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Biomedical subjects

Alvisa Palese

Publications and source records attributed to Alvisa Palese.

At least 19 recordsLinked to original sources
PubMed2007

Factors influencing the choice of the first ward: comparison between newly qualified nurses and managers.

We had given a questionnaire to a group of newly qualified nurses and nursing managers responsible for their recruitment with the purpose of understanding the factors influencing the choice of the first ward. For this study, 45 nurses and 10 nursing managers had been recruited. There are 19 factors that influence the choice of the first ward: the most important is the kind of patient, both, nursing managers and newly qualified nurses agreed about, while about the other factors there were different answers. Reflecting on the choice factors may help hospitals to better understand the expectations of the newly qualified nurses and start improving projects to make even the less requested wards more attractive; it can also help the faculty to reflect about the academic curriculum that mostly influences the professional future of the students.

Adult↗
PubMed2006

The experiences of nurses who participate in awake craniotomy procedures.

In awake craniotomy is a unique neurosurgical procedure in which the patient is conscious during part of the procedure. Little has been documented about how instrument nurses (ie, scrub persons) react to this complex procedure and to the tasks of caring for a conscious patient. A phenomenological investigation was conducted to document the experiences of nine instrument nurses. The nurses were challenged by having to manage the conscious presence of the patient, they placed great importance on controlling the surgical situation, and they reported that participating in this procedure had a compelling emotional effect on them.

Craniotomy↗
PubMedDate not supplied

The management of a multigenerational nursing team with differing qualifications: a qualitative study.

Retiring age is no longer fixed at 39 years of working service by Italian law, so nurses with more than 40 years of service continue to work in the wards, creating a distinct older generation. Moreover, with the closure of nursing colleges and the introduction of university degree courses for nurses, nursing education has changed significantly. This article reports on a study which explored the experiences of chief nurses in the daily management of nursing teams composed of multigenerational nurses who differed in age and qualifications. Husserls' phenomenologic approach was used, interviewing at length a purposeful sample of 10 chief nurses. Five main areas of concern emerged: (a) The generation gaps between peers and team leaders; (b) nomadism versus being settled; (c) conflicting methods of working which result in nothing being accomplished: managing the "flat paradox"; (d) different nursing values, ideals, and visions; and (e) existing generation gaps with the younger staff. The number of younger nurses will increase with time and, as a consequence, the relevance of intergenerational differences must be seriously debated, not only difficulties with age differences but also those relating to nursing education.

Adult↗
PubMedDate not supplied

Global case management: the "nurse case manager" model applied to day surgery in Italy.

Day Surgery (DS) and prehospitalization emerged in Italy--as it had previously in the United States and other European countries--as able to improve healthcare and reduce costs. The purpose of this study was to evaluate the impact of the Nurse Case Manager (NCM) Model on patients undergoing DS procedures. The study assessed the intensity of pain, anxiety, and stress factors, and the level of discomfort experienced. The quasi-experimental study design involved two groups of patients (at two different DS hospital centers): one using the NCM model (Ward A) the other based on team nursing (Ward B). All patients undergoing DS for (a) varicose veins, (b) inguinal hernia, (c) breast biopsy, and (d) hemorrhoids were included. A valid questionnaire interview based on 22 questions was used (1) the morning before surgery, (2) the evening after surgery, and (3) 48 hr after the operation, by telephone. Of the 145 patients that were involved, 66 were from Ward A (45.5%) and 79 from Ward B (54.5%). When patient care was based on the NCM Model (Ward A), it seemed that (a) the pathway before DS was more efficient; (b) they perceived lower levels of perioperative anxiety and pain; and (c) they recognized the DS center as a unique point of reference for all postoperative problems.

Adolescent↗
PubMedDate not supplied

[Variability of intestinal preparation in patients undergoing stomach, intestine, uterus surgery at 4 hospitals].

