Violence in health sector: the un-stoppable pandemic

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commentary on workplace violence against medical students in shiraz iran

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Beyond the GCS: an integrative review of new tools for neurological assessment in the intensive care unit for adult patients

The Glasgow Coma Scale (GCS) is a widely used clinical tool for assessing impaired consciousness, but concerns arise when applied to intubated patients or those receiving analgesics, sedatives, and paralytics because verbal scores are not evaluable. Furthermore, the GCS does not differentiate the neurological status of the patient once intubated, resulting in poor reliability in neurological assessment, and clinical indicators that may reflect the severity of the coma are not included in the GCS. This study explores alternative tools for neurological assessment in Intensive Care Units (ICUs) when GCS is impractical. Conducting an integrative review of studies from 2018 to 2022, we identified seven relevant papers. Results indicate the FOUR score as a promising GCS alternative, particularly in cases where the GCS is unavailable. Automated pupillometry also demonstrated the potential for monitoring neurologically impaired ICU patients. These tools, independent of verbal responses and applicable to sedated patients, offer improved accuracy in assessing consciousness. The study emphasizes the importance of adopting such alternatives, and addressing GCS limitations, and highlights the need for further research and implementation to enhance patient care in ICU settings

‘INEFFECTIVE SPONTANEOUS VENTILATION (00033)’ NURSING DIAGNOSIS: A REVISION STUDY.

Background: Spontaneous ventilation, essential for human life, is addressed by the nursing diagnosis “Ineffective Spontaneous Ventilation” which requires strong scientific support. Aim: This revision study aimed to elevate this nursing diagnosis to a higher level of evidence by clarifying its definition, clinical indicators, and differentiation from other diagnoses. The diagnosis is crucial for identifying patients with compromised breathing who may require respiratory support. Methods: Researchers searched the PubMed medical literature database for studies (2006-2021) on the "Ineffective Spontaneous Ventilation" diagnosis. Results: The search identified 45 studies, but after applying pre-defined criteria, only 10 articles were included in the final analysis. These articles mainly focused on the accuracy of defining characteristics for the diagnosis. Despite limitations of individual defining characteristics, Impaired Spontaneous Ventilation remains a valuable nursing diagnosis for patients with respiratory issues. Utilizing clusters of these characteristics and considering the specific context can significantly enhance the accuracy of ISV diagnosis. Conclusion: The findings unequivocally corroborate the definition of Impaired Spontaneous Ventilation, with eight out of ten articles providing validation. Moreover, the analysis proposes additional defining characteristics, namely dyspnea and cyanosis, to further refine the diagnosis. The clinical applicability of Impaired Spontaneous Ventilation extends to a wide range of patient populations and conditions. It serves as a critical marker for premature infants grappling with respiratory and cardiac challenges, trauma victims battling life-threatening injuries, and patients relying on mechanical ventilation in intensive care settings

La violenza nel settore sanitario: il contributo della ricerca infermieristica italiana

Introduzione: La violenza nel settore sanitario è un fenomeno severo e diffuso in tutto il mondo, che richiama sempre più l'attenzione degli studiosi internazionali. Scopo del presente lavoro è quello di analizzare il contributo della ricerca infermieristica italiana sul tema della violenza in sanití .Metodo: Partendo da una ricerca nei database internazionali PubMed, CINAHL e Scopus, e italiani ILISI e archivio SISI, sono stati trovati 49 lavori di ricercatori e studiosi infermieri italiani. La produzione scientifica italiana sí¬ è focalizzata soprattutto sul tema della violenza di Tipo 2 (client on worker) e di Tipo 3 (worker on worker), con studi prevalentemente descrittivi e osservazionali, ma anche di tipo qualitativo/fenomenologico.Risultati: Le pubblicazioni sono aumentate negli anni, internazionalizzandosi sempre più, come evidenziato dal numero di citazioni degli articoli e dal crescente fattore di impatto delle riviste. Il contributo delle scuole di dottorato si sta rivelando fondamentale per favorire la ricerca in questo campo.Conclusioni: È auspicabile la sempre maggiore diffusione e condivisione dei risultati della ricerca su questo fenomeno con tutta la comunití  scientifica e professionale cosí¬ che si possa fornire un utile e forte contributo nel contrasto alla violenza in sanití . Parole chiave: violenza sul lavoro, settore sanitario, ricerca infermieristicaViolence in health sector:"ˆthe contribution of Italian nursing researchABSTRACT Introduction: Violence in the health sector is a severe and widespread phenomenon worldwide, which increasingly attracts the attention of international scholars. The purpose of this paper is to analyze the contribution of Italian nursing research on the issue of violence in health care.Methods: Starting from a search in the international databases PubMed, CINAHL and Scopus, and Italian ILISI and the SISI archive, we found 49 works by Italian nursing researchers and scholars.Results: The Italian scientific production is focused above all on the issue of Type 2 violence (client on worker) and Type 3 (worker on worker), with predominantly descriptive and observational studies, but also qualitative/phenomenological. The publications have increased over the years, becoming increasingly internationalized, as evidenced by the number of citations in the articles and the growing impact factor of the journals. The contribution of the doctoral schools is proving to be fundamental to favor research in this field.Conclusions: The increasing dissemination and sharing of research results on this phenomenon with the entire scientific and professional community are desirable so that a useful and robust contribution can be made in combating violence in health care. Keyword: workplace violence, health sector, nursing research, Ital

Challenges and best practices of dispatcher-assisted cardiopulmonary resuscitation: A scoping review protocol

Introduction: Improved survival from out-of-hospital cardiac arrest with good neurological outcome was observed in association with dispatcher-assisted cardiopulmonary resuscitation, increasing the number of bystander-initiated resuscitations and minimizing the no-flow time in the first minutes of cardiac arrest. Objective: The objective of this scoping review is to map and summarise the existing literature on dispatcher-assisted cardiopulmonary resuscitation, focusing on reported experiences, challenges, and best practices, highlighting strategies that could improve the provision of cardiopulmonary resuscitation instructions to bystanders during out-of-hospital cardiac arrest. Inclusion criteria: Studies related to dispatcher-assisted cardiopulmonary resuscitation, involving human subjects, with an English abstract. The concept of interest is focused on the methods of provision of dispatcher-assisted cardiopulmonary resuscitation analysing specific experiences of implementation, challenges, and best practices, and can be generalized to any country; cultural factors, geographic features, and specific racial or gender-based differences will be analysed and discussed. Methods: Four databases (PubMed, Embase, Cumulative Index to Nursing & Allied Health Literature, and the Cochrane Library) will be searched for studies published from 2018 to 2023. All study designs, including experimental and observational studies, will be assessed for inclusion. Titles and abstracts of identified citations will be screened for inclusion; subsequently, full texts of potentially relevant sources will be assessed for inclusion by two reviewers. Any disagreements between the reviewers will be resolved through discussion. Relevant grey literature (conference proceedings, government documents, and theses) will be analysed and included. Data will be extracted in a standardized form, following Joanna Briggs Institute recommendations. Results will be synthesized and reported using a narrative approach, categorising findings into themes related to the effectiveness of dispatcher-assisted cardiopulmonary resuscitation, challenges, and best practices