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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.)

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]

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.

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: 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]

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 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]

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]

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 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]

Web-based learning, on its own or in combination with traditional teaching methods, has become a consolidated practice in many countries, and has been described as a valid and effective method that supports practical learning in undergraduate nursing students. The aim of this study was to explore the perception and effectiveness of web-based learning in facilitating the development of clinical skills in undergraduate nursing students. A qualitative descriptive study was conducted including online videos in three nursing schools of a university in Northern Italy. The participants were 26 undergraduate nursing students. A dedicated website was built including four videos and the respective checklists of four nursing techniques: insertion of a urinary catheter; insertion of a nasogastric tube; taking a blood sample; and the insertion of a peripheral intravenous line. Three Focus Groups were conducted, one for each nursing school. Thanks to its ease of use and unlimited access, web-based learning effectively supported students' clinical learning process by offering additional virtual visual support. Web-based learning could be effectively used to reduce the gap between theory and practice, and even as an upgrade for already qualified nurses. • Web-based learning in nursing is growing, but its use is still limited. • Few studies have explored how web-based learning can improve clinical skills. • Web-based learning impacts on patient safety and the quality of nursing practice. [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: 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]

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.

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]

Aims and objectives: To explore the experience of patients affected by chronic obstructive pulmonary disease following hospitalisation due to an acute exacerbation event. Background: Chronic obstructive pulmonary disease is a progressively debilitating disease, often with very burdensome symptoms such as acute and chronic breathlessness and fatigue. Acute exacerbation often creates a life‐threatening event. Exacerbation can also have substantial psychological effects including anxiety and depression although this aspect is less well researched—especially amongst people with chronic obstructive pulmonary disease recovering from an acute event and facing a return home. Design: A descriptive phenomenological study. Methods: In‐depth interviews were conducted with 12 chronic obstructive pulmonary disease patients recently recovering from an acute exacerbation of their chronic obstructive pulmonary disease. Data were analysed using Colaizzi's phenomenological framework. Results: Four themes were identified from the data: a sense of loss and frustration, hopelessness, uncertainty about the future and fear of becoming a burden. Participants expressed quite negative views including a loss of hope, uncertainty about their future care and the burden they may become on their families. They appeared stressed and anxious as a result of the acute event they had experienced. Conclusions: This study shows that an acute episode of illness can generate a sense of hopelessness and uncertainty about their future care in people with chronic obstructive pulmonary disease. This occurs as they recover physically and think about the future, often in quite negative terms. Relevance to clinical practice: For healthcare professionals, it is important to take into account the potential feelings of loss, hopelessness and uncertainty that people can experience following an acute exacerbation of their chronic obstructive pulmonary disease and ensure that psychological care is available as physical recovery takes place. Such care to include good discharge planning, giving patients time to express concerns and referral to counselling services if appropriate. [ABSTRACT FROM AUTHOR]

Aims and objectives To assess the effects of a texture-modified food program for dysphagia on the nutritional, biochemical and functional profile in a cohort of institutionalised older people in Italy. Background Dysphagic institutionalised older people, often also affected by dementia, are frequently exposed to malnutrition. Malnutrition in older people has negative effects on mortality, days of hospitalisation, infection, wound healing and risk of pressure injuries. Therefore, it is very important to prevent malnutrition in this frail population. Design A pre-post study without a control group. Methods The study included 479 dysphagic institutionalised older people from 20 nursing homes. Anthropometrical, biochemical, nutritional and functional parameters were collected retrospectively, 6 months before the study intervention, at time zero and, prospectively for 6 months after implementing the NUTRICARE food programme, for a total of nine evaluations. The NUTRICARE programme includes meals without nutritional supplementation, and personalised levels of density, viscosity, texture and particle size. Results The total mean body mass index of our sample passed from 17.88-19.00; body weight averagely improved by 7.19%, as well as their nutritional and biochemical profiles. There was a progressive improvement of total protein and serum albumin values. Nutritional parameters (serum transferrin and lymphocytes) displayed similar changes. Plasma lymphocytes reached normal levels in 98.23% of the sample. Plasma creatinine levels remained steady throughout the study and within the normal range. No side effects were reported. Conclusion The NUTRICARE food programme with a adequate proteins, calories, balanced nutritional and bromatological properties, and appropriate texture and palatability significantly improved the nutritional, biochemical and functional profile in a cohort of institutionalised dysphagic older people. Relevance to clinical practice The introduction of a balanced nutritional programme, using high-quality natural ingredients, appropriate texture and palatability can significantly improve health and quality of life in dysphagic older people. [ABSTRACT FROM AUTHOR]