The standard preoperative care of the surgical wards of 4 hospitals for patients undergoing abdominal (stomach and colon) and gynaecological (uterum) surgery has been described. Date collection included the comparative assessment of standard protocols and intervention, with nurses in charge of the preoperative care. Patients undergoing colon surgery may be prescribed an ash-free diet for 7-10 days or may eat normal meals till two days before the surgery. The same variability exists for the antimicrobial prophylaxis and its route of administration. Patients are not allowed to drink from the midnight before the surgery. Enemas administered the afternoon before the surgery may contain castor oil. A systematic review of preoperative care is warranted and guidelines for an evidence based practice should be provided in order to reduce the variability and improve the effectiveness of preoperative care.

Digestive System Surgical Procedures↗
PubMedDate not supplied

[Effectiveness of retraining after basic cardiopulmonary resuscitation courses: a literature review].

Cardiopulmonary resuscitation (CPR) is one of the compulsory skills for health care professionals. Health professionals (and lay people) are offered CPR courses to learn this skill that may be implemented after a long time. Is a course enough to learn and retain this skill? Are retraining courses effective? And after how long should retraining courses be offered? These are some of the questions that guided the search of the literature. Three database were searched (medline, cinahl and healthstar) with the key-words cardiopulmonary resuscitation, retention skills, psychomotor performance, refresh course and retraining and the references of the articles were manually searched to identify further articles. After the exclusion of the articles on pediatric and advanced resuscitation and whose objective was the evaluation of the effectiveness of teaching methods 8 studies were finally identified. No clear indications are proposed. Resuscitations skills deteriorate quickly and theoretical knowledge is retained longer than practical skills. The retraining should be offered frequently but no time intervals are proposed. The main suggestion is that no standard approach should be adopted and the learning needs and preferences of the learner should be considered.

Adolescent↗
PubMedDate not supplied

[Self administration of oral medications in hospitalized patients with orthopedic-traumatology conditions].

Self administration of drugs is the exception in hospitalized patients, even if an increasing body of literature shows the advantages of this practice. The aim of the study was to identify criteria for selecting patients able to self administer their drugs, and assess their number. Six focus groups with nurses of orthopaedic wards were organised to identify the main criteria for selecting patients. The criteria were: no severe disabilities, reliable (according to the nurses' judgement); willing to do so; able to swallow; spatially and temporally oriented; able to learn; already self-administering drugs at home. In a one day prevalence survey over 112 patients prescribed oral drugs 58% were considered eligible for self administration. The more relevant criterion was the reliability. If nurses allowed the eligible patients to self administer drugs they could save 70 minutes/day to spend in informing patients on their drug therapies.

Hospitalization↗
PubMedDate not supplied

[The perception of anxiety and stress in day surgery: a comparison among patients, family members and nurses].

The purpose of this study was to assess anxiety and stress in day surgery patients, and to compare anxiety and stress as perceived by patients, family members and nurses. A descriptive design involving a convenience sample of 40 patients was used. Patients were waiting for ambulatory procedures of varicectomy, inguinal hernia and breast biopsy. Researchers conducted 120 interviews (40 on patients; 40 on family members and 40 on nurses) with a Questionnaire based on 25 stress factors. The mean intensity of patients' anxiety, measured with a Numerical Rating Scale, was 5,15 (median 5, SD 2,63). Family members and nurses overestimated patients anxiety. When nurses were caring for the same patient more times measured anxiety and stress more accurately. The following stressing factors emerged from this study: a) Fear due to the consequences of the surgery; b) losing one self autonomy in ADL; c) pain; d) anaesthesia. The majority of these factors could be reduce through adequate education and information strategies.

Adult↗
PubMedDate not supplied

[Continuity of care with written information and dedicated nurses: a literature review. Part 1].

Continuity of care is one of the major challenges of contemporary care. The aim of this review is to evaluate the efficacy of written information and dedicated discharge nurses on continuity of care. A literature search was done on Medline (1966-March 2004) and Cinhal (1984-2004) with the following key words: "Community Health Nursing e Discharge Planning/Nursing Records/Continuity of Patient Care", "discharge liaison nurse", "liaison nurse", "transfer nurse" and "discharge coordinator (co-ordinator)" and "case manager nurse", a search by author was also performed. Editorials, letters and comments were excluded. Overall, 35 articles were identified. There are no evidences that written information improves the continuity of care and no agreement exists on the information to be registered: a diary of the patient hospital stay or detalied prescriptions of future interventions. A discharge professional seems to be effective on costs reduction, patients' satisfaction and according to some authors, also on the continuity of care. New and more extensive research is needed to shed a light on this pivotal aspect of care.

Community Health Nursing↗
PubMedDate not supplied

[A double blind randomised clinical trial to assess the efficacy of the treatments of the superficial pressure sores].

In spite of the progresses of knowledge and care, pressure sores continue to be a clinically relevant problem. A double blind randomised controlled trial was organised to assess the efficacy of triticum vulgaris (Fitostimoline) vs placebo in the re-epithelisation of superficial pressure sores. Patients with stage NPUAP II or superficial pressure sores, with an expected survival of more than 3 months and eligible for a follow-up up to 8 weeks were included, over a period of 2 years in 46 clinical sites. The protocol was approved by local ethical committees and informed consent was obtained before randomisation. Medications were performed by nurses if the patient was hospitalised and by nurses or properly instructed caregivers at home. Weekly follow-up controls were assumed by nurses. Out of the 294 randomised patients 270 were included in the analyses. The two groups are comparable for the main characteristics except for Norton Scale mean values, less severe in the group assigned to active treatment (10.1+/-3.7 vs 8.9+/-3.2). The mean follow-up was of 3.8 and 4.2 weeks with a mean duration of 26+/-18 and 29+/-18 days for the experimental group and controls respectively. Seventy-six patients in the treatment group and controls (58.0 and 54.7) had their lesions re-epithelized. Adjusting results for age, initial Norton and Push scores there are no differences between treated and controls (OR 0.99 95% IC 0.60-1.67). This multicentre study, sponsored by a research group of nurses, failed to support the hypothesis that triticum vulgaris, the active component of the product Fitostimoline, given on top of recommended treatment, provides a specific therapeutic advantage in terms of frequency and timing of re-epithelization in superficial pressure sores.

Aged↗
PubMedDate not supplied

[Indicators that affect the complexity of surgical patients care. The nurses' view].

Several factors contribute to the ill defined concept of complexity: critical patients, emergency situations, severity, intensity of care, dependency. The aim of this work is to assess nurses' perception of surgical patients' complexity, to obtain bottom-up data to validate a new model (of the Federazione Nazionale Collegi IPASVI) that measures the patients complexity. Data were collected over two months, by interviewing 64 nurses caring for surgical patients in 8 wards of the Friuli Venezia Giulia region. Patients' complexity (Low, Medium and High) and the explicit criteria adopted for the process of qualification, are formulated according to a priority ranking. Nurses were interviewed in 8 index days over 2 months. Criteria were independently classified by 3 nurses and any discrepancies discussed. Data on 1287 patients collected. 729 patients (56.6%) were classified as low complexity; 393 (30.6%) medium and 165 (12.8%) highly complex. The judgement is influenced by patients' age (p<0.01) but not sex. An high complexity score was assigned to patients with abdominal, soft tissues and vascular and gastrointestinal oncological surgery. 1291 different criteria were reported (2.89 +/- 1.88--range 1-15--for patient). The more frequent criteria were dependency in ADLs, need of strict monitoring/surveillance; presence of devices (such as cvc, pumps etc), and type of illness. The criteria expressed, only partially fit in the reference model. The judgement of complexity is based more on clinical problems and patients' dependency than on patients' ability to adapt to the illness and participate to his/her care.

Female↗