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Aims: To describe how workplace violence (WPV) is experienced by nurses in hospitals and community services and identify protective and risk factors. Methods: An online cross‐sectional national study was conducted from January to April 2021 in Italy. Hospitals and community services were involved in the study. The survey combined the adapted and validated Italian version of the Violence in Emergency Nursing and Triage (VENT) questionnaire, which explores the episodes of WPV experienced during the previous 12 months, the Practice Environment Scale of the Nursing Work Index (PES‐NWI) and some additional questions about staffing levels extracted from a previous RN4CAST study. Nurses working in all clinical settings and community services were invited to participate in the survey. Descriptive and inferential statistics were used for data analysis. We adhered to the STROBE reporting guidelines. Results: A total of 6079 nurses completed the survey, 32.4% (n = 1969) had experienced WPV in the previous 12 months, and 46% (n = 920) reported WPV only in the previous week. The most significant protective factors were nurses' age, patients' use of illegal substances, attitude of individual nurses and considering effective the organization's procedures for preventing and managing episodes of violence. The most significant risk factors included workload, recognizing violence as an inevitable part of the job, patients' cultural aspects and patients' agitated behaviour. The frequency of WPV was significantly higher in certain areas, such as the emergency department and in mental health wards. Conclusion: Workplace violence (WPV) against nurses is a very frequent and concerning issue, especially in hospitals and community services. Based on our findings, integrated and multimodal programmes for prevention and management of WPV are recommended. More attention and resources need to be allocated to reduce WPV by improving the quality of nurses' workplace environment and implementing violence‐free policies for hospitals. Implications for the Profession and/or Patient Care: Impact: Workplace verbal and physical violence is a widespread phenomenon, both in hospital and community settings, and even during COVID‐19 pandemic. This problem is exacerbated by the lack of effective reporting systems, fear of retaliation and the tendency to consider violence as an inevitable part of the job.The characteristics of professionals, patients, work environment and organizational factors are involved in the spread of workplace violence, determining its multifactorial nature. Integrated and multimodal programmes to prevent and manage of workplace violence are probably the only way to effectively counteract workplace violence against nurses.Healthcare policymakers, managers of hospital and community services need to proactively prevent and effectively manage and monitor episodes of violence. Nurses need to feel protected and safeguarded against any form of verbal or physical violence, to provide high‐quality care in a totally safe environment. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Introduction: The aging of the population requires an appropriate knowledge of the type of care that needs to be provided to inform healthcare policies. In Italy, neither home care nursing, nor the patient experiences have ever been described. Objectives: To describe the characteristics of nurses and care recipients involved in home care. Methods: A descriptive cross‐sectional study conducted in 18 Italian Regions. Between April and October 2023, data from nurses and patients involved in home care were collected through two surveys. Psychosocial conditions in workplaces, missed care, and care experiences were assessed using validated tools. Descriptive statistics and Pearson's correlations were performed. Results: A total of 46 local healthcare units were included in this study, with a total of 2549 nurses and 4709 care recipients. Nurses (mean age 46.60; 79.48% female; 44.68% regional nursing diploma as the highest qualification) reported good working conditions (42.37; SD = 12.25; range = 0–100) and a high mean number of missed care activities (5.11; SD = 3.19; range 0–9). Most nurses (83.41%) reported high levels of job satisfaction, while 20.28% intended to leave their job. Patients (mean age 75.18; 57.57% female; 36.95% primary school), on the other hand, rated positively the care they had received (8.23; range = 0–10). Conclusions: Despite the perception of critical issues at work and some missed care, satisfaction in nurses and patients was high. These data constitute a preliminary snapshot of the studied phenomena, which will be investigated through more in‐depth analyses. [ABSTRACT FROM AUTHOR]

