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Health systems are using ever-increasing resources on treating hip fractures. Optimal post-hospital care needs to be defined to design an effective care pathway. The aim of the present study was to describe the post-hospital care pathway of individuals with hip fracture and to assess its association with the degree of recovery of independence achieved four months after surgery. A prognostic multicentric cohort study was conducted. All patients aged 65 years and over who were admitted with a diagnosis of fragility hip fracture were enrolled. After the hospital discharge, the patients were followed either at an inpatient rehabilitation facility with an intensive or extensive regimen, a nursing home, a long-term care facility or at home. Among the various care pathways, the intensity of rehabilitation differed according to its duration, frequency of sessions, and activities proposed. Primary outcome was the patient's degree of independence achieved four months after surgery, as measured with Activities of Daily Living scale. Several covariates were collected to test the correlation between the different post-hospital care pathways and the recovery of independence. A total of 923 patients completed the follow-up. A post- hospital rehabilitation pathway was indicated for 88.2% of the patients. The extensive rehabilitation pathway, indicated for 36.7% of the patients, was the most common. The intensive rehabilitation pathway gave better results in terms of independence at four-month follow up, leading to a median ADL score of 1.4 (95% CI 1.0–2.0). The other care pathways did not show significant difference between each other. High-intensity rehabilitation was associated to better results in terms of recovering of Activities of Daily Living. Post-hospital care pathways that include an intensive rehabilitation treatment should be improved/supported to make them available to a larger number of hip fracture patients. Patient selection criteria for post-hospital rehabilitation pathways should be standardized to optimize available healthcare resources. A cost-effectiveness analysis should be performed to analyze the economic sustainability of each post-hospital care pathway. [ABSTRACT FROM AUTHOR]

Objectives: The main aim of this study was to evaluate if an individualized assisted walking program (IAWP) for hospitalized older patients could improve walking ability compared with usual geriatric care and rehabilitation. Design: A randomized controlled trial with an active control group, open labeled with parallel assignment was conducted between October 2018 and January 2020. Setting: Geriatric ward. Participants: A total of 387 hospitalized patients (≥65 years) were randomly assigned to an intervention or control (usual‐care) group. Intervention: The control group received usual hospital care. The intervention group received also an IAWP. Measurements: The primary endpoint was change in walking ability from hospital admission (considering both current and pre‐admission status) to discharge, as assessed with the Braden Activity subscale measures. The secondary endpoint was the occurrence of in‐hospital adverse events, such as complications of mobility, pressure ulcers, falls, pain and mortality, and the length of hospital stay. Intention‐to‐treat and per‐protocol analyses were performed. Results: Baseline characteristics were similar between intervention and control groups. The intervention group, relative to the control group, had significantly improved walking ability at discharge (P <.001). There were no statistically significant differences between the groups in terms of in‐hospital adverse events. No adverse effects were detected. Conclusion: In in‐hospital patients aged 65 and older, an IAWP improves walking ability at discharge. [ABSTRACT FROM AUTHOR]

Introduction. Patients with chronic kidney disease undergoing renal replacement therapy have complex care needs. To address this, nephrology and dialysis nurses must possess expertise in advanced specialist and disciplinary skills. The aim of this review is to analyze post-graduate academic training pathways and clinical-care training in the field of nephrology and dialysis nursing in the Italian context. Methodology. A narrative review of the literature was conducted in May 2024, using databases such as CINAHL and Medline-PubMed, with a selection criterion limited to primary and secondary studies published in Italian and English. To supplement the search, particularly within the Italian context, grey literature sources were consulted. Results. Post-graduate nephrology nursing education in Italy is mainly offered through First-Level Masters, as well as Second Level Masters and specialization courses, which are provided at various academic institutions. Analysis of the educational programs revealed the presence of common "core" teachings across all pathways, covering renal disease pathophysiology, hemodialysis, peritoneal dialysis, and dialysis nursing care, alongside significant heterogeneity in other proposed teachings. Clinical-care training emerged as a fundamental aspect in both post-graduate education, professional integration for newcomers, and continuous professional development. Conclusions. The growing healthcare need for specialist skills suggests the necessity of integrating field-based training with standardized post-graduate academic pathways, possibly in collaboration with relevant Nursing Scientific Societies. This synergy would not only promote the enhancement of nursing competencies but also ensure a high quality of care delivery., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)

