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Purpose: The aim of this study was to describe the prevalence of unavoidable pressure injuries (UPIs) in residents of nursing homes (NHs) and characteristics associated with UPIs., Design: A retrospective study., Subjects and Setting: Residents 65 years or older residing in any of 105 NHs in the Friuli Venezia Giulia region of Italy between January and December 2013., Methods: Database search comprised of a multidimensional assessment of NH residents., Results: Data from 7950 residents were reviewed, 925 (11.6%) of whom had 1 or more documented pressure injuries (PIs). Among these, 221 (23.9%) residents met criteria for avoidable PIs (APIs) and 704 (76.1%) for UPIs. Residents with UPIs were more frequently hemodynamically unstable, terminally ill, and had medical devices (all Ps < .001) than residents with APIs. Moreover, residents with UPIs showed higher functional, cognitive, and mood impairments compared to residents with APIs (all Ps < .001)., Conclusions: Our findings suggest a high prevalence of UPIs compared to APIs among residents residing in NHs in one region of Italy. Additional research is needed to establish the prevalence of UPIs among NH residents country-wide, as well as determine specific criteria that identify UPIs in long-term care settings and increase consistency in prevalence and incidence measurement models.

Patient-centered care is valued by health care professionals working in palliative care settings. However, studies have revealed the difficulty of adopting patient-centered care in daily practice and of sharing its meaning within the interdisciplinary team. The aim of this study was to report the process of transforming end-of-life care by implementing a patient-centered model of care in an Italian hospice. An action research process was conducted between June 2012 and June 2014. The following phases were performed: (a) "looking" phase: the diagnosis was established by collecting data through semistructured interviews in the field study and through the administration of the Frommelt Attitude Toward the Care of the Dying Scale Form B-Italian Version; (b) "thinking" phase: staff members, guided by a research team, redesigned practice by identifying priorities in improvements and actions through multiprofessional focus groups; (c) "acting" phase: actions identified in the previous phase were implemented; and (d) "relooking" phase: the same data collection processes used in the looking phase were applied to evaluate the outcomes achieved. Three areas of improvement have been established: (1) symptoms were intensively audited through patient self-reports by using validated tools; (2) patients' family needs were also regularly collected, documented in clinical records, and addressed; (3) patients' family members were involved in the plan of care through support and education. Inpatient hospice health carers in this study were aware of the concept of patient-centered care. However, its actual implementation was lacking. An action research approach helped them to implement expected changes.

Unlabelled: Pressure ulcers (PrUs) remain a concern for clinicians, patients, caregivers, and researchers. Although data on prevalence and incidence are available, as well as evidence-based prevention and management intervention, PrU healing time is underreported., Objective: The objective of this study was to evaluate the healing time of Stage II PrUs., Methods: Secondary analysis of data collected from a multicenter randomized clinical trial was undertaken. Patients (a) with a Stage II PrU, (b) older than 18 years, and (c) who had given informed consent were included. The endpoints of the study were complete re-epithelialization of the PrU measured with the Pressure Ulcer Scale for Healing Tool 3.0 and the healing time. A network of 46 healthcare centers located in northern Italy participated in the study., Results: Two hundred seventy patients with an average age of 83.9 years (95% confidence interval [CI], 82.71-85.10) were recruited. Among 270 Stage II PrUs included, 153 lesions healed (56.7%), whereas 74 (27.4%) were still present after 10 weeks of follow-up. For 43 lesions (15.9%), the follow-up evaluation was interrupted because of patient death or transfer to units not included in the study. The PrUs healed on an average of 22.9 days (95% CI, 20.47-25.37 days), with a median of 18 days. The average healing time for PrUs of less than 3.1 cm was significantly shorter (19.2 days; 95% CI, 16.6-21.8) compared with those 3.1 cm or greater (31.0 days; 95% CI, 26.4-35.6 days) (P = .000)., Conclusions: To achieve complete re-epithelialization in Stage II PrUs, it takes approximately 23 days. This is quite a long time if we consider that pressures of only 60 to 70 mm Hg for between 30 and 240 minutes are needed to cause tissue damage. On average, a small ulcer heals 12 days faster compared with those with a surface of 3.1 cm or greater.

This study extends an earlier investigation (DiIorio et al., 2004) regarding neuroscience studies published in four nursing journals over the period from 1989 to 2000. A literature review was conducted from 2001 to 2010 with the same search strategy performed by DiIorio from 1989 to 2000. A trend analysis comparing the articles published in the period of 2001-2008 with those published from 1993 to 2000 (odds ratio [OR], 95% confidence interval [CI]) was performed. From 1989 to 2010, a total of 607 articles were published, 2.2 articles per month. A significantly increased number of publications on neuroscience nursing research have emerged comparing 2001-2008 versus 1993-2000 (OR = 2.1, 95% CI [1.22, 3.29]; p = .00). From 1989 to 2000, neurological problems were the predominant object of study (389 articles, 64.1%), followed by neurotrauma problems (156, 25.7%) and those neurosurgical problems (31, 5.1%). Moreover, a progressive reduction of studies focusing on neurological problems (OR = 0.42, 95% CI [0.26, 0.68]; p = .00) has emerged comparing 2001-2008 versus 1993-2000. The setting chosen for the study from 1989 to 2000 was mainly hospitals (211, 34.8%) followed by long-term care (125, 20.6%) and the home environment (77, 12.7%). Over the years (2001- 2008 vs. 1993-2000), studies performed at the home level were lower (OR = 0.27, 95% CI [0.15, 0.47]; p = .00), whereas those carried out at the hospital level and at the long-term care level have increased. Research in neuroscience nursing has continued to grow in the last decade, involving more patients who are mainly women. In the coming years, quasiexperimental, experimental, or complex intervention designs, involving the various care settings and along the trajectories of illnesses of patients who have an acute phase but especially in a long-term phase, are needed.