Nursing Care and Clinical Management in the Post-Pandemic Era

A special issue of Nursing Reports (ISSN 2039-4403).

Deadline for manuscript submissions: 1 January 2025 | Viewed by 7527

Special Issue Editors


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Guest Editor
1. School of Medicine and Surgery, University of Milano-Bicocca, 20126 Monza, Italy
2. Department of Emergency and Intensive Care, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
Interests: mechanical ventilation; non-invasive ventilation; ARDS; respiratory mechanics; hemodynamics; respiratory pathophysiology; lung monitoring; lung imaging; nitric oxide; extracorporeal membrane oxygenation
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Guest Editor
General Intensive Care Unit, San Gerardo Hospital—ASST Monza, Milano Bicocca University, 20900 Monza, Italy
Interests: nursing workload; ECMO; non-invasive ventilation; prone position; vascular access
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Terapia Intensiva Generale–PICC Team-Ospedale S.Gerardo–ASST Monza, Università degli Studi di Milano-Bicocca, Monza 20126, Italy
Interests: vascular access; needlefree connectors; infection control; PICC; midline

Special Issue Information

Dear Colleagues, 

The intensive care unit is a dynamic and heterogeneous environment that requires nurses to balance many competing tasks and responsibilities. A rapid acceleration in levels of responsibility for intensive care unit nurses during the pandemic was observed, because of the expansion of their professional role, resulting in a significant increase in their regular workload with a significantly higher number of patients per nurse and a significantly higher nursing activity score per nurse. After the pandemic peaks, delivering advanced treatments outside the ICU may represent a new feasible strategy to manage patients after ICU discharge, especially those with care limitations. A follow-up visit, after ICU discharge, from a member of the ICU staff could be recommended in this new scenario. ICU survivors, discharged after a long stay and prolonged time of mechanical ventilation require specialized care to minimize Post Intensive Care Syndrome. Nurses, in every kind of hospital setting (ICU, HDU, general wards), are responsible for managing patients, aiming for health progress while minimizing the risk of hospital-acquired complications, but also for preventing the further spread of disease.

This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) focuses on the current state of knowledge on nursing care and clinical management in critically ill patients, before, during, and after ICU admission. Papers dealing with new approaches to the delivery of nursing care and management are also welcome. 

Here are some examples of topics that could be addressed in this Special Issue:

  • Ultrasound-guided vascular access in critical illness;
  • Set up of non-invasive ventilation;
  • Incidence of pressure injury after the COVID-19 era;
  • Nursing of ECMO patients;
  • Vascular access assessment in the ICU;
  • ICU survivor follow-up clinics;
  • Humanizing Critical Care for Patients and Families;
  • Nursing workload inside and outside the ICU;
  • Nursing management of ARDS patients after the COVID-19 era.

You may choose our Joint Special Issue in IJERPH.

Dr. Emanuele Rezoagli
Dr. Alberto Lucchini
Dr. Stefano Elli
Guest Editors

Manuscript Submission Information

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Keywords

  • vascular access
  • non Invasive ventilation
  • nursing workload
  • follow-up
  • ECMO
  • ultrasound-guided ICU diary
  • prone position
  • pressure injury
  • early mobilization in ICU

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Published Papers (5 papers)

