This was an observational multicenter study of 50 registered nurses, randomly selected, on 5 surg... more This was an observational multicenter study of 50 registered nurses, randomly selected, on 5 surgical wards in 5 Italian hospitals. There were on average 5.6 interruptions per hour. Interruptions occurred more frequently during the afternoon shift (n = 1061; 52.8%), were caused mainly by the staff members (n = 978; 48.7%) during medication administration (n = 1075; 53.5%), and were managed directly by the nurses (n = 1639; 81.6%). The average duration of an interruption was 32.7 seconds (95% confidence interval, 30.7-34.7).
The effects of advanced nursing education have been documented at the international level but the... more The effects of advanced nursing education have been documented at the international level but there is little information available in the Italian context. In Italy, the university nursing degree was introduced almost ten years ago and is facing its first reform. The aim of this study was to describe the effects of the Bachelor of Science in Nursing and Midwifery on skills as perceived by graduates of the school, and on professional and career development. A cross-sectional study design was used. All students who attended the nursing/midwifery program of the University of Udine and Trieste from 2005/2006 to 2008/2009 (n= 114) were considered eligible to participate. Participating students completed a self-assessment portfolio a few months after registering in the program and again upon completion of the program. Effects on professional and career development were assessed through a questionnaire. All participants reported having received one or more positive effects on their professional development. Only 19% of participants obtained a career advancement within 12 months of completing the program.
This was an observational multicenter study of 50 registered nurses, randomly selected, on 5 surg... more This was an observational multicenter study of 50 registered nurses, randomly selected, on 5 surgical wards in 5 Italian hospitals. There were on average 5.6 interruptions per hour. Interruptions occurred more frequently during the afternoon shift (n = 1061; 52.8%), were caused mainly by the staff members (n = 978; 48.7%) during medication administration (n = 1075; 53.5%), and were managed directly by the nurses (n = 1639; 81.6%). The average duration of an interruption was 32.7 seconds (95% confidence interval, 30.7-34.7).
The study sought to validate the Italian version of the Health Professional Education in Patient ... more 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 Cronbach's 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.
International Archives of Occupational and Environmental Health
OBJECTIVES: The aims of the study were to (a) validate N2N Healthy Work Environment tool, (b) ass... more OBJECTIVES: The aims of the study were to (a) validate N2N Healthy Work Environment tool, (b) assess the healthiness of work environments as perceived by nurses themselves and (c) identify the factors associated with Italian nurses' perception of work environment healthiness. METHODS: The linguistic and cultural adaptation of USA-N2N Healthy Work Environments was achieved through a process of forward/backward translation. Content validity was assessed by three expert nurses. The stability of the instrument was checked with a test/retest evaluation. The instrument psychometric properties, the confirmatory factor analysis as well the healthiness of the work environment and its determinant factors were evaluated with a sample of 294 nurses. RESULTS: The content and face validity of the N2N Healthy Work Environment instrument was confirmed. The instrument demonstrated good internal consistency (α of 0.82), excellent stability values (ρ > 0.70) and high levels of acceptability (re...
The recent introduction of red tabards aimed at avoiding interruptions during medication rounds h... more The recent introduction of red tabards aimed at avoiding interruptions during medication rounds has generated scientific and media debate, which is still ongoing. The principal aim of this study was to evaluate patients' perceptions of 3 different red tabards; the secondary aim was to explore individual factors associated with the negative perceptions that emerged. Eligible patients had to be admitted to the selected general surgical department and give written informed consent. A total of 104 patients were interviewed. Three real-sized red tabards, made with laminated paper and displaying different messages, were shown over 3 days to each patient involved. Despite displaying different messages, from asking everyone not to disturb to allowing only patients to interrupt, patients perceived the tabards as directed at themselves. A different risk of preventing patients from communicating urgent needs emerged. The first tabard I am administering medication-Please do not interrupt me was most at risk to inhibit the patient. A negative impact was reported by 44 patients (42.3%) for the first tabard, 50 (48.0%) for the second tabard, and 40 (38.4%) for the third. In the logistic regression, only 2 independent factors were significantly associated with the negative perception of the message reported on the tabards: a positive attitude to interrupting nurses and receiving medication during their time in hospital. However, the variance explained by these factors ranges from 9.4% to 18.3%. On the basis of the findings that emerged, the adoption of the tabards should be evaluated considering the benefits already documented, and the potential negative effects that emerged on patients, which may be influenced by cultural and linguistic aspects. Wearing the tabard with the message reported on the back, directed to the staff and not the patients, may have less negative effects on patients; in addition, using a different color not to alarm the patients may be useful. In addition, comparing the red tabard effects with other strategies introduced to deal with avoidable interruptions (e.g., "no interruption zone") to gain a comprehensive picture regarding benefits/harm is also important.
