Assistenza Infermieristica ed esiti sensibili. Unità operativa a gestione infermieristica: uno studio retrospettivo Nursing care and sensitive outcomes. Nursing management unit. a retrospective study

Obiettivo. Lo studio ha come obiettivo quello di valutare gli esiti sensibili all’assistenza infermieristica nell’Unità Operativa a Gestione Infermieristica (UOGI), analizzando il grado di completezza della documentazione e le conoscenze degli infermieri in merito alla tracciabilità dei risultati. Metodo. Studio osservazionale della durata di tre mesi e analisi retrospettiva delle cartelle infermieristiche relative all’anno 2015 all’interno dell’UOGI dell’Azienda Ospedaliero-Universitaria Policlinico Umberto I di Roma. Risultati. Come ampiamente documentato dalla letteratura nazionale e internazionale, i Nursing Sensitive Outcome (NSO) sono uno strumento fondamentale per misurare la qualità dell’assistenza e per migliorare gli esiti dei pazienti. A rigore di ciò è necessario garantire un’adeguata tracciabilità del processo assistenziale grazie all’adozione di strumenti di registrazione idonei ed esaustivi. Lo studio condotto ha preso in considerazione 97 cartelle infermieristiche, di cui soltanto il 35,05% riportava gli esiti all’assistenza. Di questi, l’82,35% hanno risvolti positivi, l’11,76% negativi e il 5,88% sono esiti parzialmente raggiunti. Conclusioni. La valutazione delle attività è significativa per il miglioramento delle cure erogate e per la sicurezza dei pazienti. Lo studio condotto dimostra l’importanza di avere uno strumento idoneo alla raccolta delle informazioni utili al processo di nursing, che prevede la documentazione e verifica degli interventi come corretto approccio assistenziale. È importante che l’infermiere, in quanto professionista, sia formato sulla corretta compilazione della documentazione assistenziale così da tracciare il processo assistenziale con dati che siano chiari e completi ed espressi con un linguaggio standardizzato.Objective. The aim of this study was to evaluate the outcomes of nursing care in U.O.G.I. (Operational Units in Nursing Management), analyzing the completeness of nursing documentation and the knowledge of nurses regarding the traceability of results. Method. The observational study was conducted during a three month period. A retrospective analysis of patients’ nursing records was performed in the UOGI of the Policlinico Umberto I of Rome. Results. As widely documented by national and international literature, the Nursing Sensitive Outcome (NSO) is a fundamental tool to measure the quality of care and to improve patient outcomes. This process requires a comprehensive data collection, a suitable registration tool and an exhaustive traceability of the care process. The number of nursing records analyzed was 97. The 35,05% of nursing records showed an outcome: the 82,35% of them are positive; the 11,76% of them are negative; the 5,88% of them are outcome partially achieved. Conclusions. The assessment of activities is significant to improve quality of nursing care and patient safety. The findings of this study showed the importance of nursing records in data collection. It’s important that nurses are educated to complete correctly clinical documents, in order to make clear, complete and accurate data collection, nursing process traceable, intervention appropriated and to use a correctly and standardized language

Smartphone distraction during nursing care. Systematic literature review

Aim: To investigate the impact of smartphone distraction on the quality and safety of care provided by the nursing population during work. Background: About 80% of nurses use the smartphone in the workplace both for personal purposes and as a useful support to improve the quality of care. Distraction from smartphones during care is a phenomenon that should be known and managed within each health service. Methods: A systematic review of the literature was conducted using the PRISMA methodology. The sources included in the review study were subjected to a qualitative assessment using the GRADE method. Results: Sixteen articles were included in the review. Studies included highlight the positive and negative consequences of using mobile devices during nursing practice. Findings identify the smartphone as a generator of stimuli capable of diverting the attention of the person from the priority activities and absorbing the cognitive resources useful for carrying out these activities. Some studies aimed to show the restriction policies and/or the strategies for reducing disruptions. This review highlights how the free and indiscriminate use of the smartphone can negatively affect patient safety and the nurse-patient relationship through the dehumanization and depersonalization of care. Conclusions: Mobile technology can improve nurses' performance and the quality of care provided. However, the application of regulations and policies by healthcare facilities is desirable to avoid inappropriate use of these devices by nurses. The available data do not provide a precise estimate of the effect that distraction from smartphones has on the outcomes of nursing care

Gestione avanzata delle vie aeree. un’overview sull’intubazione orotracheale Airways advanced management. An overview about orotracheal intubation