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Research

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11 pages, 259 KiB  
Article
Nurses’ Knowledge and Attitudes about Adult Post-Operative Pain Assessment and Management: Cross Sectional Study in Qatar
by Haya Samara, Lily O’Hara and Kalpana Singh
Nurs. Rep. 2024, 14(3), 2061-2071; https://doi.org/10.3390/nursrep14030153 - 21 Aug 2024
Viewed by 1240
Abstract
Background: Pain is a complex and challenging phenomenon. People have different pain experiences, but everyone has the right to effective pain management. Pain assessment and management are integral components of a nurse’s role. Aim: To assess the knowledge and attitudes of nurses in [...] Read more.
Background: Pain is a complex and challenging phenomenon. People have different pain experiences, but everyone has the right to effective pain management. Pain assessment and management are integral components of a nurse’s role. Aim: To assess the knowledge and attitudes of nurses in Qatar about adult post-operative patients’ pain assessment and management, and the factors that may be associated with such knowledge and attitudes. Methods: Post-operative registered nurses from all peri-operative areas at Hamad Medical Corporation participated in a cross-sectional online survey using a self-administered questionnaire. A knowledge and attitudes (K&A) score was calculated. Associations between K&A and potential explanatory variables were assessed using t-tests and one-way ANOVA. Results: A total of 151 post-operative nurses participated in the study. The mean knowledge and attitudes (K&A) score was 19.6 ± 4.5 out of 41 (48%), indicating a large deficit in nurses’ knowledge and attitudes about adult post-operative pain. There were no statistically significant differences in the mean K&A scores of participants based on gender, nationality, education level, marital status, workplace facility, current job designation, or hours of pain education. Conclusions: There is a significant deficit in post-operative nurses’ knowledge and attitudes about pain across the nursing workforce in post-operative care. Implications for nursing education and policy: Evidence-based, innovative nursing education courses are needed to improve nurses’ knowledge and attitudes about pain assessment and management. Health service policy is required to ensure that evidence-based in-service education on pain management is compulsory for all nurses. This study was not registered. Full article
(This article belongs to the Special Issue Nursing Care and Clinical Management in the Post-Pandemic Era)
10 pages, 251 KiB  
Article
Primary Health Care Case-Management Nurses during the COVID-19 Pandemic: A Qualitative Study
by María José Molina-Gil, María Dolores Guerra-Martín and Rocío De Diego-Cordero
Nurs. Rep. 2024, 14(2), 1119-1128; https://doi.org/10.3390/nursrep14020084 - 28 Apr 2024
Viewed by 1355
Abstract
The COVID-19 has caused high morbidity and mortality in vulnerable people, such as those affected by chronic diseases, and case-management nurses (CMNs) are reference professionals for their health care and management. The objective of this study is to better understand the discourse, experiences, [...] Read more.
The COVID-19 has caused high morbidity and mortality in vulnerable people, such as those affected by chronic diseases, and case-management nurses (CMNs) are reference professionals for their health care and management. The objective of this study is to better understand the discourse, experiences, and feelings about the professional performance of CMNs during the pandemic. A qualitative study was conducted by conducting semi-structured interviews with CMNs (n = 31) from the province of Seville (Spain) and performing a narrative discourse analysis. The Atlas Ti 6.2 software program was used. Two categories were defined: 1. CMNs’ competencies (76 verbatim testimonies); and 2. Consequences of the COVID-19 pandemic (61 verbatim testimonies). This study was granted due permission by the Research Ethics Committee belonging to the University of Seville, under protocol code: 1139-N-22. The pandemic caused an increase in CMNs’ workload, and they had to assume their usual care tasks for vulnerable populations in addition to simultaneously prioritizing assistance in nursing homes. We can highlight CMNs’ adaptation to the pandemic situation and to these new requirements in the context of their significant social commitment to the advanced practice of the profession, a commitment that is closely related to leadership. We should also indicate that interpersonal relationships were improved, and that there was technological progress. Some CMNs mentioned an increase in their workload and reported experiencing burnout syndrome. We conclude that CMNs’ management of health care during the pandemic has been extraordinary, especially in regard to the most vulnerable populations of patients, including individuals with chronic diseases and institutionalized older adults, a fact that has been valued by the institutions and by society in general. Full article
(This article belongs to the Special Issue Nursing Care and Clinical Management in the Post-Pandemic Era)
11 pages, 1108 KiB  
Article
Emergency First Responders’ Misconceptions about Suicide: A Descriptive Study
by Elena Victoria Ayala Romera, Rosa María Sánchez Santos, Giulio Fenzi, Juan Antonio García Méndez and Jose Luis Díaz Agea
Nurs. Rep. 2024, 14(2), 777-787; https://doi.org/10.3390/nursrep14020060 - 28 Mar 2024
Cited by 1 | Viewed by 947
Abstract
Background: In 2022, suicide was the second leading cause of external death in Spain (the first among young people aged 15–29 years). This study aims to analyze the presence of myths among emergency first responders and identify the most prevalent false beliefs among [...] Read more.
Background: In 2022, suicide was the second leading cause of external death in Spain (the first among young people aged 15–29 years). This study aims to analyze the presence of myths among emergency first responders and identify the most prevalent false beliefs among them. Methods: The research is a observational and descriptive study carried out using a questionnaire composed of a total of 25 myths, with the response options being true or false. A total of 543 professionals took part in the study. All of them could intervene before, during, and after a suicide attempt. Results: The main finding of the study is that more than 50% of the participants accept as true the statement "There are more serious and less serious problems", underlining the idea that caring for patients could be related to the importance the health professional gives to the patients’ problem. Myths such as “The suicidal person wants to die” and “The suicidal person is determined to die” are also evident. Conclusion: The subjective thought the first responder has about suicide could affect their acts, and there is a need to train first responders in suicidal behavior to be able to create an adequate approach. Full article
(This article belongs to the Special Issue Nursing Care and Clinical Management in the Post-Pandemic Era)
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Review

