Violence towards nurses and factors affecting violence in hospital settings: an Italian cross-sectional study.

AIM: To investigate the prevalence of violence towards nurses in a health care structure in the north of Italy. METHOD: An observational cross-sectional study. Data were collected anonymously with a questionnaire developed by Zampieron et al. (2010) on a stratified sample of 198 nurses working in a major Italian Hospital in the Lombardy Region. RESULTS: 43% of the sample (n=85/198) experienced violence in the previous twelve months with a mean of 4 aggressions each. Aggressors were mainly patients (53.3%) or relatives (26.7%), men (63.1%) aged between 36 and 50 years (27.9%). Of the verbal aggressions, one out of four was by a colleague or a superior. The emotional, physical and professional consequences were serious and the result of both physical and verbal violence. Nevertheless, among those who experienced aggressions, 57% did not ask for help and of those who did (43.0%) about 75% asked for help and support from their colleagues. CONCLUSIONS: Violence toward nurses exists and it is commonplace in the workplaces studied, even in the horizontal form. It is important to implement assessment and risk prevention and management measures, via specific training of nurses, and offer support for the victims and an anonymous formal report system guaranteed by the authorities.

[Pre-analytical errors in blood sampling: an observational study on specimen collection technique and laboratory results]. / Gli errori preanalitici nel prelievo ematico: uno studio osservazionale sulle modalità di raccolta dei campioni e sugli esiti di laboratorio.

INTRODUCTION: Around 60-70% of diagnostic and therapeutic decisions are based on blood exams. Several errors occur during the pre-analytic phase. AIMS: of this study were: to describe nurses' behaviours in blood specimen collection; to describe prevalence and type of pre-analytical errors; to assess the association between pre-analytical errors and occurrence of unsuitable specimens. METHODS: An observational cross-sectional study was conducted by means of a structured form based on up-to-date clinical recommendations. A researcher observed nurses' behaviors during 172 blood sampling procedures in medical, surgical and emergency care settings. Unsuitable procedures were registered. RESULTS: Most behaviours were correct, however some significantly diverged from recommended practices: active and passive patient identification; respect of antiseptic solution's drying time; rapid removal of tourniquet when blood started flowing. The prevalence of unsuitable specimen reports was significantly higher when the procedure involved a small calibre vein (RP: 0.19; IC95% 0.04 - 0.98; p = 0.03) and when blood drawing was difficult (RP; 3.83; IC95% 1.63 - 9.01; p <0.001). CONCLUSIONS: The pre-analytical phase is important for the diagnostic process and safety of patients. Although some factors ­ as patients' characteristics ­ are non-modifiable, some nurses' behaviours could be improved to reduce risk of pre-analytical errors. Further studies are needed to clarify the associations between pre-analytical errors and laboratory outcomes.