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While for a long-time emotional reaction and moral distress, have been primarily investigated for the possible outcomes of the nursing decision-making process rather than in terms of their role as antecedents of the final decision taken. The primary study's aim is to explore how inpatient nurses' decision-making takes place in different care settings, with a special focus on the role played by emotions during decision-making. The secondary aim is to explore the subjective experience of hospital nurses in relation to successful and unsuccessful decision-making situations. Multicentre qualitative study, consisting of three phases with different designs: participatory study, grounded theory study, and phenomenological study. Participants will be nurses and may be doctors with various levels of professional experience working in hospital, outpatient, or ward settings. Participants will be recruited through different sampling (purposive and convenience). Data will be collected through focus groups and in-depth interviews with nurses working in different hospital care settings. The researchers expect to find themes that will contribute to a better understanding of the role of emotions in decision-making. The results of this study have the potential of providing important implications to support nurses in the recognition and management of their emotions during the decision-making process., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 Published by Elsevier B.V.)

The objective of this study was to describe the COVID-19 intensive care unit population and analyze the characteristics and outcomes of gastrointestinal bleeding patients. An observational prospective study design was used following the STROBE checklist. All patients admitted between February and April 2020 to the intensive care unit were included. Main outcome measures were first bleeding event timing, sociodemographic and clinical data before admission, and gastrointestinal symptoms. A total of 116 COVID-19 patients were included; 16 (13.8%) developed gastrointestinal bleeding, 15 were males (93.7%), and the median age was 65.64 ± 7.33 years. All 16 patients were mechanically ventilated, one (6.3%) already had gastrointestinal symptoms, 13 (81.3%) had at least one concomitant disease, and six (37.5%) died. Bleeding episodes occurred on a mean of 16.9 ± 9.5 days after admission. Nine cases (56.3%) had effects on their hemodynamics, hemoglobin levels, or transfusion requirements; six (37.5%) required diagnostic imaging; and two (12.5%) underwent endoscopy procedures. The Mann-Whitney test showed statistically significant differences between the two groups of patients concerning comorbidities. Gastrointestinal bleeding can occur in critically ill patients with COVID-19. Having a solid tumor or chronic liver disease seems to increase that risk. Nurses caring for COVID-19 patients are urged to individualize patients at higher risk in order to improve safety., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 Society of Gastroenterology Nurses and Associates.)

The incidence of COVID-19 gastrointestinal manifestations has been reported to range from 3% to 61%. There are limited data on the incidence rates and risk factors associated with gastrointestinal bleeding (GIB) in patients with COVID-19. A rapid review has been designed to investigate whether there is a relationship between COVID-19 and GIB in adult patients. PubMed, CINAHL, EMBASE, Cochrane Library, and Scopus databases have been analyzed. A total of 129 studies were found; 29 full texts were analyzed, and of these, 20 were found to be relevant to the topic. The key findings of the included studies present an overall GIB rate in COVID-19 patients ranging from 1.1% to 13%. The bleeding involves mucosal damage of the duodenum, stomach, colon, and rectum. The management of gastrointestinal bleeding could be conservative. The use of fecal diversion systems for the management of diarrhea in COVID-19 patients should be minimized and closely evaluated for the risk of rectal mucosal damages and erosions. It is recommended to provide an accurate nutritional assessment; an early setting up of enteral nutrition, if not contraindicated, can help protect the gut mucosa of patients and restore normal intestinal flora. Larger cohort studies are needed to increase the information about this topic., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Society of Gastroenterology Nurses and Associates.)

Objective: To describe predictors of adjustment to living with an ostomy among Italian adults with an enterostomy or a colostomy., Methods: A multicenter, cross-sectional design was performed, sampling 403 patients with an ostomy in three different outpatient clinics of northern Italy between April 2018 and December 2020. Data were collected by stoma therapists in ambulatory settings using the Italian version of the Ostomy Adjustment Inventory-23 and patient medical records., Results: Acceptance was lower among women, patients who underwent emergency surgery, those with a urostomy, and those with a body mass index of less than or equal to 25 kg/m2. Negative feelings were associated with higher body mass index, colostomies, shorter length of time of living with an ostomy, and emergency ostomy creation., Conclusions: Being young and having a high level of education are protective against psychosocial problems and help promote acceptance and social engagement. The findings of this study help identify patients who are likely to be more vulnerable and need greater support through specific educational and motivational interventions., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: The discontinuity between the high ideals of nursing education and real-world practice is a major cause of frustration, moral distress and burnout among the youngest, and pushes up to half nurses to change career within two years. These conditions are accentuated in the care of elderly patients with multiple chronic needs., Methods: A multidisciplinary team of nurses and philosophers investigated the chronic determinants of ethical issues in aged care nursing, building on insightful experiences from different institu-tional settings, in order to provide evidence for contextualized and patient-oriented professio-nal support. A scoping review protocol was employed at this purpose., Results: Most of the environmental and organizational deteminants of chronical ethical issues are out-side the control of nurses, and most of the relational ones follow as a result in both settings. Many of the them have been confirmed and further aggravated by the COVID-19 pandemic., Discussion: Although there are not universal solutions to the issues described, still it is possible to distin-guish which determinants fall within the control of nurses, to help them prevent or manage their occurrence; and what are beyond, to help them avoid self-blame and transfer constructive information to those who can intervene., Conclusions: Education can help exercise critical thinking and communicate properly. However, once maximized team cooperation, orga-nizational efficiency and individual soft skills, diminishing room for improvement will be available at increasing human and financial costs. Improving the condition of nurses is an urgent political responsibility and requires a broader socio-cultural change.