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Aim: To expand knowledge about the predictive factors of nurses' intention to leave their job and consequently to turnover. Background: Nurse turnover is costly and negatively influences quality of care. Understanding the association between intention to leave and modifiable features of hospital organisation may inform strategies to reduce turnover. Methods: A cross‐sectional survey of 3,667 medical and surgical nurses was conducted in Italy. Measures included intention to leave; work environment; burnout; job satisfaction; and missed care using the RN4CAST instruments. Descriptive, logistic regression analysis was used. Results: Due to job dissatisfaction, 35.5% of the nurses intended to leave their current job, and of these, 33.1%, the nursing profession. Push factors included the following: understaffing, emotional exhaustion, poor patient safety, performing non‐nursing care and being male. Pull factors included the following: positive perception of quality and safety of care, and performing core nursing activities. Conclusion: The present study expands knowledge about the predictive factors of nurses' intention to leave their job and consequently to turnover, which is one of today's major issues contributing to the shortage of nurses. Implications for Nursing Management: Nurses' intention to leave their job is the consequence of a poor work environment, characterized by factors such as understaffing and performance of non‐nursing activities. [ABSTRACT FROM AUTHOR]

Background: Prisons are contexts where nurses are required to have specific skills to ensure that, in a setting designed for the expiation of crime, prisoners receive the same type of care as anyone else. But this is not always the case, giving rise to ethical issues. Research questions: 'How do correctional nurses describe their working experience in prisons? What issues emerged?' Methodology: This is a qualitative descriptive study. Following purposive sampling, we conducted five focus groups. Thematic analysis was used to analyse the data. Participants and research context: Our sample included 31 correctional nurses in seven prisons in Northern Italy. Ethical considerations: The scientific merit of this study was recognized by the Academic Board of the University of Genoa. Approval to conduct the study was obtained from the Liguria Regional Government that funded this study and from the Local Health Authority that was the prison nurses'employer. Formal consent was obtained from all the nurses who volunteered to participate in this study. Findings: Five themes emerged from the focus groups: (1) prisoners' healthcare needs, (2) negotiation between custody and care, (3) satisfaction of working in prisons, (4) obstacles to quality care and (5) safety. 'Manipulation'was a transversal theme that emerged from all the focus groups. Discussion: The problems generated by the clash between prison security and nursing care priorities did not enable nurses to practice autonomously and provide the best possible to care prisoners, giving rise to ethical issues andmoral distress.This in turn causes high nursing turnover rates that negatively impact continuum of care. Conclusion: In Italy, correctional nurses urgently require specific education interventions with the participation of all those who work in prisons. Interventions based on the post-modern concept of restorative nursing could offer prison nurses the opportunity to both resolve ethical issues and reduce moral distress. [ABSTRACT FROM AUTHOR]

Background: Nurses and nursing students appear vulnerable to moral distress when faced with ethical dilemmas or decision-making in clinical practice. As a result, they may experience professional dissatisfaction and their relationships with patients, families, and colleagues may be compromised. The impact of moral distress may manifest as anger, feelings of guilt and frustration, a desire to give up the profession, loss of self-esteem, depression, and anxiety. Objectives: The purpose of this review was to describe how dilemmas and environmental, relational, and organizational factors contribute to moral distress in undergraduate student nurses during their clinical experience and professional education. Research design: The research design was a systematic literature review. Method: The search produced a total of 157 articles published between 2004 and 2014. These were screened with the assessment sheet designed by Hawker and colleagues. Four articles matched the search criteria (one quantitative study and three qualitative), and these were separately read and analyzed by the researchers. The process of review and analysis of the data was supervised by a colleague experienced in moral distress who provided an independent quality check. Ethical consideration: Since this was a systematic review, no ethical approval was required. Findings: From the analysis, it emerged that inequalities and healthcare disparities, the relationship with the mentor, and students’ individual characteristics can all impact negatively on the decisions taken and the nursing care provided, generating moral distress. All these factors condition both the clinical experience and learning process, in addition to the professional development and the possible care choices of future nurses. Conclusion: Few studies dealt with moral distress in the setting of nurse education, and there is a knowledge gap related to this phenomenon. The results of this review underline the need for further research regarding interventions that can minimize moral distress in undergraduate nursing students. [ABSTRACT FROM AUTHOR]

The article reports on exposing hospitalized patients to death risks associated with understaffing. England-based Care Quality Commission has included staffing levels as one of the auditing quality standards when inspecting hospitals and health centres. The Royal College of Nursing (RCN) defined which nurse staffing levels should be adopted by policy makers to ensure the provision of safe care.

The article presents the study which examines the impact of adequate nurse-patient ratios and work environment on patient safety and the quality of nursing care in Italy. It highlights the finding of the study which shows a certain percentage of patient care activities that are left undone and the tendency of nurses in the country to leave undone relational, communication, educational and planning activities.

The article offers the author's insights on the noisy behavior of domestic staff of hospital wards. Topics discussed include the noise reduction initiatives in several hospitals, its impact on patients and the patient's family, and the need for raising awareness among nursing staff on the effect of noise on hospital environment.

The author reflects on the importance of RN4CAST project in health care industry in Italy. He discusses the foundation of the project which started in January 2009 under the 7th European Framework Program; the first phase of the study which was conducted for nurse, patient, and hospital organization surveys; and second phase was conducted appropriate healthcare service and quality of work environment.

The author discusses the importance of communication in emergency departments (EDs) for patient safety and quality of care delivery. Topics discussed include the lack of substantial evidence related to education, communication proficiency and transferability of communication skills, specific challenges to effective communication within the ED settings related to patients with complex health needs and the importance of effective record keeping and documentation to good communication in the ED.

