Knowledge, attitudes, and practices related to antibiotic resistance among physicians and nurses in Italian intensive care: A multicenter cross-sectional survey

Objectives: The aim of this study is to investigate the knowledge, attitudes and practices of Italian intensive-care physicians and nurses with respect to antibiotic resistance. Methods: A multicenter cross-sectional survey was conducted of 20 Italian intensive care units, supported by an online validated questionnaire. Results: A total of 143 participants took part, mainly nurses (79.7%). Most respondents were between 26 and 45 y old (62.9%), with more than 6 y of service (about 71%). Some 90% of those who took part stated that they were aware of the problem of antibiotic resistance and had easy access to guidelines and information materials on the subject. On the other hand, a high level of disagreement, mostly among nurses, emerged in relation to knowledge of the existence of national plans for the fight against AMR (62.9%) or the presence of international information campaigns (80%). A majority (76%) said they had received no specific training in the past 12 months. Most physicians (70%-90%) showed faith in their ability to prescribe, trusted guidelines, and recognized their role in antibiotic resistance by considering it while prescribing antimicrobial therapy. Conclusions: The study highlights the need for targeted training interventions, especially for nurses, and the importance of involving all healthcare professionals in the fight against antibiotic resistance

Risk of skin tears associated with nursing interventions: A systematic review

Background: Skin tears are a significant problem for patients and healthcare professionals. They can cause pain, impact quality of life, and become chronic and infected. The risk of skin tears is associated with dependence in daily life activities and with nursing interventions.Objectives: To examine which nursing interventions increase the risk of skin tears.Design: Systematic review. Data sources: The MEDLINE, CINAHL, Scopus, and Cochrane Library databases were searched in March 2022.Publication years: Publications included were from 2012 to 2022.Results: Seventeen articles were included in the final analysis reporting nursing interventions associated with the risk of skin tears. Hygiene with cold water and soap, not applying leave-on products to moisten/protect dehy-drated skin, and wearing short sleeves were found to be associated with skin tears. Transferring patients into and out of bed in a rough manner and wearing jewelry or long nails can increase the risk of skin tears. Removal of adhesive dressings or bandages can also cause skin tears.Conclusion: Nursing staff need to know which interventions put their patients at risk of skin tears and which interventions are recommended to prevent skin tears. Nursing care can affect the health of the patient's skin

Nurses’ experiences of accompanying patients dying during the COVID-19 pandemic: A qualitative descriptive study

Aims: The aim was to explore nurses' experiences of caring for and accompanying patients dying without the presence of family during the COVID-19 pandemic. Design: A qualitative descriptive design was used. Methods: A purposive sample of registered nurses, caring for dying patients in Italian health-care settings during the COVID-19 pandemic, were selected. To capture a broad range of experiences, a maximum variety of participants about workplace, age, gender and work experience were included. A total of 31 nurses agreed to participate in the study; 28 participants were female; participants were aged 41 on average (range 25-63 years) and worked in hospitals and nursing homes in the Northern and Central Italian regions. Six focus groups were conducted from August to December 2020 through Microsoft Teams, reaching data saturation. The transcripts were analysed through inductive content analysis. The COREQ checklist was followed for study reporting. Results: Four main categories emerged describing nurses' experiences: hugely increased deaths in time of COVID-19; ensuring physical, emotional, interpersonal and spiritual care for dying patients and supporting their families despite difficulties; ensuring care procedures of patients' bodies after death and psychological consequences of caring for dying people during the pandemic. Conclusion: Registered nurses provided physical, spiritual and emotional care to dying patients during the pandemic, despite limited resources and knowledge, standing in for relatives who were not allowed to visit them; the experiences of caring for dying patients in the absence of the family caused emotional distress in nurses. Impact: Health-care systems should develop guidelines aiming to meet the psychological needs of dying people in case of restrictions on patients' family visits. Health-care administrators should offer services to support the grieving process of relatives who cannot accompany dying patients and to reduce emotional distress in nurses caring for dying patients