Background/Objectives. Peritoneal dialysis stands as an established form of renal replacement therapy; yet peritonitis remains a major complication associated with it. This study, analyzing two decades of data from the Nephrology, Dialysis, and Hypertension Division of the University-Hospital IRCCS in Bologna, aimed to identify prognostic factors linked to peritonitis events. It also sought to evaluate the suitability of different peritoneal dialysis techniques, with a focus on Automated Peritoneal Dialysis (APD) and Continuous Ambulatory Peritoneal Dialysis (CAPD). Additionally, the study assessed the impact of an educational program introduced in 2005 on peritonitis frequency. Methods. Conducting an observational, retrospective, single-center study, 323 patients were included in the analysis, categorized based on their use of APD or CAPD. Results. Despite widespread APD usage, no significant correlation was found between the dialysis technique (APD or CAPD) and peritonitis onset. The analysis of the educational program's impact revealed no significant differences in peritonitis occurrence. However, a clear relationship emerged between regular patient monitoring at the reference center and the duration of peritoneal dialysis. Conclusions. Despite the absence of a distinct association between peritonitis onset and dialysis technique, regular patient monitoring at the reference center significantly correlated with prolonged peritoneal dialysis duration., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)

Background and Aim: Patient with chronic kidney disease (CKD) must adhere to a nutritional therapy characterized by a restrictive dietary scheme. Nutritional self-care can be enhanced through the use of nutritional apps. The purpose of this study is to evaluate the characteristics of specific nutritional apps for chronic renal failure available in Italy., Methods: A systematic search of mobile apps was conducted by two academic researchers in three Italian App stores: Google Play Store, Apple Store and Huawei AppGallery. Of the 1602 apps identified, 2 apps (Miku; MyFIR) were evaluated with the Italian version of a Mobile Application Rating Scale (MARS-ITA) by a multidisciplinary team of 20 professionals., Results: The study found that the two selected apps, available in the Google Play Store and Apple Store, aim to increase well-being through the acquisition of knowledge and behavioral change; but none identify health goals that should be achieved. The strategies used by the two applications are: information, education, monitoring and cognitive-behavioral challenge. The technical analysis showed adequate protection of personal data but only the most downloaded app (Miku) provides the possibility to share content, to send reminders and to browse when offline., Conclusions: The main Italian app stores have two applications to monitor physical health and nutrition in patients with renal disease. Although these are free, easily accessible, navigable and valid in terms of health monitoring and information, greater availability of the offer would be desirable.

From mid-March 2020, the pandemic caused by COVID 19 has placed health facilities in front of the need to implement a rapid and profound reorganization. However, many hospitals have not had time to organize a rapid and effective response, both for the speed of spread of the virus, and for the lack of previous experience with a pandemic of this magnitude. With the aim of assessing the knowledge and adoption of the procedures and recommendations disseminated by hospitals during the COVID-19 pandemic, in the dialysis and hemodialysis services of Italian centers, a cross-sectional survey was designed by the Society of Nurses in Nephrology (SIAN). The online survey was conducted among nurses who work in the Italian services of dialysis and hemodialysis during the first and second waves. The online survey was completed by 150 nurses. Although hospitals have set up protocols and procedures for patient management during the COVID-19 pandemic, among participants not all were aware of it. With regard to the training of personnel in the use of personal protective equipment, 18.6% declared that they have not received it. The majority implemented specific precautions for patient management, awareness and information., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)

