Protocol for evaluating quality and safety for the public through home care nursing in Italy: a multicentre cross-sectional descriptive observational study (AIDOMUS-IT)

introduction: considering the increasing complexity of care and workload for home care nurses due to the ageing of the population, it is crucial to describe the work environment and the community care setting. the aim of this study protocol is to map the characteristics and identify gaps of home care in the community to design future interventions aimed at ensuring quality and safety. methods and analysis: this is a national cross-sectional descriptive observational study using the survey method. nurses from all participating community care centres will be recruited through convenience sampling by the coordinators of each centre, who will act as facilitators for this study. all community care recipients and their informal carers during the study period will be invited to complete a survey.to map the characteristics and identify gaps of home care in the community, three sources of data will be collected: (1) organisational characteristics, professional satisfaction, intention to leave and burn-out; (2) experience of care recipients and their informal carers and (3) improper access to the emergency department, readmission to hospital, comorbidities, services offered and users' level of autonomy, and main and secondary diagnoses.considering the total italian nursing population of approximately 450 000 registered nurses, a sample size of 1% of this population, equal to approximately 4600 nurses, was hypothesised.This study started in July 2022 and is planned to end in december 2023.data will be analysed using descriptive and inferential statistics. ethics and dissemination: this study protocol was approved by the liguria regional ethics committee in november 2022. informed consent will be obtained from participants and confidentiality will be ensured. data collected for this study will be kept anonymised in a protected database.the results of the study will be disseminated mainly through conferences, publications and meetings with government representatives

L'infermiere e la percezione del Moral Distress nella cura del fine vita nel paziente dializzato

The phenomenon of Moral Distress in nursing practice is described as a situation of suffering that arises when the nurse recognizes the ethically appropriate action to be taken and yet institutional impediments make it impossible for him to follow the right course of action. Dialysis patients often have a complex disease trajectory that sometimes involves professional and emotional challenges for staff, especially at the end of life. The objective of this review is to identify which strategies are useful for preserving emotional integrity and awareness in operational settings, for the benefit of both operators and patients

La misurazione delle cure personalizzate: traduzione e validazione semantica dell'Individualized Care Scale

RIASSUNTO Tradurre e validare semanticamente in italiano l'Individualized Care Scale e fornire alcune indicazioni per il suo utilizzo nel contesto culturale e professionale italiano per migliorare la capacití  di misurazione di questo indicatore di esito dell'assistenza infermieristica in Italia. La strategia d'indagine utilizzata ha suddiviso il lavoro in due fasi distinte, una dedicata alla traduzione dello strumento e l'altra incentrata sulla sua validazione semantica e culturale. Anche la traduzione semantica ha avuto due momenti distinti: prima una doppia forward translation parallela in cieco eseguita da traduttori bilingui specializzati italiano-inglese di madrelingua italiana e successivamente l'applicazione della tecnica definita Committee approach che consiste nell'eseguire una valutazione delle traduzioni svolte tramite panel specifico. La seconda fase del lavoro, con un approccio esplorativo e descrittivo di tipo fenomenologico, ha testato la validití  culturale dei contenuti dell'ICS per ottenere indicazioni circa le percezioni degli infermieri sull'utilizzo dello strumento nel contesto culturale e professionale di riferimento. La traduzione italiana dell'ICS ottenuta dal nostro gruppo di studio si è rivelata essere comprensibile e facilmente utilizzabile nel contesto culturale e professionale italiano, offrendosi come un valido strumento di misurazione delle opinioni del / della paziente circa l'assistenza ricevuta e di quanto da lui / lei percepito in occasione della propria esperienza nosocomiale. I risultati confermano l'utilití  dello strumento per la misurazione delle cure personalizzate; la versione italiana dell'ICS si è dimostrata essere un promettente strumento per misurare il grado di personalizzazione dell'assistenza ricevuta durante il ricovero in ospedale. Tuttavia, dopo questa prima validazione culturale e semantica, è necessario attivare ulteriori ricerche volte alla sua piena validazione statistica. ABSTRACT Tradurre e validare semanticamente in italiano l'Individualized Care Scale e fornire alcune indicazioni per il suo utilizzo nel contesto culturale e professionale italiano per migliorare la capacití  di misurazione di questo indicatore di esito dell'assistenza infermieristica in Italia. La strategia d'indagine utilizzata ha suddiviso il lavoro in due fasi distinte, una dedicata alla traduzione dello strumento e l'altra incentrata sulla sua validazione semantica e culturale. Anche la traduzione semantica ha avuto due momenti distinti: prima una doppia forward translation parallela in cieco eseguita da traduttori bilingui specializzati italiano-inglese di madrelingua italiana e successivamente l'applicazione della tecnica definita Committee approach che consiste nell'eseguire una valutazione delle traduzioni svolte tramite panel specifico. La seconda fase del lavoro, con un approccio esplorativo e descrittivo di tipo fenomenologico, ha testato la validití  culturale dei contenuti dell'ICS per ottenere indicazioni circa le percezioni degli infermieri sull'utilizzo dello strumento nel contesto culturale e professionale di riferimento. La traduzione italiana dell'ICS ottenuta dal nostro gruppo di studio si è rivelata essere comprensibile e facilmente utilizzabile nel contesto culturale e professionale italiano, offrendosi come un valido strumento di misurazione delle opinioni del / della paziente circa l'assistenza ricevuta e di quanto da lui / lei percepito in occasione della propria esperienza nosocomiale. I risultati confermano l'utilití  dello strumento per la misurazione delle cure personalizzate; la versione italiana dell'ICS si è dimostrata essere un promettente strumento per misurare il grado di personalizzazione dell'assistenza ricevuta durante il ricovero in ospedale. Tuttavia, dopo questa prima validazione culturale e semantica, è necessario attivare ulteriori ricerche volte alla sua piena validazione statistica. Key words: Nursing, individualized nursing, instrument translation, cross-cultural research