Aims/Background: The Edinburgh Feeding Evaluation in Dementia (EdFED) scale has been shown to have good psychometric properties using a range of methods including Mokken scaling. We aimed to study the Italian version of the EdFED using Mokken scaling. Methods: Data were gathered at 7 time points from 401 nursing home residents affected by dementia in the course of a 6-month intervention study using analysis of variance, Mokken scaling, and person-item fit statistics. Results: The properties of the EdFED-I scale were stable over the course of the study with 4 items showing invariant item ordering at all time points. Some items behaved differently at different levels of difficulty in the scale and also depending on the mean level of feeding difficulty. The test information function showed a dip in the mid-range of difficulty scores. [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]

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]

The article discusses concerns regarding missed care, which is defined as unfinished care or implicitly rationalized care, in children's nursing. It explains that missed care is an error of omission in the care process that has three major influencing factors including labour resources, material resources, and communication, which influence the nurses' internal processes such as team norms, priority decision making, internal values, and beliefs determining whether or not care is missed.

Aim To test if the Barrows Cards method improves adherence to immunosuppressive therapy self-management following hematopoietic stem-cell transplantation in adolescents affected by blood cancer and reduce costs. Background Chronically ill adolescents need to be helped to improve self-management, make sure they can confidently and safely manage therapy at home and reduce readmissions and costs. We identified the Barrows Cards method, originally used to test decision-making skills and critical thinking in medical students. In this pilot study, we tested the efficacy of the Barrows Cards Method in improving adhesion to immunosuppressive therapy in a group of adolescents following hematopoietic stem-cell transplantation and analysed its cost-effectiveness. Design A mixed-method study. Methods The Barrows Cards method is an educational intervention based on the theory of problem-based learning that uses at least 15 cards specially designed to teach participants how to manage a specific problem. We piloted the Barrows cards method in terms of adherence to immunosuppressive therapy and self-management in a group of 17 adolescents affected by blood cancer before being discharged. Participants were enrolled between 2013-2015. Activity Based Costing was used to analyse the cost-effectiveness. Results The Barrows Cards method significantly improved adherence to immunosuppressive therapy in blood cancer adolescents and reduced readmissions. We also showed how this method could significantly reduce healthcare costs. Conclusions Further research is required, but the Barrows Cards method could be effectively used by nurses to improve self-management in chronic patients and reduce health costs. [ABSTRACT FROM AUTHOR]

The aim of this paper is to discuss the development of modern nursing in Italy. Specifically, the paper aims to draw attention to the fact that while nursing in Italy has mirrored developments in Europe, in many respects the advancement of the profession is much less accelerated. The paper considers the reasons for this and the contributing factors and explores possible solutions. [ABSTRACT FROM AUTHOR]

In the literature, there is evidence about the importance of ensuring a Family-Centered approach for foreign patients to provide culturally competent care. The Italian context shows a lack of studies concerning nurses’ perceptions regarding factors that influence foreign patients’ daily care. In addition, the number of pediatric patients coming to Italian hospitals to be cured has increased dramatically in the last few years. This study aims to investigate the pediatric nurses’ perception of the factors influencing nursing care for foreign pediatric patients who have undergone a stem cell transplant (SCT) and their families. A qualitative approach is used. Semi-structured interviews were recorded, transcribed verbatim, and analyzed using qualitative techniques for recurrent themes. Italian SCT pediatric nurses were interviewed until data saturation was achieved. Four themes emerged from the analysis: ‘‘Respect for other cultural traditions,’’ ‘‘Different roles,’’ ‘‘Communication,’’ ‘‘Equal treatment and different opportunities.’’ Communication was seen as a barrier in caring for foreign patients. Nurses perceived a lack in their training and knowledge when caring for foreign patients. The hospital supports nurses when caring for foreign patients. We found that pediatric nurses do not feel they are caring for foreign patients in the same way as they do for Italians, but adopt strategies to improve their relationships with them. Semi-structured interviews proved to be useful in highlighting the nurses’ perceptions. These data were confirmed by the results of the audit conducted with the ‘‘Children and Young People’s Audit Policy Tool,’’ The tool suggests specific interventions when foreign patients are admitted. [ABSTRACT FROM PUBLISHER]

