Quali sono le ragioni delle Missed Care? Risultato di uno studio bilaterale. Ragioni delle Missed Care.

BACKGROUND: Evidence of missed nursing care in clinical practice has been well documented; however, fewer studies highlighting why care is missed have been conducted and this prevents effective interventions aimed at minimizing the missed care. METHODS: A secondary analysis of two cross-sectional study designs was performed to capture the direction and strength of 1,114 Italian and Australian nurses' perceptions about why care was missed in their hospitals. The MISSCARE survey was used to collect data and the specific section aimed at estimating the reasons for missed nursing care was used. Data were analysed using structural equation modelling. RESULTS: Six significant variables emerged as predictors of why care is missed, and these were: workplace miscommunication; increased work intensity; inadequate physical and human resources for care work; nurses' age; and years of clinical experience. CONCLUSIONS: Australian and Italian findings contribute to growing international studies as to why nursing care is missed and provides a framework for understanding precipitating factors, such as incomplete workplace communication, unpredictable workflows, staffing and material resources issues might contribute to why care is missed and must thus be addressed/improved.

Hospital safety climate from nurses' perspective in four European countries.

BACKGROUND: Nursing shortages, the substitution of practical nurses for registered nurses, an ageing workforce, the decreasing number of nurse graduates and the increasing migration of young nurses are important factors associated with the hospital safety climate in Central European countries. AIMS: The aim of the study was to investigate nurses' perceptions of the safety climate in four selected central European countries (Croatia, the Czech Republic, Poland and Slovakia) and to determine the relationship between safety climate and unfinished nursing care. METHODS: A cross-sectional study was used. The sample consisted of 1353 European nurses from four countries. Instruments used were the Hospital Survey on Patient Safety Culture and the Perceived Implicit Rationing of Nursing Care. Data were analysed using descriptive statistics and multiple regression analyses. RESULTS: Significant differences were found between countries in all unit/hospital/outcome dimensions. 'Perceived Patient Safety' and 'Reporting of Incident Data' were associated with aspects of 'Organizational Learning' and 'Feedback and Communication about Error'. Higher prevalence of unfinished nursing care is associated with more negative perceptions of patient safety climate. CONCLUSIONS: Cross-cultural comparisons allow us to examine differences and similarities in safety dimensions across countries. The areas with potential for initiating strategies for improvement in all four countries are 'Staffing', 'Non-punitive Response to Error' and 'Teamwork across Hospital Units'. IMPLICATIONS FOR NURSING AND HEALTH POLICY: 'Feedback and Communicating about Error' and 'Organizational Learning - Continuous Improvement' were the main predictors of 'Overall Perception of Patient Safety' and 'Reporting of Incident Data'. Therefore, nurse managers should focus on how to empower nurses in these areas in order to foster a no-blame culture and effective reporting. In addition, it is important for policymakers to update nursing education standards in order to address patient safety.

Low-Temperature Deposition Modeling of ß-TCP Scaffolds with Controlled Bimodal Porosity.

Low-temperature deposition modeling (LDM), otherwise termed freeze-form extrusion fabrication or rapid freeze prototyping, involves dispensing an aqueous-based ceramic paste or polymeric hydrogel along predefined paths in subzero ambient temperatures, followed by freeze-drying. The solidification of the material after the deposition of each layer enables large parts to be built without the need for organic binders, which can often have cytotoxic effects. Freeze-dried parts obtained from LDM typically exhibit pores with openings that range in average between 1 and 40 µm. The technique offers the ability to control their size distribution and orientation through varying a number of processing and material parameters. Herein, we describe the construction of an LDM system from readily available electromechanical components, as well as the preparation of a ß-ΤCP paste formulation with the appropriate flow characteristics for fabricating hierarchical scaffolds with tailorable bimodal porosity for applications in bone tissue engineering.

Content of Orthopedic Patient Education Provided by Nurses in Seven European Countries.

