Nursing Management of Frail Patients with Hematologic Malignancies during COVID-19 Pandemia in the Viterbo Domiciliary Care Unit: Data Analysis from March 2020 to March 2021

Introduction In the Viterbo province (3612 Km 2 divided into 60 municipalities) is operative a Domiciliary Hematologic Care Unit (DHCU) for clinical assistance to frail patients (pts) with hemopathies: DHCU nursing activity is done by 4 units who were employed during Covid-19 pandemia to avoid as possible risks of viral contagium due to hospital admissions of our pts. Aims To evaluate the entity and type of nursing management for frail pts followed by DHCU during the first year of Covid-19 pandemia. Methods All nursing activities from 3/2020 to 3/2021 in the lockdown framework were analysed. On the whole, 107 pts in 43 municipalities of Viterbo province were followed by DHCU nurses in the study period. Results Main features of the pts at baseline of domiciliary assistance are reported in the Table. At beginning of the study period (08/03/2020), 37 pts (34.5%) were already followed by DHCU, while 70 pts (65.5%) entered domiciliary assistance during the year of study. Median distance from DHCU central site to pts house was 25 Km [Interquartile range (IQR) 16 - 34]: distance from DHCU was < 20 Km in 32 cases (29.9%), ≥ 20 < 40 Km in 57 (53.2%) and ≥ 40 Km in 18 (16.9%). A total number of 2609 nursing accesses was done in the whole period. According to different procedures, 1152 blood samples were performed, with a median number of 7 (IQR 3 - 15) for each pts: in addition, there were 1040 accesses for chemotherapy (CHT) administration (108 cycles of azacytidine in 15 pts, 87 bortezomib-based cycles in 30 pts, 16 administrations of other CHTs in 2 pts) and 417 accesses for other procedures (260 venous catheter medications, 125 therapy other than CHT, 32 nursing assistances of transfusions or marrow aspirates). Finally, 20 pts were vaccinated at home with respective caregivers. During the entire study period, 2 pts (1.8%) developed Covid-19 infection while in home care. At the last follow-up (31/03/2021), 59 pts (55.1%) were alive and still followed by DHCU, 20 pts (18.6%) were alive and returned to sDay-Hospital (DH) setting due to improvement of clinical conditions and 28 pts (26.3%) died while in domiciliary assistance. Conclusions Domiciliary nurse assistance during Covid-19 pandemia allowed to follow in a safer way compared to standard DH/ordinary admission settings > 100 frail pts with hemopathies, most of them in 1 st or subsequent active lines of therapy, in a wide geographic area. In our opinion, this approach should represent the best type of assistance for a high rate of hematologic pts even beyond Covid-19 period of pandemia. Figure 1 Figure 1. Disclosures Stagno: Novartis: Consultancy, Honoraria, Other: Support for attending meetings and/or travel, Research Funding; Pfizer: Consultancy, Honoraria, Other: Support for attending meetings and/or travel; InCyte: Consultancy, Honoraria. Latagliata: BMS Cellgene: Honoraria; Pfizer: Honoraria; Novartis: Honoraria.

Medical and Nursing Civil Liability and Ethics in the Provision of Health Services

After 2000, specific legislation on civil liability and ethics of nurses and doctors was introduced, as well as specific acts. For nurses and the nursing profession, since 2001, the Code of Nursing Ethics (NCSD, Presidential Decree 216/2001) has been in force. In 2005, the current Code of Medical Ethics (KID, Law 3418/2005) was passed. Special Law 3305/2005 on the application of assisted reproduction methods was introduced to specify how the methods introduced in the Civil Code were applied as methods of generating kinship among persons under Law 2089/2002 (MAP). The chapter summarizes the main points regarding civil liability of medical and nursing activity with a special focus on oncological patients.

Medical and Nursing Civil Liability and Ethics in the Provision of Health Services

After 2000, specific legislation on civil liability and ethics of nurses and doctors was introduced, as well as specific acts. For nurses and the nursing profession, since 2001, the Code of Nursing Ethics (NCSD, Presidential Decree 216/2001) has been in force. In 2005, the current Code of Medical Ethics (KID, Law 3418/2005) was passed. Special Law 3305/2005 on the application of assisted reproduction methods was introduced to specify how the methods introduced in the Civil Code were applied as methods of generating kinship among persons under Law 2089/2002 (MAP). The chapter summarizes the main points regarding civil liability of medical and nursing activity with a special focus on oncological patients.