Ensuring safety in health-care settings is provoking improvements both in education and clinical ... more Ensuring safety in health-care settings is provoking improvements both in education and clinical practice. However, the studies available have not offered to date information regarding knowledge and competence on patient safety (PS) developed by nursing students over their academic career. There is no documentation of the amount of close calls and/or adverse events that students may have witnessed and the degree of safety perceived in the attended clinical settings. To describe the perception of nursing students regarding their own knowledge and competence on PS and describe differences, if any, among students attending the first, second and third academic year. A cross-sectional study design was undertaken in 2013. A convenience sample of 621 nursing students of two bachelors nursing degrees located in two Italian universities, was the population target of the study. Students attending the first, second and third academic year, obtaining admission to the annual clinical competence examination, were eligible. The Italian version of the Health Professional Education in Patient Safety Survey (H-PEPSSIta) and open-ended questions was administered to the students after having obtained their informed written consent. A total of 573 students (response rate 92.4%) participated. Around a quarter (28.8%) of students reported having experienced an adverse event or close call during their clinical experience. The settings where they learn were perceived as unsafe by 46.9% of students. PS knowledge and competence as perceived by students, was high (Median=4) in all factors and dimensions of the H-PEPSSIta tool. High PS knowledge and competence was reported by first-year students, moderate by second-year students and higher at the end of the third-year. Faculties and health-care institutions offering clinical placements have to share the responsibility of well-prepared future nurses, working together to improve PS through dialogue when issues are identified by students.
Randomized controlled trials (RCTs) may be categorized as either effectiveness trials or efficacy... more Randomized controlled trials (RCTs) may be categorized as either effectiveness trials or efficacy trials, which may be categorized by the Pragmatic-Explanatory Continuum Indicator Summary (PRECIS) tool. However, no data regarding the application of the PRECIS tool in a cluster of RCTs belonging to a specific discipline such as nursing are available. The principal aim of this study was to assess the prevailing nature (pragmatic vs. explanatory) of a cluster of clinical nursing RCTs. Evaluating the suitability of the PRECIS in the analysis of nursing RCTs was the secondary aim. All nursing RCTs published in 2010 were identified through a systematic review and extracted in full-text form. An explanatory-pragmatic (E-P) group consisting of 11 researchers trained in the use of the PRECIS tool evaluated each RCT in terms of 10 domains, respectively scored on a scale ranging from 5 (pragmatic) to 1 (explanatory). The E-P group further scored the feasibility of the PRECIS tool using a numer...
Roles and competences of nurses with postgraduate master degree in nursing science in everyday pr... more Roles and competences of nurses with postgraduate master degree in nursing science in everyday practice. Multicentre descriptive survey. Few information are available on the role and activities of Italian nurses with Laurea Magistrale (postgraduate master degree in nursing science). To describe the implementation of the advanced competences acquired after Laurea Magistrale by nurses, as well as changes in their professional career. A multicenter descriptive study on 7 consecutive cohorts (from 2004/2005 to 2011/2012) of nurses of 3 universities of northern Italy was conducted. Data on managerial, teaching, research and clinical competences and changes in the professional role were collected with semi-structured questionnaires. 232/285 graduates completed the questionnaire; 216 (88.8%) used their managerial competences, 178 (76.7%) educational competences, 122 (52.6%) clinical competences and 115 (49.5%) research competences. Eigthy graduates (34.4%) changed their professional roles,...