A main identifying factor of professions is professionals' willingness to comply with ethical and professional standards, often defined in a code of ethics and conduct. In a period of intense nursing mobility, if the public are aware that health professionals have committed themselves to the drawing up of a code of ethics and conduct, they will have more trust in the health professional they choose, especially if this person comes from another European Member State. The Code of Ethics and Conduct for European Nursing is a programmatic document for the nursing profession constructed by the FEPI (European Federation of Nursing Regulators) according to Directive 2005/36/EC On recognition of professional qualifications, and Directive 2006/123/EC On services in the internal market, set out by the European Commission. This article describes the construction of the Code and gives an overview of some specific areas of importance. The main text of the Code is reproduced in Appendix 1. [ABSTRACT FROM AUTHOR]

The aim of this study was to adapt the National Aeronautics and Space Administration Task Load Index (NASA‐TLX) to the home care setting and translate and validate it in Italian.An online questionnaire containing the Italian version of the NASA‐TLX adapted to the home care setting was administered to home care nurses to measure workload. Content Validity Index, Exploratory, and Confirmatory Factor Analyses were used to measure the psychometric characteristics of the modified NASA‐TLX.The modified Italian version of NASA‐TLX_HC‐IT showed good psychometric characteristics in measuring the workload of home care nurses, with excellent fit indices. The reliability, calculated with Cronbach's alpha, was 0.73, indicating adequate reliability. A negative correlation between workload and job satisfaction among home care nurses, as well as a positive association between high workload and intention to leave the workplace, was verified.The modified Italian version of the NASA‐TLX_HC‐IT was confirmed to be a valid and reliable instrument to measure workload in home care nursing. Furthermore, the correlation between workload and the intention to leave the workplace among home care nurses was an important result that community nursing managers should consider preventing the shortage of home care nurses. [ABSTRACT FROM AUTHOR]

Background Introduction Methods Results Discussion Conclusions and implications for health policy To meet the population's needs, community care should be customized and continuous, adequately equipped, and monitored.Considering their fragmented and heterogeneous nature, a summary of community healthcare services described in European literature is needed. The aim of this study was to summarize their organizational models, outcomes, nursing contribution to care, and nursing‐related determinants of outcomes.A systematic review was performed by searching PubMed, CINAHL, Scopus, and Embase in October 2022 and October 2023 (for updated results). Quantitative studies investigating the effects of community care, including nursing contribution, on patient outcomes were included and summarized. Reporting followed the PRISMA checklist. The review protocol was registered on PROSPERO (CRD42022383856).Twenty‐three studies describing six types of community care services were included, which are heterogeneous in terms of target population, country, interventions, organizational characteristics, and investigated outcomes. Heterogeneous services’ effects were observed for access to emergency services, satisfaction, and compliance with treatment. Services revealed a potential to reduce rehospitalizations of people with long‐term conditions, frail or older persons, children, and heart failure patients. Models are mainly multidisciplinary and, although staffing and workload may also have an impact on provided care, this was not enough investigated.Community health services described in European literature in the last decade are in line with population needs and suggest different suitable models and settings according to different care needs. Community care should be strengthened in health systems, although the influence of staffing, workload, and work environment on nursing care should be investigated by developing new management models.Community care models are heterogeneous across Europe, and the optimum organizational structure is not clear yet. Future policies should consider the impact of community care on both health and economic outcomes and enhance nursing contributions to care. [ABSTRACT FROM AUTHOR]

Aim Design Data Sources Methods Results Conclusion Implications for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution To identify, synthesize, and interpret the scientific literature on the experience, perspectives, and feelings of transgender people during hospitalization.A qualitative metasynthesis.PubMed, CINAHL and PSYCHINFO were consulted in March 2024.A literature review was conducted following Sandelowski and Barroso's four‐step metasynthesis methodology. The article selection process was conducted using the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guidelines. Studies were selected based on the objectives of the review, pre‐established criteria and quality appraisal. A thematic analysis was conducted after extracting relevant quotations and a metasynthesis table was created to compare quotations and analyse overarching themes.Twenty‐two studies were included after screening titles and abstracts, full texts, and references. Three themes were identified: ‘Perception of self‐identity’; ‘Misgendering’ and ‘Lack of staff training and awareness’.Transgender people's healthcare experiences during hospitalization were mainly negative, delayed or uncomfortable. Misgendering and lack of awareness of transgender issues among healthcare workers generated anxiety and frustration. Key aspects of care for transgender people need to be included in all training programs for health professionals.There is a need to increase education and awareness among healthcare professionals towards transgender people's needs during hospitalization ensure high quality care. This study addressed the negative experience, perspectives and feelings of transgender people during hospitalization. Misgendering and unawareness of transgender peoples' issues create anxiety and frustration among nurses. Elements to improve care for transgender people need to be integrated into all nursing curricula and training programs. The authors adhered to the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guidelines and the Critical Appraisal Skills Programme (CASP).Since this was a metasynthesis, no patient or public contribution was required. [ABSTRACT FROM AUTHOR]

Introduction: The aging of the population requires an appropriate knowledge of the type of care that needs to be provided to inform healthcare policies. In Italy, neither home care nursing, nor the patient experiences have ever been described. Objectives: To describe the characteristics of nurses and care recipients involved in home care. Methods: A descriptive cross‐sectional study conducted in 18 Italian Regions. Between April and October 2023, data from nurses and patients involved in home care were collected through two surveys. Psychosocial conditions in workplaces, missed care, and care experiences were assessed using validated tools. Descriptive statistics and Pearson's correlations were performed. Results: A total of 46 local healthcare units were included in this study, with a total of 2549 nurses and 4709 care recipients. Nurses (mean age 46.60; 79.48% female; 44.68% regional nursing diploma as the highest qualification) reported good working conditions (42.37; SD = 12.25; range = 0–100) and a high mean number of missed care activities (5.11; SD = 3.19; range 0–9). Most nurses (83.41%) reported high levels of job satisfaction, while 20.28% intended to leave their job. Patients (mean age 75.18; 57.57% female; 36.95% primary school), on the other hand, rated positively the care they had received (8.23; range = 0–10). Conclusions: Despite the perception of critical issues at work and some missed care, satisfaction in nurses and patients was high. These data constitute a preliminary snapshot of the studied phenomena, which will be investigated through more in‐depth analyses. [ABSTRACT FROM AUTHOR]

An editorial is presented which argues that qualitative research can enhance the quality, rigor, and depth of an randomized controlled trial (RCT.) Topics discussed include information of RCT which involve standard approach to testing the efficacy of medicines; importance of qualitative research with patients which helps to identify several health issues; and information for RCT designs by analysis of risks to trial concordance and the way participants feel about the process of the trial.

