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Higher nurse-to-patient ratios are associated with poor patient care and adverse nurse outcomes, including emotional exhaustion and intention to leave. We examined the effect of nurses' intention to leave and nurse-patient workload on in-hospital patient mortality in Italy. A multicentered descriptive and regression study using clinical data of patients aged 50 years or older with a hospital stay of at least two days admitted to surgical wards linked with nurse variables including workload and education levels, work environment, job satisfaction, intention to leave, nurses' perception of quality and safety of care, and emotional exhaustion. The final dataset included 15 hospitals, 1046 nurses, and 37,494 patients. A 10 % increase in intention to leave and an increase of one unit in nurse-patient workload increased likelihood of inpatient hospital mortality by 14 % (odds ratio 1.14; 1.02-1.27 95 % CI) and 3.4 % (odds ratio 1.03; 1.00-1.06 95 % CI), respectively. No other studies have reported a significant association between intention to leave and patient mortality. To improve patient outcomes, the healthcare system in Italy needs to implement policies on safe human resources policy stewardship, leadership, and governance to ensure nurse wellbeing, higher levels of safety, and quality nursing care., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

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., (© 2022 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

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., (© 2022 John Wiley & Sons Ltd.)

Introduction: Heart failure has an enormous impact in terms of mortality, morbidity, and costs for healthcare organizations. Indications for implanted heart devices, such as pacemakers or implantable cardioverter defibrillators (ICDs) are constantly increasing. With the arrival of the telemedicine, nurses play an important role in the remote management of chronic heart diseases. The purpose of this study was to describe the experiences of nurses who remotely monitor patients with an implanted heart device in Italy., Methods: A qualitative study with a phenomenological approach was conducted. The sample consisted of 7 nurses dedicated to remote monitoring (RM), from three cardiology clinics in Northern Italy. We conducted semi-structured interviews to understand the experience and training nurses received to conduct RM., Results: From the analysis of the interviews, six themes were identified: 'Specialized knowledge and skills', 'Learn through practice', 'Organization of work', 'Decision making', 'Trust', and 'Need for information'. The majority of our sample developed their competencies directly on the field, in absence of a certified recognized pathway, on RM in patients with heart failure implanted with cardiac devices. Therefore, nurses performing RM activities do not receive the same type of education and training., Conclusion: Currently, in Italy, there is no standardised training for nurses who perform RM activities for heart failure patients with implanted heart device, and yet it is instrumental to have appropriate knowledge and training to effectively perform this type of activity and care.

Introduction: The COVID-19 pandemic is heavily hitting healthcare systems around the world, and nurses are battling in the front line. Previous studies have reported nurses' responses to catastrophic situations, but also interviews released by Italian nurses to the main mass media channels could bear important messages for policy makers and stakeholders. This study describes Italian front-line nurses' experiences during the COVID-19 pandemic through television interviews., Methods: This is a descriptive qualitative study. Data were collected through purposive sampling from Italian front-line nurses' interviews during the COVID-19 pandemic. Publicly available interviews between 7th and 29th March 2020 were collected from the websites of national and regional television stations. Thematic content analysis was used to describe, summarize, and classify data into macro themes. The study is compliant with Standards for Reporting Qualitative Research., Results: A total of 21 television interviews were collected from front-line clinical nurses, nursing managers, nursing trade union representatives and representatives of the Nursing Regulator. Thematic analysis yielded four macro-themes: psycho-social effects of the COVID-19 pandemic on health professionals; altered patient relationships; personal safety; recognition and promotion of the profession., Conclusions: The COVID-19 pandemic has exacerbated some problems already present, such as the shortage of nurses, but has also turned the spotlight on the nursing profession. Highly involved and affected by the pandemic, nurses have become better known by the public and often also protagonists of public discussions. It is important that nurses' value as allies of the public emerges stronger from this dramatic situation., Competing Interests: Conflict of interest statement The authors declare no conflict of interest., (©2021 Pacini Editore SRL, Pisa, Italy.)

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., (© 2019 John Wiley & Sons Ltd.)

Background: In some clinical settings, nurses have difficulty describing the outcomes of their caring activities. Understanding the reasons for this could help nurse leaders to improve the effectiveness and visibility of nursing practice and safeguard nurses' working conditions., Objective: The aims of this study were to understand how nurses working in 2 different adult cancer centers make healthcare decisions and assess the respective outcomes on their patients., Methods: Through a constructivist grounded theory approach, we involved 15 clinical cancer nurses with different experiences and educational backgrounds and 6 nurse managers, working in 2 comprehensive cancer centers, 1 in Italy and 1 in Switzerland. Data were collected in 2 phases using 20 semistructured interviews and 9 field observations., Results: Six macrocategories emerged: interacting with situational factors, deciding relevant interventions, using multiple decision-making approaches, evaluating interventions and reporting them, pursuing healthcare outcomes, and clarifying professional identity and roles. Nurses' decision-making processes varied and were influenced by various factors, which mutually influenced one another. This process was interpreted using an explicative theory called "dynamic decision-making adaptation.", Conclusions: The present study showed how the aims, contents, and degree of autonomy in the nurses' decision-making process are strongly influenced by the dialectic interaction between professional and contextual factors, such as competency and professional identity., Implications for Practice: Cancer nurses could influence their clinical practice by developing nursing competencies that effectively resolve patients' problems. This is a key factor that nurses govern autonomously and therefore a responsibility that involves the entire nursing educational, organizational, and scientific leadership.

