Heart failure has an enormous impact in terms of mortality, morbidity, and costs for healthcare organizations. Indications for implanted heart devices, such as pacemakers or implantable cardioverter defibrillators (ICDs) are constantly increasing. With the arrival of the telemedicine, nurses play an important role in the remote management of chronic heart diseases. The purpose of this study was to describe the experiences of nurses who remotely monitor patients with an implanted heart device in Italy. A qualitative study with a phenomenological approach was conducted. The sample consisted of 7 nurses dedicated to remote monitoring (RM), from three cardiology clinics in Northern Italy. We conducted semi-structured interviews to understand the experience and training nurses received to conduct RM. From the analysis of the interviews, six themes were identified: 'Specialized knowledge and skills', 'Learn through practice', 'Organization of work', 'Decision making', 'Trust', and 'Need for information'. The majority of our sample developed their competencies directly on the field, in absence of a certified recognized pathway, on RM in patients with heart failure implanted with cardiac devices. Therefore, nurses performing RM activities do not receive the same type of education and training. Currently, in Italy, there is no standardised training for nurses who perform RM activities for heart failure patients with implanted heart device, and yet it is instrumental to have appropriate knowledge and training to effectively perform this type of activity and care.

Nurses who work at night often experience high levels of sleepiness, which are the biological consequence of the circadian rhythm, which induces sleep at particular hours of the night, increasing the risk of errors and accidents. According to the latest data declared by the World Organization of Healthcare (WHO), at least 134 million patients are victims every year adverse events that occur due to the lack of safety in the health care and and 2.6 million those who die from it, but most of these deaths are avoidable. The study aims to investigate the relationship between sleep deprivation and errors in patient care by the nursing staff who works the night shift. In the aviation and transportation sectors, studies conducted revealed as sleep deprivation increases the risk of mistakes. Few researches have investigated nighttime nursing. A literature search was conducted by interrogating banks PubMed and Cochrane data limiting article selection to the last 10 years. Only one study met our benchmarks: "Sleep deprivation and error in Nurses who work the night shift "of 2014, by Arlene L. Johnson, whose questionnaire it was adapted to the Italian situation and administered to a sample of 41,000 nurses, to which 3358 responded. 94.7% of the interviewees, during the night shift, carry out ordinary activities. 16.8 of respondents made mistakes in the last two night shifts; in 59.5% of the cases only one mistake was made. Lack of sleep (3-5 hours of sleep during the 24 hours of the day before the interview) seems to determine a higher frequency of errors. This trend is particularly marked a nurses working in critical wards (23.9%). Even the number of nights, affects the propensity to make mistakes, with an error rate of 20.5%.

Digital and technological solutions (DTS) might have an impact on people's personal and professional lives. These types of solutions, according to studies, have the potential to revolutionize and improve the quality and long-term sustainability of healthcare activities, with nurses playing a significant role. Although DTS appears to be intimately linked to the future of nursing, technology must be utilized as an active rather than passive tool. Nonetheless, understanding DTS appears to be difficult, and a scoping study can provide a thorough overview of such a complicated topic. As a result, the scoping study on this topic will map all of the important aspects of DTS and synthesize studies on the nursing workforce, as well as analyze and clarify knowledge gaps and aid future research and development. This article presents the study protocol. The Joanna Briggs Institute (JBI) scoping review methodology will be used for the proposed scoping review. It will include both quantitative and qualitative scientific research as well as grey literature on DTS in nursing. Only English-language works will be considered for inclusion. Two independent reviewers will take part in an iterative process of evaluating literature, choosing papers, and extracting data. Disagreements among reviewers will be resolved through debate until a consensus is reached or through consultation with the study team if necessary. Results will be presented using descriptive statistics, diagrammatic or tabular displayed information, and narrative summaries, as specified in the JBI guidelines. This scoping review protocol explained why it is important to describe the literature on embracing DTS in the nursing field, how to approach the research process, and what the study's key implications will be. The protocol itself may be helpful to increase transparency in the research process, attract interested researchers to work with the group that developed the protocol and offer a practical methodological benchmark for researchers interested in performing scoping reviews by serving as an example of a scoping review protocol.

