Search

Objective To validate the International Skin Tear Advisory Panel (ISTAP) Classification System in Italian. Methods In collaboration with the ISTAP, the classification system was translated into Italian using a forward-back translation process. To validate the translated system, a convenience sample of 212 health professionals classified 30 photographs of skin tears originally used by ISTAP. The wound images were labeled type 1, 2, or 3 as described by the classification system. The resulting scores were compared with the ISTAP classification, and the reliability of agreement was calculated with Fleiss κ. Results Complete data were obtained from 209 healthcare professionals. When the image classifications were compared with the original ISTAP indications, 72.5% of all classifications were correct. Data indicated a moderate level of agreement (Fleiss κ = 0.466, range = 0.41-0.60). Data analysis showed similar agreement levels between nurses (n = 197, Fleiss κ = 0.466) and nonnurses (n = 12, Fleiss κ = 0.46). Conclusions The study validates the Italian version of the ISTAP skin tear classification system. Further studies are necessary to confirm the system's usability in Italian research and clinical settings.

Falls of hospitalised people and resulting injuries are an important event, particularly in elderly people, since they can be cause of morbidity, disability and mortality. Frequently, fall result in deterioration of quality of life, reduction of personal autonomy and lengthening of stay in hospital. Literature reported one fall in the year in about one third of over 65 years old people; in 25% of old people admitted to hospital; in 43% of total guests in RSA (Ungar et al., 2004, Rubenstein et al., 2002).We report data relative to experimental introduction of a new notification system and statistical monitoring, made by the Nursing Directorate of Niguarda Hospital in Milan, in the 8 wards that have recorded the highest number of falls in 2006 and 2007. The reports received (n = 119) made possible to assess the functionality of the system designed with the specific nature of the data collected. Falls of patients with minimal or absent risk factors for falls at the admission (50%) have been analyzed. The relationship of falls with age of patients, drugs assumption and nursing needs have been evaluated.75% of fallen patients were over 68 years old. Taking a single or a combination of drugs considered as dangerous for falls was a recurring data. The most common modality of falls was to get out of bed. 30% of patients involved presented some nursing care needs (moving and personal hygiene). These needs were not particularly limiting their autonomy, but a nursing support and supervision had been in any case planned.Over 68 years old patients, taking drugs dangerous for falls and presenting nursing care needs should be strictly look after by nurses while the mobilization.

The rapid evolution of healthcare and the need to contain costs, to decrease the time of patients' hospitalization, and to improve the quality of care has led the nursing profession to face new challenges. This paper describes the case study of A.O. Ospedale Niguarda in Milan (Italy), a public healthcare provider where the key role of Nursing is being recognized according to international common practice. Also considering the context of Italian healthcare, attention will be drawn to concrete actions carried out on the organizational side and also for what concerns IT tools supporting nursing activities. This was done aiming with success at rising nurses' knowledge level of the patient, support its activities, increase quality of care, in a precise managerial and methodological framework. We will describe four cases of projects (Intensive Care Unit patient record, First Aid Station care reporting, pressure ulcers management, transfusion traceability) carried out by Niguarda with the support of its partner Fondazione Politecnico di Milano, set up to support bedside nursing activities with the most suitable technology for the purpose.

The theory of continuous quality improvement is related to the principles of Total Quality and focuses on three main elements: client satisfaction, erogation of services and the informative system. In this wide context, the experience of the Niguarda Cà Granda Hospital regarding the introduction of certified nursing documents is described. The aspects considered are the introduction and management of the document, also taking into consideration the strategies adopted for modifying professional behaviour such as training. The evaluation confirms that any project aimed at improving the quality of care can be achieved as long as the Hospital management make a strategic decision and there is involvement of the individual professionals.

The present article illustrates results of a survey, introduced in occasion of the celebration of the International Day of the Nurse, in the "Ospedale Niguarda Ca' Granda" of Milan, finalized to know the opinions and the expectations that the customers have developed in the comparisons of the nurses, taking into consideration Services and Operating Units. From it turns out that the customers have a much positive image of the nurse as a person who helps more than to be a professional. However when this dimension comes expressed from the customers, it very turns out defined and specified, independent regarding the medical profession.

The objects can substantially synthesizes: 1. To reflect on the evolution of the organizational configuration of the nursing function based on the various theoretical contributions; 2. To make a picture of the organizational configurations of nursing function that more frequently appear in the immense and heterogeneous health system; 3. To formulate future hypotheses that concur on nursing autonomy in the comparisons with new and old professions and to strengthen out direct responsibility.