Parkinson's Disease is associated with a high assistive complexity, thus generating in caregivers a burden proportional to the intensity of the care provided. This study aims to evaluate whether the ...stress-related level of caregivers is related to their perception of the need for healthcare education. A cross-sectional study was conducted on 69 family caregivers that completed the Stress-related Vulnerability Scale (SVS scale) with a tool of proposed interventions stratified according to caregivers' need as “nothing”, “somewhat”, “moderately” and “extremely”. A direct association between the SVS scale and the perception of the usefulness of interventions was detected, and significant differences were observed for “Caregivers tele-support group” and “Peer-led support group” interventions, thus suggesting an important role for caregivers' emotional status in considering of training courses. Caregivers are split between low vulnerability, with minimal perception of training need, and high burden state with the acute necessity of support to manage patients.
•Caregivers’ stress level can affect opinions about the usefulness of educational interventions•The incidence of stress vulnerability on perceptions about training is not explored in literature•What emerges from the study is that caregivers’ emotional status influences the opinions about training courses.
To describe which elements of nurses' knowledge, training, behaviour and attitude can prevent errors in intensive care units during all steps of the administration of intravenous medication.
An ...anonymous questionnaire made up of 43 items was drafted and delivered to a sample of 123 nurses at 2 university hospitals in Rome.
The majority of the sample (96.7%) stated that topics related to the preparation and administration of intravenous medications were covered during the basic nursing course. Just over 95% of the sample considered it important to improve their knowledge about preparation and administration of intravenous medications; 94.3% said that teaching about the use of intravenous medications should be enhanced during the degree course they attended and 91.1% agreed that specific postgraduate courses should be set up on the use of intravenous drugs.
Pharmacological knowledge is a prerequisite for the proper administration of drugs and for the clinical evaluation of the effects on the patient. This knowledge implies the understanding of the theoretical and clinical principles of pharmacology, the ability to contextualise medication management according to the complex and changing needs of patients, and it also includes the appropriate skills of drug administration.
Cancer diagnosis not only shakes the lives of those who are affected, but also has impacts on the entire family system, which is involved as if it were itself an organism affected by cancer. The ...oncological illness may cause a breakdown of the existing balance in the family system and demands a progressive degree of mutual adaptation to family members. The ‘VoiNoi’ Listening Centre of the Campus Bio-Medico University Hospital in Rome has been close to caregivers for several years, to support them in the difficult task of providing assistance through individual or group psychological support therapy and health education. The ‘Charter of Rights for Family Caregivers’ stems from the experience gained over the years, with the aim of protecting, supporting and strengthening the role and the assistance activity that families carry out in support of their loved ones under conditions of fragility.
Aims. The aim of this study is to evaluate the consistency between the care given to patients and that documented, by comparing care observations with nursing records and describing which ...interventions were reported and which were omitted.
Background. Assumptions have been made about the relationship between documentation and care actually delivered, but there is insufficient evidence on the relationship between the actual care given and its recording.
Design. Observational study of the care given, completed by interviews and retrospective survey of records.
Methods. Structured observation during day shifts in the first six days of admission of pre and postsurgical care provided to 21 consecutive patients undergoing major abdominal surgery and audit of their nursing records. Each observation was completed by short interviews to nurses to ensure observations validity.
Results. Only 40% of nursing activities observed were included in the nursing records (37% of the assessments and 45% of the interventions). This indicated that nurses carry out more activities than they report. Consistency between performed and recorded care decreased significantly during the days when a higher number of activities were performed. Consistency between recording and observation of assessment activities was 38% for physical needs and 0% for educational needs. Consistency was higher for the assessments of physical signs/symptoms and risk factors for complications compared to the assessment of basic needs and pain. Consistency was 47% for technical interventions and 3% for educational activities.
Conclusions. Nursing records were not found to be an adequate tool for quality care evaluation, because they did not include all the caring activities that the nurses had carried out.
Relevance to clinical practice. This study supports the need to identify documentation systems that are easy to complete. Moreover, nursing education should pay more attention to the competences in the field of holistic care and patient education.