Knowledge translation is attracting different professional, educational and institutional strateg... more Knowledge translation is attracting different professional, educational and institutional strategies mainly focused on how new knowledge should be tailored and transferred at bedside. Less attention is dedicated to the antecedent of knowledge translation, which is the availability of the knowledge itself. Knowledge diffusion is a process by which an innovation is communicated through certain channels among members of a social system over time. Publishing in peer review journals is recognised as the main method for knowledge diffusion: nevertheless publication efficiency has received little attention to date. Describing publication efficiency via nursing journals as the time occurring between data collection and manuscript publication was the main aim of the study. The secondary aim was to discover the differences, if any, in publication efficiency within manuscripts reporting results from different study designs. A retrospective study design was adopted in 2010. The 2009 Impact Fact...
The effects of advanced nursing education have been documented at the international level but the... more The effects of advanced nursing education have been documented at the international level but there is little information available in the Italian context. In Italy, the university nursing degree was introduced almost ten years ago and is facing its first reform. The aim of this study was to describe the effects of the Bachelor of Science in Nursing and Midwifery on skills as perceived by graduates of the school, and on professional and career development. A cross-sectional study design was used. All students who attended the nursing/midwifery program of the University of Udine and Trieste from 2005/2006 to 2008/2009 (n= 114) were considered eligible to participate. Participating students completed a self-assessment portfolio a few months after registering in the program and again upon completion of the program. Effects on professional and career development were assessed through a questionnaire. All participants reported having received one or more positive effects on their profess...
Academic failure is the inability of a nursing student to graduate or to complete the nursing deg... more Academic failure is the inability of a nursing student to graduate or to complete the nursing degree on time. This longitudinal cohort study, involving 2 Italian universities, documents the effects of selected individual variables and the quality of the clinical learning experience as perceived by students on academic success. Factors related to the clinical learning experience were the quality of the supervisory relationship, pedagogical atmosphere, and commitment of the ward related to the level of personalized nursing care delivered and clarity of nursing documentation.
Clinical learning environments are defined as an interactive network of forces within the clinica... more Clinical learning environments are defined as an interactive network of forces within the clinical context that influence students' learning outcomes. Nursing students' satisfaction could be strictly related to their learning outcomes. Aim. To analyze the first year nursing students' clinical learning experience and to identify the main determinants of students' satisfaction. The observational study was carried out in five Italian nursing degree courses. 420 students filled out the validated Italian version of the "Clinical Learning Environment and Supervision plus Nurse Teacher (CLES+T) scale" after the conclusion of their first clinical placement. The mean values of the main sub-dimensions of CLES+T varied from 4.02 (pedagogical atmosphere) to 3.30 (supervisory relationship). Students were mainly satisfied with their clinical placement, however the findings showed statistical significantly differences among the five nursing courses. The main determinants ...
In the last few years the significance of life-long learning skills has been greatly realised wit... more In the last few years the significance of life-long learning skills has been greatly realised with regard to adult learning, which is based on self-motivation, engagement in learning and making full use of a person's resources. In this context, it is paramount that healthcare professionals take responsibility for their profession by being innovative, creative and flexible to change in order to facilitate the adaptation process and encourage responsiveness to change. The main principles can be summarized as lifelong learning, which are strictly linked to self-directed learning. The aims of this study were to describe (a) the self-directed learning competence of Nurses (Registered Nurse, RN) and Radiologist Technicians (RT); (b) the self-directed learning competence of RN and RT students before their graduation. A comparative cross-sectional study approach was adopted; a consecutive sample of RNs and RTs attending continuing education seminars, workshops and other initiatives from 2009 to 2010 were considered for this study. Moreover, all Nursing and Radiology Technicians students about to graduate in the same course and studying in the same region were included. The Self-Rating Scale of Self-Directed Learning (SRSSDL) was used to collect data for the purpose of the study. Eight hundred and forty-seven participants were involved (453 RNs, 141 RTs, 182 RN students and 68 RT students) who obtained an average SRSSDL score of 224.7 (AE25.0). RNs and RTs got on average a medium-high score (229.1 AE 22.9 and 219.6 AE 29.2, respectively) and the majority of them (63.8e51.1%) reached a high level of self-directed learning. In order to promote tailored continuing education programs and interprofessional continuing education strategies, and identify the support to offer to healthcare workers according to their needs, educators should be aware of their self-directed learning skills. Therefore, individuals with high competence should adopt different strategies from those who have limited skills. Reflecting on self-directed learning competence of students before their graduation incorporates self-directed learning into the professional continuum and clarifies the University's contribution in developing this important skill.
