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Background: Prolonging the duration of peripheral venous catheters (PVC) as long as possible in children is a nursing priority. However, available studies provide conflicting evidence on what kind of flush/lock solution should be used to increase the life of PVCs in children., Objectives: To describe the clinical behavior of nurses working in Italian pediatric units with regards to PVCs flushing and locking practices., Methods: Cross-sectional study. Nurses were invited to participate using the network of the Italian Society of Pediatric Nursing Science. Those participating completed an online questionnaire available on a website established for this specific purpose. Results: 405 questionnaires were completed., Results: The majority of nurses reported using Normal saline solution (NS) to flush 22 gauge PVCs: 77.6% in children up to 6 months of age, 74.7% in children 6 months to 2 years, and 74.6% in children over 2 years. Nurses tend to use heparin solutions (HS) more frequently when a smaller gauge PVC is used (24 instead of 22) and when access is less frequent. The use of HS for PVC lock is more common in onco-hematology units (54.5% in children over 6 months with 24 gauge PVC), pediatric surgery units (35%), and in short-stay units (55.6%), whereas NS is used more frequently in Intensive care units (9.4%) and neonatology units (12.2%)., Conclusion: Although the majority of respondents use NS, we found a high variability in practices among Italian nurses. More research on the effectiveness and safety of HS in maintaining the patency of PVCs is needed.

Purpose: The aim of this study was to assess the incidence of late onset complications of totally implantable venous access devices (TIVAD) in patients with cystic fibrosis (CF) and to investigate possible associations between the rate of complications and different policies of TIVAD management., Methods: A multicenter prospective cohort study was performed in 11 Italian CF Centers. Patients with CF and a TIVAD were recruited and followed-up., Results: The study commenced on May 2008 and ended on September 2010. Eighty subjects were studied (77.5% women--mean age 27.2 years). Eighteen late complications of ports were observed (22.5%; incidence 0.96 per 1000 days of observation): three lumen occlusions, seven catheter-related infections , three port-related venous thrombosis, in addition to five other complications. A statistically significant association was found between the onset of catheter-related infection and the presence of CF-related diabetes (CFRD) (P=.0064), Conclusions: Our data suggest that TIVADs represent a safe and effective device for the intermittent IV administration of drugs in people with CF. However, people with CFRD have a higher risk of developing TIVAD-related infection.

Unlabelled: Commuting is an additional burden that affects working stress, reduces leisure time and raises the risk of accidents. Little data are available about nurses' commuting patterns or the impact of commuting on their lives., Objectives: The study aims to describe commuting patterns among Italian nurses and to explore possible associations with nurses' intention to change job., Methods: This is a cross-sectional study carried out in central Italy. Nurses were invited to participate through a variety of public measures. Those participating completed an online questionnaire available on a website established for this specific purpose., Results: Five hundred sixty-five nurses participated. The mean distance covered every day to go to work and back home is 30.8 km. A total of 43.3% of nurses cover 25 km or more every day to work; 5.7% cover 100 km or more. The mean time spent in commuting is 52.9 min daily. Furthermore, 14.5% of nurses spend every month commuting a time equal to or longer than the working time of 1 week. The mean monthly expenditure is 87.30 Euro (6% of mean salary). Nurses younger than 30 cover longer distances (P=0.0006), spend more time (P=0.001) and have higher expenditure (P=0.003) than their older colleagues. Willingness to change job seems associated with the use of public means of transportation (P=0.04). Nurses from the population under study cover longer distances, spend longer time in daily commuting and have higher monthly costs than the rest of the Italian workers' population., Conclusions: Travelling to work represents a non-negligible burden for nurses, particularly for younger nurses. Nurses seem to have lesser opportunities to rest and to recover energies than other workers. The Italian nurses' recruiting system may have a role in explaining our data. Further studies are needed to investigate the impact of nurses' commuting on the healthcare system., (© 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.)

