Ethical dimensions of paediatric nursing: A rapid evidence assessment

© 2016, © The Author(s) 2016. Background: Paediatric nurses often face complex situations requiring decisions that sometimes clash with their own values and beliefs, or with the needs of the children they care for and their families. Paediatric nurses often use new technology that changes the way they provide care, but also reduces their direct interaction with the child. This may generate ethical issues, which nurses should be able to address in the full respect of the child. Research question and objectives: The purpose of this review is to describe the main ethical dimensions of paediatric nursing. Our research question was, ‘What are the most common ethical dimensions and competences related to paediatric nursing?’ Research design: A rapid evidence assessment. Method: According to the principles of the rapid evidence assessment, we searched the PubMed, SCOPUS and CINAHL databases for papers published between January 2001 and March 2015. These papers were then independently read by two researchers and analysed according to the inclusion criteria. Ethical considerations: Since this was a rapid evidence assessment, no approval from the ethics committee was required. Findings: Ten papers met our inclusion criteria. Ethical issues in paediatric nursing were grouped into three areas: (a) ethical issues in paediatric care, (b) social responsibility and (c) decision-making process. Conclusion: Few studies investigate the ethical dimensions and aspects of paediatric nursing, and they are mainly qualitative studies conducted in critical care settings based on nurses’ perceptions and experiences. Paediatric nurses require specific educational interventions to help them resolve ethical issues, contribute to the decision-making process and fulfil their role as advocates of a vulnerable population (i.e. sick children and their families). Further research is needed to investigate how paediatric nurses can improve the involvement of children and their families in decision-making processes related to their care plan

Patient safety competencies in undergraduate nursing students: a rapid evidence assessment

Aims To identify patient safety competencies, and determine the clinical learning environments that facilitate the development of patient safety competencies in nursing students. Background Patient safety in nursing education is of key importance for health professional environments, settings, and care systems. To be effective, safe nursing practice requires a good integration between increasing knowledge and the different clinical practice settings. Nurse educators have the responsibility to develop effective learning processes and ensure patient safety. Design Rapid Evidence Assessment. Data Sources MEDLINE, CINAHL, SCOPUS, and ERIC were searched, yielding 500 citations published between 1 January 2004 - 30 September 2014. Review Methods Following the Rapid Evidence Assessment process, 17 studies were included in this review. Hawker's (2002) quality assessment tool was used to assess the quality of the selected studies. Results Undergraduate nursing students need to develop competencies to ensure patient safety. The quality of the pedagogical atmosphere in the clinical setting has an important impact on the students’ overall level of competence. Active student engagement in clinical processes stimulates their critical reasoning, improves interpersonal communication, and facilitates adequate supervision and feedback. Conclusion Few studies describe the nursing students’ patient safety competencies and exactly what they need to learn. In addition, studies describe only briefly which clinical learning environments facilitate the development of patient safety competencies in nursing students. Further research is needed to identify additional pedagogical strategies and the specific characteristics of the clinical learning environments that encourage the development of nursing students’ patient safety competencies

Rehabilitation strategies for low anterior resection syndrome. A systematic review

Objective. To summarize the evidence in the literature about rehabilitative treatments that reduce low anterior resection syndrome (LARS) symptoms in patients who underwent surgery for colorectal cancer.Methods. We have search in PubMed, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health and Scopus databases. Studies selected were limited to those including only patient undergone low rectal resection with sphincter preservation and with pre-post assessment with a LARS score. Five articles fit the criteria.Results. The percutaneous tibial nerve stimulation demonstrated moderate results and sacral nerve stimulation was found to be the best treatment with greater symptom improvement. Only one study considered sexual and urinary problems in the outcomes assessment.Conclusions. In clinical practice patients should evaluate with the LARS and other score for evaluation of urinary and sexual problems. Future research must be implemented with higher quality studies to identify the least invasive and most effective treatment/s.