Current literature has paid increasing attention to the factors influencing career decisions; nev... more Current literature has paid increasing attention to the factors influencing career decisions; nevertheless, few studies have compared candidates that have chosen a nursing versus a non-nursing degree. A multicenter, cross-sectional study design was performed to explore whether or not certain individual variables and having inaccurate data about nursing as a profession influenced the choice of a non-nursing degree. Six non-nursing and three nursing degree programs offered by two public Italian universities were involved. A total of 507 students who had just enrolled in non-nursing degree programs and 202 in nursing degree programs were invited to complete a questionnaire comprising 12 closed items. Overall, from 40.0% to 57.1% of the variation in choosing a degree other than nursing was explained by variables such as age, and having inaccurate data on the nursing profession. For each year over 19 years of age, the likelihood that the student would decide to enroll in a nursing degree program increases. For each wrong answer reported on the questionnaire evaluating knowledge on nursing profession, there was a reduction of approximately six times in the likelihood that the student would enroll in a nursing degree program. Information regarding the nursing profession should be offered in early stages of life; in addition, offering accurate data on the profession is a key factor in evaluating the congruence of the career with the individual's personal motivations, aspirations, and talents.
s u m m a r y Background: Nursing student academic failure is a phenomenon of growing internation... more s u m m a r y Background: Nursing student academic failure is a phenomenon of growing international interest, not only because of its economic impact but also because it negatively affects the availability of future nurses in different healthcare systems. To recruit the students with the highest probability of academic success, an open challenge for universities is to recruit students who have previously demonstrated superior scholastic aptitudes that appear to be associated with a greater likelihood of academic success. Documenting the relationship between the selection methods used when selecting nursing students and academic failure will contribute to the international debate concerning the optimisation of the selection strategies. Objectives: The principal aim of this study was to investigate the role in predicting nursing student academic success of (1) the upper-secondary diploma grades and (2) the score obtained by students in the nursing degree program admission test. Design: A retrospective observational study was conducted. Participants and Methods: Five cohorts of nursing students, matriculated in consecutive academic years from 2004 to 2008, in an Italian bachelor's degree program were observed retrospectively. Results: Overall, 61.2% of the 1006 considered students concluded their degree within the legal duration allowed for the nursing degree. Students who failed were those who had lowest grades associated with their upper-secondary diploma coursework (p = 0.000) and were male (p = 0.000). The grades associated with the upper-secondary diploma coursework, unlike the admission test score, correlates positively with the final degree grade and the average value of degree program examination scores. No correlation was found between the upper-secondary diploma coursework grades and the scores obtained in the test for the nursing degree program admission test (r = −0.037). Conclusions: These results suggest that upper-secondary diploma coursework grades are a parameter that should receive great consideration, especially in cases where there are planned numbers of incoming nursing degree students.
With the increasing standardization of nursing education in Europe under the Bologna Process Decl... more With the increasing standardization of nursing education in Europe under the Bologna Process Declaration (1999), there is a growing interest in defining a common concept of academic success and/or failure, measuring associated factors and comparing differences and similarities between different countries. While there is literature available on these issues from other countries, the phenomenon has not been studied in Italy. The aim of this study was to define the factors associated with academic success or failure in an Italian cohort of nursing students on a bachelor's degree course. A retrospective multicenter study design was adopted. All students enrolling in the academic year 2004-05 on two different bachelor's courses in the north of Italy were interviewed. Only 81 of the 117 students considered (69.2%) concluded their course in three years. Multivariate analysis identified two factors determining academic success/failure: good results in the entry examination for the bachelor's degree in nursing sciences were associated with academic success (OR 4.217, IC 95% 1.501-11.84), while family commitments, e.g. caring for children or elderly people were associated with academic failure (OR 0.120, IC 95% 0.03-0.471). Academic failure has a strong impact on students, their families, the teaching faculties and the community, and its prevention is a challenge in the countries with a shortage of nurses.