Frontline Involvement in Population COVID-19 Vaccinations: Lived Experience of Nursing Students

(1) Background: The globally promoted vaccination campaign has been shown to be the solution for the COVID-19 pandemic, reducing transmission, hospitalisation and the need for intensive care. Although several studies have examined the experiences of healthcare workers during the pandemic, few studies have investigated healthcare student experiences. The aim of this study is to explore the lived experience of third-year nursing students during the COVID-19 vaccination campaign. (2) Methods: A phenomenological qualitative method was adopted. The researchers selected third-year students undertaking a bachelor’s nursing degree who took part in the COVID-19 vaccination campaign at a high-volume vaccination centre in the period from May to August 2021. (3) Results: Thirteen students were included in the study. Three themes and twelve subthemes emerged from the study. The themes were: a challenging experience; it is not as easy as it seems; a learning experience worth living; and teamwork and trust leading to professional development. (4) Conclusions: Participation in the vaccination campaign was a novelty for students in their degree program. Students emphasized the positive aspects of having the opportunity to participate in the vaccination campaign and help the entire community in the fight against COVID-19

Levels of Moral Distress among Health Care Professionals Working in Hospital and Community Settings: A Cross Sectional Study

Moral distress is a concern for all healthcare professionals working in all care settings. Based on our knowledge, no studies explore the differences in levels of moral distress in hospital and community settings. This study aims to examine the level of moral distress among healthcare professional working in community or hospital settings and compare it by demographic and workplace characteristics. This is a cross-sectional study. All the professionals working in the hospitals or community settings involved received personal e-mail invitations to participate in the study. The Moral Distress Thermometer was used to measure moral distress among healthcare professionals. Before data collection, ethical approval was obtained from each setting where the participants were enrolled. The sample of this study is made up of 397 healthcare professionals: 53.65% of the sample works in hospital setting while 46.35% of the sample works in community setting. Moral distress was present in all professional groups. Findings have shown that nurses experienced level of moral distress higher than other healthcare professionals (mean: 4.91). There was a significant differences between moral distress among different professional categories (H(6) = 14.407; p < 0.05). The ETA Coefficient test showed significant variation between healthcare professionals working in community and in hospital settings. Specifically, healthcare professionals who work in hospital experienced a higher level of moral distress than those who work in community settings (means 4.92 vs. means 3.80). The results of this study confirm that it is imperative to develop educational programs to reduce moral distress even in those settings where the level perceived is low, in order to mitigate the moral residue and the crescendo effect

Moral Distress of Intensive Care Nurses: A Phenomenological Qualitative Study Two Years after the First Wave of the COVID-19 Pandemic

Background: The COVID-19 pandemic has imposed great pressure on healthcare facilities, exposing healthcare professionals to various challenges that may result in the onset of moral distress, a condition of psychological distress caused by the inability to act as it would be most morally appropriate. The purpose of this research was to investigate the experience lived by nurses who worked in an intensive care unit during the COVID-19 pandemic. Methods: This is a phenomenological study using interpretative phenomenological analysis. Sixteen nurses who worked in the COVID-19 Intensive Care Unit of Northern Italian Hospitals from January to April 2022 were selected through purposive sampling. Data on experiences, thoughts, and symptoms were collected through semi-structured interviews with in-person and remote modalities. Results: Five themes and fourteen subthemes emerged from the study. The themes are: (1) pride, isolation, and fear; (2) teamwork and organisation; (3) moral/ethical aspect; (4) true heroes; and (5) dignity. Conclusions: This study highlights the impact of the COVID-19 pandemic on intensive care unit nurses. It has emerged that the risk of moral distress is high among healthcare workers in the front line of the fight against the virus. This condition should be avoided and managed through early psychological interventions, sharing of experiences, and a good organization that supports decision-making and professional well-being

Characteristics of registered clinical trials assessing strategies of medication errors prevention. An unusual cross sectional analysis.

Background: ClinicalTrials.gov is the oldest and largest of these registries. Through this, the researchers can explore and monitor the clinical research landscape. In the last decades, the number of Medline-indexed publications on adverse events and medication errors have increased exponentially. The aims were to define the prevalence of clinical trials that have as outcome the medication errors and to describe the characteristics of these trials, including their distribution across countries, and publication rate. Methods: A cross-sectional analysis of all clinical trials reporting as primary outcome medication errors identified through ClincialTrials.gov. Results: Among 5.881 trials, only 1,68% focused on intervention to improve medication safety process and prevent medication errors. 25,3% of clinical trials included had their primary outcome changed (p= ,005). Recording study results in ClinicalTrials.gov was associated with trials that had their primary outcome changed (OR: ,060; 95% C.I.: ,007 – ,541). Only few interventional trials were totally compliant with the ICMJE policy. For all trials completed in our sample, in mean 7,44 months (median: 12 months) elapsed between study completion and the first publication in Medline showing the trial’s identification number. Conclusions: This study demonstrates several strengths of using ClinicalTrials.gov to track intervention to improve medication safety process. It is unknown how many trials are designed to focus on medication errors. However, 1,68% of trials focused on intervention to improve medication safety process