of the zoeae that characterize the Palicidae and separate them from the Crossotonotidae are confirmed. Also, the larval development comprising only two zoeal stages observed in Palicus caronii, the peculiar and uncommon carapace surface setation, and the presence of anterodorsal and posterodorsal sensory dorsal organs suggest that these characters could be common to the Palicoidea.The collection of the larval stages used in the present work was performed in the context of a project carried out with the financial support of the Italian Ministero della Salute (Research Project IZSPLV 14/14 RC). COI sequence of adult crab of Palicus caronii was obtained within the framework of the MEGALOPADN project (CGL2009-11225) funded by the “Ministerio de Economía y Competividad (MINECO)” Spanish Plan R + D + I and FEDER. Authors would like to thank Prof. Simona Bonelli, Department of Life Sciences and Systems Biology (UNITO), for her support, and the entomology laboratory of Department of Agriculture, Forestry and Food Sciences (UNITO) for loaning the camera lucida, with a special thanks to Enrico Busato for his availability. The study was funded by the Italian Ministero della Salute (Research Project IZSPLV 14/14 RC)

Are knowledge and skills acquired during the Master Degree in Nursing actually put into practice? A pilot study in Italy

Background. Literature on the evaluation of the Master’s Degree in Nursing is scarce. The objective of this pilot study was to test a questionnaire aimed at monitoring the activities of nurses after receiving the Master’s degree. Methods. An electronic questionnaire was administered to 36 graduates who obtained the Master’s degree during the academic year 2010/2011. Results. Almost 80% of the participants judged their level of improvement in knowledge and skills during the course to have been satisfactory, but the level of implementation of these competencies at work was quite low. Conclusion. Competencies acquired during the Master’s degree course are not always put into practice

Indagine conoscitiva sul concetto di competenza avanzata nella professione infermieristica

Introduzione: L’evoluzione della formazione infermieristica ha di fatto portato ad un accrescimento di conoscenze e competenze che hanno reso gli infermieri dei veri e propri professionisti. Con l’introduzione del comma 566 della Legge di stabilità del 2015 e della Legge 24 del 2017, è stata posta una maggiore attenzione sull’utilizzo delle Linee Guida e su come esse, insieme alla buona pratica, possano ridurre il ricorso ad una medicina difensiva. Obiettivo: Indagine sulle conoscenze del personale infermieristico riguardanti i concetti di competenza avanzata e responsabilità professionale, in relazione al loro agire quotidiano, e ai nuovi assetti normativi. Materiali e Metodi: Uno studio cross-sectional è stato eseguito su un campione di 60 soggetti fra Giugno 2019 e Settembre 2019, presso l’ospedale Policlinico Umberto I di Roma. È stata condotta una survey, rivolta agli infermieri operanti nel setting dell’area critica e chirurgica, mediante l’utilizzo di un questionario non validato, in forma anonima in cui vengono analizzati e saggiati: a) dati anagrafici; b) analisi dell’attività lavorativa; c) analisi delle conoscenze. Risultati: Sono stati convalidati per lo studio 60 questionari correttamente compilati, con un tasso di risposta del 63.8%. Il 68.3% degli infermieri era di sesso femminile ed il 31.6% di sesso maschile. L’età media del campione è di 35.2 anni. Il 16.7% degli infermieri utilizza sempre le linee guida aziendali/ministeriali nella pratica clinica; il 36.7% le usa raramente; il 41.7% le utilizza abbastanza, mentre il 5% non le utilizza mai. In relazione alla conoscenza della normativa vigente, emerge che il 48.3% non conosce il comma 566 della Legge di stabilità, con il 48.3% del campione che asserisce di conoscere la Legge Gelli. Conclusione: Dai risultati ottenuti emerge la necessità del personale infermieristico di una maggiore formazione circa gli aspetti legali della professione mediante una formazione dedicata. Inoltre emerge l’importanza dell’aggiornamento professionale come mezzo per non incorrere in atti di medicina difensiva.Introduction: The evolution of nursing education has in fact led to an increase in knowledge and skills that have made nurses real professionals. With the introduction of paragraph 566 of the 2015 Stability Law and Law 24 of 2017, greater attention has been paid to the use of the Guidelines and how they, together with good practice, can reduce the use of defensive medicine. Aim: The aim of this is to investigate the knowledge of nursing staff regarding the concepts of advanced competence and professional responsibility in relation to their daily actions, considering the new law framework. Materials and Methods: A cross-sectional study was performed on a sample of 60 responders between June 2019 and September 2019, at the Policlinico Umberto I hospital in Rome.A survey was conducted, aimed at nurses operating in the critical and surgical area setting, through the use of an anonymous, non-validated questionnaire in whic the following are analyzed and tested: a) personal data; b) analysis of work activity; c) knowledge analysis. Results: 60 correctly completed questionnaires with a response rate of 63.8% were validated for the study. 68.3% of the nurses were female and 31.6% male. The average age of the sample is 35.2 years. 16.7% of nurses always use company / ministerial guidelines in clinical practice; 36.7% rarely use them; 41.7% use them enough, while 5% never use them. In relation to the knowledge of current legislation, it emerges that 48.3% do not know paragraph 566 of the Stability Law, with 48.3% of the sample claiming to know the Gelli Law. Conclusion: The results obtained show that the nursing staff need more training on the legal aspects of the profession through dedicated training. Furthermore, the importance of professional updating emerges as a means of not incurring defensive medicine