This was an observational multicenter study of 50 registered nurses, randomly selected, on 5 surg... more This was an observational multicenter study of 50 registered nurses, randomly selected, on 5 surgical wards in 5 Italian hospitals. There were on average 5.6 interruptions per hour. Interruptions occurred more frequently during the afternoon shift (n = 1061; 52.8%), were caused mainly by the staff members (n = 978; 48.7%) during medication administration (n = 1075; 53.5%), and were managed directly by the nurses (n = 1639; 81.6%). The average duration of an interruption was 32.7 seconds (95% confidence interval, 30.7-34.7).
The effects of advanced nursing education have been documented at the international level but the... more The effects of advanced nursing education have been documented at the international level but there is little information available in the Italian context. In Italy, the university nursing degree was introduced almost ten years ago and is facing its first reform. The aim of this study was to describe the effects of the Bachelor of Science in Nursing and Midwifery on skills as perceived by graduates of the school, and on professional and career development. A cross-sectional study design was used. All students who attended the nursing/midwifery program of the University of Udine and Trieste from 2005/2006 to 2008/2009 (n= 114) were considered eligible to participate. Participating students completed a self-assessment portfolio a few months after registering in the program and again upon completion of the program. Effects on professional and career development were assessed through a questionnaire. All participants reported having received one or more positive effects on their professional development. Only 19% of participants obtained a career advancement within 12 months of completing the program.
This was an observational multicenter study of 50 registered nurses, randomly selected, on 5 surg... more This was an observational multicenter study of 50 registered nurses, randomly selected, on 5 surgical wards in 5 Italian hospitals. There were on average 5.6 interruptions per hour. Interruptions occurred more frequently during the afternoon shift (n = 1061; 52.8%), were caused mainly by the staff members (n = 978; 48.7%) during medication administration (n = 1075; 53.5%), and were managed directly by the nurses (n = 1639; 81.6%). The average duration of an interruption was 32.7 seconds (95% confidence interval, 30.7-34.7).
The study sought to validate the Italian version of the Health Professional Education in Patient ... more 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 Cronbach's 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.
International Archives of Occupational and Environmental Health
OBJECTIVES: The aims of the study were to (a) validate N2N Healthy Work Environment tool, (b) ass... more OBJECTIVES: The aims of the study were to (a) validate N2N Healthy Work Environment tool, (b) assess the healthiness of work environments as perceived by nurses themselves and (c) identify the factors associated with Italian nurses' perception of work environment healthiness. METHODS: The linguistic and cultural adaptation of USA-N2N Healthy Work Environments was achieved through a process of forward/backward translation. Content validity was assessed by three expert nurses. The stability of the instrument was checked with a test/retest evaluation. The instrument psychometric properties, the confirmatory factor analysis as well the healthiness of the work environment and its determinant factors were evaluated with a sample of 294 nurses. RESULTS: The content and face validity of the N2N Healthy Work Environment instrument was confirmed. The instrument demonstrated good internal consistency (α of 0.82), excellent stability values (ρ > 0.70) and high levels of acceptability (re...
The recent introduction of red tabards aimed at avoiding interruptions during medication rounds h... more The recent introduction of red tabards aimed at avoiding interruptions during medication rounds has generated scientific and media debate, which is still ongoing. The principal aim of this study was to evaluate patients' perceptions of 3 different red tabards; the secondary aim was to explore individual factors associated with the negative perceptions that emerged. Eligible patients had to be admitted to the selected general surgical department and give written informed consent. A total of 104 patients were interviewed. Three real-sized red tabards, made with laminated paper and displaying different messages, were shown over 3 days to each patient involved. Despite displaying different messages, from asking everyone not to disturb to allowing only patients to interrupt, patients perceived the tabards as directed at themselves. A different risk of preventing patients from communicating urgent needs emerged. The first tabard I am administering medication-Please do not interrupt me was most at risk to inhibit the patient. A negative impact was reported by 44 patients (42.3%) for the first tabard, 50 (48.0%) for the second tabard, and 40 (38.4%) for the third. In the logistic regression, only 2 independent factors were significantly associated with the negative perception of the message reported on the tabards: a positive attitude to interrupting nurses and receiving medication during their time in hospital. However, the variance explained by these factors ranges from 9.4% to 18.3%. On the basis of the findings that emerged, the adoption of the tabards should be evaluated considering the benefits already documented, and the potential negative effects that emerged on patients, which may be influenced by cultural and linguistic aspects. Wearing the tabard with the message reported on the back, directed to the staff and not the patients, may have less negative effects on patients; in addition, using a different color not to alarm the patients may be useful. In addition, comparing the red tabard effects with other strategies introduced to deal with avoidable interruptions (e.g., "no interruption zone") to gain a comprehensive picture regarding benefits/harm is also important.
