[Activity in a nephrology ward in 2009, Piemonte, Italy]. / Fotografia dell'attivita' in un anno di una corsia nefrologica in Piemonte.

The characteristics of patients hospitalized in nephrology wards in Italy have changed in recent years due to the aging Italian population and the increased immigration. We analyzed the demographic and clinical characteristics of patients hospitalized in our nephrology ward (17 beds) from 15 November 2008 to 15 November 2009. In this period there were 507 hospitalizations including 448 patients. The mean age was 64.4+/-18 years (range 16-96 years). Foreigners accounted for 10% of the total; their mean age was significantly lower than that of Italian patients (38.2+/-13.4 vs 67.4+/-15.9 years, p<0.01). 36.3% of patients were on dialysis, 10% were transplant recipients: the reasons for admission in these cases were internal medicine related; 18.15% were hospitalized because of emergency unit crowding without indications for admission to a nephrology ward. Hospitalization lasted a mean of 13+/-13 days. The most frequent diagnosis at discharge was acute renal failure (ARF) (28.9%) (prerenal 42.1%, obstructive 12.2%, drug induced 6.8%, other causes of ARF 38.7%). Patients with ARF were older than patients with other kidney conditions (67.05+/-16.98 vs 56.03+/-18.65 years, p<0.01). ARF resolved or improved in 86 patients (63.7%). Other diagnoses were cardiovascular disease 25.1%, glomerular disease 18.7%, acute pyelonephritis 10.6%, other 16.7%. Foreign patients presented infectionrelated diseases more often than Italian patients (39.2% vs 20.4%, p=0.02). 392 patients were discharged to their homes, 40 (7.9%) found a place in a long-term care facility or home for the elderly, 25 (4.9%) in other hospital units, and 50 patients died (9.8%). In conclusion, patients hospitalized in nephrology wards in 2009 were mostly elderly with a high frequency of cardiovascular disease and diabetes. The most frequent diagnosis was prerenal ARF. These data suggest the necessity of improving the prevention of this type of kidney disease. Moreover, the length of hospitalization, which is increasing because of difficult clinical and social situations, could be shortened if more nursing homes, convalescent homes and homes for the elderly were available in Italy.

[Planning and activation of a nursing consultancy service with formal recognition inside the San Giovanni Bosco Hospital of Turin]. / Progettazione e attivazione di un servizio di consulenza infermieristica formalmente riconosciuto all'interno del presidio ospedaliero San Giovanni Bosco di Torino.

In some countries the figure of the Consultant Nurse already exists. The literature highlights the experience of the United Kingdom has formally defined the role and profile. In Italy there are few experiences in this area and all local initiative, although the Code of Ethics recognizes the nurse the opportunity to engage in counseling. In the Hospital San Giovanni Bosco di Torino as a result of increased complexity of patients to be treated has been developed at the informal advisory nursing. The aim of this paper is to describe the methodology used for the realization of plans to activate a service of advice nursing, recognized, in the Presidio and to present the results achieved from its application. It is a working group, reviewed the literature and shared the definition of "Nurse Consultant". This is done to administration of a validated questionnaire to map the types of assistance required and paid and payable, graduation of the types detected by means of a weighing system based on frequency, urgency and seriousness, elaboration of the structure of each profile with the declination of the requirements enabling focus groups with experienced professionals, develop a procedure for the activation of the advice and the schedule training. Results are identification of 5 types of advice and drafting of the profile priority, establishment of requirements for the suitability of staff to cover the position and drafting an operating procedure which governs the operation of the service within the Presidio.