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18 pages, 667 KiB  
Review
A Comparison among Score Systems for Discharging Patients from Recovery Rooms: A Narrative Review
by Khadija El Aoufy, Carolina Forciniti, Yari Longobucco, Alberto Lucchini, Ilaria Mangli, Camilla Elena Magi, Enrico Bulleri, Cristian Fusi, Paolo Iovino, Pasquale Iozzo, Nicoletta Rizzato, Laura Rasero and Stefano Bambi
Nurs. Rep. 2024, 14(4), 2777-2794; https://doi.org/10.3390/nursrep14040205 - 6 Oct 2024
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Abstract
Introduction: The recovery room (RR) is a hospital area where patients are monitored in the early postoperative period before being transferred to the surgical ward or other specialized units. The utilization of scores in the RR context facilitates the assignment of patients to [...] Read more.
Introduction: The recovery room (RR) is a hospital area where patients are monitored in the early postoperative period before being transferred to the surgical ward or other specialized units. The utilization of scores in the RR context facilitates the assignment of patients to the appropriate ward and directs necessary monitoring. Some scoring systems allow nurses to select patients who can be discharged directly to their homes. Aim and methods: The aim of this narrative review was to describe and compare the scoring systems employed to discharge postoperative patients from RR, with a focus on item characteristics. Results: Nine scoring systems were identified and discussed: the “Aldrete Score System” and its modified version, the “Respiration, Energy, Alertness, Circulation, Temperature Score”, the “Post Anesthetic Discharge Scoring System”, the “White and Song Score”, the “Readiness for Discharge Assessment Tool”, the “Anesthesia and Perioperative Medicine Service Checklist”, the “Post-Anesthetic Care Tool”, the “Post-operative Quality Recovery Scale”, and the “Discerning Post Anesthesia Readiness for Transition” instrument. Discussion and conclusions: To obtain a comprehensive overview, the items included in the scoring systems were compared. Despite the availability of guidelines for patients’ discharge readiness from the RR, there is no universally recommended scoring system. Next-generation scores must be improved to ease their use, minimize errors, and increase safety. The main goals of the scores included in this narrative review were to be simple to use, feasible, intuitive, comprehensive, and flexible. However, these goals frequently conflict because patient assessment takes time, and a smart and comprehensive score may not consider some clinical parameters that may be crucial for the discharge decision. Therefore, further research should be conducted on this topic. Full article
(This article belongs to the Special Issue Nursing Care and Clinical Management in the Post-Pandemic Era)
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Other

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13 pages, 2734 KiB  
Systematic Review
Brachial Tunneled Peripherally Inserted Central Catheters and the Risk of Catheter Complications: A Systematic Review and Meta-Analysis
by Davide Giustivi, Mattia Donadoni, Stefano Maria Elli, Francesco Casella, Massimiliano Quici, Chiara Cogliati, Silvia Cavalli, Giulia Rizzi, Leyla La Cava, Arianna Bartoli, Elena Martini, Alba Taino, Martina Perego, Antonella Foschi, Roberto Castelli, Maria Calloni and Antonio Gidaro
Nurs. Rep. 2024, 14(1), 455-467; https://doi.org/10.3390/nursrep14010035 - 18 Feb 2024
Cited by 2 | Viewed by 2101
Abstract
Introduction: Situations involving increased workloads and stress (i.e., the COVID-19 pandemic) underline the need for healthcare professionals to minimize patient complications. In the field of vascular access, tunneling techniques are a possible solution. This systematic review and meta-analysis aimed to compare the effectiveness [...] Read more.
Introduction: Situations involving increased workloads and stress (i.e., the COVID-19 pandemic) underline the need for healthcare professionals to minimize patient complications. In the field of vascular access, tunneling techniques are a possible solution. This systematic review and meta-analysis aimed to compare the effectiveness of tunneled Peripherally Inserted Central Catheters (tPICCs) to conventional Peripherally Inserted Central Catheters (cPICCs) in terms of bleeding, overall success, procedural time, and late complications. Methods: Randomized controlled trials without language restrictions were searched using PUBMED®, EMBASE®, EBSCO®, CINAHL®, and the Cochrane Controlled Clinical Trials Register from August 2022 to August 2023. Five relevant papers (1238 patients) were included. Results: There were no significant differences in overall success and nerve or artery injuries between the two groups (p = 0.62 and p = 0.62, respectively), although cPICCs caused slightly less bleeding (0.23 mL) and had shorter procedural times (2.95 min). On the other hand, tPICCs had a significantly reduced risk of overall complications (p < 0.001; RR0.41 [0.31–0.54] CI 95%), catheter-related thrombosis (p < 0.001; RR0.35 [0.20–0.59] IC 95%), infection-triggering catheter removal (p < 0.001; RR0.33 [0.18–0.61] IC 95%), wound oozing (p < 0.001; RR0.49 [0.37–0.64] IC 95%), and dislodgement (p < 0.001; RR0.4 [0.31–0.54] CI 95%). Conclusions: The tunneling technique for brachial access appears to be safe concerning intra-procedural bleeding, overall success, and procedural time, and it is effective in reducing the risk of late complications associated with catheterization. Full article
(This article belongs to the Special Issue Nursing Care and Clinical Management in the Post-Pandemic Era)
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