The contribution of nursing doctoral schools to the development of evidence 10 years after their establishment in Italy: An exploratory descriptive survey of former and current doctoral students’ publications

AimTo analyse through an exploratory descriptive survey how former and current doctoral students’ publications have contributed to the development of evidence between the establishment of the doctoral schools of nursing between 2006 - 2015.Design An exploratory descriptive survey.Methods We analysed the papers published in peer-reviewed journals by the four Italian PhD Schools of Nursing between 2006 - 2015. Additional missing information was retrieved from Web of Science.Results We identified 478 scientific papers. The papers increased from 12 in 2006 to 110 in 2015. Most are published in 29 journals, of which 15 have an impact factor ranging between 0.236-3.755. These results show the increasingly significant contribution of nursing doctoral programs to the production of evidence, which can be used to improve the quality of nursing and inform health policies. Nursing doctoral schools deserve a greater recognition, especially by Italian funding agencies and political institutions

Concurrent validity of self-rating scale of self-directed learning and self-directed learning instrument among Italian nursing students

BACKGROUND: Self-Directed Learning develops when students take the initiative for their learning, recognising needs, formulating goals, identifying resources, implementing appropriate strategies and evaluating learning outcomes. This should be seen as a collaborative process between the nurse educator and the learner. At the international level, various instruments have been used to measure Self-Directed Learning abilities (SDL), both in original and in culturally-adapted versions. However, few instruments have been subjected to full validation, and no gold standard reference has been established to date. In addition, few researchers have adopted the established tools to assess the concurrent validity of the emerging new tools. Therefore, the aim of this study was to measure the concurrent validity between the Self-Rating Scale of Self-Directed Learning (SRSSDL_Ita) - Italian version and the Self-Directed Learning Instruments (SDLI) in undergraduate nursing students. METHODS: A concurrent validity study design was conducted in a Bachelor level nursing degree programme located in Italy. All nursing students attending the first, second or third year (n=428) were the target sample. The SRSSDL_Ita, and the SDLI were used. The Pearson correlation was used to determine the concurrent validity between the instruments; the confidence of intervals (CI 95%) bias-corrected and accelerated bootstrap (BCa), were also calculated. RESULTS: The majority of participants were students attending their first year (47.9%), and were predominately female (78.5%). Their average age was 22.5\ub14.1. The SDL abilities scores, as measured with the SRSSDL_Ita (min 40, max 200), were, on average, 160.79 (95% CI 159.10-162.57; median 160); while with the SDLI (min 20, max 100), they were on average 82.57 (95% CI 81.79-83.38; median 83). The Pearson correlation between the SRSSDL_Ita and SDLI instruments was 0.815 (CI BCa 95% 0.774-0.848), (p=0.000). CONCLUSIONS: The findings confirm the concurrent validity of the SRSSDL_Ita with the SDLI. The SRSSDL_Ita instrument can be useful in the process of identifying Self-Directed Learning abilities, which are essential for students to achieve the expected learning goals and become lifelong learners

La concettualizzazione dell'assistenza infermieristica nella letteratura italiana: un'analisi integrativa a supporto dello sviluppo di una teoria

