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Background: Delirium has a high incidence pathology associated with negative outcomes. Although highly preventable, half the cases are not recognized. One major cause of delirium misdiagnosis is the absence of a versatile instrument to measure it. Aims: Our objective was to translate the nursing delirium screening scale (Nu-DESC) and evaluate its performance in Italian settings. Methods: This was a methodological study conducted in two sequential phases. The first was the Italian translation of Nu-DESC through a translation and back-translation process. The second aimed to test the inter-rater reliability, the sensibility and specificity of the instrument on a convenience sample of 101 hospitalized elderly people admitted to relevant wards of the San Gerardo Hospital in Monza. To evaluate the inter-rater reliability, two examiners tested Nu-DESC on 20 patients concurrently without comparison. To measure the sensibility and specificity of Nu-DESC, the confusion assessment method was used as a gold standard measure. Results: The inter-rater reliability (Cohen Kappa) was 0.87—an excellent agreement between examiners. The study of the ROC curve showed an AUC value of 0.9461 suggesting high test accuracy. Using 3 as a cut-off value, Nu-DESC showed 100 % sensibility and 76 % specificity. Discussion and conclusion: Further research is needed to test Nu-DESC on a larger sample. However, based on our results, Nu-DESC can be used in research and clinical practice in Italian settings because of its very good and similar performances to previous validation studies. The value of 3 appears to be the optimal cut-off in the Italian context.

To investigate the prevalence of violence towards nurses in a health care structure in the north of Italy.An observational cross-sectional study. Data were collected anonymously with a questionnaire developed by Zampieron et al. (2010) on a stratified sample of 198 nurses working in a major Italian Hospital in the Lombardy Region.43% of the sample (n=85/198) experienced violence in the previous twelve months with a mean of 4 aggressions each. Aggressors were mainly patients (53.3%) or relatives (26.7%), men (63.1%) aged between 36 and 50 years (27.9%). Of the verbal aggressions, one out of four was by a colleague or a superior. The emotional, physical and professional consequences were serious and the result of both physical and verbal violence. Nevertheless, among those who experienced aggressions, 57% did not ask for help and of those who did (43.0%) about 75% asked for help and support from their colleagues.Violence toward nurses exists and it is commonplace in the workplaces studied, even in the horizontal form. It is important to implement assessment and risk prevention and management measures, via specific training of nurses, and offer support for the victims and an anonymous formal report system guaranteed by the authorities.