Ensuring safety in health-care settings is provoking improvements both in education and clinical ... more Ensuring safety in health-care settings is provoking improvements both in education and clinical practice. However, the studies available have not offered to date information regarding knowledge and competence on patient safety (PS) developed by nursing students over their academic career. There is no documentation of the amount of close calls and/or adverse events that students may have witnessed and the degree of safety perceived in the attended clinical settings. To describe the perception of nursing students regarding their own knowledge and competence on PS and describe differences, if any, among students attending the first, second and third academic year. A cross-sectional study design was undertaken in 2013. A convenience sample of 621 nursing students of two bachelors nursing degrees located in two Italian universities, was the population target of the study. Students attending the first, second and third academic year, obtaining admission to the annual clinical competence examination, were eligible. The Italian version of the Health Professional Education in Patient Safety Survey (H-PEPSSIta) and open-ended questions was administered to the students after having obtained their informed written consent. A total of 573 students (response rate 92.4%) participated. Around a quarter (28.8%) of students reported having experienced an adverse event or close call during their clinical experience. The settings where they learn were perceived as unsafe by 46.9% of students. PS knowledge and competence as perceived by students, was high (Median=4) in all factors and dimensions of the H-PEPSSIta tool. High PS knowledge and competence was reported by first-year students, moderate by second-year students and higher at the end of the third-year. Faculties and health-care institutions offering clinical placements have to share the responsibility of well-prepared future nurses, working together to improve PS through dialogue when issues are identified by students.
Randomized controlled trials (RCTs) may be categorized as either effectiveness trials or efficacy... more Randomized controlled trials (RCTs) may be categorized as either effectiveness trials or efficacy trials, which may be categorized by the Pragmatic-Explanatory Continuum Indicator Summary (PRECIS) tool. However, no data regarding the application of the PRECIS tool in a cluster of RCTs belonging to a specific discipline such as nursing are available. The principal aim of this study was to assess the prevailing nature (pragmatic vs. explanatory) of a cluster of clinical nursing RCTs. Evaluating the suitability of the PRECIS in the analysis of nursing RCTs was the secondary aim. All nursing RCTs published in 2010 were identified through a systematic review and extracted in full-text form. An explanatory-pragmatic (E-P) group consisting of 11 researchers trained in the use of the PRECIS tool evaluated each RCT in terms of 10 domains, respectively scored on a scale ranging from 5 (pragmatic) to 1 (explanatory). The E-P group further scored the feasibility of the PRECIS tool using a numer...
Roles and competences of nurses with postgraduate master degree in nursing science in everyday pr... more Roles and competences of nurses with postgraduate master degree in nursing science in everyday practice. Multicentre descriptive survey. Few information are available on the role and activities of Italian nurses with Laurea Magistrale (postgraduate master degree in nursing science). To describe the implementation of the advanced competences acquired after Laurea Magistrale by nurses, as well as changes in their professional career. A multicenter descriptive study on 7 consecutive cohorts (from 2004/2005 to 2011/2012) of nurses of 3 universities of northern Italy was conducted. Data on managerial, teaching, research and clinical competences and changes in the professional role were collected with semi-structured questionnaires. 232/285 graduates completed the questionnaire; 216 (88.8%) used their managerial competences, 178 (76.7%) educational competences, 122 (52.6%) clinical competences and 115 (49.5%) research competences. Eigthy graduates (34.4%) changed their professional roles,...