Prisons are a unique context where nurses are required to have specific skills to ensure that prisoners receive the same type of holistic care as anyone else out of prison, including spiritual care. This discussion paper focuses on understanding how nurses deliver spiritual care in Italian prisons where there are often limited resources and where organizational priorities hinder the provision of holistic nursing. This paper draws from a previous qualitative research study that we had conducted. In this study, we observed that prison nurses reported that they experienced many difficulties related to the provision of holistic care to prisoners. This was particularly true for spiritual care in vulnerable forensic patients, such as older individuals, and physically andmentally frail prisoners. Prison officers did not allow nurses to just "listen and talk" to their patients in prison, because they considered it a waste of time. The conflict between prison organizational constraints and nursing goals, along with limited resources placed barriers to the development of therapeutic relationships between nurses and prisoners, whose holistic and spiritual care needs remained totally unattended. Therefore, prison organizational needs prevailed over prisoners' needs for spiritual care, which, while fundamental, are nevertheless often underestimated and left unattended. Educational interventions are needed to reaffirm nurses' role as providers of spiritual care. [ABSTRACT FROM AUTHOR]

In the literature we found many studies that confirmed our concerns about nursing students' poor maths skills that directly impact on their ability to correctly calculate drug dosages with very serious consequences for patient safety. The aim of our study was to explore where students had most difficulty and identify appropriate educational interventions to bridge their mathematical knowledge gaps. This was a quali-quantitative descriptive study that included a sample of 726 undergraduate nursing students. We identified exactly where students had most difficulty and identified appropriate educational interventions to bridge their mathematical knowledge gaps. We found that the undergraduate nursing students mainly had difficulty with basic maths principles. Specific learning interventions are needed to improve their basic maths skills and their dosage calculation skills. For this purpose, we identified safeMedicate and eDose™ (Authentic World Ltd.), only that they are only available in English. In the near future we hope to set up a partnership to work together on the Italian version of these tools. [ABSTRACT FROM AUTHOR]

Aims To describe the utility of artificial neural networks in predicting communication risks. Background In health care, effective communication reduces the risk of error. Therefore, it is important to identify the predictive factors of effective communication. Non-technical skills are needed to achieve effective communication. This study explores how artificial neural networks can be applied to predict the risk of communication failures in emergency departments. Design A multicentre observational study. Methods Data were collected between March-May 2011 by observing the communication interactions of 840 nurses with their patients during their routine activities in emergency departments. The tools used for our observation were a questionnaire to collect personal and descriptive data, level of training and experience and Guilbert's observation grid, applying the Situation-Background-Assessment-Recommendation technique to communication in emergency departments. Results A total of 840 observations were made on the nurses working in the emergency departments. Based on Guilbert's observation grid, the output variables is likely to influence the risk of communication failure were 'terminology'; 'listening'; 'attention' and 'clarity', whereas nurses' personal characteristics were used as input variables in the artificial neural network model. A model based on the multilayer perceptron topology was developed and trained. The receiver operator characteristic analysis confirmed that the artificial neural network model correctly predicted the performance of more than 80% of the communication failures. Conclusion The application of the artificial neural network model could offer a valid tool to forecast and prevent harmful communication errors in the emergency department. [ABSTRACT FROM AUTHOR]

