Aim The aim of the present study was to conceptualize the basic social process by which nursing intervention affects patient outcomes in Italian daily practice.



Background  Different frameworks explain the relationship between nursing care and patient outcomes. However, several authors have suggested the need to develop further theory in order to understand this relationship.



Method  A qualitative study based on a grounded theory approach was undertaken to generate a conceptual description of nursing care in Italy and its relationship to patient outcomes. Data collection and analysis processes were conducted simultaneously in an Italian Teaching Hospital from 2007 to 2009.



Findings  Nursing effectiveness (the core variable) expresses the positive effects of the nursing system on patient outcomes, on patient safety and on the multi-disciplinary outcomes. The two interdependent social processes that assure nursing effectiveness are: creating a supportive environment for potentially effective nursing (causative factors); and performing organizational, clinical and collaborative intervention (nursing strategies and consequences).



Conclusions  The factors determining a potentially supportive environment for nursing effectiveness are similar to those documented in the literature but the need for clinical nurses to compensate systematically when this support is not available seems to be unique.



Implications for Nursing Management  Understanding the basic processes involved in the determination of nursing effectiveness in one country has implications for nursing leaders’ decision-making, on National Health Service policy recommendations and on professional development both at national and international levels.

Nursing effectiveness in Italy: findings from a grounded theory study

Background and aim of the work The Chiba Inter-professional Competency Scale (CICS29) validated in several languages, it is a self-report instrument that investigates the degree of interprofessional collaboration in six areas: attitudes and beliefs of the professional; ability to manage a work group; actions to achieve goals; providing assistance that respects the patient; attitudes and behaviours that improve the cohesion of the working group; fulfilling or performing the own professional role. In addition to being recent, the scale investigates collaboration among all health professionals, and is not limited to specific professionals. The aim of the study was to validate the Italian version of CICS29. Method A questionnaire-based study was conducted with an Italian sample consisting of 530 health professionals (419 women¸ mean age = 40 years, SD = 10.7; range 23- 58 years). The internal validity was measured using factor analysis. To verify the convergent validity, the Italian Version of Interprofessional Collaborative Competency Attainment Survey (ICCAS) was correlated with the CICS29; Results: The reliability and the internal validity of the CICS29 revealed 6 factors corresponding to the original subscales. The analysis presents an excellent sample adequacy measure (KMO = .933) with the scores ranging from 0.62 to 0.78 for the interclass correlation coefficients of the 6 domains. A significant level of correlation was found between the subscales of the CICS29 and the ICCAS. Conclusions In conclusion, the Italian version of CICS29 has a satisfactory level of reliability and validity and it is recommended for measuring interprofessional collaboration of the health professionals. (www.actabiomedica.it).

Italian Validation of the Chiba Interprofessional Competency Scale (CICS29).

The aim of this study was to analyze collaboration berween nurses and auxiliary staff and it was implemented at the Santa Maria Nuova Hospital of Reggio Emilia. Although this topic is of great interest for the health structures, so far few studies dealing specifically with the inte- ractions between these rwo categories have been published. The international scenario offers an extremely varied picture of rhe staff employed in such tasks : in fact, only Italy has a single national legislation which establishes that auxiliary staff are figures supporring the health professions in both a social and healty context. The study assessed the areas susceptible to improvement in rerrns of nursing-auxiliary staff collaboration , thus improving the quality of care, by promoting negotiation and confrontation between the two categories. In the liter- ture the )efferson Scale of Attitude Toward Physician Nurse Collaboration was used. Results identified that the priority areas of intervention regarded how the patient was received on hospital entry and during his stay and the safety of the patient throught hospitalization.

la collaborazione tra infermieree operatoresocio sanitario: indagine conoscitiva suicomportamenti in ambito ospedaliero Collaboration between nurses and auxiliary staff: cognitive study on behaviour in a hospital environment

Scenario 4_2007

A Nurse-Led Model of Care with 2 Telemonitoring to Manage Patients with Heart Failure in Primary Health Care: A Mixed-Method Feasibility Study [Response to Letter]

Lavorare in gruppo: la collaborazione medici-infermieri

[How to work in group: doctors-nurses collaboration].

Purpose To determine whether a nurse-led care model with telemonitoring in primary care for patients with stable heart failure and their caregivers is feasible and acceptable. Patients and Methods A mixed-methods feasibility study was conducted. Patients with stable heart failure and their caregivers were consecutively enrolled from March 2021 to April 2022. Participants were managed by nurses in a community health center through education and monitoring with a mobile app. The outcomes were feasibility outcomes, self-care outcomes, and qualitative acceptability and satisfaction. Quantitative and qualitative outcomes were linked to understanding how the model of care might benefit patients. Results Twenty-six patients and nine of their caregivers were enrolled. Ten participants used the mobile app. Nineteen patients and eight caregivers were interviewed. Participants who improved their self-care appreciated the help in finding coping strategies, being close to the clinic, and feeling cared for. Participants with fewer improvements in self-care perceived the model of care as useless and were far from the centre. Participants decided to use the app mainly for usefulness prevision, and most of them were satisfied. Conclusion The model of care was not successful in recruiting patients, and adjustments are needed to improve the recruitment strategy and to engage people who perceive the model of care as not useful or unable to use the app.

A Nurse-Led Model of Care with Telemonitoring to Manage Patients with Heart Failure in Primary Health Care: A Mixed-Method Feasibility Study

. The TeMP_cardio Model for the district management of heart failure patients: a feasibility study for the implementation of the family nurse.


INTRODUCTION
The need to enhance primary health nursing care and chronic disease management requires the development of complex and feasible models in local contexts.


AIM
To test the feasibility of a complex care model, based on the introduction of the family and community nurse for patients with stable heart failure and their caregivers.


METHODS
A pre-post six-month feasibility study was conducted in 2021-2022 in the Autonomous Province of Trento. Patients with stable heart failure able to access services were taken in charge with a multidisciplinary model, with the nurse as care manager, and technological and telemonitoring support.


RESULTS
26 patients out of 137 were included and nine of their caregivers. Ten participants accepted to use the mobile app. Twenty-three patients and seven caregivers completed the study, and the app was used regularly by five participants. Self-care skills improved in patients, mostly in self-monitoring, less in caregivers. One access to the emergency department for heart failure exacerbation was detected.


CONCLUSIONS
The model was evaluated feasible to retain patients, with the need to build effective strategies for the recruitment, and the regular use of telemonitoring tools.

[The TeMP_cardio Model for the district management of heart failure patients: a feasibility study for the implementation of the family nurse].

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