Awareness and Perspective of Nursing Tutee on Proof Relied Enactment at Selected Nursing Colleges of Central Gujarat, India

Introduction: Nursing tutee are traditionally following the set benchmarks of nursing care. Several researchers have observed a wide gap between present awareness and perspective of nursing tutee in relation to recent health care developmental proofs and their day-to-day nursing activity. In the present study researcher has made an attempt to assess the Proof Relied Enactment (PRE) skills to find out their status. Aim: To assess the possessed awareness and perspective of final year Bachelor of Science (BSc) Nursing tutee regarding PRE. Materials and Methods: This descriptive survey was conducted among the IVth year BSc Nursing students in selected Nursing colleges of central Gujarat from January 2020 to December 2020. Purposive sampling technique was used and a sample of 120 students was included in the study. Descriptive and inferential statistics including mean, Chisquare and Karl Pearson coefficient of correlation was used to analyse the results. Results: The study showed that learning of fundamentals of PRE has significant correlation with utilisation status of PRE whereas rest of variables displayed negative correlation. The mean awareness score was 20.1 and SD was 2.91, whereas mean score for use of evidence resources was 28.24 and SD was 2.95, mean score for utilisation status for PRE was 6.15 whereas SD was 1.47, mean perspective score was 107.94 and SD was 10.93. None of the demographic showed statistically significant association with perspectives of tutee on PRE. There was positive correlation between awareness and perspective of nursing tutee on PRE. Conclusion: Nursing tutee who learned PRE in their curriculum consciously improved their PRE skills and were more productive during study.

Association of nursing activity participation and clinical practice stress with career maturity during clinical practice of nursing college students

Purpose: The purpose of this study was to figure out the association of nursing activity participation and clinical practice stress with career maturity during clinical practice among nursing college students.Methods: Participants of the study were 201 nursing college students located in nationwide regions. Data collection was performed between July 18 and August 8, 2019. Data analyses were performed through an independent t-test, ANOVA, Pearson’s correlation coefficient, and multiple linear regression analysis using SPSS WIN 25.0.Results: The results of this study were as follows. We ran multiple regression analyses to see which critical factors influenced career maturity. The general characteristics significantly associated with career maturity were preference for clinical nursing, admission to nursing college due to belief, time off, and being satisfied with clinical practice. Regarding clinical practice stress, clinic environment, interpersonal relationship conflict, inappropriate role model and conflict with patients were significantly associated with career maturity.Conclusion: This study suggested that, to improve nursing students’ career maturity, nursing colleges and training fields should collaboratively make an efforts to reduce students’ stress by building educational clinic environments including managing conflicts in interpersonal relationships among patients, caregivers, and medical and non-medical personnel, and improving inappropriate role models in nursing.

Analisis Kepuasan Kerja Perawat Terhadap Manajemen Keperawatan Di RSUD Waluyo Jati Kraksaan

Hospital is one form of health service that provides services in full in accordance with theneeds of the community. The most dominant health personnel providing services are nursing staff, so that nurses in particular are one of the determinants of achieving quality hospital services. Nurses in carrying out their duties can be influenced by many things, especially the acceptance of nurses in carrying out their work, in this case the performance of nurses is one of the determinants of job satisfaction felt by nurses. Nurse job satisfaction will affect the management process carried out in the hospital, especially in each inpatient room. The purpose of this study was to analyze nurse satisfaction with nursing management at RSUD Waluyo Jati Kraksaan.In this study using a correlational analytic research design. The population is inpatientnurses at RSUD Waluyo Jati Kraksaan. The sampling technique used is stratified randomsampling. Data analysis using Kendall's Tau test to determine the relationship of variableswith a significance level of p ? 0.05.The results of the study showed that nurses' job satisfaction was mostly satisfied, as many as 73 respondents (81.5%) while overall nursing management was in a good category. Theresults of the test data analysis obtained P = 0,000 with ? = 0.05 so that the conclusion there is a relationship between nurse job satisfaction and nursing management.Management of nursing management, especially in the inpatient room, is influenced by nurse job satisfaction. All forms of management management methods carried out are strongly influenced by the work ability of each nurse so that all forms of nursing activity programs will provide good results for nursing services

