Giampiera Bulfone

A longitudinal study of the incidence of pressure sores and the associated risks and strategies adopted in Italian operating theatres.

To explore the incidence of intraoperative pressure sores, the associated risk factors and the preventive strategies adopted by nurses, we adopted a longitudinal study in a 900-bed teaching hospital with multiple operating theatres, located in the North of Italy. Patients who underwent major surgery were evaluated four times: at the moment of operating theatre admission, at operating theatre discharge, and on their third and sixth postoperative day. Of the patients included (n=102) who had an average age of 62.3 years (range 20–87), 12.7% (13/102) developed a pressure ulcer in the operating theatre; 46.1% (6/13) of these ulcers were still present on the third postoperative day. Some health conditions (diabetes mellitus, cardiac diseases) and intra-operative factors (lying on the operating table for more than 6.15 hours, intraoperative hypothermia) are associated with the occurrence of pressure sores.

Measuring patient safety knowledge and competences as perceived by nursing students: An Italian validation study.

The study sought to validate the Italian version of the Health Professional Education in Patient Safety Survey (H-PEPSS), an instrument used to assess the perceptions of health professionals regarding patient safety competence. The H-PEPSS was administered to a sample of 574 bachelor degree nursing students in two north-eastern Italian universities. Its factor structure, validity and reliability were examined using explorative factor analysis. The internal consistency of the Italian version of H-PEPSS (H-PEPSSIta) measured with Cronbachs alpha (α) was higher for both classroom (.938) and clinical training (.942) dimensions. The six factors that emerged from the analysis were composed of three to five items loading ≥.55 and explaining 69.344% of the classroom total variance and 70.425% of the clinical training total variance of the H-PEPSSIta. The H-PEPSSIta is a valid tool capable of evaluating the self-perception of nursing students regarding patient safety knowledge and competence. Therefore, the instrument could be adopted in educational settings as a periodic nursing student report. This may help students reflect on PS related-issues, and evaluate gaps in knowledge and competences; furthermore, data emerging from periodic self-reports may offer the opportunity to tailor educational strategies to fill the gaps in PS knowledge and competences that emerge.

Adverse events witnessed by nursing students during clinical learning experiences: Findings from a longitudinal study

No evidence from any longitudinal study design has been reported to date with regard to patient safety (PS) incidents witnessed by nursing students during their training. Therefore, with the aim of closing this gap in available knowledge, a longitudinal study was performed from 2012 to 2015 by involving all nursing students (n = 145) enrolled in two Italian nursing programs. At the end of each academic year, students were invited to report in writing all PS incidents witnessed during their clinical learning experience; the number of days each student spent in their clinical setting was also collected from administrative records. Ninety students were included and 94 incidents were reported: 17 (18.1%) by first year students, 27 (28.7%) by second year students, and 50 (53.2%) by third year students. One third of students did not report any PS incident at the end of each academic year, while only a few reported more than one. The incidence density was 3.8/1000 days of clinical training without statistical differences across academic years. Supporting nursing students by encouraging them to share, discuss, and reflect on their clinical learning experience might increase their confidence in reporting safety incidents.

Human rights conflicts experienced by nurses migrating between developed countries

Background: Some developed countries have recently changed their role in the context of international recruitment, becoming donors due to socio-economical and political factors such as recessions. This is also the case in Italy, where there has been a flow of immigrant nurses out of the country that has been documented over the past several years. In a short time, it has become a donor country to other developed European countries, such as the United Kingdom. Aims: To advance knowledge in the context of human rights conflicts and ethical implications of the decision-making process of nurses who migrate between developed countries, such as from Italy to the United Kingdom, during times of recession. Research design: A case study based on the descriptive phenomenological approach was undertaken in 2014. Participants and research context: A total of 26 Italian newly graduated nurses finding a job in the United Kingdom were interviewed via Skype and telephone. Ethical considerations: The Internal Review Board of the University approved the project. Findings: In accordance with the descriptive phenomenological approach undertaken, three main themes emerged: (1) escaping from the feeling of being refused/rejected in order to be desired, (2) perceiving themselves respected, as a person and as a nurse, in a growth project and (3) returning if the country changes its strategy regarding nurses. Discussion: Ethical implications in the context of human rights, such as autonomy of the decision, social justice and reciprocal obligation, non-maleficence and double effect, have been discussed. Conclusion: The call for investing in nurses and nurses’ care in developed countries facing recession is urgent. Investing in nurses means respecting individuals and citizens who are at risk of developing health problems during the recession.

Nursing Student Self-efficacy in Psychomotor Skills: Findings From a Validation, Longitudinal, and Correlational Study.

Student perceptions of self-efficacy (SE) prevent stress and burnout and improve engagement in nursing education, thus increasing learning outcomes. The study aims were to (1) validate a scale measuring nursing SE in psychomotor skills (NSE-PS), (2) describe changes in NSE-PS over time, and (3) explore NSE-PS correlations with burnout and engagement. A total of 1117 nursing students participated. A significant increase in the NSE-PS scores over the years has emerged; in addition, all NSE-PS dimensions were correlated negatively with burnout and positively with engagement.