Adult Nursing

Simulation: what is and what will be. Embark on a stimulating journey into this fascinating topic. Discover when simulation was born and how it has been changing the world surrounding us. Aerospatial industry, higher education, clinical training are some of the most representative settings in which simulation has been playing a vital role to guarantee safe, effective and sustainable procedures. How is simulation able to positively influence the learning process ? Does it have a place in any learning theory ? And if so, does it offer any support to the current educational learning needs towards a lifelong learning ? Are there any significant differences in the way information is retained due to the type of simulation performed ? Considering the learning outcomes, is this information not only more easily retained but also easly transferable, according to the type of simulation ? Explore all of these questions and take part in the debate.

Since its creation in 1978 the Italian health care system has been delivering a wide range of services and interventions and it is considered one of the most advanced health organizations among the industrialized countries.
In accordance with the Italian Constitution, it provides services free of charge to all without any discrimination.
The affirmation of the free choice principle, the progressive introduction of private hospitals and the significant increase in health spending have induced the legislator to introduce cost - effective measures to limit cost and satisfy patients' needs.
After having examined the profound changes that have been generally  influencing the Italian health care system discover how the San Carlo Hospital of Potenza in Italy is trying to rearrange its strategy to detect patients' needs, reduce cost and face challenges posed by emerging competitors.

Il TRIAGE è un procedimento decisionale volto a stabilire le priorità assistenziali secondo protocolli condivisi fra personale medico ed infermieristico addestrato, basato sull'attribuzione di un codice di gravità. Altra finalità è contribuire all'efficienza complessiva del P.S. e facilitare l'analisi della qualità delle prestazioni. Dal Gennaio 2000 presso il Nostro Pronto Soccorso, ove vengono visitati oltre 50.000 pazienti l'anno, è stato attivato un servizio di TRIAGE DA BANCONE attivo tutti i giorni dalle ore 8 alle ore 21 (nelle ore notturne solo a domanda). Scopo del presente lavoro è la valutazione dell'attività di triage con la relativa verifica della qualità delle prestazioni ed il suo impatto sull'efficienza della intera Unità Operativa. PERCENTUALI DEI CODICI COLORE NEL 2001 E 2002 TEMPI DI ATTESA SUDDIVISI PER CODICE COLORE SOVRASTIMA SULL'APPROPRIATEZZA DEL CODICE COLORE Non c'è stata sottostima per i codici rossi, mentre per i codici gialli la sottostima si è attestata al di sotto del 3%.Una ulteriore valutazione della prestazione di TRIAGE è stata eseguita con l'analisi della corretta individuazione del sintomo/problema principale verificata con la congruità con la successiva diagnosi medica; la verifica ha dimostrato nel 2002 una congruità pari al 95%, con un range di variabilità dal 92 al 97%.
In conclusione possiamo affermare che, nel corso del tempo, la prestazione del triager e’ migliorata in relazione all’appropriatezza nell’assegnazione dei codici e nel riconoscimento del sintomo principale; l’attivita’ di triage ha anche decisamente contribuito ad una migliore efficienza della unita’ operativa.
Resta ancora da risolvere la problematica della sovrastima di alcuni codici e dei tempi di attesa oltre lo standard di riferimento.

BACKGROUND: Simulation is a teaching method largely used to facilitate learning of BlsD (Basic Life Support) techniques. This study investigates real life experiences of undergraduate nursing students related to sudden cardiac death including events occurring during their practicum. The study explores students’ perception of the value simulation as a teaching method to respond to sudden
cardiac death. Furthermore it explores the potential of two methods of teaching BlsD techniques in order to facilitate retention of knowledge and limit resource consumption.
METHODS: A sample (N=33) of nursing students was randomly selected for this prospective observational study.
RESULTS: 99 questionnaires were collected, 55 related Low-Fidelity and 54 related to Moderate-Fidelity simulation teaching. Early evaluation demonstrated an increase of knowledge in each group. Post-test 2 showed that there are no significant differences between the two groups in terms of knowledge retention.
CONCLUSIONS: Despite the limit of small sample size, the study showed that the two teaching methods are equally effective in acquisition and retention of information on BlsD techniques. However, the low-fidelity method was more efficient and less resource intensive.

Triage is the process of deciding which patients should be treated first based on how sick or seriously injured they are. Specifically developed to meet the needs of the military medicine it has become a daily management tool within civilian emergency departments and it can be adapted to work in a variety of settings.
Overcrowded emergency departments which result in the consequent lengthening of patients waiting times constitute a serious problem widespread all over the industrialized countries.
Vital signs represent sensitive data often taken by the triage nurse with the perceived aim of making the triage process more accurate, objective, and able to reflect the urgency of the patient’s presentation.
Very often patients categorized in a lower triage acuity level are requested to wait for a considerable amount of time before they are admitted in the emergency department.
During this timeframe the triage nurse should constantly monitor these patients and make sure that they are not deteriorating. If this is the case, the nurse must allow the patient to enter the emergency department by changing the triage acuity level.

Methodology

Web-based literature review.

Conclusion

Vital signs measurement has always been believed to be an essential component of patient triage in the emergency department.
The essential task of taking of vital signs in order to determine triage acuity is still a matter of debate.
In fact, the impact of vital signs measurement has been explored by different studies highlighting that it is still controversial whether or not all patients arriving at triage need a complete set of measurements, especially in case of pediatric patients.
Therefore, clinical experience and common sense represent key elements in decision making when it comes to speeding up the triage process and making it more efficient when triaging a new patient.