Electronic patient-reported outcomes (ePROMs) in palliative cancer care: a scoping review

Background: In palliative oncology settings, electronic patient-reported outcome (PRO) assessment can play an important role in supporting clinical activities for clinicians and patients. This scoping review aims to map the technological innovation of electronic patient-reported outcome measures (e-PROMs) in cancer palliative care and how PRO data collected through e-PROMs can influence the monitoring and management of symptoms and enable better communication between health professionals and patients. Methods: A scoping review study was designed according to the Arksey and O'Malley framework. Medline, Embase, Web of Science, SCOPUS, PsycINFO and CINAHL and gray literature sources were consulted. The inclusion criteria were people over 18 years old receiving palliative and/or end-of-life care using e-PROMs. Results: Thirteen primary studies were included: nine quantitative studies, two qualitative studies, and two mixed-method studies. The recently developed software that supports e-PROMs allows patients to receive feedback on their symptoms, helps clinicians prioritize care needs and monitors patients’ conditions as their symptoms change. Electronic PRO data prompt difficult, end-of-life communication between clinicians and patients to better organize care in the last phase of life. Conclusion: This work shows that electronic PRO data assessment provides valuable tools for patients’ well-being and the management of symptoms; only one study reported conflicting results. However, with studies lacking on how clinicians can use these tools to improve communication with patients, more research is needed

Nurses’ knowledge about malnutrition in older people : A multicenter cross-sectional study

Objectives: Malnutrition, among older people, has a prevalence of 22% in hospitals, 17.5% in nursing homes, and 8.7% in home care. Adequate knowledge among health care staff is necessary for risk identification and adequate intervention. The aim of this study was to translate and validate the Knowledge of Malnutrition-Geriatric (KoM-G) questionnaire in Italian and to investigate the malnutrition knowledge of registered nurses working in hospitals, nursing homes, home care, and palliative care in Italy. Method: The KoM-G questionnaire was translated and validated in terms of content validity, internal consistency, and interrater reliability. Subsequently, a multicenter cross-sectional study in different settings was performed. Results: The KoM-G ITA questionnaire showed excellent content validity, internal consistency, and good intrarater reliability. There were 511 nurses who completed the questionnaire. On average, 61.9% of the respondents answered the questions correctly. Conclusion: The level of knowledge about malnutrition in nurses is adequate. Training courses and management protocols should be implemented to improve nursing care for malnourished older people

Chronic, acute and acute-on-chronic pain prevalence in a tertiary care hospital setting

OBJECTIVE: The aim of the study was to develop appropriate pain therapy and prevention plans; pain needs to be understood in terms of prevalence and associated predictor factors in hospital and primary care. The purpose of our research was to assess the prevalence of chronic, acute, and acute-on-chronic pain, and ascertain the effects of several factors on the likelihood of pain in an Italian Tertiary Care Hospital. PATIENTS AND METHODS: This is a prevalence study in which the primary outcome was the prevalence rate of chronic pain inpatients. Fisher’s exact tests and binomial logistic regression were performed for the prevalence measures, and to ascertain the effects of Hospital Unit, sex, age, surgery and preexisting chronic pain on the likelihood of pain during the hospitalization, respectively. RESULTS: Chronic pain was reported in one-fifth of inpatients [21.7% (95% CI: 0.1764, 0.2625)], with a high prevalence of pain-related interference on sleep and emotional status. Nearly 70% of chronic pain patients accused acute-on-chronic pain [15.3% (95% CI: 0.1178, 0.1934)]. High pain prevalence rates were assessed at the time of the interview (37.3%; 95% CI: 0.3234, 0.4239) and in the last 24 hours of hospitalization (53.3%; 95% CI: 0.4814, 0.5850). A 2.7 and 2.6 higher odds to suffer from pain during the hospitalization were associated with surgery, and preexisting chronic, respectively. CONCLUSIONS: This study raises awareness of the necessity to refine pain assessment and management in hospital and outpatient services. The promotion and enhancement of hospital-territory integration are essential for improving pain prescribing practices and increasing patient safety