Job satisfaction impacts on multiple aspects of work environment, influencing productivity, performance, absenteeism, permanence, hiring, organizational commitment, nursing care. The purpose of the study was to describe the perception of the level of organizational well-being and job satisfaction by identifying the determinants of unwellness organizational at the ASL 3 Genovese "Villa Scassi Hospital". The cross-sectional study was conducted from April to June 2019; the information was collected through a questionnaire administered to a sample of 318 nurses made of 72 items and socio-demographic characteristics, of which 22 items examining the level of burnout and 50 items investigating the influence of psychosocial factors on the well-being of workers. A total of 318 questionnaires were administered with an adhesion rate of 36.16%. 76.52% of the population is not satisfied with their working condition, while 20.86% is. The levels of emotional exhaustion were high as 30% of the interviewed sample was found to be emotionally stressed "several times a month" due to the work performed. 33.9% and 42.6% of the sample judged their work complex and interesting with a grade of 10. There is a need to make health care organizations more aware that having a class of nurses who show passion and interest in their profession improves the quality of the work itself and the quality of care provided to clients.

In recent years, and even more following the need for social distancing generated by the global COVID-19 pandemic, e-health has become an increasingly widespread reality in clinical practice, especially for those clinicians operating in the front-line, like nurses. Its growing importance has been followed by increasing attention both by the literature as well as in the generation of specific rules aimed at regulating the phenomenon. A regulatory review of the literature aims to outline the current regulatory framework relating to telemedicine. Telemedicine, especially in a pandemic context, calls for regulation that runs parallel to the rapid evolution of the phenomenon itself. The paper traces the European, Italian, and Regional legislation, focusing then on a practical experience of telemedicine, called Doctor @ Home, active at the IRCCS National Cancer Center in Aviano (Italy). First, the need for regulatory harmonization emerges. Secondly, the potential of co-production and co-learning processes for healthcare professionals and patients arises to adapt to the outpatient needs of patients in a post-pandemic "new normal," exploiting the new technological tools made available by the National Health Service.

Nurses dedicate majority of working time to satisfy patients' needs, which are oftentimes complex. Although the concept of patient's complexity of care (PCC) has been extensively studied, it remains undefined in its essential characteristics. Various tools for assessing PCC have been developed, yet, there is no gold standard of reference. This study intends to explore the elements that determine PCC focusing on the patient's needs. The bed management team of a University Hospital developed in 2010 a PCC measurement instrument, similar to a triage system, to classify rapidly patients into macro-levels of care complexity (low, medium, high, intensive). Descriptive analysis of prospectively collected data registered in nursing records during 2016-2017 are presented in this study. The incidence of individual metrics on the value assigned to the overall PCC level was calculated. 26593 patients' records were analyzed. The final level of PCC was equal to patient's level of autonomy in 92,2% of cases, to clinical stability in 74,4% and to cognitive status in 58,4%. Our finding indicate that essential elements to determine PCC are patient's autonomy and clinical stability. Therefore, nurses can use these metrics to classify quickly PCC in their work settings. Identifying and measuring PCC is very important for nurses. It can facilitate and support nurse decision-making in design, implementation and evaluation of activities aimed at improving patient care. Moreover, it can help in the distribution of care loads in the shift, and from an organizational point of view, it can allow defining staffing assets.