Knowledge translation is attracting different professional, educational and institutional strateg... more Knowledge translation is attracting different professional, educational and institutional strategies mainly focused on how new knowledge should be tailored and transferred at bedside. Less attention is dedicated to the antecedent of knowledge translation, which is the availability of the knowledge itself. Knowledge diffusion is a process by which an innovation is communicated through certain channels among members of a social system over time. Publishing in peer review journals is recognised as the main method for knowledge diffusion: nevertheless publication efficiency has received little attention to date. Describing publication efficiency via nursing journals as the time occurring between data collection and manuscript publication was the main aim of the study. The secondary aim was to discover the differences, if any, in publication efficiency within manuscripts reporting results from different study designs. A retrospective study design was adopted in 2010. The 2009 Impact Fact...
The effects of advanced nursing education have been documented at the international level but the... more The effects of advanced nursing education have been documented at the international level but there is little information available in the Italian context. In Italy, the university nursing degree was introduced almost ten years ago and is facing its first reform. The aim of this study was to describe the effects of the Bachelor of Science in Nursing and Midwifery on skills as perceived by graduates of the school, and on professional and career development. A cross-sectional study design was used. All students who attended the nursing/midwifery program of the University of Udine and Trieste from 2005/2006 to 2008/2009 (n= 114) were considered eligible to participate. Participating students completed a self-assessment portfolio a few months after registering in the program and again upon completion of the program. Effects on professional and career development were assessed through a questionnaire. All participants reported having received one or more positive effects on their profess...
Academic failure is the inability of a nursing student to graduate or to complete the nursing deg... more Academic failure is the inability of a nursing student to graduate or to complete the nursing degree on time. This longitudinal cohort study, involving 2 Italian universities, documents the effects of selected individual variables and the quality of the clinical learning experience as perceived by students on academic success. Factors related to the clinical learning experience were the quality of the supervisory relationship, pedagogical atmosphere, and commitment of the ward related to the level of personalized nursing care delivered and clarity of nursing documentation.
Clinical learning environments are defined as an interactive network of forces within the clinica... more Clinical learning environments are defined as an interactive network of forces within the clinical context that influence students' learning outcomes. Nursing students' satisfaction could be strictly related to their learning outcomes. Aim. To analyze the first year nursing students' clinical learning experience and to identify the main determinants of students' satisfaction. The observational study was carried out in five Italian nursing degree courses. 420 students filled out the validated Italian version of the "Clinical Learning Environment and Supervision plus Nurse Teacher (CLES+T) scale" after the conclusion of their first clinical placement. The mean values of the main sub-dimensions of CLES+T varied from 4.02 (pedagogical atmosphere) to 3.30 (supervisory relationship). Students were mainly satisfied with their clinical placement, however the findings showed statistical significantly differences among the five nursing courses. The main determinants ...
In the last few years the significance of life-long learning skills has been greatly realised wit... more In the last few years the significance of life-long learning skills has been greatly realised with regard to adult learning, which is based on self-motivation, engagement in learning and making full use of a person's resources. In this context, it is paramount that healthcare professionals take responsibility for their profession by being innovative, creative and flexible to change in order to facilitate the adaptation process and encourage responsiveness to change. The main principles can be summarized as lifelong learning, which are strictly linked to self-directed learning. The aims of this study were to describe (a) the self-directed learning competence of Nurses (Registered Nurse, RN) and Radiologist Technicians (RT); (b) the self-directed learning competence of RN and RT students before their graduation. A comparative cross-sectional study approach was adopted; a consecutive sample of RNs and RTs attending continuing education seminars, workshops and other initiatives from 2009 to 2010 were considered for this study. Moreover, all Nursing and Radiology Technicians students about to graduate in the same course and studying in the same region were included. The Self-Rating Scale of Self-Directed Learning (SRSSDL) was used to collect data for the purpose of the study. Eight hundred and forty-seven participants were involved (453 RNs, 141 RTs, 182 RN students and 68 RT students) who obtained an average SRSSDL score of 224.7 (AE25.0). RNs and RTs got on average a medium-high score (229.1 AE 22.9 and 219.6 AE 29.2, respectively) and the majority of them (63.8e51.1%) reached a high level of self-directed learning. In order to promote tailored continuing education programs and interprofessional continuing education strategies, and identify the support to offer to healthcare workers according to their needs, educators should be aware of their self-directed learning skills. Therefore, individuals with high competence should adopt different strategies from those who have limited skills. Reflecting on self-directed learning competence of students before their graduation incorporates self-directed learning into the professional continuum and clarifies the University's contribution in developing this important skill.