Clostridioides difficile is, worldwide, the leading cause of hospital-acquired infection. Outbreaks are largely related to antibiotic exposure and contact contamination, but little is known about C. difficle infection (CDI) awareness in the nurse population. We conducted a cross-sectional survey to study Italian nurses, based on CDI guidelines. We recruited 200 nurses working in 14 Italian hospitals. Using a one-way analysis of variance of knowledge scores, female nurses (mean 9.67 (standard deviation ± 1.63), p = 0.03), and nurses with a higher level of university education (mean 9.79 (SD ± 1.67), p = 0.04) were demonstrated to have better knowledge about CDI. In addition, 92.5% (n = 184) of the sample declared that they did not have specific postgraduate training about CDI. Seventy-four percent (n = 149) of the respondents declared that they used procedures, protocols and guidelines about CDI in their workplace, but only 46.5% (n = 93) reported using C. difficile-specific bundles during their daily practice. In conclusion, our study highlights a lack of knowledge concerning CDI clinical guidelines among Italian nurses. [ABSTRACT FROM AUTHOR]

Aims: To determine coronavirus disease 2019 (COVID‐19) vaccination hesitancy in healthcare professionals and healthcare students in Italy across four generations (baby boomers, generations X, Y and Z). Design: A cross‐sectional descriptive study was performed through an online survey conducted from May to June 2021. The STROBE guidelines were adopted for reporting. Methods: Data were collected by initially sending a survey link to a convenience sample of healthcare professionals and students, which was followed by snowball sampling. The VAX scale was validated and adopted. An ANOVA was performed to detect differences in vaccine‐hesitancy beliefs between the four generational groups. Results: The survey was completed by 1226 healthcare professionals and students. Worries about unforeseen future effects accounted for the higher vaccination hesitancy factor across generations. More positive attitudes towards COVID‐19 vaccination were expressed by members of generation Z than by members of generation Y and baby boomers. Members of generation X had the highest vaccination hesitancy scores in the overall scale. Conclusion: The results suggest that public health campaigns should take into account the generational differences in COVID‐19 vaccination hesitancy to achieve higher levels of vaccine acceptance, including amongst healthcare professionals and students. Impact Vaccination is the most effective strategy to tackle the COVID‐19 pandemic. The advice of health professionals strongly influences vaccination willingness in the general population. A consideration of the generational patterns in the COVID‐19 vaccination hesitancy of healthcare workers and students may increase vaccination uptake in these populations, which in turn may lead to greater public acceptance of the vaccine. [ABSTRACT FROM AUTHOR]

Aims: To describe the mentoring competence of clinical practice nurse mentors and identify different mentor profiles. Design: Cross‐sectional research design, secondary analysis. Methods: An international, cross‐sectional study design was performed in five European countries. A total of 1 604 mentors from 33 healthcare organizations participated in the study between 2016–2019. The Mentors' Competence Instrument (MCI), which includes seven sub‐dimensions and 44 items, was used to collect data. K‐means cluster and binary regression analyses were performed to detect mentor profiles and determine how various factors affect competence, respectively. Results: The K‐means cluster analysis identified three distinct profiles: A (n = 926); B (n = 566); and C (n = 85). The profiles showed significantly different values (p <.001) across all seven areas of mentoring competence. In comparison with the other profiles, nurses in profile A were older, had more work experience and were more probably to have completed mentoring‐specific training. [ABSTRACT FROM AUTHOR]

Aims: To investigate which morality traits are more important for nurses to determine positive opinions of their nurse manager. Background: People selected morality more often than sociability and competence when forming a positive opinion towards an ideal or a newcomer manager. Methods: A multicentre, cross‐sectional study was carried out by administering two questionnaires to 775 nurses on the influence of morality, sociability and competence traits on their impression formation processes. Results: Regarding nurses' perceptions about the morality, sociability and competence traits of an ideal nurse manager, the total score for morality was 20.0; for sociability, it was 14.2; and for competence, it was 19.6. For nurses' opinions about a new nurse manager, the total score of the morality section was 16.2, which was very similar to the total score of the competence section (mean = 16.1). Conclusion: Morality positively influences nurses' initial impression of an ideal manager, and though it seems to be a necessary condition, it is not sufficient by itself to support the nursing staff's perception towards a new manager. Implications for Nursing Management: Our findings could be useful in better understanding the role of morality in social perceptions and behavioural consequences of staff nurses towards their nurse manager. [ABSTRACT FROM AUTHOR]