Evaluation of a project on Nursing education of refugees and other persons in need of support

The European Social Fund, in cooperation with Baden-Württemberg, Germany, supports projects to attract people to care. Results of the project New paths in training occupations of the nursing assistant in Ulm (PfAU) (01.02.2017 to 31.03.2019) are presented. PfAU is divided into a) recruit interested persons, b) two-month preparatory course, c) one-year training in care for elderly or nursing with special support from school and care facilities. Focus is on individual participation in employment, non-discrimination and equality. The evaluation was formative and summative. A milestone discussion and semi-structured interviews with participants, project team and leader in care facilities were used. Data of participants were provided for evaluation. There were two rounds involving 40 people (f = 17, m = 23); shown following categories: I_Refugees (mainly men under 30, for religious reasons resistances against care for elderly); II_Economic migrants (mainly women under 30, preparing for migration in their home country); III_Non-European migrants (mainly women from different countries of origin, Au-pair employment or partnership in Germany); IV_Persons with learning disabilities and/ or individual difficulties from Germany (women and men mostly under 33 years). Reasons for leaving PfAU are motivational or language gaps, cognitive limitations, religious reasons, error expectations, health problems, child care, single parenting. Reasons for staying are financial support for the family, image, meaningful task, social network through chain migration. PfAU works, but long-term perspective and financial resources are necessary. Future funding should be based on the identified categories, with special attention to their individual support needs. Important are motivation and the idea of nursing activity. Preparation course should be extended. There should be an individual selection for the training. Existing teams in the care facilities must be supported in the integration. Key messages PfAU is just a pilot project. In future, permanent implementation is necessary to close the gap due to demographic change and skill shortages. Existing teams in the care facilities must be supported in the integration.

An Evaluation of the Impact of Barcode Patient and Medication Scanning on Nursing Workflow at a UK Teaching Hospital

Barcode medication administration (BCMA) is advocated as a technology that reduces medication errors relating to incorrect patient identity, drug or dose. Little is known, however, about the impact it has on nursing workflow. Our aim was to investigate the impact of BCMA on nursing activity and workflow. A comparative study was conducted on two similar surgical wards within an acute UK hospital. We observed nurses during drug rounds on a non-BCMA ward and a BCMA ward. Data were collected on drug round duration, timeliness of medication administration, patient identification, medication verification and general workflow patterns. BCMA appears not to alter drug round duration, although it may reduce the administration time per dose. Workflow was more streamlined, with less use of the medicines room. The rate of patient identification increased from 74% (of 47) patients to 100% (of 43), with 95% of 255 scannable medication doses verified using the system. This study suggests that BCMA does not affect drug round duration; further research is required to determine the impact it has on timeliness of medication administration. There was reduced variability in the medication administration workflow of nurses, along with an increased patient identification rate and high medication scan rate, representing potential benefits to patient safety.

Workflow for Intensive Care Unit Nurses: A Time and Motion Study

This time and motion study aimed to explore the nursing workflow of intensive care unit (ICU) registered nurses in mainland China. We identified 107 kinds of nursing activity (six categories and 20 subcategories), observed 30 nurses for a total period of 580.8 hr, and analyzed 5,588 nursing activities. The nurses spent most of their time in direct nursing care (51.27% of the total working time), nursing documentation (17.91%), and communication (17.61%). Direct nursing care was the most time-consuming activity between 5:00 and 7:00 a.m. and the least time-consuming between 12:00 and 1:00 p.m. and 1:00 and 2:00 a.m. Although nursing records were kept by an information system, documentation still required a large percentage of the nurses’ working time. It was found that the time-consumption for each nursing activity varied during the day among the studied Chinese ICUs. Hence, nursing managers should arrange shift dynamics based on nurses’ actual workflow and load.