Come migliorare i percorsi formativi per la segnalazione di sospette reazioni avverse a farmaci (ADR): una revisione della letteratura

Introduction: nurses, especially those operating in contexts such as Emergency Units, play a strategic role in identifying suspected adverse drug reactions (ADR). Despite the increasing number of training courses in pharmacovigilance targeting nurses, the number of reports of suspected ADR by nurses is, in Italy, still poor. The aim of this review is to identify the most effective training approaches and methods for nurses on pharmacovigilance. Materials and methods: a literature search has been conducted in the databases PubMed, The Cochrane Library, CINAHL and ILISI for studies published from 2002 to 2012. Results: out of 193 works found in PubMed, 24 in CINAHL, and 1 in ILISI, only 6 studies were found perfectly relevant to research question and were analysed. Discussion: the results show that it is useful to plan training courses on the basis of the initial assessment of the knowledge, attitudes and practices of nurses in pharmacovigilance. Furthermore, it is beneficial to implement a training based on the assumptions of andragogy, to focus on interactive learning strategies, to carry out a training on the job (experiential learning), to provide continuing support by tutors and/or expert facilitators, to strengthen learning through repeated encounters over time. Conclusion: the review found that educational activities for nurses can be integrated into other interventions aimed to improve the organizational culture in Pharmacovigilance. Some questions remain open, concerning the competences that should be acquired in this field during the basic education and the most effective training to be given in specific contexts, such as Emergency Units. Future research is needed to evaluate outcomes training overtime through indicators such as the increase in the number and quality of ADR reports

Interventions to reduce the risk of violence toward emergency department staff: current approaches

Nicola Ramacciati,1,2 Andrea Ceccagnoli,2 Beniamino Addey,3 Enrico Lumini,4 Laura Rasero1,5 1Department of Experimental and Clinical Medicine, University of Florence, 2Emergency Department, S. Maria della Misericordia Hospital, 3Emergency Medical System, S. Maria della Misericordia Hospital, Perugia, 4Department of Health Sciences, University of Florence, 5Research and Development Unit, Azienda Ospedaliero Universitaria Careggi, Florence, Italy Introduction: The phenomenon of workplace violence in health care settings, and especially in the emergency department (ED), has assumed the dimensions of a real epidemic. Many studies highlight the need for methods to ensure the safety of staff and propose interventions to address the problem. Aim: The aim of this review was to propose a narrative of the current approaches to reduce workplace violence in the ED, with a particular focus on evaluating the effectiveness of emergency response programs. Methods: A search was conducted between December 1, 2015 and December 7, 2015, in PubMed and CINAHL. Ten intervention studies were selected and analyzed. Results: Seven of these interventions were based on sectoral interventions and three on comprehensive actions. Conclusion: The studies that have attempted to evaluate the effectiveness of interventions have shown weak evidence to date. Further research is needed to identify effective actions to promote a safe work environment in the ED. Keywords: workplace violence, violence prevention and control, emergency department, aggression, security, revie

Come migliorare i percorsi formativi per la segnalazione di sospette reazioni avverse a farmaci (ADR): una revisione della letteratura

Introduction: nurses, especially those operating in contexts such as Emergency Units, play a strategic role in identifying suspected adverse drug reactions (ADR). Despite the increasing number of training courses in pharmacovigilance targeting nurses, the number of reports of suspected ADR by nurses is, in Italy, still poor. The aim of this review is to identify the most effective training approaches and methods for nurses on pharmacovigilance. Materials and methods: a literature search has been conducted in the databases PubMed, The Cochrane Library, CINAHL and ILISI for studies published from 2002 to 2012. Results: out of 193 works found in PubMed, 24 in CINAHL, and 1 in ILISI, only 6 studies were found perfectly relevant to research question and were analysed. Discussion: the results show that it is useful to plan training courses on the basis of the initial assessment of the knowledge, attitudes and practices of nurses in pharmacovigilance. Furthermore, it is beneficial to implement a training based on the assumptions of andragogy, to focus on interactive learning strategies, to carry out a training on the job (experiential learning), to provide continuing support by tutors and/or expert facilitators, to strengthen learning through repeated encounters over time. Conclusion: the review found that educational activities for nurses can be integrated into other interventions aimed to improve the organizational culture in Pharmacovigilance. Some questions remain open, concerning the competences that should be acquired in this field during the basic education and the most effective training to be given in specific contexts, such as Emergency Units. Future research is needed to evaluate outcomes training overtime through indicators such as the increase in the number and quality of ADR reports

Aggressions on social networks: what are the implications for healthcare providers? An exploratory research

Incidents of violence by healthcare users against staff have been considered as sentinel events. New forms of aggression, i.e., cyberbullying, have emerged with the advent of social networks. Medical literature includes some reports about workplace cyberbullying on nurses and young doctors by colleagues/supervisors, but not by users. To investigate cyberbullying on healthcare providers via social networks, we carried out an exploratory quali-quantitative study, researching and analyzing posts and comments relating to a local Health Trust (ASL5) in Italy, published from 2013 until May 2020 on healthcare worker aggressions on social networks on every local community’s Facebook page. We developed a thematic matrix through an analysis of the most recurring meaning categories (framework method). We collected 217 texts (25 posts and 192 comments): 26% positive and 74% negative. Positive posts were shared about ten times more than negative ones. Negative comments received about double the “Likes” than the positive ones. Analysis highlighted three main meaning categories: 1. lack of adequate and functional structures; 2. negative point of view (POV) towards some departments; 3. positive POV towards others. No significant differences were observed between the various categories of healthcare workers (HCW). Geriatric, medical wards and emergency department were the most frequent targets of negative comments. All the texts referred to first-line operators except for one. Online violence against HCW is a real, largely unknown, problem that needs immediate and concrete attention for its potentially disastrous consequences. Compared to traditional face-to-face bullying, it can be more dangerous as it is contagious and diffusive, without spatial, temporal or personal boundaries