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This chapter focuses on the importance of workers’ personal resources during difficult times, such as the pandemic period. In particular, the role of self-compassion in the work context is examined as an important resource for maintaining psycho-physical well-being. Further attention will be given to the impact of self-compassion on neuroscience research and possible organizational interventions to develop and/or support self-compassion in workers.

Delirium is a common condition during hospitalisation that should be prevented and treated. Several recommendations have been established to date, whereas few studies have investigated their applicability in daily practice for medical and post-acute settings.The aim of this research exercise was to emerge the applicability of the interventions recommended by studies in the daily care of patients at risk or with delirium cared in medical and post-acute settings.The study was organised in three phases. A systematic literature review according to Centre for Reviews and Dissemination was conducted (January-February 2021). Cochrane Library, Pubmed, Scopus, Cumulative Index to Nursing and Allied Health Literature, Psychological Information Database, and the Joanna Briggs Institute databases were searched. Primary and secondary studies were evaluated in their methodological quality with the Standard Quality Assessment Criteria, the Critical Appraisal Skills Programme, and the Appraisal of Guidelines for ResearchEvaluation. Then, the interventions identified were assessed in their applicability using the Nominal Group Technique who ranked their judgement on a four-point Likert scale from 1 (totally inapplicable) to 4 (totally applicable). Qualitative feedbacks were also considered, and a validation of the final list was performed by the Nominal Group.A total of 12 studies were included producing a list of 96 interventions categorised into four macro-areas (prevention, non-pharmacological, communication and pharmacological management). The Nominal Group identified 51 interventions (average score 3.5) as applicable in medical and post-acute settings. Then, through a process of re-reading, and revising according to the comments provided by the Nominal Group, a list of 35 interventions out of the initial 96 were judged as applicable.Applicability should be assessed with experts in the field to understand the involved factors. One-third of interventions have been judged as applicable in the Italian context; the nurses' expertise, the work environment features, and the time required for each intervention in a high workload setting may prevent the full applicability of the interventions recommended by the literature.

Italy was the second country to be affected by COVID-19 in early 2020, after China. The confrontation with the pandemic led to great changes in the world of work and, consequently, to the personal world of workers. In such a challenging situation, it is essential to be able to rely on resources that facilitate individual coping. The aim of this study was to understand the association between personal resources (optimism and humor) and exhaustion, and the role of self-compassion in this relationship. A structural equation model (SEM) was used to test the hypotheses on a heterogeneous sample of 422 Italian workers during the first lockdown in April–May 2020. The results revealed that optimism and humor were positively associated with self-compassion; optimism and humor also had a negative association with exhaustion; and self-compassion had a mediating role between the two personal resources and exhaustion. These results confirmed the importance of personal resources in maintaining workers’ wellbeing during a challenging period such as the pandemic. The present study also contributes to the body of knowledge on self-compassion, a relatively new construct that has been little studied in the organizational field.

Self-care for health care professionals is essential in order to optimize the care they provide and to prevent serious consequences for their health. This scoping review aimed to identify (a) the concepts used in the literature to describe self-care; (b) interventions that influence self-care. The scoping review was conducted according to the criteria and methodology by Arksey and O’Malley, from November 2020 to January 2021, by consulting the following databases: Pubmed, CINAHL, Scopus, PsycInfo, Cochrane Library, Joanna Briggs Library. Various keywords and MesH terms were used for the search, including self-care, nurses, midwives, nursing, midwifery, self-compassion, and self-awareness. Eighteen studies were included. The concept of self-care is related to three constructs: (a) Mindfulness; (b) Compassion; and (c) Resilience. In the literature, self-care interventions can be distinguished as (a) mindfulness-based; (b) educational; (c) multimodal approach; and (d) mind-body interventions. In recent years, the concept of self-care is a topic of great interest in the literature; dealing with self-care from both a theoretical and a practical—personal and professional—perspective has become more important in order to promote practitioners’ well-being. This scoping review helps to clarify the terms related to self-care and looks at tested interventions to improve the well-being of caregivers.

