Nursing Perception on Patient Safety Culture: The Latest Methodological Approaches

Safety culture can be defined as “the values shared among organization members about what is important, their beliefs about how things operate in the organization, and the interaction of these with work unit and organizational structures and systems, which together produce behavioral norms in the organization that promote safety”. This literature review aimed to identify the latest methodological approaches quantifying patient safety culture perception among nurses. The available literature was searched from January 2018 to today . Eleven eligible works were found and analyzed and the main key concepts highlighted were: the research approaches to assess patient safety culture, the development of quantitative survey tools for data collection for further reproducibility and the levels of data aggregation for conducting data analyses. A cohesive body of literature of evaluation tools is requiring on patient safety culture among nurses which is still limited in the current literature. Keywords: Health Safety; Methodological Approach; Nursing Perception; Patient Safety; Safety Culture; Safety Survey. DOI: 10.7176/JHMN/62-12 Publication date:May 31st 201

How Patients and Nurses defined Advocacy in Nursing? A Review of the Literature

Objectives: Advocacy is an important aspect in current professional nursing care and it is a relatively new role for nursing, emerged in the United States in 1980s. This article aimed to explore the basis of advocacy concept viewed by both nurses and patients.Design: A computerized search in PubMed, Medline, Embase databases was conducted to highlight the relevance of nursing advocacy by nurses and patients. This review included qualitative studies which explained better advocacy concept in nursing practice and analyzed the concept of nursing advocacy. Data sources: Fifteen articles were found. Of these, only six met all the requirements of the inclusion criteria Review methods: Articles were compared by considering for each paper the purpose, the design, the methodology, the finding, in order to define advocacy concept by both patients and nurses.Results: Six articles were found, which were published between 1996 and 2018.Conclusions: It was found that the concept and the practice of the nursing advocacy was still enshrouded in confusion, conflict and change. Keywords: Advocacy; Nursing Advocacy; Literature Review; Patient Advocacy. DOI: 10.7176/JHMN/63-08 Publication date:June 30th 201

Assessment of Correlations among Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) and Cumulative Illness Rating Index (CI) Scores in the Elderly Patients with Femur Fractures: A Prospective Study

Background: The World Health Organization (WHO) has established that injury will be the second principal cause of the world disease onerous by the year 2020. Purpose: In this study comorbidity was evaluated with the Cumulative Illness Rating Index, (CI) and studied in relation to the functional status of the elderly participants, by considering: Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL), scores. Method: Ninety-five elderly patients with femur fracture were recruited for this study. A prospective investigation and evaluation of their comorbidity and their physical activity conditions was performed. Results: Correlations were evaluated between: ADL and CIRS values (r = 0.23); CIRS and IADL values (r = 0.24), and finally correlations between patients age and CIRS values (r = 0.09).Conclusion: No significant correlations were assessed to standardize the different score levels. Keywords: Activities of Daily Living (ADL), Cumulative Illness Rating Index (CI), Instrumental Activities of Daily Living (IADL), Elderly Patients. DOI: 10.7176/JHMN/63-05 Publication date:June 30th 2019

Identifying people at risk for influenza with low vaccine uptake based on deprivation status: a systematic review

Background: Influenza vaccination is an important public health intervention for controlling disease burden, but coverage rates are still low also in risk groups. In order to identify non-vaccinating subgroups, deprivation and socio-economic indices, i.e. measures used to synthetically describe people\u2019s socio-economic status while taking into account several dimensions, may be used. We aimed to synthetize evidence from studies investigating association between deprivation/socio-economic indices and influenza vaccination coverage in population at risk\u2014 persons 65 years of age, individuals with comorbidities, pregnant women and health-care workers. Methods: We searched PubMed, ISI WoS, CINAHL and Scopus to identify observational studies published up to October 10th 2017 in English or Italian. Studies reporting quantitative estimates of the association between deprivation/socioeconomic indices and influenza vaccination coverage in populations at risk were included. Results: A total of 1474 articles were identified and 12 were eventually included in the final review. Studies were mostly cross-sectional, performed in European countries, from 2004 to 2017. Seven studies focussed on deprivation and five on socioeconomic indices. Studies on deprivation indices and vaccination coverage showed that people from the most deprived areas had lower coverage. Regarding socio-economic condition, results were contrasting, even though it may also be concluded that people from lower groups have lower vaccination coverage. Conclusions: Our work supports the possibility to identify people likely to have lower influenza vaccination coverage based on deprivation/socio-economic indices. Efforts should be performed in order to further strengthen robustness, transferability and suitability of these indices in addressing public health problems

Electrochromic device composed of a Di-Urethanesil electrolyte incorporating lithium triflate and 1-Butyl-3-Methylimidazolium chloride

