The Nursing Management of Tourniquet: the infective risk related to its use.

BACKGROUND AND AIM OF THE WORK: Reusable tourniquets should be considered and used in clinical practice as semi-critical devices, as they are colonized by potentially pathogenic agents, a possible cause of care-related infections. The aim of the study was to analyse the management of tourniquets in the clinical reality of wards, investigating the aspects related to their use in venepuncture procedures, the cleaning process after their use and storage. METHODS: It has been conducted an observational study with a questionnaire on a sample of nurses (N = 73) and nursing students (N = 60) recruited in a hospital and in an University of northern Italy. RESULTS: Data revealed a very positive attitude regarding the high standards of hand hygiene among nurses and nursing students sampled; the critical issues concern the lack of shared protocols or guidelines for the management of tourniquets that lead to discussion both on their use in clinical practice and on the disinfection process after use as well as tourniquets disposal. CONCLUSIONS: Tourniquets can represent a serious potential danger in terms of infections transmission, especially in the pandemic period we are experiencing; their use is practically transversal in all healthcare settings and it is therefore necessary to implement the use of shared management and disposal guidelines / protocols. From this research it appears that in the setting explored, although much attention is paid to hand hygiene, this aspect still seems to be a critical point of nursing care.

The nurses' uniform in pediatrics, the opinion of children and nurses.

BACKGROUND AND AIM: The nursing uniform represents a non-verbal mean of communication which in the case of children can arouse positive or negative emotions. The first study conducted on a sample of 107 children, aimed to define their preferences on different models of decorated nursing uniforms; the second one conducted on 101 nurses to understand the preferences, the meanings attributed to the uniform and their availability to adapt it according to the preferences expressed by the children. METHODS: We conducted an observational study with a qualitative approach. For the first objective with the children, a visual stimulus was used, showing 6 models of uniform: the traditional plus 5 models of different colors and themes (cartoons characters and videogames). For the second objective with the nurses, in addition to reproducing the same visual stimulus, a semi-structured questionnaire was used. RESULTS: Children and nurses seem to be in perfect accord, because in both groups, color models were the most chosen. Nurses defined their uniform with terms of particular moral, intellectual and professional value and declared themselves available to align with the preferences of the children. CONCLUSIONS: This study leaves little doubt about preferences; it also represents the true originality of the study because almost never in the literature have been compared the point of views of children and professionals, generally favoring the comparison between children and care givers. Our findings could represent a further landmark for guiding the choices of health organizations on currencies to be adopted in the pediatric field. (www.actabiomedica.it).

Nurse training in self-management of patients with cardiovascular diseases: a multicentre observational study.

BACKGROUND AND AIM: The therapeutic education and self-management carried out by nurses, are winning elements in cardiovascular secondary prevention, but because they are complex matters, they require special training by the professionals. The target of the study has been to assess the effects in clinical practice of a training program for nurses in the management of patients with cardiovascular diseases, leaning towards a self-oriented patient management and therapeutic patient education. METHOD: The research utilized a quali-quantitative study to compare the responses of 53 trained nurses (experimental group) and 101 untrained nurses (control group). The instrument used was a self-report structured in two sections: the first, a qualitative kind, was used to investigate the portrayal of nurses regarding self-management; the second, a quantitative kind, included a Likert scale based on 5 points (1=never, 5=always) that investigated the professional nurse's action in its bio-psycho-socio-relational and clinical activities (La Sala, 2012). RESULTS: The trained nurses' approach is more oriented towards the psycho-socio-relational dimension, compared to the untrained nurses. A difference also emerged regarding activities of a bio clinical nature, which are performed much more by untrained nurses compared to trained professionals. CONCLUSIONS: The health education and self-management skills were used by trained nurses during their care of patients with cardiovascular diseases, stressing the importance for professional nurses to develop an integrated competence, using narrative talks as the main tool in a patient-centred approach.

Cultural Competence Assessment Instrument: Initial Italian validation and proposed refinement.

BACKGROUND AND AIM OF THE WORK: Italy has become a target of immigration in the last three decades. Accordingly, the Italian population is progressively changing, becoming increasingly culturally different. Cultural competences are a fundamental requirement for many industries and, especially, for healthcare organizations. The aim of this paper is to propose an initial Italian validation of the Cultural Competence Assessment Instrument (CCAI) and to propose a refinement of this scale in terms of measured constructs. METHODS: The CCAI was translated into Italian through a team-based iterative approach and then administered to a sample of 289 nurses with symbolic and realistic threat scale and social dominance orientation scale. An on-line cross-sectional survey questionnaire was used. RESULTS: Confirmatory factor analysis revealed that the original two dimensions of the CCAI can be divided into two other sub-scales, thus leaving us with the following dimensions: cultural awareness, cultural sensitivity, seeking information and active behavior. These dimensions appeared to be sufficiently reliable and independent one from another. Moreover, they showed specific and different correlations with other measured constructs. CONCLUSIONS: The Italian version of the CCAI would seem to be a useful instrument for measuring both attitudes and behavioral intention of nurses with respect to intercultural care. Using four dimensions instead of two appears to increase the understanding of professionals' cultural competence and supply a deeper picture of dimensions which compose cultural competence in healthcare settings.