Purpose: Immigration and multiculturalism are relatively recent in Italian society, and social adaptation to this new reality is still ongoing. Immigrants to Italy mainly come from China, Albania, Northern Africa, and Eastern Europe. Because no study about this topic was found, our goal was to investigate attitudes and problems encountered by Italian nurses in a paediatric setting with regard to nursing care of children and their families from other countries., Design and Methods: Exploratory study. An anonymous 11-item "ad hoc" questionnaire was distributed to 201 ward nurses of the Meyer Paediatric Hospital, Florence, Italy in May 2007., Findings: In all, 129 nurses (64.1%) answered the questionnaire; 78.3% reported having experienced some difficulties in providing care to foreign children and their families. The language barrier was reported as the most important, although more than two-thirds of nurses speak a language in addition to Italian. About half of the nurses encountered problems in care because of different nutrition and personal hygiene customs of patients and their families. Religious and spiritual practices were perceived as a problem by only a minority of nurses. Almost half of the nurses reported having been involved in care situations wherein they felt embarrassed or disapproval concerning the behaviour of parents of foreign children. This included discomfort about different views concerning the social role of women. Nurses also perceived in foreign parents opinions different from their own about the role of nurses (10%) and attitudes of children toward pain associated with medical procedures (45%)., Conclusions: This is the first study we know about regarding attitudes of Italian nurses toward multicultural care. Effective communication is the main aspect of delivering culturally competent care. Language as a means of communication is paramount for an effective nurse-patient relationship without which nursing care is unsatisfactory. Our study indicates the importance of teaching transcultural nursing, cultural diversity, and culturally competent nursing care in university and continuing professional education programs for Italian nurses and nursing students., Clinical Relevance: This study indicates the strengths and weaknesses of Italian nurses in managing the care of non-Italian children and their families; and the need for a background of transcultural nursing and theory.

Background: Cystic fibrosis (CF) is the most common life-threatening genetic disease in the Western world. Its incidence varies between 1:4,000 and 1:2,500 among Europeans. No data are available on the incidence of CF among Albanians, mainly due to difficulties of the local health system., Goals: To estimate the incidence of CF and the prevalence of healthy carrier status among Albanian ethnic people; to evaluate the incidence of hypertrypsinaemia at birth among Albanian newborns., Methods: We used the database of the newborn screening of Tuscany, Italy for the period 1991-2005. Children born to both Albanian parents in Tuscany were identified and incidences were calculated., Results: The incidence of CF among Albanians (1/555, 99% CI: 1/2,980-1/306) was significantly higher than the rest of the Tuscan population (1/4,101, 99% CI: 1/5,564-1/3,248). The prevalence of CF carrier status among Albanians living in Tuscany is estimated to be 1/12 (99%CI 1/27-1/9) while in the rest of the Tuscan population it is 1/32 (99%CI 1/37-1/28). The incidence of hypertrypsinaemia at birth among Albanian newborns (1/55 99%CI: 1/74-1/44) was significantly higher than in the rest of the population (1/84, 99%CI 1/88-1/82)., Conclusion: The incidence of CF among Albanians is considerably higher than expected. Albanian people have a risk to give birth to children with CF higher than the rest of Europeans. The implementation of a newborn screening program in Albania, together with a CF follow up program is highly advisable., ((c) 2008 Wiley-Liss, Inc.)

Unlabelled: In recent years Voluntary Incident Reporting (VIR) has spread as a tool to monitor and prevent adverse events in healthcare (AE). In Italy, experiences of VIR are limited., Aim: The goals of this pilot study were to test the feasibility of a VIR system in a population of nurses of a Pediatric Hospital and to make a preliminary survey of situations of risk for patients' safety, to plan corrective actions., Methods: Nurses of 3 wards were asked to report AEs with or without harm for patient, near misses and unsafe behaviours or situations at risk for generating AEs. Results were cumulatively reported to participating nurses during ward's meetings and possible corrective interventions were discussed., Results: The study was carried out from April to August 2006. Eighty-seven nurses participated. Forty-eight reports were made (one third signed, two thirds anonymous). Twenty reports (41.6%) regarded unsafe behaviours or situations at risk for AEs, 11 near misses, 15 AEs without patient harm and 2 AEs with harm. Twenty-three reports involved patients. Reports regarded mainly therapy (62.5%), care delivery (14.5%), equipment (8.3%), clinical documentation (6.3%). 40% of all AEs and near misses were reported to happen during the first or the last hour of the shift. AEs most frequently reported were: missing administration of treatments, administration of a wrong drug or of a wrong dose. "Look-alike" drugs and incomplete or illegible prescriptions., Conclusions: Our pilot study confirms that nurses are generally willing to get involved in VIR systems. It also suggests that to succeed VIR systems have to ensure that reporters remain anonymous and non-prosecutable.