1,721,054 research outputs found
Relazione tra mentore e neofita : indagine fenomenologica sulla socializzazione del novizio infermiere in area critica
No full textGOAL: this article is aimed at examining the relationship and experience between expert and novice nurses in intensive care unit; it also assesses the implementation of mentorship functions by expert nurses. DESIGN: phenomenological. SETTING: three university hospitals, in Milan. SAMPLE: 11 expert nurses, 11 novice nurses. Outcome measurement: the expert and novice nurses of our sample have been interviewed in a semi-structured context; the interviews have been audio taped and transcribed. The results of transcription have been analyzed through the Van Kaam method, to find major topics, and compared the topics found with the literature reviewed. Furthermore Darling's questionnaire was tested, as a pilot study, to assess the implementation of mentorship functions by expert nurses. RESULTS: during the first three months in ICU, novice nurses experienced a reality shock. They said that the environment was very different from the other wards, patients were complex and unstable and there were too many things to learn. Frequently they felt frustration and inadequacy. For novice nurses positive mentoring experience, group support, congruent assignment and evaluation were related to high self-confidence, low anxiety, high job satisfaction, and low intention to leave the unit. Despite there were not formal mentoring program in the structure analyzed, novice nurses gave high evaluation to expert nurses in Darling's questionnaire. CONCLUSION: the socialization process of a neophyte in ICU is complex. Therefore, it is necessary to plan it very well. Great importance have in this period mentor relationship, group support, congruent assignment and evaluation. This things could lower voluntary turnover and shortage, two big problems for the nowadays nursing profession. It could be interesting to implement a formal mentoring program in Italy too, to assess the practicability of it
Embolia polmonare in un paziente sottoposto a By pass aorto coronarico in trattamento con eparina non frazionata: un caso di trombosi associata a trombocitopenia eparino-indotta.
No full textL'articolo riporta il caso di un paziente con embolia polmonare da HIT e riassume il quadro clinico e diagnostico della trombocitopenia eparino-indott
La figura del mentore e l'infermiere : indagine conoscitiva sulla relazione novizio/esperto in tre Aziende Ospedaliere universitarie di Milano
No full textIl processo di inserimento e socializzazione dell'infermiere novizio in area critica : una revisione della letteratura
No full textIl presente lavoro nasce dall’osservazione empirica delle problematiche più frequentemente incontrate durante l’inserimento in area critica di infermieri neolaureati e/o senza precedenti esperienze nello specifico settore (“infermieri novizi”). Il percorso di socializzazione all’interno dell’area critica è infatti un fenomeno complesso e che può presentare numerosi ostacoli. È stata condotta una revisione della letteratura manageriale e infermieristica, dal 1996 a oggi, sul processo di socializzazione in area critica del novizio infermiere, per individuare strategie atte a facilitare tale percorso e a renderlo meno problematico. La ricerca bibliografica è stata condotta nelle principali banche dati di interesse infermieristico (Medline/Pubmed, Cinahl, Medscape), utilizzando specifiche parole-chiave (nurse, socialization tactics, newcomers, novice, ICU, turnover).
Gli studi infermieristici reperiti che affrontano specificamente il processo di socializzazione in area critica sono prevalentemente di tipo qualitativo. Sono stati evidenziati i diversi punti di contatto tra i vari studi e, in particolare, le diverse ricerche concordano nel sostenere che la socializzazione del novizio in area critica può essere favorita dalla strutturazione di un percorso codificato, con obiettivi e criteri di valutazione chiari e che preveda il supporto del gruppo e di figure di riferimento dedicate
Traduzione e validazione in italiano della Behavioral Pain Scale (BPS) per la valutazione del dolore in pazienti incoscienti e sedati
No full textIntroduzione: la valutazione del dolore in terapia intensiva non è sempre possibile, principalmente perchè i pazienti sono spesso in uno stato d’incoscienza o coma. La letteratura indica la scala Behavioral Pain Scale (BPS) come strumento adatto a valutare il dolore nei pazienti critici sedati. Il punteggio si basa su osservazioni che riguardano le espressioni facciali, i movimenti degli arti e l’adattamento alla ventilazione. Lo strumento non è ancora stato validato in italiano. L’articolo presenta la preparazione e validazione della versione italiana della BPS (BPS-ITA).
Materiali e metodi: la scala è stata sottoposta a back-translation e inviata all’autore originale per un parere. Quattro infermieri esperti hanno valutato la validità di contenuto e facciata. L’autore dello studio e gli infermieri di una terapia intensiva hanno applicato la scala ad 11 pazienti, raccogliendo i dati all’ammissione, prima di una procedura dolorosa e di una non dolorosa, e dopo le procedure stesse.
Risultati: sono state effettuate 194 osservazioni. La BPS-ITA ha mostrato buona stabilità (rho=0.789, p<0.001), ottima affidabilità intervalutatore (k=0.945) e buona omogeneità (alpha=0.8), consentendo una netta distinzione tra pazienti sedati e non sedati.