Aim To support the development of appropriate policies and actions in the field of missed nursing care (MNC). Background There has been an ever-growing international debate on MNC, interventions that nurses have identified as necessary for their patients, but which for various reasons they are unable to provide or are forced to delay. Despite MNC's relevance, its translation into policies and actions has not been documented to date. Method A consensus development method was employed involving (a) a nominal group composed of experts in the field, policymakers and the President of the Regional Nursing Professional Boards, and (b) 218 nurses appointed primarily at the managerial levels. Results A total of eight consensus statements were approved and organized in a series of sub-statements designed to (1) render the concept of MNC culturally acceptable in the Italian context, with the agreement that compromised nursing care (CNC) is the best term to be used in this field, as a synonym for MNC; (2) measure CNC as a strategy to increase patient safety; (3) select an appropriate CNC measurement tool; (4) optimize CNC measurement; (5) conduct effective CNC data analysis; (6) design and implement interventions to prevent and/or minimize CNC; (7) assess and disseminate findings on interventions' effectiveness; and (8) provide final remarks on the way to move forward. Conclusions We developed a process to introduce the phenomenon of MNC in the Italian culture and agreed firstly on the term compromised nursing care, which better reflects MNC's meaning according to the context and facilitates an open discussion on the phenomenon both within and outside the profession. The following consensus statements emerged represent a systematic approach, starting from the measurement and finishing with the re-measurement of the occurrence of MNC after having implemented concrete actions. Implications for nursing management The approved consensus statements can guide decision-makers to develop concrete policies and actions that promote the improvement of quality of care and patients' safety by minimizing and/or preventing MNC's occurrence.

The COVID-19 epidemic caught governments and health authorities off guard and found them unprepared to face its impact on the world population. Italy was the second country after China to face the outbreak of COVID-19 in the first few months of 2020 and the northern part of the country was hit first and most heavily. Following the JD-R theory, an online survey was administered to investigate which specific risk and protective factors predicted depression in a heterogeneous sample of workers. The analyses (analysis of variance, correlations, multiple linear regressions) were run in the total sample and in the sample split by possibility of remote working. The sample consists of 301 workers in northern Italy, 65.1% being women, and a mean age of 42 years. Depression levels were higher in women and in those who were not able to work remotely. In the total sample, emotional exhaustion at work, sleep–wake cycle problems, and longing for touch were significant predictors of depression. The sample split by the possibility of remote working also showed interesting differences. The results show the importance of monitoring the mental health of workers from professional contexts that are currently less widely studied than the healthcare sector, with particular interest in the possibility of remote working.

Decision Making process and missed nursing care: findings from a scoping review.Several aspects of the Missed Care (MNC) model have been studied (conceptual aspects, causes, process, measurement instruments, outcomes) however, the decision-making processes influencing the MNC have not yet been settled into an accessible guide.To describe (a) the terms most used in the literature to define the decision-making processes influencing the MNC, (b) the conceptual models, as well as (c) the available tools.A scoping review was carried out in March-August 2020 by consulting the following databases: Cochrane Library, Pubmed, Scopus, CINAHL Complete, PsycINFO. Of the 385 retrieved studies, 92 abstracts were evaluated and 36 studies included.Four terms are used to address the process of nursing intervention delivered on time, postponed or missed: (a) Priority setting; (b) Prioritisation of clinical care; (c) Implicit rationing; and (d) Time scarcity. While the lack of time expresses the common denominator, a substantial difference emerges between priority setting and rationing: the first establishes a preferential sequence of activities with the result of delaying those less significant; the second leads to unfinished nursing care. Decision models to date have not considered the processes influencing MNC; therefore, the available measurement instruments are also of little use.The decision-making processes underlying MNC have not yet been well understood, and described using different terms. Reliable instruments to measure them are still lacking.