Background: The Trust in Nurses Scale (TNS) was developed and psychometrically assessed so that patients' trust could be accurately and reliably measured. The TNS has been translated, assessed and administered to patients in Europe, Asia and North America. Aim: This descriptive, cross‐sectional, correlational study aimed to assess the psychometric characteristics of the Italian version of the Trust in Nurses Scale. Methods: An Italian version of the TNS was developed. We used a forward–backward translation methodology to establish semantic and conceptual equivalence within the Italian context. The scale was then administered to a convenience sample of 200 hospitalised patients in medical, surgical or oncology units. Internal consistency and construct validity were assessed performing Cronbach's alpha and confirmatory factor analysis (CFA). Both a 4‐item and a 5‐item TNS were assessed. Results: The 4‐item TNS demonstrated better construct validity than the 5‐item version. Similarly, the internal consistency reliability was better with 4 items than 5 (0.83 and 0.79, respectively). Conclusion: The Italian version of the scale has acceptable reliability and validity and may be used to assess this aspect of the nurse–patient relationship. Being tested in different settings, it may be used with all patients admitted to hospital. Trust in nurses is critically important to patient outcomes; however, it is rarely measured quantitatively on a wide scale. The use of the Italian validated scale could be useful to increase evidences on this important topic, as it represents a core component of nursing care. [ABSTRACT FROM AUTHOR]

Aim and objectives: To assess the prevalence of anxiety, sleep disorders and self‐efficacy and their predicting factors among nurses facing COVID‐19. Background: The spread of COVID‐19 throughout the world determined a series of modifications of several National Health Service organisations, with a potential series of psychological consequences among nurses, who were particularly afflicted by this situation of changes and precariousness. Design: A cross‐sectional study was carried out from February–April 2020. Methods: A total of 1,005 nurses employed in different Italian hospital wards, during the COVID‐19 pandemic, were recruited. Analyses were based on descriptive statistics and multivariate logistic regression. The STROBE checklist for cross‐sectional studies was used in this study. Results: The prevalence of sleep disturbances, moderate anxiety and low self‐efficacy was 71.4%, 33.23% and 50.65%, respectively. We found a positive correlation between anxiety and sleep quality (0.408; p <.0001) and negative correlations between self‐efficacy and anxiety (−0.217; p <.0001) and sleep quality and self‐efficacy (−0.134; p <.0001). The factor independently associated with all variables was gender. Females were more prone to sleep disturbances, anxiety and low levels of self‐efficacy than males (p <.05). Conclusions: The prevalence of anxiety, sleep disorders and low self‐efficacy among Italian nurses during the COVID‐19 pandemic was high. Healthcare managers should recognise and consider these results to reduce the risk of the onset of major mental problems that could result in post‐traumatic stress disorder. Relevance to clinical practice: Nurses facing major incidents as COVID‐19 pandemic are among healthcare personnel exposed to a high risk to develop psychological disturbance that should be assessed and recognised, in order to find helpful coping strategies to inform support services and avoid to hesitate in post‐traumatic stress disorders. [ABSTRACT FROM AUTHOR]