Introduction: Nursing theories are essential for orienting nursing practice. To date, three models for nursing practice have been developed in Italy. In addition, significant epistemological reflections have been published, sparking a rich professional debate regarding the theoretical foundations of nursing in Italy. However, conceptual models from other countries are often still used, despite many difficulties associated with applying them in practice. In order to investigate and redress this ‘theoretical gap’ and related implications for intervention, three scoping reviews of the Italian nursing literature were conducted to examine three categories of nursing knowledge: (a) nursing practice in Italy; (b) the basic nursing concepts of person, health, environment and nursing; and (c) regulatory/normative statements regarding what nursing practice should be in Italy. Objective: The purpose of this investigation was to identify how nursing is conceptualized in the Italian literature through an integrative narrative analysis of three scoping reviews. Methods: The Scoping Review according to the recommendations published by Arksey and O'Malley and subsequently implemented by Levac et al. has been selected as the optimal methodology for mapping nursing knowledge. At the end of the reviews carried out to answer the three research questions, the researchers integrated the results by conducting a coding of the results. Results: The narrative synthesis highlighted a systemic conception of persons in their social context, ‘incorporated’ within relational systems. Persons are imagined as active agents with self-determination toward promoting their own health. Health, derived from levels of equilibrium between multiple systemic components and based on the person's holistic view, is a fundamental right and a collective social interest. Maintaining or promoting a person’s health requires careful consideration of all these constitutive and integral elements. The nursing process is implemented through technical acts as well as relational and caring skills. Professional autonomy, influenced by clinical and organizational contexts, is expressed in collaboration with other professionals who contribute to the healthcare process. The results of this integrative narrative analysis suggest the need for a holistic vision of persons, with an active role in their health management, indissociable from the system of relationships in which this is contextualized, within which nurses are embedded. Conclusion: In light of the results of our investigation, the promotion of a conceptualization of nursing based on the centrality of the person-social relational system and on the active role of persons that nurses work with, this could guide approaches used in nursing education and administration. This could help enhance care provided by nurses and persons' participation in decisions regarding their own health. Keywords: nursing theory, nursing discipline, review, metaparadigm Introduzione: Le teorie infermieristiche costituiscono un riferimento imprescindibile per la prassi infermieristica. In Italia sono stati elaborati e proposti tre modelli professionali italiani. Oltre ad essi, il dibattito professionale si è arricchito anche di significative riflessioni di tipo epistemologico. Tuttavia, ancora oggi risultano essere spesso adottati modelli concettuali provenienti da altri Paesi con la difficoltà del loro utilizzo nella prassi infermieristica. Allo scopo di studiare e approfondire “questo divario teorico” e le possibili linee di intervento sono state realizzate tre revisioni della produzione scientifica infermieristica italiana su tre categorie di conoscenze infermieristiche: la pratica infermieristica in Italia, i concetti fondanti di persona, salute, ambiente e assistenza e tutte le dichiarazioni normative riguardo a cosa dovrebbe essere in Italia la pratica infermieristica. Obiettivo: Lo scopo di questo studio è la produzione di una sintesi narrativa che identifica la concezione di infermieristica nella letteratura italiana attraverso un’analisi integrativa di scoping reviews. Metodi: La Scoping Review secondo le raccomandazioni pubblicate da Arksey and O’Malley e successivamente implementate da Levac et al. è stata selezionata come la metodologia ottimale per eseguire la mappatura delle conoscenze infermieristiche. Al termine delle revisioni realizzate per rispondere alle tre domande di ricerca, i ricercatori hanno integrato i risultati conducendo una codifica dei risultati. Risultati: La sintesi narrativa ha evidenziato una concezione sistemica di base riguardante le persone nel loro contesto sociale, “incorporate” nei sistemi di relazioni. La persona è identificata come agente attivo nell'autoderminazione della salute. La salute derivante da livelli di equilibrio tra più componenti sistemiche e basata sulla visione olistica della persona è un bene fondamentale e un interesse sociale collettivo. Mantenere o promuovere la salute della persona richiede un'attenta considerazione di tutti quelli elementi che ne sono parte costituiva e integrante. La processualità dell'assistenza è messa in atto attraverso atti di natura tecnica e attraverso competenze relazionali e di caring. L'autonomia professionale, influenzata dai contesti clinici e organizzativi si esprime anche nella collaborazione con gli altri professionisti che contribuiscono alla realizzazione del processo di cura. I risultati di questa analisi integrativa suggeriscono la necessità di una visione olistica della persona, del suo ruolo attivo nella gestione della salute e della sua inscindibilità dal sistema di relazioni in cui questa è contestualizzata e del quale l’infermiere entra a far parte. Conclusione: Alla luce dei risultati del nostro studio, la promozione di una concezione di assistenza infermieristica basata sulla centralità dell’intero sistema persona-relazioni sociali e sul ruolo attivo della persona assistita potrebbero orientare sia i processi formativi sia le amministrazioni infermieristiche così da consentire e valorizzare la presa in carico globale da parte dei professionisti infermieri e la partecipazione della persona alla presa di decisioni riguardanti la propria salute

Nursing students’ self-directed learning abilities and related factors at graduation: A multi-country cross-sectional study

AimTo describe nursing students’ level of self-directed learning abilities and identify possible factors related to it at graduation in six European countries.DesignA cross-sectional comparative design across the countries.MethodsThe study was conducted from February 2018 to September 2019. Nursing students (N = 4,135) from the Czech Republic, Finland, Italy, Portugal, Slovakia and Spain were invited to respond to the research instruments (the Self-Rating Scale of Self-Directed Learning and the Nurse Competence Scale) at graduation. The data were analysed using the chi-square test, Pearson correlation coefficient and the linear model.ResultsThe nursing students’ (N = 1,746) overall self-directed learning abilities were at high level in all countries. Statistically significant differences occurred between countries. Spanish nursing students reported the highest level of self-directed learning abilities while students from the Czech Republic reported the lowest. Higher level of self-directed learning abilities was related to several factors, particularly with the self-assessed level of competence and country.</p