ABSTRACT
Transitioning Italian nursing education in the post-pandemic period: priorities in the light of lessons learnt. Introduction. Once back to normalcy, many nursing edu-cation activities have been restored without an in-depth analysis of which transformations enacted in the pandem-ic period should be maintained and valued. Aim. To iden-tify priorities to effectively transitioning nursing education in the post-pandemic period. Method. Descriptive quali-tative design. A network of nine universities involved 37 fac-ulty members, 28 clinical nurse educators and 65 stu-dents/new graduates. Data were collected through semi -structured interviews;the main priorities reported in each university were combined to gain a global view. Results. Nine priorities emerged, including the need to: 1. reflect on dis-tance learning to promote its complementary role to face-to-face teaching;2. rethinking the rotations of clinical prac-tical training by refocusing their aims, duration, and pre-ferred settings;3. understanding how to integrate the vir-tual and the in-presence learning spaces into the educational pathway;4. continuing with inclusive and sustainable strate-gies. Considering that nursing education is essential, it is a priority to develop a pandemic education plan capable of guaranteeing its continuity in all circumstances. Conclusions. Nine priorities have emerged all considering the importance of digitalization;the lessons learnt, however, indicate the need to enact an intermediate phase capable of guiding to-wards the complete transition of the education in the post -pandemic era.
ABSTRACT
Background: The kidney may be affected by coronavirus (COVID) in the setting of acute kidney injury (AKI) or glomerular diseases. Data about AKI in Intensive Care Unit (ICU) patients of Latin-America are scarce. The aim of this study is evaluate the risk of AKI, dialysis (HD) and death in ICU patients diagnosed with COVID pneumonia in a brazilian center. Methods: Analysis from medical records of ICU patients with diagnosis of COVID pneumonia in a brazilian single-center. AKI was defined according to KDIGO criteria. Results: During the period of February 2nd to May 4th, 95 ICU patients diagnosed with COVID were analyzed. There was predominance of male (64.2%), median age of 64.9 years, previous diagnosis of hypertension, diabetes and obesity in 51.6%, 27.4 and 30.5% respectively. AKI was diagnosed in 54 (56.8%) patients and 32 (59.2%) of them required HD. Mortality rate was 17.9%. Patients with AKI, compared to no-AKI were statisticaly significant more frequently hypertensive and diabetic, worse SAPS3 and SOFA scores and need for organ support therapies. Laboratory tests depicted more anemia, lymphopenia, and higher levels of inflamatory markers as well as longer lenght of stay in ICU, hospital and death. Similar findings were seen in those ones who required HD compared to those with conservador treatment. Comparing patients who undergone death to survivors, they were older, more frequently diabetic, worse SAPS3 and SOFA scores and need for organ support therapies, AKI and dialysis. Multinomial logistic regression predicted that hypertension (p=0.01), mechanical ventilation (p=0.01) and use of hydroxychloroquine (p=0.009) were independent risks factors for AKI;hypertension (p=0.002), mechanical ventilation (p=0.03), use of vasopressor (p=0.04), and use of hydroxychloroquine (p=0.009) for HD patients;and age >;65 years (p=0.03) and AKI (p=0.04) for death. Conclusions: In our study, AKI was a common complication of ICU COVID patients, it was associated to hypertension, organ support therapies and use of hydroxichloroquine. As well as age >;65 years, AKI was an independent risk fator to death.