Discussione: la BPS italiana consente un’affidabile valutazione del dolore nei pazienti sedati. Il numero di osservazioni ha parzialmente compensato la modesta ampiezza campionaria.
Conclusioni: la BPS italiana è valida e affidabile nel misurare il dolore nei pazienti sedati non tetraplegici. Semplifica l’accertamento e può migliorare la gestione complessiva del dolore e la qualità dell’assistenza.Background: the assessment of pain in an Intensive Care Unit (ICU) is not always possible, mainly because patients are often in a state of unconsciousness or coma. The literature indicates the Behavioral Pain Scale (BPS) as a good tool for assessing pain in sedated, critically ill patients. The score is based upon observations regarding facial expressions, limb movements, and compliance to ventilation. The scale has not yet been translated into Italian. Aim: to test the validity and reliability of the Italian version of the Behavioral Pain Scale (BPS). Methods: we back-translated the scale, and submitted it to the original author. Four experienced nurses assessed its content and face validity. The author of this study and the nurses of an ICU applied the scale to eleven patients, performing assessments at the admission and before and after a painful and a painless procedure, for each patient.
Results: 194 observations were collected in the ICU. The Italian scale showed good stability (Spearmanís rho=0.789, p<0.001), excellent interrater reliability (Cohenís Kappa=0.945) and good homogeneity (Cronbachís alpha=0.8), and allowed clear separation between sedated and non-sedated patients. Discussion: the Italian version of the BPS will allow reliable assessment of pain In sedated patients. The number of observation partially remedied the limit of the small sample size. Conclusion: The Italian version of the scale is valid and reliable for measuring pain in sedated, non-quadriplegic critically ill patients. The BPS simplifies pain assessment in this patients and can improve overall pain management and quality of care
Accoglimento ed inserimento dell'infermiere novizio : un'indagine nelle "aree critiche" di 10 aziende ospedaliere milanesi
No full textGOAL: this article examined the socialization tactics implemented by the organizational system in intensive care units of ten Hospitals of Milan, in order to help novice nurses to better start their new job. DESIGN: descriptive.Setting: Intensive Care Unit (ICU) in ten hospitals in Milan. OUTCOME MEASUREMENTS: the organizational systems of our sample were interviewed through e-mailed questionnaires. They were asked about which kinds of socialization tactics they plan and implement to help novice nurses to socialize with the new context during the first period in ICUs. RESULT: in most of the ten Hospitals there is a planned process to help novice nurses to socialize with the new context, with congruent assignment and evaluation (the percentage varied from 66% in emergency rooms to 100% in Neurosurgery Intensive Care Units). In every hospital, a novice nurse is assigned to expert nurses who help him/her during the first months. The period in which a novice nurse is in excess in the staff and where He/She depend closely to mentor's supervision varies from one to tree months. The total planned socialization period varied from three to six months but It is never shorter then tree months. The nurses' turn-over is a criticality since it often causes a decrease in the abovementioned periods. The criteria used to chose experts nurses often include clinical experience and good evaluation of their job. In the examined contexts, expert nurses lacked specific qualifications in educational skills or specific training adult education. CONCLUSIONS: a neophyte's socialization process in ICUs is complex. Therefore, it is necessary to plan it carefully. The relationship with the mentor, the group support, a congruent assignment and evaluation are matters of great importance during this period. In the examined contexts, almost all these factors were considered and implemented, but shortage and voluntary turn-over of nursing staff often compromised the full implementation of these socialization tactics. Another feature usually not implemented in the hospital managements interviewed was a specific education of expert nurses, especially in the adult-education field
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Left atrial size after cardioversion for atrial fibrillation: effect of external DC shock
No full textOBJECTIVE: The aim of this study was to evaluate the effect of external direct current (DC) shock on left atrial (LA) dimension and volumes after cardioversion for atrial fibrillation, and the relation between LA size and atrial function. METHODS: We evaluated 180 patients who were randomly cardioverted with DC shock (90 patients) or drugs (90 patients). Echocardiographic evaluations included LA size and volumes. LA passive and active emptying volumes were calculated, and LA function was measured as atrial ejection force. Changes in LA diameters and volumes were correlate with atrial systolic function. RESULTS: The LA was dilated in all patients during arrhythmia and decreased after the restoration of sinus rhythm. The entity of reduction was different in the 2 groups of patients. LA maximal and minimal volumes were increased after DC shock as compared with patients treated with drugs (LA maximal volume 34 +/- 4 vs 31 +/- 5; P <.01; LA minimal volume 18 +/- 2.6 vs 15 +/- 3.6; P <.01). The atrial function was also depressed after DC shock and the delay in the recovery of atrial contractility was related to LA dilation. Patients treated with drugs had a higher atrial ejection force that was associated with a more marked reduction in LA maximal volume after the restoration of in sinus rhythm. A relationship between LA volumes and atrial ejection force was observed in the group of patients with depressed atrial mechanic function (r = -0.78; P <.001). The active emptying fraction was lower, although not significantly, in this group, whereas the conduit volume was increased. CONCLUSION: External DC shock induced a depressed atrial mechanic function in many patients and this was associated with a persistence of LA dilation
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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