Perceived competences by graduated nurses before and during COVID-19 restrictions: A repeated cross-sectional study from 2019 to 2022.

AIMS: To explore the differences, if any, in the competences perceived by newly graduated nurses who attended their education before and during the COrona VIrus Disease 19 (COVID-19) restrictions. BACKGROUND: Nursing education has undergone significant changes because of the COVID-19 restrictions. However, to date the perceived competences at the point of graduation have not been investigated over the restrictions years compared with the pre-restrictions era. DESIGN: A repeated cross-sectional study followed by a pseudo-panel analysis. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used. Data on individual, nursing programme and perceived competences with Nurse Competence Scale (NCS) were collected and analysed by also using a pseudo-panel approach. METHODS: Two universities were involved. Those eligible were nursing students who graduated: (1) in 2020 (=323) as the first post-COVID-19 group, who were studying in the 3rd year at the onset of the restrictions; (2) in 2021 (=250) as the second post-COVID-19 graduated group, who were in the 2nd year at the restrictions onset; and (3) in 2022 (=247) as the third post-COVID-19 group, attending the 1st year of nursing education at the onset of the restrictions. Data were compared with those who graduated in 2019 (=336, pre-COVID-19 group). RESULTS: The overall NCS score was higher in the pre-COVID-19 group (68 out of 100, 95 % Confidence of Interval [IC] 66.4-69.5), lower in the first post-COVID-19 graduates (62.9, 95 % CI 60-65.8), higher in the second (66.6, 95 % CI 63.6-69.4) and lower again in the third post-COVID-19 group (63.8, 95 % CI 60.9-66.5). A sinusoidal pattern also emerged for the frequency of use of the competences from the pre-COVID-19 (2.3 out of 3) and the first group (2.1) and increased between the second and the third group (from 2.1 to 2.3) (p< 0.001). These sinusoidal trends are also evident in the pseudo-panel analysis. CONCLUSIONS: A different degree of perceived competences at the point of graduation emerged, with higher competences in the pre-restrictions group, lower in the first post-COVID-19 generation, higher again in the second and third group. However, all scores were over 60 points out of 100, thus indicating sufficient competences. The frequency of use of such competences slightly changed over the years with limited practical relevance. The findings may inform reflections regarding innovations in the clinical placements pathways as well as in the strategies supporting newly graduates nurses in their transition from education to health-care settings.

[The nurses' strike in the United Kingdom: the reasons, the debate and the implications]. / Lo sciopero degli infermieri nel Regno Unito: le ragioni, il dibattito e le implicazioni.

. The nurses' strike in the United Kingdom: an overview of the reasons, debate and implications. INTRODUCTION: In the UK, where the National Health Service (NHS) was founded, one of the most important and long-lasting strikes in nursing is taking place. AIM: To understand the historical, professional, political/social reasons for the UK nurse's strike. METHOD: Historical, scientific literature and data from key informant interviews have been analysed. Data has been summarized narratively. RESULTS: On 15th December 2022, more than 100,000 NHS nurses went on strike in England, Northern Ireland, and Wales asking for an increased salary; on the 6th and 7th of February and 1st of March the protest has continued. By improving pay, nurses believe the attractiveness of the profession can increase and counteract the loss of nurses who are leaving the public for the private sector, and the lack of attractiveness of the profession towards young people. The strike is organized by the Royal College of Nursing in a structured form which gives nurses precise information on how it should be explained to patients: according to a survey, 79% of the population supports the nurses' strike. However, not all agree with this strike action. DISCUSSION: The media, social media and professional debate is passionate with some polarization between who is in favor and who is against. Nurses strike not only for better wages but also to increase patient safety. What we see in the UK today is the result of years of austerity, lack of investment and health priorities: a similar situation experienced in several countries as well.

[What are the alternatives to restraints in clinical practice? Results of a multicentre study]. / Quali alternative alle contenzioni fisiche sono applicate nella pratica quotidiana? Risultati di uno studio multi-metodo multicentrico.

. What are the alternatives to restraints in clinical practice? Results of a multicentre study. INTRODUCTION: Physical restraint is still very widespread and debated due to its implications; however, available literature focuses on prevention, neglecting recommendations on possible alternatives. OBJECTIVE: To explore whether and which alternatives nurses apply before deciding to restrain patients. METHOD: A two-phase multi-centre multi-method study was performed. In the first, a prevalence survey on restraints was conducted; in the second, a short interview was carried out with the nurses responsible for the care of restrained individuals to identify the alternatives implemented before deciding to restrain. RESULTS: 37 facilities in Friuli-Venezia Giulia region were included, 17 Nursing Homes (NHs), 10 Intermediate Units (IUs) and 10 Medical/Surgical wards. On the index day 1818 (78.2%) patients were present in the NHs, 157 in the IUs (6.8%) and 308 in the hospital wards (13.3%) (= 2283). A total of 28.9% (659/2283) patients were restrained (31.3% in NHs; 26.8% in IUs; 15.6% in hospitals). Only for 81 (12.3%) of them the restraints had been preceded by the application of an alternative (e.g., involving family members, lowering the bed, or using pillows). DISCUSSION: In the physical restrain decision-making process, nurses consider few alternatives, approximately one in every eight restraints, more frequently in IUs, less in NHs and never in hospital wards. Those used are simple, and depend on the context and the resources available.