The Coronavirus (Covid-19) pandemic caused a severe health crisis that has affected millions of people and quarantined half of the world's population. The health emergency from Covid-19 has seen health workers on the front line face all the difficulties related to the burden of care and the reorganization of procedures, roles, and tools at the hospital level. One of the most significant and probably underestimated aspects is the psychological stress of frontline nurses. The article aims to analyze the literature relating to the impact on the mental health of nurses engaged in the management and care of Covid-19 patients. A systematic review of the published articles on the subject was conducted from January 2020 to November 2020. The search for papers was conducted on scientific databases like PubMed, Scopus and Embase. The results show the onset of anxiety, depression and stress and insomnia in healthcare workers. These aspects are closely related to numerous factors, including the fear of contracting the disease and infecting family members, stressful shifts and little rest, leading to a state of psychological and physical tension capable of activating pathological behaviours. The literature highlights the importance of support interventions for frontline personnel to avoid the onset of psycho-pathophysical severe problems. The review suggests that frontline nurses during the emergency phase of Covid- 19 may be prone to psychological disorders that can compromise mental health. Therefore, the surveillance and monitoring of symptoms, together with targeted support interventions, should be guaranteed daily to all professionals involved to prevent the onset of psychological disorders.

Nursing theories are essential for orienting nursing practice. To date, three models for nursing practice have been developed in Italy. In addition, significant epistemological reflections have been published, sparking a rich professional debate regarding the theoretical foundations of nursing in Italy. However, conceptual models from other countries are often still used, despite many difficulties associated with applying them in practice. In order to investigate and redress this 'theoretical gap' and related implications for intervention, three scoping reviews of the Italian nursing literature were conducted to examine three categories of nursing knowledge: (a) nursing practice in Italy; (b) the basic nursing concepts of person, health, environment and nursing; and (c) regulatory/normative statements regarding what nursing practice should be in Italy. The purpose of this investigation was to identify how nursing is conceptualized in the Italian literature through an integrative narrative analysis of three scoping reviews. The Scoping Review according to the recommendations published by Arksey and O'Malley and subsequently implemented by Levac et al. has been selected as the optimal methodology for mapping nursing knowledge. At the end of the reviews carried out to answer the three research questions, the researchers integrated the results by conducting a coding of the results. The narrative synthesis highlighted a systemic conception of persons in their social context, 'incorporated' within relational systems. Persons are imagined as active agents with self-determination toward promoting their own health. Health, derived from levels of equilibrium between multiple systemic components and based on the person's holistic view, is a fundamental right and a collective social interest. Maintaining or promoting a person's health requires careful consideration of all these constitutive and integral elements. The nursing process is implemented through technical acts as well as relational and caring skills. Professional autonomy, influenced by clinical and organizational contexts, is expressed in collaboration with other professionals who contribute to the healthcare process. The results of this integrative narrative analysis suggest the need for a holistic vision of persons, with an active role in their health management, indissociable from the system of relationships in which this is contextualized, within which nurses are embedded. In light of the results of our investigation, the promotion of a conceptualization of nursing based on the centrality of the person-social relational system and on the active role of persons that nurses work with, this could guide approaches used in nursing education and administration. This could help enhance care provided by nurses and persons' participation in decisions regarding their own health.

Nurses, particularly emergency nurses, are among the health workers most exposed to workplace violence (WPV). Despite WPV recording systems are becoming more common, the under-reporting is still widespread. Studies suggest that the use of simple and easy registration systems could facilitate the reporting of violent events. To verify if a friendly reporting system based on a Mobile-app can facilitate the WPV reporting. The University of Florence has developed an application for Android and iOs to report incidents of violence towards emergency nurses. Started from 5 February 2018 and ended on 17 March 2019 in 20 Italian emergency departments, our 6-month study involved the participation of 386 nurses enabled to use this mobile app. 189 participants answered the questionnaire at the beginning (time T0) and at the end (time T1) of the trial period. The questionnaire item about the frequency of reporting of violent events in the last 6 months was scored: 1 for "Yes, all", 2 for "Yes, some", 3 for "No, only informally", and 4 for "No, not at all". The answers obtained the following arithmetic mean values (M), standard deviation (SD) at time T0 and T1, respectively M = 2.65, SD = 0.972, and M = 2.26, SD = 0.864. The result of the Paired Samples t-Test returned a t=3.614, df= 99 CONCLUSIONS: This result indicates a statistically significant difference in the change in the propensity to report, even if for small values. The technology cannot solve the problem of underreporting alone. To solve this problem it is necessary to act on several front.