Missed nursing care and italian nursing practice: preliminary findings of a consensus conference. In recent years in Italy there has been renewed interest in missed nursing care due to various factors, such as participation in the RANCARE project, with 28 European and non-EU countries, the opportunity to develop international exchanges, specific projects and field based research. We explored a range of ideas and processes, culminating in a conference designed to address specific issues relating to missed nursing care, in the Italian nursing practice. After a preliminary review of the literature on the psychometric properties of the available tools, with the intent of further deepening our understanding of the concept of missed nursing care, its implications for practice, management, education and research. After two days of presentations and discussions, the more than participating nurses agreed on a set of preliminary recommendations regarding missed nursing care and Italian nursing practice. This paper reports on the preliminary consensus findings from the conference.

The Missed Nursing Care (MNC) refers to nursing interventions that are not completed, partially completed, or postponed. Despite the relevance of MNC, no assessment tools are available in the Italian context, and no data regarding the occurrence of this phenomenon has been documented on a large scale to date.The study aims were: (1) to validate the Italian version of the MISSCARE Survey tool; (2) to measure the prevalence of missed interventions and reasons for missed care as perceived by clinical nurses working in Italian health care settings.After having conducted the forward and backward translation, pre-pilot and pilot phases were developed to ensure face and content validity as well as semantic and conceptual equivalence of the Italian version with the original version. The MISSCARE survey questionnaire was then distributed to 1,233 clinical nurses of whom 1,003 completed the questionnaire. Overall, 979 questionnaires were analysed. The questionnaires were completed from January to March 2012, by nurses working in medical and surgical hospital departments in the Emilia Romagna region of Italy. Construct validity and internal consistency of the instrument were assessed.The face and content validity were ascertained by a group of experts. The instrument acceptability was good given that 79.4% of respondents replied to all items. Construct validity was investigated by an Exploratory Factor Analysis. Four factors explaining 64.18% of variance emerged: communication, lack of facilities/supplies, lack of staff, and unexpected events. Internal consistency, evaluated with Cronbach a, was 0.94. The nursing interventions omitted with greater frequency were, in order: ambulation (74.8%), passive mobilization (69.6%) and oral care (51.3%). The three main reasons for missed interventions were: an unexpected increase in the number of patients (90.5%), increased instability of the clinical condition (86.1%) and insufficient human resources (85.5%).The Italian version of the MISSCARE Survey was shown to have good psychometric properties. Therefore, it can be used to evaluate the missed nursing care phenomenon in Italy and will allow for international comparisons.

To describe the concept and consequences of missed nursing care.A literature review was conducted searching on Medline, Trip Database, Cinahl, Cochrane, with the following key words: missed care, missed nursing care.Any needed nursing intervention omitted (totally or in part) or postponed is considered missed care. The causes of missed care are the scarcity of human resources, of equipment or communication, but also the criteria for setting priorities and the relationships with nurses aids may also have an impact. The missed care may be measured with the Misscare tool: those more frequently missed are deambulation, passive mobilization, hygiene and oral care. CONCLUSIONS. A description of the interventions omitted or only postponed at international level, a measurement of the variability of missed care according to the number of nurses, and their impact on patients'outcomed could improve a better understanding of this problem.

Nurses case managers were implemented since 2000 in several wards of S. Orsola hospital in Bologna.The aim of this study is to assess the association of ICM to clinical outcomes and patients and nurses satisfaction.The mean hospital length of stay, the number of planned discharges and of falls were assessed the year before and after the implementation of case managers in 14 wards. Nurses satisfaction was assessed exploring in 13 wards the nurses, doctors and nurses aids' perception of positive changes and benefits after the implementation of case-managers and patients satisfaction (8 wards) with the Newcastle satisfaction with nursing scale.No differences were observed in mean length of stay, only a small increase of planned discharges (+8.2%) and a decrease (-24%) of patients falls. The questionnaire on perception of positive changes showed an higher satisfaction of nurse managers but an overall appreciation (agreement2.8 on a 4 points likert scale) for improvement on organization and patients management. The unaffected elements were perception of workload and stress. The patients' satisfaction with nursing care supported the nurses perception.The choice of indicators to document organizative changes is not simple. Positive effects were observed only on health care workers perception and on the decreased number of falls. Future studies are needed to confirm the positive trends observed.