Current literature has paid increasing attention to the factors influencing career decisions; nev... more Current literature has paid increasing attention to the factors influencing career decisions; nevertheless, few studies have compared candidates that have chosen a nursing versus a non-nursing degree. A multicenter, cross-sectional study design was performed to explore whether or not certain individual variables and having inaccurate data about nursing as a profession influenced the choice of a non-nursing degree. Six non-nursing and three nursing degree programs offered by two public Italian universities were involved. A total of 507 students who had just enrolled in non-nursing degree programs and 202 in nursing degree programs were invited to complete a questionnaire comprising 12 closed items. Overall, from 40.0% to 57.1% of the variation in choosing a degree other than nursing was explained by variables such as age, and having inaccurate data on the nursing profession. For each year over 19 years of age, the likelihood that the student would decide to enroll in a nursing degree program increases. For each wrong answer reported on the questionnaire evaluating knowledge on nursing profession, there was a reduction of approximately six times in the likelihood that the student would enroll in a nursing degree program. Information regarding the nursing profession should be offered in early stages of life; in addition, offering accurate data on the profession is a key factor in evaluating the congruence of the career with the individual's personal motivations, aspirations, and talents.
s u m m a r y Background: Nursing student academic failure is a phenomenon of growing internation... more s u m m a r y Background: Nursing student academic failure is a phenomenon of growing international interest, not only because of its economic impact but also because it negatively affects the availability of future nurses in different healthcare systems. To recruit the students with the highest probability of academic success, an open challenge for universities is to recruit students who have previously demonstrated superior scholastic aptitudes that appear to be associated with a greater likelihood of academic success. Documenting the relationship between the selection methods used when selecting nursing students and academic failure will contribute to the international debate concerning the optimisation of the selection strategies. Objectives: The principal aim of this study was to investigate the role in predicting nursing student academic success of (1) the upper-secondary diploma grades and (2) the score obtained by students in the nursing degree program admission test. Design: A retrospective observational study was conducted. Participants and Methods: Five cohorts of nursing students, matriculated in consecutive academic years from 2004 to 2008, in an Italian bachelor's degree program were observed retrospectively. Results: Overall, 61.2% of the 1006 considered students concluded their degree within the legal duration allowed for the nursing degree. Students who failed were those who had lowest grades associated with their upper-secondary diploma coursework (p = 0.000) and were male (p = 0.000). The grades associated with the upper-secondary diploma coursework, unlike the admission test score, correlates positively with the final degree grade and the average value of degree program examination scores. No correlation was found between the upper-secondary diploma coursework grades and the scores obtained in the test for the nursing degree program admission test (r = −0.037). Conclusions: These results suggest that upper-secondary diploma coursework grades are a parameter that should receive great consideration, especially in cases where there are planned numbers of incoming nursing degree students.
With the increasing standardization of nursing education in Europe under the Bologna Process Decl... more With the increasing standardization of nursing education in Europe under the Bologna Process Declaration (1999), there is a growing interest in defining a common concept of academic success and/or failure, measuring associated factors and comparing differences and similarities between different countries. While there is literature available on these issues from other countries, the phenomenon has not been studied in Italy. The aim of this study was to define the factors associated with academic success or failure in an Italian cohort of nursing students on a bachelor's degree course. A retrospective multicenter study design was adopted. All students enrolling in the academic year 2004-05 on two different bachelor's courses in the north of Italy were interviewed. Only 81 of the 117 students considered (69.2%) concluded their course in three years. Multivariate analysis identified two factors determining academic success/failure: good results in the entry examination for the bachelor's degree in nursing sciences were associated with academic success (OR 4.217, IC 95% 1.501-11.84), while family commitments, e.g. caring for children or elderly people were associated with academic failure (OR 0.120, IC 95% 0.03-0.471). Academic failure has a strong impact on students, their families, the teaching faculties and the community, and its prevention is a challenge in the countries with a shortage of nurses.
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