Introduzione. L’ampia produzione scientifica relativa al trattamento del paziente critico mette in risalto la forte eterogeneità organizzativa dei sistemi di emergenza sanitaria presenti nel panorama internazionale, evidenziando come gli operatori sanitari impegnati in questo setting siano in possesso di livelli di competenza e responsabilità operativa differenti. Obiettivo. L’obiettivo della revisione è quello di analizzare le competenze e responsabilità dell’infermiere nella manovra di intubazione orotracheale (IOT) e i principali strumenti tecnologici in uso. Materiali e Metodi. È stata effettuata una revisione della letteratura mediante interrogazione di banche dati di interesse infermieristico (Cinahl Complete, Cochrane Library, PubMed e Scopus). Non sono stati posti limiti temporali. Risultati. Gli articoli reperiti hanno permesso l’esplorazione di tre ambiti: le tecnologie e gli strumenti a disposizione del professionista; le conoscenze e competenze del professionista abilitato all’intubazione; le responsabilità dell’infermiere nella gestione delle vie aeree in Italia. Sebbene, infatti, in Italia l’IOT sia appannaggio della sola professione medica, in ambito internazionale suddetta manovra rientra tra le competenze del personale infermieristico e non, previa opportuna e adeguata formazione. Studi dimostrano che le percentuali di intubazioni riuscite, eseguite da personale non medico si avvicinano molto a quelle dei medici e, inoltre, per la gestione avanzata delle vie aeree in rapidità e sicurezza, è stato dimostrato di uguale efficacia l’utilizzo dei dispositivi sovraglottici (SG), sebbene il tubo endotracheale sia indicato come gold standard nel management delle vie respiratorie. Conclusioni. L’appropriatezza ed efficacia del trattamento, specie in ambito extra ospedaliero, richiede una fattiva e consolidata collaborazione multiprofessionale e multidisciplinare. Nel contempo, le strategie d’intervento attuate e la qualità delle cure prestate risultano fortemente condizionate da fattori quali competenze cliniche del personale sanitario, abilità tecniche ed esperienza degli operatori e abilità non tecniche (esempio, capacità di lavoro in team).Introduction. The wide scientific production related to the critical patient treatment, underlines the strong organizational heterogeneity of the health emergency systems in the international scene, highlighting how the health workers involved in this setting have different levels of competence and operational responsibilities. Objective. The aim of the review is to analyze skills and responsibilities of nurse in the orotracheal intubation (OTI) and the main used technological tools. Materials and Methods. A literature review was performed by querying nursing databases (Cinahl Complete, Cochrane Library, PubMed and Scopus). No time limits were set. Results. The articles found, allowed the exploration of three areas: the technologies and tools available to the professional; the knowledge and skills of the professional enabled to intubation; the responsibilities of nurse in the airway management in Italy. In fact, although in Italy the OTI is a prerogative of medical profession, in the international sphere this procedure, after an appropriate and adequate training, is part of nursing, and not, skills. Specific studies show that the percentage of successful intubations performed by non-medical staff is very close to the ones performed by doctors. Moreover, for the quickly and safely advanced airway management, has been shown that the use of the supraglottic airway devices (SAD) is equally effective compared to the endotracheal intubation, referred as the gold standard in respiratory management. Conclusions. The treatment’s appropriateness and effectiveness, especially in the extra-hospital setting, requires an effective and consolidated multi-professional and multidisciplinary collaboration. At the same time, the implemented intervention strategies and the quality of provided care are strongly influenced by: healthcare staff clinical skills, operators technical skills and experience and non-technical skills (example, ability to work in a team)

The association between personality trait and the development of postoperative complications in enterostomized patients. Systematic review of literature

Aim: To investigate the presence of association between the personality trait and the onset of postoperative complications in patients undergoing enterostomy packaging. Materials and methods: Systematic review of the literature. Results: Type D personality traits and those with a low tendency to optimism and temperament (ex. anxiety-depressive syndrome) would seem to be associated with an increased risk of developing postoperative psychiatric morbidity and reduced levels of health-related quality of life (HRQoL) in enterostomized patients for colorectal cancer (CRC). Also, type-D personality, has been associated with greater risk of multiple comorbidities including an increased risk of heart failure unrelated to other sociodemographic causes 32-34-35. Personality with little tendency to optimism may represent a predictive factor on the development of psychological suffering one year after the diagnosis of CRC 3. Patients with personality traits associated with reduced levels of life satisfaction and / or reduced coping capacity require longer hospitalization time 26. Discussion: Several studies highlight the presence of association between personality traits oriented to performance, persistence and extroversion and outcomes in various areas of surgery 14,2,-27,30. However, in almost all cases, the outcomes measured do not correspond to the early post-operative complications defined in the inclusion criteria but to mediumlong term psychological and rehabilitative outcomes. Conclusions: From the review study, no sources were found concerning the association between the personality trait and the onset of early postoperative complications in enterostomised patients, highlighting, furthermore, a lack of data on the subject involving the entire field of abdominal surgery