Purpose: Neonatal palliative care becomes an option for critically ill neonates when death is inevitable. Assessing nurses' attitudes towards, barriers to, and facilitators of neonatal palliative care is essential to delivering effective nursing care. Methods: This study was conducted from January to September 2015 and involved Italian nurses employed in Level III neonatal intensive care units in 14 hospitals in northern, central, and southern Italy. A modified version of the Neonatal Palliative Care Attitudes Scale (NiPCAS) was adopted to assess nurses' attitudes. Findings: A total of 347 neonatal nurses filled out the questionnaire. The majority were female (87.6%), with a mean age of 40.38 (±8.3) years. The mean score in the "organization" factor was 2.71 (±0.96). The "resources" factor had a mean score of 2.44 (±1.00), while the "clinician" factor had a mean score of 3.36 (±0.90), indicating the main barriers to and facilitators of implementing palliative nursing care. Conclusions: Italian neonatal nurses may face different obstacles to delivering neonatal palliative care and to improve their attitudes in this field. In the Italian context, no facilitators of, only barriers to, palliative care delivery were identified. Clinical Relevance: Nurses' attitudes towards neonatal palliative care are essential to supporting nurses, who are constantly exposed to the emotional and moral distress connected with this field of end‐of‐life nursing care. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate factors involved in the blood donation (BD) in a population of Italian nursing students (NSs). Background: Young people are still numerically limited among potential blood donors. Recent research on this topic has underlined the need to promote recruitment programmes and focused advertising campaigns to specific targeted population. Design: Cross‐sectional study. The STROBE checklist was used to grant adequate and complete reporting of research. Methods: The study was carried out in five Italian Universities, and a structured, 22‐item questionnaire was distributed to 532 NSs (mean age = 24.64, SD = 7.41, min = 19; max = 55; population, female = 80.8% of total) to explore propensity, obstacles, knowledge of BD and to assess associations between variables. Descriptive (frequency, mean and SD) and inferential (χ2) statistics were conducted. Results: The overall level of knowledge among NSs donors is high, when compared with non‐donors (p < 0.05); the propensity for donation is acceptable (34.8% of the total are donors; mean = 3.17 donation). The obstacles perceived by participants are "practical" (20% and 22.8% think they do not have enough time to donate or are unsuitable because of lifestyle reasons; respectively). A relevant aspect regards the NSs' perceived role as future healthcare professionals to be responsible to educate and influence potential donors (81.5%). Conclusions: Specifically tailored BD campaigning should be implemented to sensitise University students. NSs could become effective motivators among students of different Universities or faculties. Thanks to their role and capability to put themselves in the peer group. NSs could contribute to the promotion of this selfless practice and to the development of a mature, responsible civic attitude. Relevance to clinical practice: Nursing educators should play a pivotal role in developing teaching methods to promote BD among NSs. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To assess Italian nurses’ knowledge and attitudes towards gay and lesbian sexual orientation and lesbian, gay, bisexual, and transgender (LGBT) patients, as there is currently no literature exploring the attitudes of nurses in Italy. Methods: A multicenter, cross‐sectional study was conducted between May 2015 to January 2016, using a data collection tool composed of three validated questionnaires and a sociodemographic form. Findings: Eight hundred twenty‐four nurses filled out the questionnaire. Despite their awareness of homosexuality as a “natural expression of one's sexuality,” Italian nurses showed only moderately positive attitudes towards lesbian and gay patients. A more positive attitude was displayed by women when compared with men (p < .001). Greater knowledge of homosexuality was associated with female gender (p = .042), moderate‐wing political affiliation (p = .014), and more affirmative behaviors (p = .008). Men were found to have greater awareness of being prepared to care for LGBT people (p = .022). Conclusions: Although Italian nurses displayed moderately positive attitudes and affirmative behaviors, there is the need to increase their cultural competencies regarding sexual minorities. Clinical Relevance: LGBT patients feel some discomfort in approaching physicians or nurses. It is important to know nurses’ attitudes in caring for LGBT patients in order to modify inappropriate and discriminatory behaviors. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: This study explored children's perceptions about the quality of nursing care and the determinants of their evaluations according to different categories of children's ages. Design: Multicenter cross‐sectional study carried out on 692 pediatric patients in eight large Italian regional hospitals. Methods: We used a validated questionnaire, translated and adapted to the Italian context, consisting of 49 items (5‐point Likert scale) exploring nurse characteristics, nursing activities, and nursing environment. Findings: The mean score of children's perceptions of their overall experience of hospitalization was 3.96; the nurse characteristics factor obtained the highest score (mean = 3.79), and it was in positive correlation with the satisfaction level across different age categories: 4 to 6 years, β = .37; 7 to 11 years, β = .31; and 12 to 14 years, β = .32. Conclusions: Nurse characteristics is the only significant factor contributing to children's satisfaction across the three different age categories. Clinical Relevance: In pediatric nursing care, it is important to emphasize that nurses’ personal characteristics and the ability to connect with children are essential compared to the ability to perform tasks. [ABSTRACT FROM AUTHOR]