Medication errors during drug administration represent a current issue in intensive care units due to the complexity of patients, the large quantity of drugs administered intravenously, the frequent ...prescription changes and frenetic activities in an emergency setting. The aim of this review is to increase knowledge about prevention and types of medication errors in intensive care units. The review was conducted using the following biomedical databases: PubMed, Cinahl, and Google Scholar. A total of 40 studies were considered useful for research purposes. Most studies showed a higher prevalence of medication errors in complex and intensive care settings. Although there are several different strategies aimed at preventing and reducing errors, available literature data show that a multimodal and multidimensional approach is required to make their use effective.
In literature, the structural empowerment and the job satisfaction have been studied in many different work settings but more need to be done in the setting of Head Nurses.
The goal of the study is ...to evaluate the structural empowerment level of head nurses and if it impacts on the job satisfaction.
A cross sectional design study was used. We enrolled 125 head nurses from three different hospitals of Rome. To collect the data we used a questionnaire that included both a part of the collection of sociopersonal data and the two scales (job satisfaction and structural empowerment). We used the SPSS19.0 statistical Software for data analysis to detect significant results.
Head Nurse declared to be not enough satisfied at work (mean=3.43) and their structural empowerment level resulted moderate (mean=3.16). The structural empowerment of head nurses impacts their job satisfaction especially concerning opportunities for social and professional interactions, praises, awards, audit and responsibilities.
Results underline structural empowerment relevance in head nurses job satisfaction. Healthcare organizations need to address job satisfaction to improve quality of care and more specifically that of head nurses since they directly impact on nurses job satisfaction.
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.
Interest in cancer-related fatigue has been growing over the last two decades and efforts have been dedicated to investigate this topic. However, research addressing the adequacy of educational ...resources for patients with this distressing and common symptom is lacking. Only one study has been undertaken and this explored Swiss and British patients' views.
The current study replicated and extended the study previously undertaken in the United Kingdom (UK) and Switzerland. It sought views on the adequacy of materials on cancer-related fatigue available to patients with cancer living in Italy, and to determine the educational preferences and needs of Italian patients with cancer-related fatigue. These were attained through conduct of two focus groups. One was undertaken with Italian patients and the other with a group of Italian nurses.
Findings from this study supported patients' desire for timely, accurate and individualised information. Barriers to effective fatigue education included the limited dialogue regarding fatigue initiated in clinical settings. It appeared that nurses and patients held different priorities in symptom management. Further, it was acknowledged that there was often insufficient time to inform patients adequately about fatigue. Participants considered written materials as helpful complements to oral information, thus supporting the provision of information in both forms. However, it was clear that fewer written resources concerning cancer-related fatigue were available in Italy compared to either in Switzerland or in the UK.
The study supported the view within the current literature that whilst cancer-related fatigue is recognised as a frequent and disruptive symptom, patient education about this symptom and its management still needs to be enhanced. The resources available to educate patients about cancer-related fatigue should be improved and made more accessible to patients who experience it.
The remote monitoring of patients is based on digital systems that enable the remote collection, usually at home, of health data and its transmission to health centers. The telemedicine paradigm is ...of particular interest in chronic diseases, fragile population and elderly monitoring. Parkinson's disease (PD) is a neurodegenerative disorder having high impact on the lives of patients and their families. Such a disease impacts on the physical and psychological abilities of the patient and may have an effect on the relationship among family members. The strict monitoring of PD patients and their caregivers is of paramount importance in the implementation of prompt actions counteracting the worsening of the disease or that of the caring process. In this paper we present a mobile App developed for PD patients and their caregiver. The App aims at improving the communication among the patient/caregiver and the specialists, covering aspects related to both the disease symptoms and the caring process. In the paper we describe the App along with results collected during a one year experimentation on a cohort of 10 patients and 7 caregivers. The results show that the approach is accepted by patients and caregivers. Furthermore, obtained results demonstrate that the monitoring system is effective in the identification of dangerous conditions for the patient and useful in the implementation of reactive health management strategies.
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