To briefly discuss the results of our literature review aiming to clarify whether wearable devices can help in preventing hospital readmission in chronic patients, to illustrate the types of wearable devices currently available for this purpose and whether they can contribute to improve chronic patient safety in the home care setting

This poster briefly explores the evidence obtained through a literature review, which aims to clarify whether wearable devices can help in preventing hospital readmission in chronic patients, to illustrate the types of wearable devices currently available for this purpose and whether they can contribute in improving chronic patient safety in the home care setting.

INTRODUCTION: According to the World Health Organisation (WHO) chronic diseases are the leading cause of mortality in the world, representing 60% of all deaths. Strategies employed to tackle chronic diseases aim to act on risk factors through adopting a healthy diet, increasing physical activity and avoiding exposure to tobacco and other toxic substances. These strategies can be greatly implemented from the adoption of modern technologies, which allow a thorough and minimally invasive monitoring of patients' clinical data. Wearable electronics are defined as " devices that can be worn or mated with human skin to continuously and closely monitor an individual's activities, without interrupting or limiting the user's motions ". This presentation explores the evidence obtained through a literature review, which aims to clarify whether wearable devices can help in preventing hospital readmission in chronic patients, to illustrate the types of wearable devices currently available for this purpose and whether they can contribute in improving chronic patient safety in the home care setting. METHOD: A literature search of electronic databases in the healthcare field was performed in January 2017. The following databases were searched: The Cochrane Database of Systematic Reviews, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Pub Med, EMBASE and MEDLINE. In addition, an electronic and hand search of the reference lists of all the selected publications was performed to include more suitable publications. The following keywords were used: wearable devices OR wearable technology, chronic conditions OR chronic diseases, hospital admission OR hospital admission prevention OR hospital readmission OR hospital readmission prevention, elderly, safety, barriers OR obstacles OR changes. RESULTS: 35 qualitative and quantitative articles met the inclusion criteria and were included in the literature review. Quality assessment and data extraction were carried out and themes relating to the questions posed were abstracted for synthesis. DISCUSSION: Despite the large number of articles on wearable devices only few of them try to shed light on the clinical benefits of the adoption of these devices by chronic patients, since most of the papers are purely technical. Various wearable devices are currently available to monitor and keep records of different clinical information with the aim of helping users to improve their quality of life. Some of them are proved to prevent hospital re-admissions and to treat effectively life-threatening situations in certain categories of chronic patients. Higher level of acceptability and usability are achieved when users are involved in the testing stage prior to the release of the device and/or the features and terms of use are clearly described to patients and carers. In addition to the effective treatment of life-threatening conditions, wearable devices are also proved to be more accurate than clinical assessment in estimating the risk of falls in chronic patients, thus improving safety in the home care setting. Regardless of their features, wearable devices are yet to be used by both healthcare professionals and patients on a large scale. More studies need to be undertaken to understand how these useful technologies can be integrated into the healthcare system and how clinical data can be flawlessly shared among patients and healthcare professionals.

Background and aim of the study: Nursing students are at high risk of injury while on clinical placement. The incidence of injury is three times higher in comparison to other healthcare workers, with a prevalence ranging from 25% up to 33,2%. Lack of knowledge and of experience in delivering nursing care, anxiety and unfamiliarity with the clinical environment all represent risk factors for injury. This study describes the number and type of injuries occurring in an organizational setting where nursing students are trained in simulation laboratories before being exposed to a real clinical environment. Methods: An eight year retrospective observational study (2009 to 2017) was conducted on a non-probabilistic population of 1,403 nursing students from a university in the north of Italy. Incident reports were anonymised and entered in a database. Results: Overall the percentage of students who reported an injury (6,2%) was much lower than the one reported in the literature. Conclusions: The nursing programme curriculum of the above mentioned university consists of frontal lectures, group works, simulation based sessions and supervised clinical practice designed to equip students with all the necessary knowledge and clinical skills to prevent health care injuries. Despite the encouraging results of this study, further actions in order to protect first year students, who are more subject to risk of injuries, are recommended.

INTRODUCTION: According to the World Health Organisation chronic diseases are the leading cause of mortality in the world, representing 60% of all deaths. Strategies employed to tackle chronic diseases aim to act on risk factors through adopting a healthy lifestyle. These strategies can be greatly implemented from the adoption of wearable devices, which allow a thorough and minimally invasive monitoring of patients’ clinical data.
This article aims to clarify whether wearable devices can help in preventing hospital readmission and improve quality of life in chronic patients.
Method: A literature search of electronic databases was performed in January 2017. The following databases were searched: The Cochrane Database of Systematic Reviews, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Pub Med, EMBASE and MEDLINE. RESULTS: 33 articles met the inclusion criteria and were included in the literature review. DISCUSSION: Various wearable devices are currently available to monitor and keep records of diffe- rent clinical information. Some of them are proved to prevent hospital re-admissions and to treat effectively life-threatening situations in certain categories of chronic patients.
Higher level of acceptability and usability are achieved when users are involved in the testing stage prior to the release of the device and/or the features and terms of use are clearly described to patients and carers. Wearable devices are also proved to be more accurate than clinical assessment only in estimating the risk of falls in chronic patients, thus improving safety in the home care setting.
Regardless of their features, wearable devices are yet to be used by both healthcare professionals and patients on a large scale.
KEYWORDS: wearable devices, chronic conditions, hospital admission prevention, safety, quality of life, healthcare professionals.