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Background: There is limited information to compare the qualitative and semi-quantitative performance of rapid diagnostic tests (RDT) and serology for the assessment of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Therefore, the objective of the study was (a) to compare the efficacy of SARS-CoV-2 antibody detection between RDT and laboratory serology, trying to identify appropriate semi-quantitative cut-offs for RDT in relation with quantitative serology values and to (b) evaluate diagnostic accuracy of RDT compared to the NAAT gold standard in an unselected adult population. Methods: SARS-CoV-2 antibodies were simultaneously measured with lateral flow immunochromatographic assays (LFA), the Cellex qSARS-CoV-2 IgG/IgM Rapid Test (by capillary blood), the iFlash-SARS-CoV-2 IgG/IgM chemiluminescent immunoassay (CLIA) (by venous blood) and the nucleic acid amplification test (NAAT) in samples from in- and out-patients with confirmed, suspected and negative diagnosis of coronavirus disease 2019 (COVID-19) attending Udine Hospital (Italy) (March-May 2020). Interpretation of RDT was qualitative (positive/negative) and semi-quantitative based on a chromatographic intensity scale (negative, weak positive, positive). Results: Overall, 720 paired antibody measures were performed on 858 patients. The qualitative and semiquantitative agreement analysis performed in the whole sample between LFA and CLIA provided a Kendall’s tau of 0.578 (p Conclusion: The RDT used in our study can be a non-invasive and reliable alternative to serological tests and facilitate both qualitative and a semi-quantitative antibody detection in COVID-19.

Background This study aimed to map and summarise the state of the research regarding doctoral programs in nursing, as well as the issues debated in the context of nursing doctoral education. A Scoping Review in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension scoping reviews statement (PRISMA-ScR) was conducted. Three electronic bibliographic data bases were searched: Cumulative Index to Nursing and Allied Health Literature Complete, Medline (on EBSCO Host) and SCOPUS to identify empirical studies published between January 2009 and December 2019. The review process was based on framework identified by Arksey and O’Malley and further revised by Levac and colleagues. Analysis was performed with the use of the Donabedian framework regarding the structure of the doctorate programmes, the process, and the outcomes. Results The review included 41 articles, mostly originating in the United States (n=26) and Europe (n=8), mainly by collecting the perceptions of students and faculty members with descriptive studies. The following issues were investigated at the (a) structure level: Prerequisite for doctoral candidates, Qualifications of faculty members, Mission of doctoral programs; (b) process level: Doctoral programs contents, Doctoral programs resources and quality, Mentoring and supervision, Doing doctorate abroad; and (c) outcome level: Academic performance outcomes in doctoral programs, Doctoral graduates’ competences, Doctoral students/graduates’ satisfaction, Doctoral graduates’ challenges. Conclusions Doctoral programs have mainly been investigated to date with descriptive studies, suggesting more robust research investigating the effectiveness of strategies to prepare future scientists in the nursing discipline. Doctorates are different across countries, and there is no visible cooperation of scholars internationally; their structure and processes have been reported to be stable over the years, thus not following the research development in nursing, discipline and practice expectations. Moreover, no clear framework of outcomes in the short- and long-term have been established to date to measure the quality and effectiveness of doctorate education. National and global strategies might establish common structure, process and outcome frameworks, as well as promote robust studies that are capable of assessing the effectiveness of this field of education.