Patients' and their significant others' education during the perioperative phase is an important and challenging aspect of care. This study explored the content of education provided by nurses to arthroplasty patients and their significant others. Data were collected with the Education of Patients-NURSE content (EPNURSE-Content), Received Knowledge of Hospital Patient (RKhp), and Received Knowledge of Significant Other (RKso) scales. The results showed that the content of education emphasized biophysiological and functional needs, differed between countries, and was related to how physically demanding nurses found their job to be and the amount of education provided. There is congruence between the received knowledge of patients and their significant others in relation to the content of education provided by nurses. The findings can support nurses in developing aid material for patients and significant others explaining the nature of education and advising them what to expect and how to optimize their participation in the process.

Cypriot and Greek nurses' perceptions of the professional practice environment.

BACKGROUND: Research evidence supports that the role of the professional practice environment is crucial for the delivery of quality care as it is significantly correlated with patient and nurse outcomes. However, in countries sharing similar cultural and ethnic backgrounds, like Cyprus and Greece, as well as the increased mobility of patients and healthcare workers, there is a lack of information regarding this issue. The aim of this study is to explore and compare Cypriot and Greek nurses' perceptions of their professional practice environment. METHODS: A descriptive comparative survey was employed using a sample of nurses in Cyprus (N = 150) and Greece (N = 147). Information was collected with the Revised Professional Practice Environment Scale (RPPE). RESULTS: The results revealed significant differences between the two countries in three out of eight factors of the RPPE, with Greece's mean value being higher than Cyprus's: Handling Disagreements and Conflicts, Leadership and Autonomy in Clinical Practice, and Teamwork. CONCLUSIONS: The findings generate additional knowledge about the organizational context of care delivery that might help nursing leaders to understand how nurses perceive their work environment and how this influences their work, and consequently the care provided. The results can be utilized by nurse ward managers to improve the quality of nursing care provided. Further research is needed using different approaches to explore nurses' experience in more depth. IMPLICATIONS FOR NURSING OR HEALTH POLICY: Measuring nurses' perceptions of their professional practice environment may assist managers and policymakers in introducing interventions that contribute to a better practice environment and consequently to improved nursing, as well as patient, outcomes.

Challenges in mental health nursing: working in institutional or community settings?

Professional environments likely affect patient safety, quality of care provided, and nurses' satisfaction and retention. The aim of this study was to explore mental health nurses' perceptions of their professional practice environment and examine differences in perceptions between nurses working at institutions and those practising in community care. The methodology used was descriptive and comparative. The sample consisted of 248 mental health nurses working within the public sector (76% response rate) drawn from a psychiatric hospital (n = 163) and community settings (n = 85). We administered the Revised Professional Practice Environment (RPPE) questionnaire. Comparisons of the two groups were made using eight subscales of the RPPE. The results indicated that mental health nurses' ratings of their practice environment were slightly positive (M = 2.69; range = 1-4). Nurses working in a psychiatric hospital perceived the professional practice environment more negatively (M = 2.66) than their colleagues in community care (M = 2.73). A t-test comparison revealed statistically significant differences between the two groups within subcategories of work motivation (P = 0.04) and leadership and autonomy (P = 0.03). Nurses working in the community gave higher ratings in comparison with their colleagues working in institutional settings. In conclusions, an in-depth analysis of differences in practice environments is required to define causes of these differences and how they might influence nurses' abilities to provide quality care.

[Italian validation of the Patient Satisfaction Scale]. / Misurare la soddisfazione del paziente: validazione della versione italiana della Patient Satisfaction Scale.

Patient's satisfaction is a major outcome of the health care services and it is mainly determined by patients' perception of the nursing care received. Many instruments measuring patients' satisfaction are described in the literature. In this study the validation of the Patient Satisfaction Scale in the Italian context is documented. Content validity of the scale has been reached with forward-backward translation, achieving semantic equivalence with the original scale. The scale has been completed by 220 (response rate 91%) surgical patients during their hospitalization and has showed a good response variability and a high reliability (Cronbach alpha = 0.93). The Italian version of the PSS is considered valid and reliable; moreover the high response rate obtained indicates a good level of acceptability of the scale in clinical settings.