[An almost ignored Florence Nightingale battle: the opposition to the creation of the state professional register of nurses]. / Una battaglia di Florence Nightingale pressoché ignorata: l'opposizione alla creazione dell'albo professionale statale delle infermiere.

This contribution intends to draw attention to some little-known facts in the history of nursing regarding Florence Nightingale, whose 200th anniversary is celebrated. This is her battle against the establishment of the register of qualified nurses (what is now the Order of Nurses). Her reasons were well argued and ranged from the still insufficient education, to the strong medical interference in the Campaign in favour of the register, to the risk that the still poorly defined scientific and social solidity of the profession would have made it ancillary to medicine, up to the concrete impracticability of keeping a register always updated to exclude any subjects who were no longer suitable. In addition to information on the patroness of the Campaign for the registration of nurses Ethel Bedford Gordon Fenwick, one of the founders of the International Council of Nurses (ICN), the links with women's associations of the early twentieth century and the current Italian National Association of Nurses (Consociazione nazionale delle Associazioni infermieri, CNAI) emerge. Furthermore, little known information on the origins of professional regulation of nurses, particularly in the United Kingdom and Italy is reported. In the concluding part, several questions are asked that stimulate reflections on the Italian professional situation and, in particular, on the fundamentals of nursing care, on nursing education and training necessary for professional, specialist and advanced qualification, and the consequent career development.

[Accuracy of hospital nursing documentation: a multi-center observational study]. / L'accuratezza della documentazione infermieristica in ospedale: uno studio osservazionale multicentrico.

INTRODUCTION: In literature it is reported that accurate nursing documentation improves patients' outcomes but nursing planning data is seldom available. The accuracy of nursing documentation in hospitals has been assessed in many healthcare settings through the detection of three key elements of nursing decision-making: diagnoses, interventions and outcomes. However, studies conducted in Italy are scant and none of them have been conducted in Lombardy Region. AIM: the aim of this study is to assess the accuracy of nursing documentation in six hospitals. Accuracy in documentation's compilation was sought, as well as the three essential elements expected in the nursing decision-making process: diagnoses, interventions and outcomes. METHOD: a multicentre retrospective observational study was conducted on a sample of 430 computerized and paper-based nursing records in surgical and medical areas. D-Catch instrument was used to evaluate documentation's accuracy. This instrument is divided into six sections, with scores ranging from one to four: a higher score corresponds to a greater accuracy of the documentation. The six sections assess whether the documentation structure and the assessment are accurate, the presence of a nursing diagnosis, the accuracy of interventions and assessments and documentation's clarity and legibility. RESULTS: it emerged that in the six hospitals there is a structured and personalized nursing documentation. From the 430 nursing documentations, a total of 623 nursing diagnoses were observed. Diagnoses reached an average score of 2.5, with significant differences between surgical and medical areas and between computerized and paper documentations. Interventions also showed significant differences between surgical and medical areas, and between computerized and paper documentation, with an average score of 2.04. The outcomes received the lowest scores with an average of 1.75. CONCLUSIONS: the specific nursing data that would make the care process evident are hardly visible and, despite the nursing records of the six hospitals being oriented by a conceptual model, there is no shared terminology that helps nurses to describe univocally the care process. The introduction of a standardized nursing language and an integrated computerized medical record could help to improve the accuracy of the documentation.

[L'impiego dell'ICNP® nella formazione infermieristica con modelli teorici infermieristici: una revisione della letteratura]. / Using ICNP® in undergraduate nursing education with nursing theoretical models: a literature review.

INTRODUCTION: The International Classification for Nursing Practice (ICNP®) is the only nursing terminology that has been accepted within the Family of International Classification of the World Health Organization. The academic teaching of ICNP® could contribute to improve nursing clinical practice. However, standards for its implementation in undergraduate nursing education together with a nursing theoretical model are not available. AIM: To know the state of the art about the use of ICNP® in undergraduate nursing education and its use with a nursing theoretical model. METHOD: A narrative literature review was conducted searching main health scientific databases and including monographs, statements from international associations, and published conference papers. RESULTS: Available literature about ICNP® implementation in nursing education and its use with theoretical models is limited. Results supported the organization of a specific course on ICNP® before clinical teaching programs, the development of paper or electronic ICNP® based educational tools, and the use of active learning strategies. Only three experiences reporting the use of ICNP® with theoretical models have been found. CONCLUSIONS: Both the use of ICNP® in nursing undergraduate education and its use according to one or more nursing theoretical models, could help students to learn nursing process. However, weak recommendations can be found in the literature to orient ICNP® implementation in undergraduate nursing education and/or with an explicit theoretical framework. Further studies focusing on these issues are strongly needed.