. A three-months follow up of a randomized controlled trial of Assisted Walking Program for in-hospital geriatric patients., Introduction: Functional decline is common among older hospitalized patients. In fact, low mobility and bed rest during hospitalization have been considered as predictable causes of independent ambulation decline in older hospitalized patients., Primary Endpoint: the older patients' walking ability change, compared with usual care, from hospital pre-admission/admission to discharge and 90 days follow-up, assessed with the Braden Activity subscale. The secondary end point was the occurrence of re-hospitalization and mortality., Methods: A 90-days follow-up randomized controlled trial, open labeled was conducted in a geriatric ward., Results: A total of 307 hospitalized patients (>65 years) were included. The intervention group received an Individualized Assisted Walking Program (IAWP), which significantly improved walking ability at discharge (p<.001) and 90-day follow-up (p=0.009), compared to the control group, which received the usual care. There were no significant differences in terms of mortality and re-hospitalizations., Conclusions: An individualized assisted walking program improves walking abilitiy during hospitalization and over time. For this, a nurse staffing and workload reorganization, a multidisciplinary approach, and an early nurses' planning, could be relevant factors in influencing successfully the older patients' healthcare.

Introduction: Antisepsis of the skin of adults, children and newborns before the insertion of a peripheral venous catheter (PVC) reduces the risk of catheter related infections (CRI). Data on the effectiveness of electrolytic sodium hypochlorite are missing., Methods: An explorative study was conducted on children, adults and newborns admitted to hospital and with skin antisepsis with sodium hypoclorite 0.057g with active chlorine 0.055g in 100ml (Amukine Med®) to assess the level of contamination of PVC tips, as surrogate sign of infection. Quantitative methods were used and the catheter tip was considered colonized if >1000 CFU (colony forming Units)/catheter segment., Results: In the sample of 42 adults, 51 children and 52 newborns, 16.7%, 7.8% and 3.8% of catheter tips were contaminated respectively. No catheter related phlebites were observed., Conclusions: Skin antisepsis with Amukine Med® seems effective in preventing CRIs but further comparative studies are needed with the antiseptics recommended by guidelines.

Unlabelled: Randomized controlled trial on the effectiveness of Corpitolinol 60 in the prevention of pressure sores in surgical patients., Introduction: The risk of pressure sores in surgical patients is widely recognised. The Corpitolinol 60 (Sanyréne®) applied on compressed areas seems to reduce the risk of pressure sores., Aim: To assess the efficacy of Corpitolinol 60 in preventing pressure sores in the operatory theatre., Methods: The open label randomized clinical trial was conducted in 5 operating theatres of Northen Italy. Patients were randomized to receive Corpitolinol 60 in areas undergoing compression. Experimental group and controls were treated with usual measures for preventing pressure sores. The lesions were staged according to NPUAP up to 24 hours after surgery., Results: Three-hundred-one patients were randomized (155 in the Sanyréne® group and 143 controls). The main variables predictive of pressure sores risk (ASA class, sex, age, duration of the surgery, and BMI) were comparable across groups. At the end of the surgery 71 patients (23.8%) in the experimental group and 47 controls (30.8%) had a pressure sore (p 0.006; RR 1.81 IC95% 1.17-2.79). Twelve and 24 hours after surgery the differences between groups were not significant., Conclusions: The aim of reducing pressure sores was not reached for patients treated with Corpitolinol 60.

Unlabelled: Multicenter prospective cohort study, to validate the Italian version of the Braden Q scale for the risk of pressure sores in newborns and up to 8 years old children., Introduction: Children admitted to Intensive care Units (ICU), oncology and neurology/neurosurgery wards are at risk of developing pressure sores., Aim: To validate the Italian version of the Braden Q scale for the assessment of the risk of developing pressure sores in children., Methods: Children from 21 days to 8 years, admitted to intensive and sub intensive units were recruited. Premature babies, children admitted with a pressure sore and with a story of congenital cardiomiopathy were excluded. In this cohort, multicentre and with repeated measurements study, the first assessment was performed after 24 hours from hospital admission, using the Braden Q Scale (Suddaby's version). The pressure sores were assessed with the Skin assessment Tool and staged according to the National Pressure Ulcer Advisory Panel. RESULTS. On the 157 children 524 observation were conducted. The incidence of pressure sores was 17.2%. Only the analysis on specific subgroups of patients showed a good diagnostic accuracy: 71.4% on children 3-8 years; 85.6% in sub intensive wards., Conclusions: The Braden Q scale may be reliably used and shows a good diagnostic accuracy in children 3-8 years of age admitted to sub-intensive, neurology, oncology and heamatology wards.