Purpose This article profiles the establishment and initial phase (2010-2014) of a Center of Excellence (CoE) as an instrument to strengthen nursing scholarship and improve health care in Italy. Approach This CoE is unique as a non-university-based center. The National Regulatory Board of Registered Nurses, Health Visitors, and Pediatric Nurses (IPASVI) designated substantial administrative and funding support to the CoE for advancing nursing education, clinical practice, research development, and research training. Boyer's Model of Scholarship underpinned the CoE's conceptual framework, and its operational infrastructure was adapted from the U.S. National Institutes of Health P20 program award mechanism. Diverse methods included sponsoring research studies by nurse-led teams, research training courses, nursing education longitudinal studies, evidence-based practice training, and related pilot studies. Findings Multiple collaborative projects were conducted via the CoE in conjunction with the successful launch of an expansive digital library and communication system accessible to nurses. The introduction of English proficiency courses was also a unique contribution. Conclusions The CoE concept is a potential instrument to strengthen nursing scholarship in Italy with potential scalability considerations to other global settings. Clinical Relevance An overlapping focus on research, education, and practice under the umbrella of nursing scholarship within a CoE while engaging all levels of nursing is important to impact healthcare changes. [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.

The article discusses barriers to research awareness among nurses in Italy. Topics discussed include spread of evidence-based practice, Italian study revealing 41percent of care that nurses were expected to perform was missed and barrier due to refusal of regional research ethics committees for applications made by nurse researchers.

Background The psychological climate within organisations affects not only the behaviour and the attitude of group members, but also the performance of the group itself. According to the ecological model, this research examines how learning in different classroom contexts of the same nursing degree programme can affect academic performance, well-being, self-esteem and perceived climate. Methods Four scales were used to assess students' perceptions by collecting primary data while academic performance was measured by obtaining students' academic records. A questionnaire completed by 391 first-year nursing students was administered. Results Differences were observed in the perceptions of climate and academic performance in different classroom contexts with trends, which did not always overlap; however, strong correlations were observed among self-esteem, well-being and climate, and schoolmate relationships. Conclusions Universities should not merely train competent professionals but also build learning communities that support the well-being of relationships and the development of well-being contexts. Implications for nursing management The findings support the need for an educational intervention for improving the quality of life and well-being of the community and individual students. This type of intervention requires a 'compliant' organisational environment that puts studetns, teachers and professionals in the condition to practice their professional skills. [ABSTRACT FROM AUTHOR]

Copyright of Children's Nurses: Italian Journal of Pediatric Nursing Science / Infermieri dei Bambini: Giornale Italiano di Scienze Infermieristiche Pediatriche is the property of Societa Italiana di Scienze Infermieristiche Pediatriche 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.)

Aims and objectives To describe what puerperal women know about postpartum contraception and to identify their related needs and expectations. Background Puerperal women face the problem of beginning or resuming contraception, the choice of the right method of contraception and the right time to start it. This choice becomes particularly important in case they breastfeed since the contraceptive method should not interfere with breastfeeding. Different factors, such as the level of knowledge women have about various contraceptive methods, their individual preferences or their desire to have a baby, can strongly influence this choice. Design A cross-sectional study had been carried out within the period of six months, from November 2011-February 2012. Methods Three hundred puerperal women were interviewed before their discharge from a Maternity Home. The women were asked for their personal characteristics, their maternity history, the information they had received, their knowledge and expectations about postpartum contraception and their intention to use contraception. Results During pregnancy and postpartum, 45·5% of the women reported that they had received adequate information about contraception. Of these ones, 64·3% reported their intention to use contraception either to avoid pregnancy or to space out future births, even if they did not always have appropriate knowledge about fertility and the use of contraceptive methods during postpartum. During this study, we also discovered that women's intention to use contraception was proportional to their level of education. Conclusion Women need more and appropriate information about postpartum contraception, to make a conscious choice in relation to their needs and without putting their health at risk. Relevance to clinical practice To promote awareness of the choices related to postpartum contraception, it is important to understand the personal characteristics that influence or hinder this choice. Midwives can play a very important role in informing women and in developing educational interventions to support a safe contraceptive choice. [ABSTRACT FROM AUTHOR]

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]

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.)