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 and moral 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.

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., (© 2016 John Wiley & Sons Ltd.)

Aims: To investigate how the issue of malnutrition in institutionalised older people is perceived by nurses in a Teaching Hospital in Italy and how some aspects that can prevent malnutrition are dealt with., Background: Malnutrition in institutionalised older people is still a significant and unresolved problem. Many studies have been published on the inadequacy of nutritional care. Nurses play a strategic and key role in the prevention of malnutrition. Knowing how nurses perceive the problem of malnutrition and how they deal with aspects that can prevent malnutrition can be an important starting point for implementing strategies that will improve overall nutritional care., Methods: A Focus Group (FGs) study was conducted in a Teaching Hospital in the north-west of Italy with 33 nurses, who were still working or had worked with older people. The FGs were audio-taped and transcribed verbatim. Data collection was stopped when we achieved saturation. Two researchers independently analysed the transcription for content analysis and negotiated the emerging categories., Results: Although nurses perceived malnutrition as a significant issue, it was often considered of secondary importance compared with other aspects of care. Food choice, although available, is often limited to very few options, diets are standardised and monotonous and patients must choose 'sight unseen'. Time constraints and understaffing were the obstacles for the identification of the need for nutritional care. Organisational and managerial decision-making did not ensure the provision of high-quality nutritional care. Patients' nutritional status was often not assessed, and tools such as the Mini Nutritional Assessment were not mentioned by the participants., Conclusion: Our study substantially confirmed what is reported in the literature. However, it is necessary to raise nurses' awareness around poor nutritional care to prevent malnutrition in institutionalised older people., (© 2012 Nordic College of Caring Science.)

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]

Copyright of L'Infermiere is the property of IPASVI - Italian Nursing Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of L'Infermiere is the property of IPASVI - Italian Nursing Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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 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]

Copyright of L'Infermiere is the property of IPASVI - Italian Nursing Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

Copyright of L'Infermiere is the property of IPASVI - Italian Nursing Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

Copyright of L'Infermiere is the property of IPASVI - Italian Nursing Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: This integrative review aims to explore how nursing leadership influences evidence‐based practice in contemporary health care settings. Background: Although managers and environmental ward culture have long been identified as being among the main barriers to evidence‐based practice, there is little overall conceptualization and understanding of the specific role of nurse leaders in directly influencing and supporting this. Evaluation: The team carried out an integrative literature review (n = 28) utilizing PubMed, CINAHL and the Cochrane Library (2006–2016). Key Issues: The key role of leadership, the methodology used, and understanding and addressing barriers to or facilitators of the implementation of evidence‐based practice emerged as key issues. Conclusion: Nurse managers have a particular influential role on the implementation of evidence‐based practice in terms of providing a supportive culture and environment. For this they need to have an underlying knowledge but also to be aware of and address barriers to implementation, and understand the key role of nurse managers in creating and supporting the optimum environment. Implications for Nursing Management: Nurse managers need to facilitate and enhance nurses' use of evidence‐based practice. Both managers and nurses need to have the necessary academic preparation, support and resources required for practising using an evidence base. [ABSTRACT FROM AUTHOR]

The article offers information on lack of suitable personal protective equipment (PPE) in Italy amid COVID-19 pandemic. Topics discussed include online courses for health professionals to help to keeping safe against Covid-19 by Italian National Institute of Health; fear of introducing the virus in nurses; and need to ensure provide appropriate logistic and financial support to help medical personnel with course of action.

Objectives To describe the experience and sources of comfort and discomfort in tracheostomy patients, when they communicate with nurses in the Intensive Care Unit. Research methodology/design Benner’s interpretive phenomenology. Data were collected through: a) semi-structured interviews conducted with the patients after leaving the intensive care unit; b) participant observation; c) situated interviews with intensive care nurses. Setting The intensive care unit of a hospital in Northern Italy. Findings Eight patients and seven nurses were included in this study. Two main themes were identified 1) feeling powerless and frustrated due to the impossibility to use voice to communicate; 2) facing continual misunderstanding, resignation, and anger during moments of difficulty and/or communication misunderstandings. The main communication discomfort factors were: struggling with not knowing what was happening, feeling like others had given up on me, living in isolation and feeling invisible. The main comfort factors were: being with family members, feeling reassured by having a call bell nearby and nurses' presence. Conclusions This study highlights the important role of communication in tracheostomy patients in intensive care and how closely it is linked to all the aspects of a person’s life, which cannot be underestimated as just not being able to use one’s voice. [ABSTRACT FROM AUTHOR]