Aims and objectives: To assess the levels of health literacy of Italian caregivers of patients with heart failure. Background: Health literacy is related to patients’ health outcomes. Low health literacy has been found in older people with heart failure, and less is known on the health literacy of caregivers whose patients are suffering from heart failure. Design: Observational, multicentre, cross-sectional study. Methods: From July 2015–May 2016, caregivers were recruited in five hospitals from Central and Southern Italy. To assess health literacy, the Italian version of the Short Test of Functional Health Literacy tool was used. Results: A total of 173 caregivers participated in the research, the majority being females (60.1%), aged between 46–60 years (52.6%) and 96 (55.5%) were from Central Italy. 33.5% of caregivers were patients’ children, and 16.2% were paid caregivers of foreign origins. The average level of health literacy was adequate; however, lower levels were found among patients’ spouses and those of older age. Conclusion: Our results, in contrast with previous studies, showed adequate health literacy levels of caregivers. However, caregivers older in age and with a low education level showed the lowest health literacy, emphasising the need for healthcare workers, to check caregivers’ health literacy, before entrusting them with the care of patients. Relevance to clinical practice: As this research gives, for the first time, an overview on Italian caregivers’ levels of health literacy, its results may be used to improve Italian healthcare professionals’ knowledge of caregivers’ health literacy, before entrusting them with the care of patients. [ABSTRACT FROM AUTHOR]

Aim To correlate workgroup engagement in nursing teams and the clinical learning experience of nursing students. Background Work engagement plays a pivotal role in explaining motivational dynamics. Nursing education is workplace-based and, through their clinical placements, nursing students develop both their clinical competences and their professional identity. However, there is currently a lack of evidence on the role of work engagement related to students' learning experiences. Methods A total of 519 nurses and 519 nursing students were enrolled in hospital settings. The Utrecht Work Engagement Scale ( UWES) was used to assess work engagement, and the Clinical Learning Environment and Supervision plus nurse Teacher ( CLES+T) scale was used to assess students' learning experience. A multilevel linear regression analysis was performed. Results Group-level work engagement of nurses correlated with students' clinical learning experience (β = 0.11, P < 0.001). Specifically, the 'absorption' and 'dedication' factors mostly contributed to enhancing clinical learning (respectively, β = 0.37, P < 0.001 and β = 0.20, P < 0.001). Conclusions Nursing teams' work engagement is an important motivational factor to enhance effective nursing education. Implication for nursing management Nursing education institutions and health-care settings need to conjointly work to build effective organisational climates. The results highlighted the importance of considering the group-level analysis to understand the most effective strategies of intervention for both organisations and nursing education. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aims of the study were to describe which of the core techniques of the physical assessment are regularly performed by a sample of Italian nurses, and to investigate the potential predictors of a more complete examination. Background. Physical examination is among the essential tasks of nursing professionals, who are requested to perform a correct and complete physical assessment. Design. Cross-sectional survey. Methods. The study was performed between August 2013 and January 2014 in 17 Italian regions. A total of 1182 questionnaires were collected. Results. Most participants were females (age range 41-50 years), and worked in Internal Medicine, Intensive Care and Surgical hospital units. Of the 30 core techniques that are currently taught and performed according to the Italian Baccalaureate degree requirements, 20 were routinely performed, 6 were seldom used and 4 were learnt but almost never performed (auscultation of lung, heart and bowel sounds and spine inspection). Graduate and postgraduate nurses, working in Intensive Care Units and Nursing Homes, were more prone than the others to carry out a more complete physical assessment. Conclusions. The skills to perform a physical assessment are suboptimal among this sample of Italian nurses. Health and educational providers should pose more attention and efforts to provide nurses with an acceptable training in physical examination practice. Relevance to clinical practice. This study describes the specific physical techniques performed by nurses in real practice and provides information on which skills require more attention in nursing educational programmes. [ABSTRACT FROM AUTHOR]