Technology to Support Older Adults in Home Palliative Care: A Scoping Review

Background: Today, many older adults use health technologies, approach their final days with laptops, smartphones, and tablets. Telepalliative care is a service that remotely delivers palliative care through videoconferencing, telephonic commu-nication, or remote symptom monitoring. The service meets the needs of patients who want to die at home and reducing unnecessary hospitalizations. The objective of this study is to map the literature on the use of technology by the terminally ill older adult population being cared for at home, to identify which technology systems are in use, to determine how technology can change communication between palliative care professionals and patients, and to explore the strengths or weaknesses patients perceive regarding the use of technology. Methods: We conducted a scoping review following the methodology of Arksey and O'Malley. A literature search was conducted in the MEDLINE, Embase, Web of Science, SCOPUS, PsycINFO, CINAHL, Ilisi and Google Scholar databases. Results: Fourteen eligible papers identified various tools available in clinical practice and found that most older adults are comfortable and satisfied using them. Despite being physically distanced from clinicians, patients felt cared for even though eye contact was lacking. Being unfamiliar with technology emerged as a barrier to telepalliative care in addition to difficulties caused by screen size and internet connection problems. Conclusions: Older adults in palliative care at home perceive technology as a means of receiving efficient care. However, future research is needed to investigate what they look for in a technological tool and to develop more suitable technologies for them. Clinical Trial Registration: The protocol of this study has been published in the Open Science Framework (OSF) preregistrations at https:// osf.io/acv7q to enhance replicability and transparency and reduce any publication or reporting bias

The association between mutuality and quality of life in adults with chronic illnesses and their nurses : actor-partner interdipendence model analysis

Aim: To examine the association between mutuality and quality of life in nurse–patient dyads. Design: A cross-sectional multi-centre study was conducted. Methods: The study was conducted in five tertiary hospitals in Italy. We enrol both inpatients and outpatients with chronic diseases and their nurses with a convenience sampling. One-hundred ninety-two dyads participated to the study. A self-assessment instrument including the Short-Form 12 Health Survey (SF-12), and the Nurse Patient Mutuality in Chronic Illness scale (NPM-CI scale), in the two versions—one for patients and one for nurses, was administered. The effects of nurse–patient mutuality on the physical and mental quality of life of nurses and patients were estimated with a series of actor-partner-interdependence models (APIM). Results: Patients' and nurses' perceptions of their mutuality were positively correlated. For patient mental quality of life, there was a statistically significant actor effect both for patients, and for nurses. There was also a consistent statistically significant partner effect for patient mental quality of life. There were no statistically significant actor or partner effects for the nurses' and patients' physical quality of life. This construct may be influenced by additional components, further studies are needed. Conclusions: Mutuality between nurses and patients in chronic diseases influence both patient and nurse quality of life. Implications for the Profession and/or Patient Care: Our results support the importance of taking a dyadic perspective when considering mutuality and quality of life in nurse–patient dyads. Impact: Nurse–patient mutuality is an indicator of a high-quality relationship, which allows shared goals and shared decision-making. Quality of life is one of the most important outcomes for chronic conditions patients and is an indicator of well-being. Quality of life is also an important variable in healthcare professionals' lives. Little is known about the association between mutuality and quality of life in nurse–patient dyads. Mutuality has an actor effect on patient's and nurse's quality of life and has a negative partner effect on patient's quality of life. The understanding of mutuality and interdependence within the dyad, could increase mental quality of life in nurse–patient dyads. Reporting Method: STROBE checklist for cross-sectional studies was followed in this study. Patient or Public Contribution: Patients were involved in the sample of the study