Background Modern healthcare institutions are continuously changing, and Self-Directed Learning (SDL) abilities are considered a prerequisite for both nursing students and nurses in order to be proactive about these demanding challenges. To date, no systematic reviews of existing instruments aimed at detecting and critically evaluating SDL abilities have been published. Therefore, the aims of this review are: 1) identify the instruments for assessment of SDL abilities among nursing students and nurses; 2) critically evaluate the methodological studies quality; and 3) compare the psychometric properties of the available instruments. Methods A psychometric-systematic-review was performed. CDSR, CINAHL, ERIC, MEDLINE, PROSPERO, SCOPUS databases were searched without restrictions in time and setting. All primary studies involving nursing students or nurses, written in English and aimed at validating SDL assessment tools, were included. Studies retrieved were evaluated according to the COnsensus-based-Standards for the selection of health Measurement-INstruments (COSMIN) panel. Study inclusion, data extraction and quality assessment were performed by researchers independently. Results Eleven studies were included and four tools based on Knowles’s theory have emerged: 1) the Self-Directed Learning Readiness Scale; 2) the Self-Directed Learning Readiness Scale for Nursing Education; 3) the Self-Rating Scale of Self-Directed Learning, and 4) the Self-Directed Learning Instrument. A few psychometric properties have been considered in each study, from two to four out of the ten required. The quality of the methodologies used was in general, from fair to poor with the exception of one instrument (the Self-Directed-Learning-Instrument). The psychometric proprieties that emerged across the tools were good in general: the Cronbach α was from 0.73 to 0.91; structural validities have also reported good indexes both in the explorative and in the confirmative factor analyses. Conclusions On the basis of the findings, the Self-Directed-Learning-Instrument can be recommended for the assessment of SDL abilities among nursing students and nurses, given the excellent methodology quality adopted in estimating the psychometric properties. However, rigorous study designs aimed at estimating psychometric properties of tools in wide samples of nursing students and nurses across different stages of professional life, from undergraduate education to professional maturity, in different cultural, educational, and work settings, are strongly recommended.

According to available evidence, when the nurse-to-patient ratio is insufficient the occurrence of accidental falls, pressure sores, malnutrition, hospital-acquired dependency in activities of daily living, infections associated with nursing practice and errors in administration of medication as well as mortality all increase. However, while several countries have established a body of evidence and policies concerning the minimum nurse-to-patient ratio, the amount of nursing care offered in Italian medical units remains under-studied.Evaluating variability in the nurse-to-patient ratio and in the skill-mix offered, 12 medical units willing to participate were evaluated with a face-to-face interview performed by a researcher to the nurse manager of the unit. The role of the unit at the hospital level, the nurse-to-patient ratio available on a daily basis, the skill-mix and the strategies enacted in the case of patient overcrowding or understaffing were collected.The mission of the medical units is devoted mainly towards elderly people. The bed occupancy is high and the strategies adopted in case of patient overcrowding determine unstable environments both for medical units (extra beds) and other units (patients temporarily hosted). In the medical units, nurses attend to 5-13 patients in the morning, 7.6-14.6 in the afternoon, and 12.3-30.5 during the night. The skill-mix ranges from 43.5 % (more nursing aides than nurses are available on the ward) to 81.2 % (more nurses than nursing aides are available).This assessment exercise indicates that nursing care in medical units faces high workloads. Establishing national minimum standards of nursing care to be delivered towards older people admitted in Italian medical units is recommended.

Background Self-Directed Learning develops when students take the initiative for their learning, recognising needs, formulating goals, identifying resources, implementing appropriate strategies and evaluating learning outcomes. This should be seen as a collaborative process between the nurse educator and the learner. At the international level, various instruments have been used to measure Self-Directed Learning abilities (SDL), both in original and in culturally-adapted versions. However, few instruments have been subjected to full validation, and no gold standard reference has been established to date. In addition, few researchers have adopted the established tools to assess the concurrent validity of the emerging new tools. Therefore, the aim of this study was to measure the concurrent validity between the Self-Rating Scale of Self-Directed Learning (SRSSDL_Ita) – Italian version and the Self-Directed Learning Instruments (SDLI) in undergraduate nursing students. Methods A concurrent validity study design was conducted in a Bachelor level nursing degree programme located in Italy. All nursing students attending the first, second or third year (n = 428) were the target sample. The SRSSDL_Ita, and the SDLI were used. The Pearson correlation was used to determine the concurrent validity between the instruments; the confidence of intervals (CI 95 %) bias-corrected and accelerated bootstrap (BCa), were also calculated. Results The majority of participants were students attending their first year (47.9 %), and were predominately female (78.5 %). Their average age was 22.5 ± 4.1. The SDL abilities scores, as measured with the SRSSDL_Ita (min 40, max 200), were, on average, 160.79 (95 % CI 159.10–162.57; median 160); while with the SDLI (min 20, max 100), they were on average 82.57 (95 % CI 81.79–83.38; median 83). The Pearson correlation between the SRSSDL_Ita and SDLI instruments was 0.815 (CI BCa 95 % 0.774–0.848), (p = 0.000). Conclusions The findings confirm the concurrent validity of the SRSSDL_Ita with the SDLI. The SRSSDL_Ita instrument can be useful in the process of identifying Self-Directed Learning abilities, which are essential for students to achieve the expected learning goals and become lifelong learners.