Aims and objectives To review the use of mixed-methods research in nursing with a particular focus on the extent to which current practice informs nurse researchers. It also aimed to highlight gaps in current knowledge, understanding and reporting of this type of research. Background Mixed-methods research is becoming increasingly popular among nurses and healthcare professionals. Emergent findings from this type of research are very useful for nurses in practice. The combination of both quantitative and qualitative methods provides a scientific base for practice but also richness from the qualitative enquiry. However, at the same time mixed-methods research is underdeveloped. Methods This study identified mixed-methods research papers and critically evaluated their usefulness for research practice. To support the analysis, we performed a two-stage search using CINAHL to find papers with titles that included the key term 'mixed method'. Conclusion An analysis of studies that used mixed-methods research revealed some inconsistencies in application and reporting. Attempts to use two distinct research methods in these studies often meant that one or both aspects had limitations. Overall methods were applied in a less rigorous way. This has implications for providing somewhat limited direction for novice researchers. There is also potential for application of evidence in healthcare practice that limited validity. Relevance to clinical practice This study highlights current gaps in knowledge, understanding and reporting of mixed-methods research. While these methods are useful to gain insight into clinical problems nurses lack guidance with this type of research. This study revealed that the guidance provided by current mixed-methods research is inconsistent and incomplete and this compounds the lack of available direction. There is an urgent need to develop robust guidelines for using mixed-methods research so that findings may be critically implemented in practice. [ABSTRACT FROM AUTHOR]

Aims and objectives To describe the knowledge, attitudes and beliefs of nurses and midwives who have attended to women who suffered violence. This study further analyses the possible changes of attitude that have occurred over the past five years. Background Gender violence or violence against women is the largest problem with regard to public health and violated human rights all over the world. In Italy, it is estimated that 31·5% of women suffer physical or sexual violence during their life. Healthcare operators play a crucial role in recognising the signs of the violence suffered when taking care of victims. Design A cross-sectional study was conducted. Methods A questionnaire was administered; this was used in a previous survey of a convenience sample of 51 nurses and midwives who work in an emergency room or in an obstetrics emergency room and gynaecological ward. Results Of the respondents, 51 (80·4%) have taken care of women who suffered violence, and 25 (49%) believe they can detect violence. The relational/communicative approach presents the most difficulty, and all the operators believe they need more knowledge. The number of operators who suggest women be observed in an emergency room and file a complaint or who primarily consider listening to women has decreased. A tendency to 'blame' women, although decreasing, persists; it is higher among male nurses and, in general, among male operators. Conclusion Knowledge of this issue has not been completely recognised among operators despite training and the emergence of the phenomenon in the mass media. Difficulties in receiving and in relational procedures continue to exist, in addition to 'blaming' the woman. Relevance to clinical practice Awareness paths and cultural changes regarding the phenomenon of violence need to be developed, as does a specific training programme on the approach to and assessment of the abused woman. [ABSTRACT FROM AUTHOR]

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.

Aim To validate the Staff Attitudes to Nutritional Nursing Care Geriatric scale in Italian, a tool created in Sweden to measure nurses' attitudes towards nutritional care in older people. Background Malnutrition in institutionalized older people is a serious problem having negative impact on patient outcomes. It is reported in the literature that nurses have negative attitudes towards nutritional care. Methods Forward and back-translation were carried out to build the Italian version of the tool. Content and face validity were then examined by pilot study. Test-retest reliability with Spearman's rho (rs) correlation, intraclass correlation ( ICC) and internal consistency reliability with Cronbach's α were assessed. Differences between test-rest were assessed by t-test. Results Linguistic and semantic adaptation of the tool into Italian was successful. Thirty-three nurses skilled in caring for older patients did pilot testing and 46 test-retesting. SANN- G GITA-scale achieved good content and face validity, good internal consistency reliability ( Cronbach's α = 0.85) and acceptable stability [rs = 0.75, P = 0.001; ICC = 0.76, 95% confidence interval ( CI) 0.63-0.86; P = 0.001]. The t-test showed no significant difference between test and retest results, confirming stability of the tool ( t(64) = −0.98; P = 0.33). Discussion The process of adaptation of the scale from Swedish to Italian language was successful. Thus, the SANN-GITA scale can be useful to assess attitudes of nursing staff to nutritional care in the Italian context. Conclusions This tool will allow the identification of areas where Italian nurses have negative attitudes and where to implement strategies to improve overall nutritional care. [ABSTRACT FROM AUTHOR]

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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]

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 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.

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.