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Background: Parents play a crucial role in the care of infants during their stay in the neonatal intensive care unit (NICU). Recent studies have reported a decrease in parental participation due to the coronavirus disease (COVID-19) pandemic, which has led to restricted access policies in hospitals. The aim of this study was to describe the barriers to good parental participation during their stay in the neonatal intensive care unit in the COVID-19 era. Methods: This was a quantitative, observational study. Results: A total of 270 parents participated in this study. Mothers' participation in care was higher than that of fathers (p = 0.017). Parents who lived at the birth of their first child reported a better level of participation in care compared to those who lived at the birth of their second-born (p = 0.005). Parents of extremely preterm neonates reported a lower interaction with their infants than parents of term newborns (p < 0.001). Conclusions: Some disadvantaged categories reported lower scores for cultural and linguistic minorities, parents of multiple children, and fathers. The COVID-19 pandemic has made several family-centred care activities impossible, with a higher impact on those who benefited most of these facilities. This study was prospectively approved by the IRB-CRRM of the University "G. d'Annunzio" Chieti-Pescara on 23 January 2024 (approval number CRRM: 2023_12_07_01). [ABSTRACT FROM AUTHOR]

The term "systemwell-being" canmove forward a new vision, meaning the result coming from the addition of the well-being of persons belonging to different institutions and organizations, which are all parts of the "health care system." Beginning with this "new definition," with the aim of analyzing the multifaceted issues related to nurses' well-being, we could use the "classical nursing metaparadigm" composed of 4 concepts: "health,""nursing," "environment," and "person."We briefly describe this conceptualmap and provide some focused suggestions for further reflection on topics such as physical and psychological well-being, economic gain and career opportunities, work climate, burnout, low job satisfaction, moral distress, compassion fatigue, and a joyful work environment. This view may help organizations to focus on interventions to prevent or eliminate stress, whichmay be more proactive and effective than interventions to manage stress. Moreover, it offers a multidimensional map to analyze the different aspects influencing the well-being issue, keeping in mind that a concrete solution can be obtained only if all the components of health care systems and society do their part. Some solutions proposed by authors and organizations to increase nurses' well-being are mindfulness based, such asmeditation, yoga, acupuncture, gratitude, journaling, choirs, coaching, workload reduction, job crafting, and peer networks. Other reflections on work organization, expected professional behaviors, nurses' retention, and education should be added to the discussion on this multidimensional issue. [ABSTRACT FROM AUTHOR]

Background: During the pandemic outbreak, helmet continuous positive airway pressure (CPAP) was widely used as respiratory support for COVID‐19 patients, inside and outside of intensive care units. The available literature suggests specific interventions to improve the comfort of patients treated with helmet‐CPAP. Few reports are available on the experiences of patients undergoing this treatment. Aim: This qualitative study aimed to explore the views and recollections of COVID‐19 patients undergoing helmet‐CPAP. Study Design: We conducted semi‐structured interviews with thematic analysis. Participants were recruited from the follow‐up programme for COVID‐19 patients discharged from an Italian general intensive care unit. Participants were interviewed by telephone. Data analysis followed the principles of thematic synthesis approach. Findings: We conducted 29 phone calls in patients eligible for the study. Five participants declared that they did not remember the time spent in hospital on helmet‐CPAP. Twenty‐four patients were then included. Two themes and six subthemes were generated from their interview data: (1) The helmet‐CPAP as a life‐saving treatment (subthemes: recognition of the usefulness of treatment and resilience); (2) the negative feelings related to helmet‐CPAP application (subthemes: communication problems, entrapment, mental confusion, fear of dying). Each patient's experience was unique, but some discomfort elements such as noise, gas flow turbulence, choking sensation and thirst were found to be very common. Conclusions: The application of helmet‐CPAP treatment generated positive and negative memories and feelings in COVID‐19 patients during the pandemic. The patients' experience has provided an overview of the main factors of discomfort. This can be a starting point for taking corrective measures to promote greater helmet tolerance and subsequent treatment success. Relevance to Clinical Practice: This study has provided an insight into the patient's recollections about helmet‐CPAP treatment during a worldwide pandemic. The findings suggested strict applications of interventions aimed to reduce some issues that participants reported, to improve their compliance to treatment. Results from this study could help nurses in understanding the needs of patients treated with helmet‐CPAP and may foster a care focused on patient‐centred outcomes. [ABSTRACT FROM AUTHOR]

Introduction: The recovery room (RR) is a hospital area where patients are monitored in the early postoperative period before being transferred to the surgical ward or other specialized units. The utilization of scores in the RR context facilitates the assignment of patients to the appropriate ward and directs necessary monitoring. Some scoring systems allow nurses to select patients who can be discharged directly to their homes., Aim and Methods: The aim of this narrative review was to describe and compare the scoring systems employed to discharge postoperative patients from RR, with a focus on item characteristics., Results: Nine scoring systems were identified and discussed: the "Aldrete Score System" and its modified version, the "Respiration, Energy, Alertness, Circulation, Temperature Score", the "Post Anesthetic Discharge Scoring System", the "White and Song Score", the "Readiness for Discharge Assessment Tool", the "Anesthesia and Perioperative Medicine Service Checklist", the "Post-Anesthetic Care Tool", the "Post-operative Quality Recovery Scale", and the "Discerning Post Anesthesia Readiness for Transition" instrument., Discussion and Conclusions: To obtain a comprehensive overview, the items included in the scoring systems were compared. Despite the availability of guidelines for patients' discharge readiness from the RR, there is no universally recommended scoring system. Next-generation scores must be improved to ease their use, minimize errors, and increase safety. The main goals of the scores included in this narrative review were to be simple to use, feasible, intuitive, comprehensive, and flexible. However, these goals frequently conflict because patient assessment takes time, and a smart and comprehensive score may not consider some clinical parameters that may be crucial for the discharge decision. Therefore, further research should be conducted on this topic.

Introduction: Moral injury involves the adverse psychological, biological, spiritual, behavioural, and social consequences of actions that violate moral values. It can lead to anxiety, depression, burnout, and post-traumatic stress disorder. Nurses, who often face ethical dilemmas, are particularly vulnerable. Despite its significance, the relationship between moral injury and mental health outcomes in nurses remains underexplored. Aim: This systematic review aimed to describe the associations among moral injury, anxiety, depression, and quality of life in nurses. Methods: The review was registered in PROSPERO (CRD42023438731) and was conducted following the PRISMA guidelines. A literature search was performed in December 2023 across PubMed, CINAHL, Scopus, and Web of Science. Peer-reviewed primary research involving nurses, published in English or Italian, without time restrictions, was considered eligible. The risk of bias and the quality of evidence were assessed using the Joanna Briggs Institute checklist and the GRADE approach. Results: Out of 4730 articles identified, eight met the inclusion criteria. The analysis revealed significant positive associations between moral injury, anxiety, and depression, along with a significant negative association with quality of life. Conclusion: These findings highlight the need for healthcare systems to implement strategies that mitigate moral injury among nurses. Future research should prioritize longitudinal studies to explore causal relationships and develop targeted interventions. Additionally, standardizing the concept and measurements of moral injury is crucial for enhancing the comparability and understanding of this phenomenon., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.