Aim Design Methods Results Conclusions Implication for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution To explore the attitudes of healthcare workers towards COVID‐19 vaccines.A qualitative descriptive design was used.Five focus groups were conducted between October and November 2021, with a total of 30 nurses from different contexts in Northern Italy. Thematic analysis was used to analyse the transcripts.Three main themes were identified: ‘favourable’, ‘unsure’ and ‘contrary to’ COVID‐19 vaccines. The favourable position was underpinned by trust in science, research and vaccination; protection for themselves, their families, patients and the population; duty as professionals; necessity to set an example for others. Participants who were unsure had doubts about the composition, safety and efficacy of the vaccine and were sometimes afraid that media provided incomplete information. The main reason why nurses were against was the feeling that being forced to vaccinate perceived as blackmail. Favourable or unsure nurses struggled to deal with those who were against and developed a series of emotions that ranged from respect and attempt to rationalize, to frustration and defeat.Identifying the areas of hesitation is essential to understand what affects the choices of acceptance, delay or refusal of vaccination. The issues that emerged regarding proper communication within the vaccination campaign highlights the key importance of adequate vaccination strategies.Understanding attitudes towards vaccine and related motivations among healthcare workers could help develop more specific and targeted vaccination campaigns that can ensure proper vaccination coverage rates and avoid hesitancy or refusal. Healthcare workers experiences of COVID‐19 vaccines, their views and know how they feel during COVID‐19 vaccinations. Healthcare workers had three different positions in COVID‐19 vaccination. This research will guide and target future vaccination campaigns. The study is reported using the Standards for Reporting Qualitative Research (SRQR).No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusion Implications for the Profession and/or Patient Care Impact Patient or Public Contribution To describe how workplace violence (WPV) is experienced by nurses in hospitals and community services and identify protective and risk factors.An online cross‐sectional national study was conducted from January to April 2021 in Italy. Hospitals and community services were involved in the study. The survey combined the adapted and validated Italian version of the Violence in Emergency Nursing and Triage (VENT) questionnaire, which explores the episodes of WPV experienced during the previous 12 months, the Practice Environment Scale of the Nursing Work Index (PES‐NWI) and some additional questions about staffing levels extracted from a previous RN4CAST study. Nurses working in all clinical settings and community services were invited to participate in the survey. Descriptive and inferential statistics were used for data analysis. We adhered to the STROBE reporting guidelines.A total of 6079 nurses completed the survey, 32.4% (n = 1969) had experienced WPV in the previous 12 months, and 46% (n = 920) reported WPV only in the previous week. The most significant protective factors were nurses' age, patients' use of illegal substances, attitude of individual nurses and considering effective the organization's procedures for preventing and managing episodes of violence. The most significant risk factors included workload, recognizing violence as an inevitable part of the job, patients' cultural aspects and patients' agitated behaviour. The frequency of WPV was significantly higher in certain areas, such as the emergency department and in mental health wards.Workplace violence (WPV) against nurses is a very frequent and concerning issue, especially in hospitals and community services. Based on our findings, integrated and multimodal programmes for prevention and management of WPV are recommended. More attention and resources need to be allocated to reduce WPV by improving the quality of nurses' workplace environment and implementing violence‐free policies for hospitals. Workplace verbal and physical violence is a widespread phenomenon, both in hospital and community settings, and even during COVID‐19 pandemic. This problem is exacerbated by the lack of effective reporting systems, fear of retaliation and the tendency to consider violence as an inevitable part of the job. The characteristics of professionals, patients, work environment and organizational factors are involved in the spread of workplace violence, determining its multifactorial nature. Integrated and multimodal programmes to prevent and manage of workplace violence are probably the only way to effectively counteract workplace violence against nurses. Healthcare policymakers, managers of hospital and community services need to proactively prevent and effectively manage and monitor episodes of violence. Nurses need to feel protected and safeguarded against any form of verbal or physical violence, to provide high‐quality care in a totally safe environment. No patient or public contribution. [ABSTRACT FROM AUTHOR]

The author discusses clinical competence in the field of nursing in relevance with patient care. Other topics addressed include nurse-sensitive outcome issue, bachelor educated nurses, and study and teaching of nurses. Particular focus is given to the meaning and importance of competence in nursing.

Background The Nurse Forecasting Project in Europe (RN4CAST) [1] has already been conducted in 12 European countries, and it has shown that each additional surgical patient per nurse results in a 7% increase in the likelihood of dying within 30 days of admission, a 23% increase in burnout, and a 15% increase of job dissatisfaction [2]. Since Italy has 6.6 nurses per 1000 inhabitants in Italy, which is lower than the European average (11 nurses per 1000 inhabitants), we conducted the RN4CAST project also in Italy [3]. The main purpose of this study was to measure the impact of nurse staffing on patient outcomes, healthcare outcomes, and job satisfaction. Materials and methods RN4CAST survey including nurses, patients, and hospitals across Italy. Results The results will be officially presented at the RN4CAST@IT Dissemination Conference, which will be held on the 10th June 2016 at the University of Genoa in Italy. Conclusions The RN4CAST project will bring about a significant change in Italy in terms of producing data that measure the impact of nurse staffing on patient outcomes, healthcare outcomes, and job satisfaction. In this way, health policy decision makers will have the information necessary to make informed decisions on nurse staffing levels, by considering nurses not just in terms of numbers, but also in relation to what type of patient outcomes nurse staffing levels are able to ensure in terms of reduced adverse events, complications, readmissions, and mortality, achieving the best cost-benefit ratio. The RN4CAST project will enable to produce a database that can be used to measure the impact of nurse staffing and on patient outcomes, healthcare outcomes, and nurses' job satisfaction. These results can be used to improve the accuracy of health workforce forecasting models and generate new approaches to ensure a more effective management of the nursing workforce across Europe. [ABSTRACT FROM AUTHOR]

The article discusses the use of research-based evidence by nurses as a reason for the gap in nursing between evidence and practice in Europe. The authors confirm a study which showed the association between the decrease in the use of research-based evidence and the increase in nurses' working seniority. They identify several factors and possible areas for actions suggested by the Commission of the European Communities, including ensuring better working conditions for health workers.

The author reflects on the guest editorial by D. R. Thompson and R. Watson titled "H-Indices and the Performance of Professors of Nursing in the UK," published in a 2010 issue of the "Journal of Clinical Nursing." She claims that the decision to set an exceedingly high Hirsch (h)-index for Italian nursing academics has no rational foundation. She adds that the h-index cannot be the sold measurement to rate nurses' academic excellence.