Aim The aim of this study was to assess the number of falls that occurred among children admitted to a children's hospital and explore their characteristics. Method A descriptive, longitudinal, prospective design was chosen. Data were collected from records of a children's hospital over six months and analysed using descriptive statistics. Results Fifty eight falls were investigated. Most of these involved children, mainly boys, aged between one and three years, and most occurred in the evenings. All but one child was injured and 30 received medical interventions. In most cases an adult was present but was not paying sufficient attention to the child. Conclusion Falls among children admitted to a children's hospital are increasingly recognised as an issue to be addressed by health organisations. Further investigation is required on a larger scale to agree definitions, classifications and preventive measures concerning children falling in hospital. [ABSTRACT FROM AUTHOR]

To understand what level of awareness health professionals working in a hospital of Northern Italy had of the patient safety culture by using the Italian version of the Hospital Survey on Patient Safety Culture questionnaire and also validate its use in this setting. The Hospital Survey on Patient Safety Culture questionnaire was developed by the Agency for Health Research and Quality in 2008 and validated by several studies. Therefore, we decided to test the Italian version of this tool to see if it could be used effectively to measure and appraise patient safety culture also in Italy. Survey. To check the validity of the questionnaire, we applied the continued comparison and the global data treatment methods. Of the 1008 questionnaires we administered, 724 (71%) were returned. The majority of the questions were answered (mean 98, SD 3·4%). From a Chi-square test on the consistency of the answers, we found that six of the 12 perspectives we explored had a high level of significance, whereas in the other six, the differences in the answers were just casual. The Italian version of the Hospital Survey on Patient Safety Culture questionnaire allowed us to assess health professionals' awareness of patient safety culture and thus validate the effectiveness of this tool. The findings of our survey could be useful to design an objective tool that would allow the five health professional groups involved in the study (directors/coordinators, physicians, nurses/midwives, physiotherapists and technicians) gain a better knowledge of the patient safety culture and thus improve the quality of clinical practice. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to investigate the lifestyle and eating habits of obese children. Analysis of the data reveals that just 38% of children regularly eat breakfast, 63% of children eat both main and first course for both lunch and dinner, and just one of three children eats vegetables or fruits at meals. It shows that 62% of children spend two and four hours average watching television (TV) during leisure time, while 16% between five and eight hours.

International mobility for nursing students is still a relatively new phenomenon. While educators and students are both excited by the opportunity that mobility presents, there are often many challenges inherent within third level organisations and practice organisations. These obstacles not only serve to make international mobility arrangements complex to manage but also mean that these opportunities are only available to very small numbers of students. Furthermore the benefits of undergraduate international exchanges remain largely anecdotal and the elements that facilitate success are not entirely clear. To address these issues, a qualitative study was conducted to identify the elements that characterize a nursing student's successful learning during international clinical placement. Semi-structured interviews were carried out with six students who had completed their international clinical placements experiences in Portugal, Spain, and Italy. Three common themes emerged from the data analysis: relationship with institutions and countries, student's thoughts and feelings and learning outcomes and the role of the nursing student's clinical supervisor. These themes contain seven sub-categories, representing the characterizing elements of the student's experience of mobility in the foreign country. These results are useful to nurse educators internationally to inform clinical learning experiences within exchange programmes. • International clinical placement enables the development of transcultural skills. • Nurses' transcultural skills have an impact on patient safety. • Undergraduate clinical supervisor's crucial role favours learning outcomes. • Our results are important for nursing educators to improve clinical environments. [ABSTRACT FROM AUTHOR]

An editorial is presented which discusses need for continuous professional development (CPD), and postgraduate education for cardiac nurses in order to meet evolving medical and technical environment. Topics include challenges faced by cardiac nurses in dealing with telemonitoring of patients with implanted cardiac devices; initiatives taken by the Council of Cardiovascular Nursing and Allied Professions (CCNAP), for improving clinical practice; and need for well-defined education for nurses.

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.