A di-urethane cross-linked poly(oxyethylene)/silica hybrid matrix [di-urethanesil, d-Ut(600)], synthesized by the sol-gel process, was doped with lithium triflate (LiCF3SO3) and the 1-butyl-3-methylimidazolium chloride ([Bmim]Cl) ionic liquid. The as-produced xerogel film is amorphous, transparent, flexible, homogeneous, hydrophilic, and has low nanoscale surface roughness. It exhibits an ionic conductivity of 3.64 x 10(-6) and 5.00 x 10(-4) S cm(-1) at 21 and 100 degrees C, respectively. This material was successfully tested as electrolyte in an electrochromic device (ECD) with the glass/ITO/a-WO3/d-Ut(600)(10)LiCF3SO3[Bmim]Cl/c-NiO/ITO/glass configuration, where a-WO3 and c-NiO stand for amorphous tungsten oxide and crystalline nickel oxide, respectively. The device demonstrated attractive electro-optical performance: fast response times (1-2 s for coloring and 50 s for bleaching), good optical memory [loss of transmittance (T) of only 41% after 3 months, at 555 nm], four mode modulation [bright mode (+3.0 V, T = 77% at 555 nm), semi-bright mode (-1.0 V, T = 60% at 555 nm), dark mode (-1.5 V, T = 38 % at 555 nm), and very dark mode (-2.0 V, T = 11% and -2.5 V, T = 7% at 555 nm)], excellent cycling stability denoting improvement with time, and high coloration efficiency [CEin = -6727 cm(2) C-1 (32th cycle) and CEout = +2794 cm(2) C-1 (480th cycle), at 555 nm].The authors are grateful to Fundacao para a Ciencia e a Tecnologia (FCT) and when applicable by FEDER under the PT2020 Partnership Agreement for financial support under contracts PEst-OE/SAU/UI0709/2014, UID/Multi/00709/2013, UID/QUI/00686/2016, UID/QUI/00686/2018, UID/QUI/00686/2019, PEst-OE/QUI/UI0616/2016, FCOMP-01-0124-FEDER037271, UID/CTM/50011/2013, LUMECD project (POCI01-0145-FEDER-016884 and PTDC/CTM-NAN/0956/2014), UniRCell project (SAICTPAC/0032/2015 and POCI-01-0145FEDER-016422). RP and SN acknowledge FCT-MCTES for grants (SFRH/BPD/87759/2012 and LUMECD, respectively). RP thanks FCT-UM for the contracts in the scope of Decreto-Lei 57/2016 and 57/2017. MF acknowledges FCTUTAD for the contract in the scope of Decreto-Lei 57/2016 -Lei 57/2017. HG acknowledges projects POCI-010145-FEDER-030858 and PTDC/BTM-MAT/30858/2017 for financial support

A Knowledge, Attitude, and Perception Study on Flu and COVID-19 Vaccination during the COVID-19 Pandemic: Multicentric Italian Survey Insights

In January 2020, Chinese health authorities identified a novel coronavirus strain never before isolated in humans. It quickly spread across the world, and was eventually declared a pandemic, leading to about 310 million confirmed cases and to 5,497,113 deaths (data as of 11 January 2022). Influenza viruses affect millions of people during cold seasons, with high impacts, in terms of mortality and morbidity. Patients with comorbidities are at a higher risk of acquiring severe problems due to COVID-19 and the flu-infections that could impact their underlying clinical conditions. In the present study, knowledge, attitudes, and opinions of the general population regarding COVID-19 and influenza immunization were evaluated. A multicenter, web-based, cross-sectional study was conducted between 10 February and 12 July 2020, during the first wave of SARS-CoV-2 infections among the general population in Italy. A sample of 4116 questionnaires was collected at the end of the study period. Overall, 17.5% of respondents stated that it was unlikely that they would accept a future COVID-19 vaccine (n = 720). Reasons behind vaccine refusal/indecision were mainly a lack of trust in the vaccine (41.1%), the fear of side effects (23.4%), or a lack of perception of susceptibility to the disease (17.1%). More than 50% (53.8%; n = 2214) of the sample participants were willing to receive flu vaccinations in the forthcoming vaccination campaign, but only 28.2% of cases had received it at least once in the previous five seasons. A higher knowledge score about SARS-CoV-2/COVID-19 and at least one flu vaccination during previous influenza seasons were significantly associated with the intention to be vaccinated against COVID-19 and influenza. The continuous study of factors, determining vaccination acceptance and hesitancy, is fundamental in the current context, in regard to improve vaccination confidence and adherence rates against vaccine preventable diseases

A machine-learning based bio-psycho-social model for the prediction of non-obstructive and obstructive coronary artery disease