Purpose: Total laryngectomy followed by radiotherapy is a life-preserving treatment for patients with locally advanced laryngeal cancer. This study explored how persons who had undergone total laryngectomy perceived themselves as cancer survivors in the follow-up phase. Methods: A descriptive phenomenological approach was adopted. We employed a purposive sampling strategy to collect data through interviews at the otorhinolaryngology outpatient clinics of two research hospitals in northern Italy. The interviews were transcribed verbatim and analysed, following the seven analytical steps of Colaizzi’s descriptive analysis. Results: The final sample included 19 patients. The following main themes were identified: (i) accepting a life with the “without” to survive; (ii) feeling unpleasant emotions; (iii) getting the hang of communication again; and (iv) reclaiming one’s role. Together, they highlight the lived experiences of laryngectomised patients during the follow-up phase and how they perceived themselves as cancer survivors. Conclusion: Laryngectomised patients are a uniquely vulnerable population. This study provides insights into how surgical procedures change and affect their lives over time to improve care models, patient education, and support systems. Survivors must be adequately prepared to transition from treatment and return to the community. This preparation should begin before treatment is started. Functional education, accurate information, and psychological support must be arranged and provided before surgery. Regarding the post-treatment phase, it is essential to support voice rehabilitation and peer support, and improve the family network, to ensure these patients’ reintegration into society and social recognition. [ABSTRACT FROM AUTHOR]

The article offers information on the complexities of Intimate Partner Violence (IPV) and the importance of tailored care for victims. Topics include the mechanisms by which women prioritize their children's health even in IPV situations, the role of healthcare providers within national anti-violence networks, and the biases healthcare providers may have when approaching IPV victims.

Aim: To report an analysis of the concept of fundamental care in the literature. Design: An evolutionary concept analysis. Data sources PubMed and CINAHL Complete databases were consulted using the key terms: fundamental care, fundamentals of care, essential care, basic nursing care and basic care revised. Articles published from 2008 to 2022, in English and Italian, in scholarly/peer‐reviewed nursing journals were included. Methods: Rodgers's Evolutionary Method of concept analysis was used. Our thematic analysis yielded common themes related to the concept, antecedents, attributes and consequences of fundamental care. Results: A total of 50 articles were analysed. Thirty‐eight attributes were identified, such as integration of care, patient and family centred care and trusting relationship; eight antecedents including nursing care, nursing practice and care context; and 17 consequences including the safety, quality and consistency of care. Conclusion: This review of literature reveals that there is no consistent definition of the concept of 'fundamental care'. Findings from this exploration of the literature emphasized the importance of communication, the contextual environment, leadership influence and nurse–patient relationship in providing effective and high‐quality fundamental care. Our definition of this concept may help nurse leaders in practice, research, education, management and policy to promote and enhance the application of fundamental care. Impact: What problem did the study address? While numerous studies examine fundamental nursing care, various terms are used with no consensus on definitions emerging. Given the relevance of this topic, reaching a clear and agreed definition of fundamental care is essential. What were the main findings? Fundamental care encompasses the importance of communication, the contextual environment, leadership influence and nurse‐patient relationship in providing effective and high‐quality care. Where and on whom will the research have an impact? This definition of fundamental care will assist nurse leaders and researchers to promote and enhance the examination and application of fundamental care in clinical practice to ensure better care outcomes across all healthcare settings. [ABSTRACT FROM AUTHOR]

Aim: To discuss the possible contribution of nurses to the Silver Economy. Background: Older people constitute a growing sector of the population of developed countries and there is increasing interest in the concept of the Silver Economy which is the contribution older people can and do make to the general economies of their communities and countries. Sources of evidence: We obtained a range of relevant documents from international organisations and related academic literature. Discussion: There is a range of interrelated health promotion aspects of ageing related to physical health, mental health and cognitive health. Promoting activities related to these could have both direct and indirect impact on the economy in addition to improving the health and well‐being of older people. Conclusions: Nurses have a responsibility to understand the health promotion related aspects of ageing and the contribution they can make to improving the health and well‐being of older people. Nurses could, specifically, promote activities amongst older people that will have an impact on health and on the economy. Implications for nursing: Nurses need to integrate more health promotion related aspects of ageing into their practice and to be able to evaluate the health‐related improvements they make and also to evaluate and indicate the contribution this makes to the health of older people and to the economy. [ABSTRACT FROM AUTHOR]

Background: Emergency departments are the services with the highest risk of violence for nurses. Reports of violence in health care have increased exponentially in the last decade. Front line hospital services are more at risk, and worldwide there are attempts to quantify, manage and prevent episodes of violence, but no consistent solutions have yet been identified. Aims: To stimulate reflection on causal factors of violence against nurses in emergency departments and discuss potential solutions and strategies for aspects that largely remain unresolved. Design: A position paper underpinned by experiences and evidence reported in the literature. Methods: A search of Scopus and CINAHL using the term 'violence' provided information concerning the prevalence of the term 'violence' in contemporary literature and enabled to capture a general overview of contributing factors of violence and current approaches to its management and prevention. Conclusions: However, while risk factors have been identified, there is a tendency to over accentuate the extent of their contribution. The main risk factors present conditions related to or accompanied by mental illness and the impact of overcrowding and long waiting times. Relevance to Clinical Practice: More is needed in terms of implementation of more far‐reaching, holistic, practical and effective management solutions to promote nurses' safety and adequately support vulnerable patients. [ABSTRACT FROM AUTHOR]

Aim To describe staff nurses' perceptions related to the leadership styles adopted by their nurse managers, identify which leadership style ensured job satisfaction in staff nurses and describe which behaviours nurse managers should change. Background Empirical literature suggests that leadership styles of nurse managers significantly influence staff satisfaction. However, few studies investigate how staff nurses perceive the leadership styles of their nurse managers, and how these impact upon the staff nurses' job satisfaction. Methods This was a mixed method study, which included the administration of the Multi-factor Leadership Questionnaire and three focus groups. Results Ward nurse managers mostly adopted a transactional leadership style ('Management by exception active') aimed at monitoring errors and intervening to correct errors and punish, which had a negative impact on staff nurses' levels of job satisfaction. In contrast, the transformational leadership style, which is mostly correlated with satisfaction ('Idealized Influence Attributed', which staff nurses perceived as 'respect', 'caring for others', 'professional development' and 'appreciation'), was rarely practiced by nurse managers. Conclusions The transformational leadership skills of Italian nurse managers need to be improved through behaviours based on greater respect, caring for others, professional development and appreciation. The present study could also serve as model to improve the leadership style of nurse managers in other countries. Implications for nursing management The themes of transformational leadership could serve as a guide for nurse managers to help them improve their leadership style, and improve the levels of job satisfaction in staff nurses. Owing to the complexity and the importance of this issue, classroom educational interventions would not be sufficient: it should be dealt as a strategic priority by nursing directors. [ABSTRACT FROM AUTHOR]

Aim: To investigate the factor structure of an Italian translation of the Practice Environment Scale of the Nursing Work Index (PES‐NWI). Background: Italy suffers from high turnover rates, yet validated tools in Italian to study and manage the problem are lacking. The PES‐NWI measures aspects of nurses' working environment. This study reports on the translation and investigation of the structure of the translated PES‐NWI scale. Methods: A survey was conducted with 3667 nurses from 182 hospitals across 13 Italian regions using the PES‐NWI. The structure of this scale was investigated using principal components analysis and other properties, including internal consistency (Cronbach's alpha). Construct validity was investigated using logistic regression. Results: The Italian translation of the PES‐NWI showed a five‐factor structure, and Cronbach's alpha of the factors ranged between 0.80 and 0.92. Logistic regression showed that the PES‐NWI was positively related to job satisfaction (odds ratio = 10.3; CI 8.62–12.35) and negatively related to intention to leave (odds ratio = 0.14; CI 0.12–0.16). Conclusions: The original five‐factor structure of the PES‐NWI was evident in the present study, albeit with some different factor loadings. Implications for Nursing Management: The Italian version of the PES‐NWI can be used by nurse managers to tackle the workforce issues related to nurses' work environments in a major European country. [ABSTRACT FROM AUTHOR]

The article presents the discussion on impact of declining response rates by nurses in nursing research projects. Topics include collecting data from practitioners showuing low response rates to survey type research projects by nurses; and describe staffing levels, work environment, aspects of well-being, and correlating the findings with specific patient outcomes.

Aim: To identify predictors and consequences of violence or aggression events against nurses and nursing students in different work contexts. Background: Workplace violence against nurses and nursing students is a very common and widespread phenomenon. Actions to manage or prevent violent events could be implemented knowing the risk factors and consequences. However, there is a lack of systematic reviews that summarize knowledge on the predictors and consequences of workplace violence. Evaluation: A scoping review was conducted using electronic databases including APA PsycInfo, CINAHL, Cochrane, Ovid Medline, PubMed and Scopus. Key issues: After full text analysis, 87 papers were included in the current scoping review. Risk factors of horizontal violence were grouped into 'personal' and 'Environmental and organizational', and for violence perpetrated by patients into 'personal', 'Environmental and organizational' and 'Characteristics of the perpetrators'. Conclusions: The results of this scoping review uncover problems that often remain unaddressed, especially where these episodes are very frequent. Workplace violence prevention and management programmes are essential to counter it. Implications for Nursing Management: The predictors and the consequents identified constitute the body of knowledge necessary for nurse managers to develop and implement policy and system actions to effectively manage or prevent violent events. [ABSTRACT FROM AUTHOR]

Background The indication for implantable cardioverter-defibrillators (ICDs) to prevent sudden death is now consolidated. However, there is no unanimous agreement on how patients experience certain aspects of their lives after an ICD implant. Various clinical studies have evaluated the impact of ICDs on patient mortality, survival, and their beneficial effects. Given the growing number of qualitative studies, a synthesis of qualitative evidence became desirable. Aims To explore and synthesize the results of qualitative studies addressing the experiences of patients with an ICD. Methods We employed a systematic review and meta-synthesis. PubMed, CINAHL, and PsycINFO were systematically searched to identify qualitative studies published between January 2005 and October 2020, which investigate the experience of patients living with an ICD. Selected studies were assessed for quality by two reviewers independently. Results A total of 24 papers were selected. Six themes emerged: fear and insecurity, the need for information, new impacts on life, living with ICD shocks, gender differences, and the role of the family. These results could help clinicians and researchers to develop new strategies and interventions to improve the quality of life in these patients. Conclusion This meta-synthesis underlines the difficulties experienced by patients with ICD implants. Despite the advanced therapeutic management programmes for this type of intervention, it is necessary to adopt and implement the current post-discharge care plans, where the family's involvement is essential to help patients adapt to their new lifestyle. [ABSTRACT FROM AUTHOR]

An editorial is presented on the implications of nursing work organization in Italian hospitals on job satisfaction, nurse well-being, and patient safety. Topics include the nurse-to-patient ratio, the impact of functional nursing care delivery models, missed nursing care and efforts to improve working conditions and patients' outcomes through person-centered care models and nursing-sensitive outcomes.

Background: In this study, bibliometric methods were used to investigate prevention and control of infectious diseases (IDs). The aim was to gain an overall view of published research on IDs in Europe as part of the collaborative study SPHERE (Strengthening Public Health Research in Europe). Methods: A framework for research on IDs and public health was developed with definitions, keywords, inclusion and exclusion criteria. A detailed web search strategy based on the framework was designed, piloted and refined. The PubMed electronic database was searched for 'infectious diseases' as a whole, and for several subtopic areas, across July 1995 and June 2005. Numbers of publications by year, country, population and Gross Domestic Product were calculated. Results: Nearly 21 000 publications on the main topic and sub-topics were found, with a progressive increase particularly since 2000. There was a marked heterogeneity between countries. France, Italy, The Netherlands, Spain, Germany, Switzerland, Sweden, UK and Belgium were the most prolific, and Eastern European countries less so. 'Vaccine-preventable diseases', 'Sexually transmitted diseases', 'Drug-resistant infections', 'Insect-arthropod-related diseases' and 'Childhood diseases' were the main fields of scientific production. Research on 'Epidemiology and Surveillance' appeared, in general, to be better represented than research on 'Prevention and Control'. Discussion: This is the first time such a broad approach has been used to describe public health research on IDs across Europe. A priority should be cooperation between European states where there is little or no, scientific production. Bibliometrics has limitations, but is of value to indicate a general pattern. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to explore how a nutritional intervention that improves the biochemical and functional profile of dysphagic older people impacts on nursing workload and costs for nursing homes. Background: Dysphagic institutionalized older people particularly at risk of malnutrition require more intensive support from nursing staff and higher costs for nursing homes. Method: This is an open pre–post longitudinal multicentre quasi‐experimental study without a control group. Results: There is a significant reduction in the number of enemas (from 3.51 to 1.11 enemas), with an average nursing workload reduction from 52 to 16 min per patient every month. Each nurse also spent 20 h less per patient every month spoon‐feeding. This resulted in nursing staff cost savings. Conclusions: The nutritional intervention led to a significantly better quality of life for the patients manifested through increased independence and social engagement. This reduced workload for nursing staff and costs for nursing home administrators. Implications for Nursing Management: Sensitive, targeted nutritional interventions have the potential to improve nursing home residents' quality of life and enable a more efficient use of resources. This study revealed reduced workload and cost savings due to less time spent administering enemas and spoon‐feeding, in addition to reduced malnutritional consequences. [ABSTRACT FROM AUTHOR]

Aims The management of cardiovascular patients requires increasingly competent nursing professionals. In Italy, there are no specific postgraduate courses focused on specialist cardiac skills development for nurses. To develop such courses, content incorporating appropriate competencies is required and this study was designed to meet this. To delineate a set of core competencies to develop national educational interventions to ensure cardiac nurses in Italy achieve international standards. Methods and results A three-round e-Delphi study including a panel of 32 expert cardiac nurses from the UK, Canada, Australia, New Zealand, and Italy was conducted; 26 respondents completed all three rounds. The first round sought a list of five competencies from each participant which they were asked to prioritize in Round 2. In Round 3, they were asked to prioritize again with the knowledge of the priorities identified in Round 2. The final list of competencies was those achieving 70% agreement among participants. We identified 14 core competencies spanning a range of areas of competence including technical, interpersonal, health promotion, use of evidence, and management. Only minor differences were evident between the Italian and the international panel regarding the priority given to some core competences, such a leadership and taking patient history. Conclusion This is the first study in Italy to delineate cardiac nurses' core competencies. As such, it provides a foundation for the development of postgraduate educational programmes for cardiac nurses including competencies that are congruent with international standards. [ABSTRACT FROM AUTHOR]

Aims and objectives: To understand the experiences and support needs of informal caregivers of patients with chronic obstructive pulmonary diseases chronic obstructive pulmonary disease who return home following an acute exacerbation. Background: The presence of an informal caregiver is important to provide practical and emotional support after an episode of acute exacerbation of chronic obstructive pulmonary disease. However, caregiving in such circumstances can be challenging and stressful. Design: Phenomenology. Methods: This is a phenomenological study based on semi‐structured interviews with sixteen primary caregivers of chronic obstructive pulmonary disease patients. Interview data were analysed using Colaizzi's descriptive analysis framework, to identify significant themes and sub‐themes. Data were collected between April‐December 2017 in a Teaching Hospital in Italy. The study was designed and reported following the COREQ guidelines and checklist. Results: Analysis elicited five themes embracing various aspects of the caregivers' lived experiences: (a) a home disrupted, (b) living with constant vigilance and anxiety, (c) feeling the need to escape (d) self‐justifications for caregiving role/duty, and (e) feeling abandoned by professionals. Conclusions: Our results show that carers experience a range of difficulties when caring for their relative at home with chronic obstructive pulmonary disease. Some of these are linked to the physical disruption of their home but many are linked to feelings of inability to cope and the psycho‐social impact of the caring role. The study also shows how participants felt unsupported by professionals. Focused support for carers is required to enable them to meet these challenges. Relevance to clinical practice: Healthcare professionals should be trained to provide technical and psychological support to caregivers especially during the phases of disease that may involve episodes of exacerbation. Home care and continuity of care can work if there is excellent communication and collaboration between healthcare professionals and caregivers. Developing appropriate support for family caregivers is essential to address the problems they can face. [ABSTRACT FROM AUTHOR]

Aim: To explore nursing management issues within COVID‐19 narratives of Italian front‐line nurses. Background: The COVID‐19 pandemic has dramatically affected health systems and professionals worldwide. Italian nurses have key messages for nursing leaders following their acute experiences in the pandemic. Method: A descriptive qualitative study with thematic analysis. Results: Twenty‐three testimonies from clinical nurses were analysed. Six macrothemes were identified as follows: organisational and logistic change; leadership models adopted to manage the emergency; changes in nursing approaches; personal protective equipment issues; physical and psychological impact on nurses; and team value/spirit. Conclusions: Our testimonies highlighted the huge impact of COVID‐19 on the Italian nursing workforce, especially in terms of the high risks associated with caring for COVID‐19 patients, exacerbated by the shortage of appropriate personal protective equipment. Nurses had to care for their colleagues and live separately from their families to avoid infecting them, revealing nurses' resilience and the important role of effective and sensitive management. Implications for Nursing Management: Nurse managers must be prepared for the impact of pandemics on staff and need to ensure availability and replacement of quality personal protective equipment, rehearse strategies for communicating with patients while wearing personal protective equipment and establish protocols for communicating with relatives. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore and understand the interprofessional collaboration preparation processes implemented by clinical tutors and students, in various professions, involved in interprofessional education experiences. Design: A constructivist grounded theory approach. The study was carried out between 2015‐#2017. Method: Semi‐structured interviews were conducted with a total of ten undergraduate students and the seven clinical tutors who supervised them from three undergraduate courses in a university of applied sciences and arts in Switzerland. Students were sampled during their clinical placement. Data were analysed and coded using constant comparative analysis with the support of Nvivo 10 software. Results: A substantive theory "Practicing contextual models of interprofessional care" was generated. It explains how the whole process takes place, the tutor–student interactions, and how together they gradually build models of interprofessional care, linked to their clinical context and to the patients/families who are part of it. Conclusion: The process describes a journey to comprehensively explain the roles played by the two main actors (student and tutor) who build a relationship of interaction. Impact: This theory provides an understanding of the complex process set up by students and how they are prepared for collaboration with other professionals. Its importance is mainly expressed in the educational field because it reveals a different vision from the one present so far and enables a thorough reflection from the pedagogical point of view. Teachers will be able to observe and approach the students' training curricula from a different point of view by evaluating any changes to favour it and rethink the organizational and training models of current programs. [ABSTRACT FROM AUTHOR]

Aim: To describe nurses' reported missed nursing care activities among hospitalized adult patients medical and surgical wards and explore gaps in service provision. Background: In 2015, Italy replicated the RN4CAST study, which heralded the exposition of missed care as an international phenomenon. In Italy, nurse–patient workload is high, with high levels of burnout and dissatisfaction reported, all factors associated with missed care. Methods: A cross‐sectional study (n = 3,590) was conducted using the 13‐item online Task Left Undone Tool aimed at collecting data on missed nursing care. Results: The frequency of omission of activities ranged between 7% and 50%. There were significant differences between morning, afternoon and night shifts and the various clinical settings. Oral care was the most frequently missed care activity. Conclusions: This study takes step forward in identifying and reducing missed care on medical and surgical wards, both in Italy and also internationally, which needs to take into account the specific organisational characteristics of each setting. Implications for Nursing Management: Although more essential activities are missed less frequently, much is known about the relational deficits such as information giving, education, communication and discharge advice, which managers ought to spearhead through local initiatives to improve these practices. [ABSTRACT FROM AUTHOR]

Aim: To explore influences on nurses' missed care decision‐making processes in acute hospital paediatric care. Background: Many contemporary studies describe the phenomenon of missed care. It is clear that environment and organizational culture influence the nursing activities; however, what influences their decision‐making processes has not been investigated. Method: A descriptive qualitative inquiry was performed using semi‐structured interviews with paediatric nurses (n = 20) from one Italian paediatric hospital. Findings: Thematic analysis revealed four themes: nurses' value system; hospital logistics, structures and resources; prioritization processes; and the informal caregiver's role. Conclusion: This paper offers insights into the various factors involved in nurses' decision‐making process when contemplating missed care that will be of use to managers when planning care or addressing missed care in the paediatric clinical setting. Implications for Nursing Management: Knowledge and awareness of missed care in children's nursing needs greater exploration, especially in relation to what influences nurses' decision‐making choices around missed care. Overall, a greater understanding of this will help managers to manage situations effectively and ethically so that missed care does not impact on outcomes for children in health care. [ABSTRACT FROM AUTHOR]

Aims and objectives: To conduct a systematic review and meta‐synthesis of findings from qualitative research about sexuality and intimate relationship among patients with dermatological diseases. Background: Over the last few decades, there has been an increase in clinical research investigating aspects related to sex and sexuality in patients living with dermatological diseases. In fact, studies recognise a negative impact on various aspects of intimacy, such as sexual function, self‐esteem and romantic relationships. The body of qualitative literature about sexuality in the context of dermatological diseases is emerging but consists mainly of small studies that would benefit from aggregation, synthesis and interpretation to highlight and summarise the overarching dimensions to this clinical issue. Design: A systematic review and meta‐synthesis of qualitative studies. Methods: BioMed Central, Cochrane Library, MEDLINE, CINAHL, PsycINFO, PsycARTICLES, ERIC, Scopus, and Web of Science were searched between June–November 2017 with no publication date limits. Screening and selection of studies was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines (PRISMA). After retrieval, the qualitative data were subject to meta‐synthesis to identify overarching themes. Results: Ten qualitative studies were found. We identified four themes: (a) Embarrassment and shame; (b) Impaired sense of attractiveness and sexual avoidance; (c) Relationship issues; and (d) Lack of professional support. The patients in these studies adopted negative coping styles, such as avoidance and hiding their bodies. Conclusion: When assessing and evaluating patient care in dermatology, it is important that sexuality and the impact the disease could have on relationships is included. Relevance to clinical practice: An important part of nursing care is ensuring that patients are helped to develop positive coping strategies rather than negative ones. Patients with dermatological conditions also need advice and treatment to address any physically related sexual problems. Nurses need to be the initiators of these sensitive conversations to put patients at ease and work together to implement positive measures to reduce the sexuality‐related issues patients face. [ABSTRACT FROM AUTHOR]

Aim: To explore Italian paediatric nurses' reported burnout and its relationship to their perceptions of safety and adverse events. Design: A cross-sectional study using the RN4CAST@IT-Ped database with a webbased survey design. Methods: The RN4CAST@IT-Ped questionnaire was used to collect data in 2017. This comprised three main components: three dimensions (22 items) of the Maslach Burnout Inventory including emotional exhaustion, depersonalization and personal accomplishment. Participants also scored an overall grade of patient safety and estimated the occurrence of adverse clinical events. Results: Nurses (N = 2,243) r eported h igh l evels of b urnout. M ost r ated c linical safety as high. The risk of adverse events ranged from 1.3-12.4%. The degree of burnout appeared to influence the perception of safety and adverse events. Conclusion: The association between nurses' burnout and perceptions of higher rates of adverse events and reduced safety in clinical practice is an important finding. However, it is unclear whether this was influenced by a negative state of mind, and whether reduced safety and increased adverse events negatively influenced nurses' well-being, thus leading to burnout. Regardless, the association between nurses' burnout and these quality concepts needs further exploration to examine the effect, if any, on burnout and safety, and identify supportive mechanisms for nurses. Impact: The association between reported burnout and perception of safety and risk of adverse events in Italian paediatric nurses has been reported for the first time. Nurses reporting burnout are at greater risk of intensely negative perceptions of clinical safety and adverse events. This is an important finding as perceptions can influence practice and behaviours. Quality measures in children's clinical environments need to go beyond obvious indicators to examine nurses' well-being as this also influences quality and safety. [ABSTRACT FROM AUTHOR]

Aims and objectives: To synthesise and review literature related to instruments that measure psychosocial aspects of fundamental care in acute hospital care settings. Background: Psychosocial aspects of care often receive less priority in terms of care provision in acute care environments. At the same time, if these elements are overlooked, there may be consequences. Despite the availability of many instruments designed to measure specific aspects of care, these concepts are often not studied within the broader context of fundamentals of care, but rather coexist as isolated explorations of specific subelements. Design: A scoping review was conducted, based on Arksey & O'Malley's (2005) methodological framework and following the PRISMA checklist. Methods: Using the five recommended steps—identifying the research question; identifying relevant studies; study selection; charting the data; and summarising and reporting the results—three databases were searched: MEDLINE/PubMed, CINAHL and EMBASE, in February 2019. Results: Following independent screening by two of the authors, 48 papers were included. From these 48 papers, 33 instruments were identified. Only five of these tools thoroughly assessed psychosocial aspects elements of care (dignity, respect, privacy and patients' choice) through dedicated items. Conclusions: This review provides nurses with a synthesis of 33 instruments that assess the psychosocial aspects of care. This provides an important resource to guide measurement of dignity, respect, privacy and patients' choice. The findings also provide guidance to future research in this field. Relevance to clinical practice: This paper reviews and synthesises these instruments to provide a resource to nurses to inform their decisions and practice around measurement and evaluation of these key aspects of care. This provides a useful guide to measure and monitor the improvement of fundamental care delivery in practice and points to strengths and weaknesses of the instruments concerned. [ABSTRACT FROM AUTHOR]

