Standardized Nursing Diagnoses in a Surgical Hospital Setting: A Retrospective Study Based on Electronic Health Data

Introduction: In electronic health records (EHRs), standardized nursing terminologies (SNTs), such as nursing diagnoses (NDs), are needed to demonstrate the impact of nursing care on patient outcomes. Unfortunately, the use of NDs is not common in clinical practice, especially in surgical settings, and is rarely included in EHRs. Objective(s): The aim of the study was to describe the prevalence and trend of NDs in a hospital surgical setting by also analyzing the relationship between NDs and hospital outcomes. Methods: A retrospective study was conducted. All adult inpatients consecutively admitted to one of the 15 surgical inpatient units of an Italian university hospital across 1 year were included. Data, including the Professional Assessment Instrument and the Hospital Discharge Register, were collected retrospectively from the hospital's EHRs. Results: The sample included 5,027 surgical inpatients. There was a mean of 6.3 ± 4.3 NDs per patient. The average distribution of NDs showed a stable trend throughout the year. The most representative NANDA-I ND domain was safety/protection. The total number of NDs on admission was significantly higher for patient whose length of stay was longer. A statistically significant correlation was observed between the number of NDs on admission and the number of intra-hospital patient transfers. Additionally, the mean number of NDs on admission was higher for patients who were later transferred to an intensive care unit compared to those who were not transferred. Conclusion: NDs represent the key to understanding the contribution of nurses in the surgical setting. NDs collected upon admission can represent a prognostic factor related to the hospital's key outcomes

Prevalence of nursing diagnoses as a measure of nursing complexity in a hospital setting

Aims: To describe the prevalence of nursing diagnoses on admission among inpatient units and medical diagnoses and to analyse the relationship of nursing diagnoses to patient characteristics and hospital outcomes. Background: Nursing diagnoses classify patients according to nursing dependency and can be a measure of nursing complexity. Knowledge regarding the prevalence of nursing diagnoses on admission and their relationship with hospital outcomes is lacking. Design: Prospective observational study. Methods: Data were collected for 6 months in 2014 in four inpatient units of an Italian hospital using a nursing information system and the hospital discharge register. Nursing diagnoses with prevalence higher or equal to 20% were considered as \u2018high frequency.\u2019 Nursing diagnoses with statistically significant relationships with either higher mortality or length of stay were considered as \u2018high risk.\u2019 The high-frequency/high-risk category of nursing diagnoses was identified. Results: The sample included 2283 patients. A mean of 4\ub75 nursing diagnoses per patient was identified; this number showed a statistically significant difference among inpatient units and medical diagnoses. Six nursing diagnoses were classified as high frequency/high risk. Nursing diagnoses were not correlated with patient gender and age. A statistically significant perfect linear association (Spearman's correlation coefficient) was observed between the number of nursing diagnoses and both the length of stay and the mortality rate. Conclusion: Nursing complexity, as described by nursing diagnoses, was shown to be associated with length of stay and mortality. These results should be confirmed after considering other variables through multivariate analyses. The concept of high-frequency/high-risk nursing diagnoses should be expanded in further studies

Role of PET/CT in the detection of liver metastases from colorectal cancer

The aim of this study was to compare the diagnostic accuracy of 2-[fluorine-18] fluoro-2-deoxy-D-glucose positron emission tomography (F-18-FDG-PET) and computed tomography (CT) with PET/CT in the detection of liver metastases during tumour staging in patients suffering from colorectal carcinoma for the purposes of correct surgical planning and follow-up. A total of 467 patients underwent a PET/CT scan using an iodinated contrast medium. We compared images obtained by the single PET scan, the single CT scan and by the fusion of the two procedures (PET/CT). The final diagnosis was obtained by histological examination and/or by the follow-up of all patients, including those who did not undergo surgery or biopsy. The PET scan had 94.05% sensitivity, 91.60% specificity and 93.36% accuracy; the CT scan had 91.07% sensitivity, 95.42% specificity and 92.29% accuracy. The combined procedures (PET/CT) had the following values: sensitivity 97.92%, specificity 97.71% and accuracy 97.86%. This study indicates that PET/CT is very useful in staging and restaging patients suffering from colorectal cancer. It was particularly useful when recurrences could not be visualised either clinically or by imaging despite increasing tumour markers, as it guaranteed an earlier diagnosis. PET/CT not only provides high diagnostic performance in terms of sensitivity and specificity, enabling modification of patient treatment, but it is also a unique, high-profile procedure that can produce cost savings

Healthcare workers training courses on vaccinations: A flexible format easily adaptable to different healthcare settings.

Since 2017, Italy has expanded the compulsory vaccination from 4 to 10 for those aged 0 to 16 years. Because of the great organizational effort required for the immunization services, minor attention was given to the vaccinations not included among the mandatory ones. This situation led to a real difficulty in harmonizing the vaccination procedures even inside a single region. In the Lazio region, the Laboratory of Vaccinology of the University of Rome Tor Vergata established a working group to create a new training model for healthcare professionals. The course program proposed an update of three vaccinations which are not mandatory but actively offered. It included the same part of scientific updating and a variable part based on local experiences. A specific anonymous questionnaire on knowledge and attitude was administered. The study aimed to propose a general format of training courses for vaccination centers adaptable to the individual local health units (ASLs) and to evaluate through questionnaires. The results show differences in knowledge and attitudes toward non‐mandatory vaccinations among the ASLs of Lazio, confirming the usefulness of a support to make knowledge and procedures homogeneous. This model could be adapted to any healthcare setting and exported to other services

