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Usberg G, Clari M, Conti A, Põld M, Kalda R, Kangasniemi M. COVID-19 and nurses' ethical issues: Comparisons between two European countries. Nurs Ethics 2024:9697330241255936. [PMID: 38835232 DOI: 10.1177/09697330241255936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
BACKGROUND The global pandemic raised ethical issues for nurses about caring for all patients, not just those with COVID-19. Italy was the first European country to be seriously affected by the first wave, while Estonia's infection and death rates were among the lowest in Europe. Did this raise different ethical issues for nurses in these two countries as well? AIM The aim was to describe and compare ethical issues between nurses working during the first wave of the COVID-19 pandemic in Estonia and Italy. RESEARCH DESIGN A cross-sectional survey study with a self-administered questionnaire. The impact of COVID-19 emergency on nursing care questionnaire was used. PARTICIPANTS AND RESEARCH CONTEXT Convenience sampling was used to recruit 1098 nurses working during the first wave of the pandemic in 2020: 162 from Estonia and 936 from Italy. ETHICAL CONSIDERATIONS Research ethics approvals were obtained, and the nurses provided informed consent. RESULTS The most frequent ethical issues for Estonian nurses were professional communication and ensuring access to care for patients without COVID-19, and for Italian nurses, the end-of-life care and the risk of them getting the virus and transmitting it to their loved ones. There were no statistically significant differences in the frequency of ethical issues between Estonian nurses working with patients with and without COVID-19. Italian nurses caring for COVID-19 patients faced statistically significantly more (both p < .001) issues around prioritising patients and end-of-life. Nurses working with patients without COVID-19 in Italy faced more issues about access to care (p < .001). CONCLUSIONS Estonian and Italian nurses, working in different clinical contexts during the first wave of the pandemic, faced different ethical issues. Local contextual aspects need to be considered to support nurses' ethical decision-making in providing care during future crises and to ensure ethical care for patients.
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Azzolina D, Lanera C, Comoretto R, Francavilla A, Rosi P, Casotto V, Navalesi P, Gregori D. Automatic Forecast of Intensive Care Unit Admissions: The Experience During the COVID-19 Pandemic in Italy. J Med Syst 2023; 47:84. [PMID: 37542644 PMCID: PMC10404188 DOI: 10.1007/s10916-023-01982-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 07/21/2023] [Indexed: 08/07/2023]
Abstract
The experience of the COVID-19 pandemic showed the importance of timely monitoring of admissions to the ICU admissions. The ability to promptly forecast the epidemic impact on the occupancy of beds in the ICU is a key issue for adequate management of the health care system.Despite this, most of the literature on predictive COVID-19 models in Italy has focused on predicting the number of infections, leaving trends in ordinary hospitalizations and ICU occupancies in the background.This work aims to present an ETS approach (Exponential Smoothing Time Series) time series forecasting tool for admissions to the ICU admissions based on ETS models. The results of the forecasting model are presented for the regions most affected by the epidemic, such as Veneto, Lombardy, Emilia-Romagna, and Piedmont.The mean absolute percentage errors (MAPE) between observed and predicted admissions to the ICU admissions remain lower than 11% for all considered geographical areas.In this epidemiological context, the proposed ETS forecasting model could be suitable to monitor, in a timely manner, the impact of COVID-19 disease on the health care system, not only during the early stages of the pandemic but also during the vaccination campaign, to quickly adapt possible preventive interventions.
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Affiliation(s)
- Danila Azzolina
- Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan, 18, Padova, 35131, