Università degli studi di Modena e Reggio Emilia

Background and aim of the work: The treatment of cardiac arrest in an extra-hospital environment improves with the increase in the number of people able to establish an early Cardio-Pulmonary Reanimation (CPR). The main aim of the study was to assess the validity of the two-step method in case of prolonged CPR. Methods: A randomized comparison study was conducted in the University Nursing School of a Northern Italian town, during the 2015/16 academic year, among 60 students, to teach them CPR techniques, through two different teaching methods (4-step and the 2-step of CPR training). The effectiveness of the maneuvers performed on mannequins equipped with skill-meter was verified. Results: Our study did not highlight any significant difference between the two methods of CPR training. The comparison between the two methods regarding their efficacy in practical teaching of CPR, highlighted by this study, proved the validity of both the 4-minute continuous method (1st method) and the 30:2 method (2nd method). Conclusions: The results of the study showed no differences between the 2-step and the 4-step methods, in the effectiveness of cardiac massage. The correct execution of chest compressions during a CPR is the key to increase the patient’s chances of rescue. Research has shown that any interruption in the execution of chest compressions, leads to a progressive reduction of the effectiveness of cardiac massage, with negative consequences on the prognosis of the patient undergoing at CPR.

Background and aim of the work: Cancer-related fatigue (CRF) is one of the most common symptoms experienced by cancer patients (CPs) and negatively affects quality of life. Although CRF is frequently experienced, it is often underreported, underdiagnosed and undertreated. The objectives of this study were to evaluate the level of fatigue in patients with pancreatic cancer undergoing chemotherapy and to analyse its correlation with patients’ demographic and clinical variables. Methods: A cross-sectional observational study was implemented in the Oncology Day Hospital of a Northern Italian hospital. A sample of 48 patients receiving chemotherapy were evaluated through the Brief Fatigue Inventory Italian version (BFI-I) between 1 May and 12 October 2016. Data were statistically analysed. Results: Most of our patients (94%) experienced fatigue. Women as well as patients with an age ≥65 years reported more fatigue. Anemia, pain and a weight loss of over 16 kg in the last 6 months were significantly related to the perception of fatigue. Regarding life habits, smoking was related to high global score of BFI-I. Conclusions: In accordance with literature, our study suggests that fatigue is a frequent symptom influenced by many constitutional, clinical and environmental factors. Our results highlight the need for an early and regular evaluation of fatigue among cancer patients, in order to implement all those pharmacological and non-pharmacological interventions with proven efficacy in attenuating this symptom.

Background: Effective collaboration among health professionals is an essential component to ensure quality of care. Many adverse events experienced by patients are attributed to misunderstanding or poor communication among members of the interprofessional team. Interprofessional simulation is a learning strategy used to improve collaboration and facilitate communication between medical and nursing students. Aim of the work: To determine the efficacy of educational program based on high-fidelity interprofessional simulation aimed at improving collaborative attitude. Method: For this purpose, a protocol for a planned single-center, non-blinded and Randomized Controlled Trial (RCT) was chosen. The present has been approved by the Ethics Committee of Area Vasta Emilia Nord (Italy) (n° 479/2018). All students attending the second and third year of nursing and all resident physicians in anesthesia, reanimation, intensive care and pain management of University of Modena and Reggio Emilia, will be recruited and randomly assigned to two groups. The Experimental Group (EG) will receive an educational intervention based on high-fidelity simulation and the Control Group (CG) will attend a traditional classroom lesson. Jefferson Scale of Attitudes toward Physician-Nurse Collaboration (JSAPNC) and Readiness for Interprofessional Learning Scale (RIPLS) will be administered before and after the educational program in both the EG and CG. Conclusion: Expected outcomes is that, at the end of the study, nursing students and resident physicians who participated in the interprofessional simulation show significantly higher levels of interprofessional collaboration compared to the CG, evaluated through the JSAPNC.

Background and aim of the work: Idiopathic Pulmonary Fibrosis (IPF) is an interstitial lung disease, which progressively leads to severe disability and death. The average survival expectancy, ranges from 3 to 5 years from diagnosis, and the available medicines do not lead to healing. The progression of IPF lead to a decline in forced vital capacity (FVC), dyspnea, cough, continuous sleep interruptions, resulting in increased fatigue and deteriorating quality of life (QOL), progressive limitation of daily life activities and social life, with repercussions on psychological and emotional well-being, aggravated by anxiety, loss of sense of self-confidence and depression. The aim of the study was to evaluate how the support groups influence the psychological well-being of people with IPF and their family members. Methods: A pre-post test pilot study with a single group was conducted in a university hospital in Northern Italy, a centre for diagnosis and treatment of IPF. A support group was conducted by a nurse and entirely dedicated to people with IPF and their family members. Eighteen participants were enrolled in the support group. To measure the changes in psychological well-being was chosen the Psychological General Well-Being Index (PGWBI), which was administered at the time of enrolment to the group and after six months of attendance. Results: Even if the effect is not statistically significant, the paired t-test showed that the participation in a support group conducted by a nurse, could increase psychological well-being in all of its dimensions: anxiety, depression, positivity, self-control, overall health, and vitality. Conclusions: Despite the null association, the increase of psychological well-being, closely related to the quality of life, indicates the need to further studies. In the absence of effective pharmacological treatments for healing, the support groups represent an opportunity for the wellbeing of the IPF patients and their caregivers.

Many studies have highlighted that “open” Intensive Care Unit (ICU) can bring multiple benefits for patients: reduced cardiovascular complications, mortality and length of stay. However, professionals are still reluctant to accept open units because of many concerns: risk of infection, interference with patient care, increased workload for team, reduced efficacy of intensive care, increased level of stress for patients and their families, violation of patient privacy. The aim of this study was to analyze the positive and negative aspects of an open ICU. After 18 months from the reorganization into open modality of the ICU located in an Hospital in Modena, we performed a qualitative research. We applied focus groups technique and semi-structured interviews to 70 nurses and 4 physicians of the open ICU, in order to appraise their evaluation of this organizational change. Our results evidenced many organizational issues, concerning the difficulty to guarantee the privacy of patients, the necessity of clear, well-defined and shared rules of work and the need of psychological support for the staff due to the higher emotional involvement with patients and their families. Nevertheless, professionals expressed the intention to maintain open ICU, in the belief that it can induce many advantages not only to patients and their families, but also to professionals themselves.

BACKGROUND: Nursing students have to deal with many different clinical and practical aspects of knowledge to become skilled professionals. Student perception may be considered an indicator of teaching quality, since positive perception of students is strictly related to their effective professional learning. The Clinical Learning Environment and Supervision plus Nurse Teacher (CLES+T) scale is considered the gold standard psychometric instrument to evaluate both the quality and the climate of clinical learning environment. AIMS: To evaluate the quality of nurse teaching by means of CLES+T scale and to highlight significant correlations between CLES+T scale and selected characteristics of both students and clinical environments. METHODS: On 4 March 2013, a cross-sectional survey was conducted at University of Modena: CLES+T scale was administered during a plenary convocation to 242 nursing students who attended the second and third years of Nursing Degree. All 34 items of the scale were statistically analysed using the median test. RESULTS: The median values were uniformly represented by "4" level (on the Likert scale). The final marks of clinical learning experience were the only variable statistically significantly related to the scale scores. The paediatrics and emergency areas obtained the highest scale scores. CONCLUSIONS: The nursing student evaluations were uniformly positive and related to their positive final marks. A positive ward atmosphere was identified as especially important in this study. These data indicate that a non-hostile and hospitable environment can favour the best clinical learning. We conclude that CLES+T scale can be a useful instrument to explore the clinical climate in all hospital areas and to highlight critical clinical situations.