Taking screenshots of the invisible: A study on bacterial contamination of mobile phones from university students of healthcare professions in Rome, Italy

Mobile phones (MPs) are commonly used both in the personal and professional life. We assessed microbiological contamination of MPs from 108 students in healthcare professions (HPs), in relation to their demographic characteristics and MPs handling habits, collected by means of a questionnaire. Cultural and biochemical tests were performed, and statistical analyses were carried out. Staphylococci were present in 85% of MPs, Enterococci in 37%, Coliforms in 6.5%; E. coli was never detected. Staphylococcus epidermidis was the most frequently isolated staphylococcal species (72% of MPs), followed by S. capitis (14%), S. saprophyticus, S. warneri, S. xylosus (6%), and by S. aureus (4%). Heterotrophic Plate Counts (HPC) at 37◦C, ranged from 0 to 1.2 × 104 CFU/dm2 (mean = 362 CFU/dm2). In univariate analysis, the male gender only was significantly associated with higher HPCs and enterococcal contamination. Multiple linear regression models explained only 17% and 16% of the HPC 37◦C and staphylococcal load variability, respectively. Developing specific guidelines for a hygienic use of MPs in clinical settings, for preventing cross-infection risks, is advisable, as well as introducing specific training programs to HP students. MPs decontamination procedures could also be implemented in the community

Consumo de combustible y emisiones del sector transporte aéreo en la ciudad de Rosario

El rol de las ciudades como grandes emisoras de Gases de Efecto Invernadero (GEI), determina la necesidad de estimar las emisiones relativas al consumo energético. Presentamos resultados de las emisiones de GEI en el Transporte aéreo, analizando tres métodos para el cálculo de combustible: a) Método Simplificado, b) Flight Simulator, c) Emission Inventory Guidebook. Seleccionamos como criterio el promedio de los métodos mencionados, con una incertidumbre de 8,9% con respecto a los valores extremos. El consumo anual de combustible para transporte aéreo es de 13.6 Mlitros. Para el cálculo de emisiones consideramos los cuatro criterios. Concluimos que el Método Actividad Inducida es el más apropiado con un valor total de 8.8 TnCO2equivalentes anuales. Comparamos además las emisiones de distintos medios de transporte entre Rosario-Buenos Aires con respecto al avión. El auto diésel refleja menores emisiones de GEI en un porcentaje de -98,69% y el tren de -99,90%.The role of cities as mayor contributors of Greenhouse Gases (GHG), determine the importance of measuring the relative emissions of energy consumption. In this work, we present the results of GHG emissions of aviation sector, analyzing three different methods to determine fuel consumption: a) Simplify Method, b) Flight Simulator, c) Emission Inventory Guidebook. We choose as fuel consumption criteria the average of the three mentioned methods, with 8,9% of uncertainty with respect of the extreme values. The yearly fuel consumption for aviation sector is 13.6 Ml. For the emissions calculations we analyze four methods. We come to the conclusion that the activity induced method is the more appropriate with a total value of 8.8 TnCO2eq per year. We also compare the emissions of different transportation modes from Rosario to Buenos Aires with the aviation mode. The percentage difference of a diesel car is -98.69%, and for the train is -99,90%.Tema 7: Uso eficiente y racional de la energía. Políticas y economía energética.Facultad de Arquitectura y Urbanism

Consumo de combustible y emisiones del sector transporte aéreo en la ciudad de Rosario

El rol de las ciudades como grandes emisoras de Gases de Efecto Invernadero (GEI), determina la necesidad de estimar las emisiones relativas al consumo energético. Presentamos resultados de las emisiones de GEI en el Transporte aéreo, analizando tres métodos para el cálculo de combustible: a) Método Simplificado, b) Flight Simulator, c) Emission Inventory Guidebook. Seleccionamos como criterio el promedio de los métodos mencionados, con una incertidumbre de 8,9% con respecto a los valores extremos. El consumo anual de combustible para transporte aéreo es de 13.6 Mlitros. Para el cálculo de emisiones consideramos los cuatro criterios. Concluimos que el Método Actividad Inducida es el más apropiado con un valor total de 8.8 TnCO2 equivalentes anuales. Comparamos además las emisiones de distintos medios de transporte entre Rosario-Buenos Aires con respecto al avión. El auto diésel refleja menores emisiones de GEI en un porcentaje de -98,69% y el tren de -99,90%.The role of cities as mayor contributors of Greenhouse Gases (GHG), determine the importance of measuring the relative emissions of energy consumption. In this work, we present the results of GHG emissions of aviation sector, analyzing three different methods to determine fuel consumption: a) Simplify Method, b) Flight Simulator, c) Emission Inventory Guidebook. We choose as fuel consumption criteria the average of the three mentioned methods, with 8,9% of uncertainty with respect of the extreme values. The yearly fuel consumption for aviation sector is 13.6 Ml. For the emissions calculations we analyze four methods. We come to the conclusion that the activity induced method is the more appropriate with a total value of 8.8 TnCO2eq per year. We also compare the emissions of different transportation modes from Rosario to Buenos Aires with the aviation mode. The percentage difference of a diesel car is -98.69%, and for the train is -99,90%.Tema 10: Educación y capacitación en energías renovables y uso racional de la energía.Facultad de Arquitectura y Urbanism