Background: Mechanisms of myocardial ischemia in obstructive and non-obstructive coronary artery disease (CAD), and the interplay between clinical, functional, biological and psycho-social features, are still far to be fully elucidated. Objectives: To develop a machine-learning (ML) model for the supervised prediction of obstructive versus non-obstructive CAD. Methods: From the EVA study, we analysed adults hospitalized for IHD undergoing conventional coronary angiography (CCA). Non-obstructive CAD was defined by a stenosis < 50% in one or more vessels. Baseline clinical and psycho-socio-cultural characteristics were used for computing a Rockwood and Mitnitski frailty index, and a gender score according to GENESIS-PRAXY methodology. Serum concentration of inflammatory cytokines was measured with a multiplex flow cytometry assay. Through an XGBoost classifier combined with an explainable artificial intelligence tool (SHAP), we identified the most influential features in discriminating obstructive versus non-obstructive CAD. Results: Among the overall EVA cohort (n = 509), 311 individuals (mean age 67 ± 11 years, 38% females; 67% obstructive CAD) with complete data were analysed. The ML-based model (83% accuracy and 87% precision) showed that while obstructive CAD was associated with higher frailty index, older age and a cytokine signature characterized by IL-1β, IL-12p70 and IL-33, non-obstructive CAD was associated with a higher gender score (i.e., social characteristics traditionally ascribed to women) and with a cytokine signature characterized by IL-18, IL-8, IL-23. Conclusions: Integrating clinical, biological, and psycho-social features, we have optimized a sex- and gender-unbiased model that discriminates obstructive and non-obstructive CAD. Further mechanistic studies will shed light on the biological plausibility of these associations. Clinical trial registration: NCT02737982

Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p < .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p < .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

Abdominal drainage after elective colorectal surgery: propensity score-matched retrospective analysis of an Italian cohort

background: In italy, surgeons continue to drain the abdominal cavity in more than 50 per cent of patients after colorectal resection. the aim of this study was to evaluate the impact of abdominal drain placement on early adverse events in patients undergoing elective colorectal surgery. methods: a database was retrospectively analysed through a 1:1 propensity score-matching model including 21 covariates. the primary endpoint was the postoperative duration of stay, and the secondary endpoints were surgical site infections, infectious morbidity rate defined as surgical site infections plus pulmonary infections plus urinary infections, anastomotic leakage, overall morbidity rate, major morbidity rate, reoperation and mortality rates. the results of multiple logistic regression analyses were presented as odds ratios (OR) and 95 per cent c.i. results: a total of 6157 patients were analysed to produce two well-balanced groups of 1802 patients: group (A), no abdominal drain(s) and group (B), abdominal drain(s). group a versus group B showed a significantly lower risk of postoperative duration of stay >6 days (OR 0.60; 95 per cent c.i. 0.51-0.70; P < 0.001). a mean postoperative duration of stay difference of 0.86 days was detected between groups. no difference was recorded between the two groups for all the other endpoints. conclusion: this study confirms that placement of abdominal drain(s) after elective colorectal surgery is associated with a non-clinically significant longer (0.86 days) postoperative duration of stay but has no impact on any other secondary outcomes, confirming that abdominal drains should not be used routinely in colorectal surgery

Bowel preparation for elective colorectal resection: multi-treatment machine learning analysis on 6241 cases from a prospective Italian cohort

background current evidence concerning bowel preparation before elective colorectal surgery is still controversial. this study aimed to compare the incidence of anastomotic leakage (AL), surgical site infections (SSIs), and overall morbidity (any adverse event, OM) after elective colorectal surgery using four different types of bowel preparation. methods a prospective database gathered among 78 Italian surgical centers in two prospective studies, including 6241 patients who underwent elective colorectal resection with anastomosis for malignant or benign disease, was re-analyzed through a multi-treatment machine-learning model considering no bowel preparation (NBP; No. = 3742; 60.0%) as the reference treatment arm, compared to oral antibiotics alone (oA; No. = 406; 6.5%), mechanical bowel preparation alone (MBP; No. = 1486; 23.8%), or in combination with oAB (MoABP; No. = 607; 9.7%). twenty covariates related to biometric data, surgical procedures, perioperative management, and hospital/center data potentially affecting outcomes were included and balanced into the model. the primary endpoints were AL, SSIs, and OM. all the results were reported as odds ratio (OR) with 95% confidence intervals (95% CI). results compared to NBP, MBP showed significantly higher AL risk (OR 1.82; 95% CI 1.23-2.71; p = .003) and OM risk (OR 1.38; 95% CI 1.10-1.72; p = .005), no significant differences for all the endpoints were recorded in the oA group, whereas MoABP showed a significantly reduced SSI risk (OR 0.45; 95% CI 0.25-0.79; p = .008). conclusions MoABP significantly reduced the SSI risk after elective colorectal surgery, therefore representing a valid alternative to NBP