Nursing student plans for the future after graduation: a multicentre study.

BACKGROUND: When modelling the nursing workforce, estimations of the numbers and characteristics of new graduates over the forecast period are assumed on the basis of previous generations; however, new graduates may have different plans for their future than those documented previously in different socio-economical contexts. AIMS: To explore (a) nursing student plans after graduation and factors influencing their plans, and (b) factors associated with the intention to emigrate. METHODS: A survey questionnaire was developed and distributed to students attending their final third year of nursing education in seven universities in Italy in 2015. Nine hundred and twenty-three (90.4%) students participated. FINDINGS: Four different plans after graduation emerged: about two-thirds reported an intention to look for a nursing job in Italy; the remaining reported (a) an intention to emigrate, looking for a nursing job abroad, (b) an intention to search for a nursing job in both Italy and abroad, and (c) while a few an intention to continue nursing education in Italy. Having previous experience abroad, the need to grow and be satisfied, trusting the target country and a desire to increase knowledge encouraged an intention to emigrate, whereas the desire to stay in a comfortable environment and nurture personal relationships prevented the desire to migrate. CONCLUSION: Nursing students may have different plans after graduation, and this should be considered when modelling the nursing workforce of the future. IMPLICATIONS FOR NURSING/HEALTH POLICY: Policymakers should be aware of different plans after graduation to guide healthcare human resource strategies. Knowing these trajectories allows policymakers to estimate the appropriate nursing workforce, and also to act at both macro- and meso-levels, on work environments and opportunities for professional development, according to the different levels of expectations.

Securing of naso-gastric tubes in adult patients: a review.

OBJECTIVES: To establish the most effective securing devices and techniques for preventing nasogastric tube displacement or inadvertent extubation, mucosa and skin lesions, discomfort, and complications (ab ingestis pneumonia, reduced caloric intake, mortality) in adult patients. DESIGN: Systematic review of published and unpublished reports in any language, identified by searching 5 electronic databases, websites, reference lists, and existing systematic reviews and papers identified by experts in the field. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Systematic reviews, randomised controlled trials, and comparative studies that compared ≥2 techniques or devices to secure nasogastric tubes in patients 18 years old or older. RESULTS: Five studies (of which two were randomised controlled trials) were included. Four studies reported on bridle versus the tape technique (unbridled). The studies' population was comprised of mostly Intensive Care Unit patients. Four studies measured unintentional dislodgement or removal and found a statistically significant advantage in favour of the bridle. Three studies measured time until failure: two studies compared the bridle versus tape technique whereas the other compared different types of tape. One study did not find any significant difference between the two groups of patients whereas the second demonstrated a significantly longer time until failure in the bridled patients. Three studies comparing bridled and unbridled patients measured adverse events such as external nasal ulceration, epistaxis and sinusitis, and there was no agreement between their results. One study measured caloric intake and found that bridled patients received a higher percentage of their caloric goal than unbridled patients. Only one study analysed the cost-effectiveness of the bridle versus the tape technique and found a cost saving by implementing routine bridling of nasoenteric feeding tubes. Discomfort was not measured in the included studies. CONCLUSIONS: Despite the large number of patients receiving this intervention, there is insufficient evidence to suggest one securing technique or device over another. Data are lacking on the beneficial effects of the various methods or systems. There is little or no statistically significant evidence regarding bridling of nasogastric tubes but more research is needed. There is a need for more well-designed studies conducted in various clinical settings.

[Processes and strategies of teaching from the experiences the tutor elicits in the apprentice]. / Processi e strategie di apprendimento dall'esperienza attivati dai tutor in tirocinio.

The teaching styles adopted by the 10 nurse-tutors of the Trento Nursing School, that teach students during their practical training to elicit the experiential learning, were studied. The instruments adopted were a questionnaire and five vignettes. The nurses were asked to 'think aloud' (verbal protocol technique) and practically explain how they would have used the case presented if occurred during the practical training of one of their students. The most widely adopted style is the connection between theory and practice, while less efforts are made to support the student from the emotional point of view and to help her/him to reflect on the feelings experienced during practice. The teaching style is supportive (5 nurse-tutors) and directive (the other 5 tutors). The small sample size does not allow reasonable comparisons between novice and expert tutors. The tutor's experience in the specific ward where students have their practical training leads to the adoption of a more supportive style, to a minor use of judgements and to a deeper exploration of the students' reasoning.