Aims and objectives: To review and synthesise research studies on surgical and medical inpatients' perceptions on unmet nursing care needs. Background: Missed nursing care is a growing phenomenon that has been shown to adversely affect care outcomes—mainly in adult medical and surgical care settings. However, to date the aggregated and synthesised evidence of missed care comes from research that measures perceptions on missed care in surgical and medical settings from nurses, but not from the patients. Design: Scoping review. Methods: In September 2018, three databases were searched: MEDLINE/PubMed, CINAHL and SCOPUS and papers were selected using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Inclusion criteria were as follows: primary studies; published in peer‐reviewed journals; in English or Italian; and regarding routine care provided to adult inpatients. Quality appraisal and a thematic analysis were conducted. Results: Of the 1541 abstracts initially identified, 44 papers were included. Five themes emerged: "communication," "self‐management, autonomy and education," "personal sphere," "essential physical care" and "emotional and psychological care." The majority of the unmet needs were related to the "personal sphere" and "emotional and psychological care." These unmet needs were not identified in previous literature on nurses' perspectives of missed care. Also, physical care deficits like oral hygiene were identified. Conclusion: It is important to take into account patients' perspectives. The themes focusing on patients' personal sphere, and emotional and psychological care, underline how patients need nurses to pay more attention to their cultural background, consider the person as a whole and for nursing care to be holistic and respectful of patients' dignity. Relevance to Clinical Practice: This study intends to raise awareness amongst nurses and policymakers about the importance of addressing missed nursing care and unmet patients' needs in adult medical or surgical inpatient settings to ensure high‐quality care and patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: Developing nursing research skills, awareness and research utilisation are important for improving healthcare outcomes and are key to ensuring the full understanding and knowledge base necessary for optimal delivery of care. Nevertheless, little is known about research awareness in children's nurses. Aims and objectives: To address this issue, an integrative literature review was conducted for studies published between January 2007 and January 2017 to obtain up‐to‐date evidence about the extent of research awareness and utilisation among children's nurses. Methods: Using PubMed, Cochrane Library, ILISI and CINAHL databases, 21 studies related to children's nurses' research awareness were included in the final review, which was later developed and structured in keeping with PRISMA checklist and guidelines. Conclusions: The studies isolated show that nurses' knowledge about and utilisation of research vary and that there are many existent barriers to and facilitators of evidence‐based practice in the paediatric setting. Some studies report that introducing a cultural and/or change in clinical practice change to improve research utilisation can have positive impacts on healthcare outcomes and the quality of nursing care of children. It is recommended that structured approaches to improving research utilisation be considered and additional research is needed to explore the benefits of these approaches. Relevance to clinical practice: Despite more than three decades of the evidence‐based practice movement within nursing, barriers still exist among children's nurses in the use of research in practice. If the use of research to improve the delivery of children's nursing care is to become a reality, then nurses' research awareness needs to improve to underpin care delivery with optimal evidence in a cohesive informed manner. [ABSTRACT FROM AUTHOR]

Aims: To synthesize the findings of qualitative research exploring the experiences of being involved in intergenerational interventions in older people's care settings. Design: A meta‐synthesis of the qualitative literature, employing Sandelowski and Barroso's method, was conducted. Data Sources: Eight databases were searched in March 2017. Review Methods: The PRISMA statement was used for reporting the different phases of the literature search and the Critical Appraisal Skills Programme (CASP) qualitative research checklist was used as an appraisal framework. Data synthesis was conducted using Sandelowski and Barroso's method. Results: Four qualitative studies were included in the meta‐synthesis. Thematic analysis revealed four themes: 'Recreating the family'; 'Building intergenerational empathy and respect'; 'Uplifting and energizing'; and 'Engagement risks and challenges'. Conclusion: The meta‐synthesis strengthens the evidence that intergenerational interventions can be positive. However, it also shows that there may also be some negative aspects if not planned or managed carefully. Impact: This review contributes to the body of evidence by synthesizing the experiences of older people and children involved in intergenerational interventions. Although qualitative literature supports the quantitative evidence that intergenerational interventions can have a positive effect, intergenerational interventions could also have negative effects on some participants. Older people may feel tired, or experience feelings of infantilization. Practitioners need to be more aware of the potential negative effects of intergenerational interventions and include risk assessment, possibly by requiring ethical scrutiny. [ABSTRACT FROM AUTHOR]

The article discusses nursing education in Italy as of 2016 and whether graduates make a match with healthcare needs in the future. Topics covered include the varying Level 7 education with a master's degree for nurses across Europe, and the current lack of subjects for advanced knowledge and clinical skills in master's nursing degrees in Italy. Also noted is the inadequate patient care activities like comfort and dialogue with patients and family in Italian nursing practice.

Background: In Italy, there are still many barriers to the development of a culture of evidence‐based practice (EBP) and nurses' knowledge of EBP is lacking. Additionally, in Italy there are still very few advanced practice registered nurses to significantly contribute to the development of EBP. Aim: This aims to identify the implications of a wide‐scale nursing education intervention to engage clinical nurses in EBP through the Italian RN4CAST study. Methods: A qualitative study based on a thematic analysis. A total of 800 clinical nurses actively participated in nine training sessions across Italy. At the end of each training session written feedback data were collected and then underwent thematic analysis. Results: All participants were strongly motivated to engage in EBP thanks to their involvement in the RN4CAST project. With regard to the implications of EBP, the thematic analysis produced the following themes: Professional identity; Quality of care; Perceptions of patients and nurses; Research impact; and Organization. Conclusions: The involvement of a large number of clinical nurses in a research project raised their awareness about the advantages of engaging in EBP, and how evidence can be used to raise motivation to change current practice policies. [ABSTRACT FROM AUTHOR]

Aim: Develop and test the validity and reliability of MISSCARE Survey‐Ped adapted from previous versions of the MISSCARE Survey, which measures omitted nursing activities and the reasons why they were left undone. Our secondary aim was to pre‐test the construct validity using Exploratory Factor Analysis (EFA). Background: Missed Nursing Care is described as "every care activity necessary for the patient that is not provided or is seriously delayed". Missed Care is correlated with negative patient outcomes, such as mortality and adverse events. Design: A mixed‐mode cross‐sectional survey. Methods: Participants included registered pediatric nurses and nurses working in pediatric wards. This study was conducted between June and September 2017 and consisted of four phases: (a) analysis of existing surveys and item construction; (b) content and face validity; (c) reliability analysis (acceptability for ease of use, Cronbach's alpha for internal consistency and test–retest to measure stability); and (d) construct validity (EFA). Results: The MISSCARE Survey‐Ped consists of two sections: Section A "Missed Nursing Care Activities" (29 items) and Section B "Reasons for Missed Nursing Care Activities" (17 items). The new survey showed good validity properties and effectively identified Missed Nursing Care activities in pediatric settings. Conclusion: The development and validation of the MISSCARE Survey‐Ped made it possible to conduct an objective and standardized study of missed nursing care activities in the field of pediatrics. This new survey offers the opportunity to collect data that enable to design and implement interventions that improve the quality and safety of pediatric nursing. [ABSTRACT FROM AUTHOR]