Purpose To assess Italian nurses' cultural competence, as they are increasingly called upon to care for people of foreign origins. Design A cross-sectional, multicentric study. Methods From September 2013 to May 2014, a survey was carried out among Italian nurses. Cultural competence was assessed by the Cultural Competence Assessment tool, translated and adapted to the Italian context. Findings Nurses who completed the survey numbered 1,432; 70.6% were female; 42.6% ranged in age from 41 to 50 years; and 50.0% were bachelor's prepared. More than 50% had participated in some kind of cultural diversity training. Overall, cultural competence was moderate, showing a moderately high level of cultural awareness and sensitivity (mean = 5.41; SD = 0.66) and a moderate level of culturally competent behaviors (mean = 4.33; SD = 1.10). Conclusions Although Italian nurses' cultural competence was acceptable, given the growing diversity of the patient population, nurses should be better prepared to face the changing health requests. Clinical Relevance Providing culturally competent care has been associated with improved provider-client communication, higher satisfaction with care, and health status improvement, as full comprehension of health status, adherence to medications and lifestyle recommendations, and appropriate utilization of the health system. Healthcare providers need to be adequately trained to provide culturally competent care. This research provides, for the first time, a report on Italian nurses' levels of cultural competence, and strengthens the current literature underlining the need for continuous education to enhance cultural competence among nurses. [ABSTRACT FROM AUTHOR]

Aims This systematic review aimed to synthesize and analyse the studies that examined the relationship between nurse empowerment and job satisfaction in the nursing work environment. Background Job dissatisfaction in the nursing work environment is the primary cause of nursing turnover. Job satisfaction has been linked to a high level of empowerment in nurses. Evaluation We reviewed 596 articles, written in English, that examined the relationship between structural empowerment, psychological empowerment and nurses' job satisfaction. Twelve articles were included in the final analysis. Key issue A significant positive relation was found between empowerment and nurses' job satisfaction. Structural empowerment and psychological empowerment affect job satisfaction differently. Conclusion A satisfying work environment for nurses is related to structural and psychological empowerment in the workplace. Structural empowerment is an antecedent of psychological empowerment and this relationship culminates in positive retention outcomes such as job satisfaction. Implication for nursing management This review could be useful for guiding leaders' strategies to develop and maintain an empowering work environment that enhances job satisfaction. This could lead to nurse retention and positive organisational and patient outcomes. [ABSTRACT FROM AUTHOR]

The article reports on a comparison of blood sample values by direct venipuncture and by Central Venous Catheters (CVC) using 5 or 10 milliliter (ml) wasted blood drawn from intensive care unit (ICU) patients. Preliminary results reportedly indicate that blood sample can be independently drawn using both methods only for specific tests which include glycemia, azotemia and alkaline phosphatase. The article states that there was no statistically significant difference in the resulting data.

Clinical placements are an important part of nursing education to developing nursing students' competencies. In enhancing clinical learning, to focus on mentors' competences is pivotal as they are the main role models and experts in guiding. This study is validated the Italian version of the Mentors' Competence Instrument. A sampling frame of 648 mentors was involved. The final sample included 291 mentors (response rate 45%). Confirmatory Factor Analysis was performed. Fit indices were also calculated to evaluate validity. The scale demonstrated optimal fit indexes and its validity was confirmed by psychometrical testing. In detail, Root Mean Square Error of Approximation is 0.058, Standardized Root Mean Residual is 0.046, Comparative Fit Index is 0.893 and Tucker-Lewis Index 0.886. Cronbach's alpha ranges from 0.77 to 0.95 among factors. This is the first validation of the scale performed in a different country from the original study. The performed psychometric testing showed that the scale is valid and reliable, as well as consistent with the theoretical structure reported for a different national context. This scale can be beneficial for comparing mentors' competencies across different clinical learning environments and could be used to build a broader model of mentors' competencies. • Clinical learning in nursing education is a hidden curriculum. • Mentors competences are essential to foster nursing students' clinical learning and professional competences. • Valid and reliable scales are needed to address mentors' competences development. • Mentors Competence Instrument is valid and reliable. • International comparison of mentors' competences is essential to harmonize nursing education. [ABSTRACT FROM AUTHOR]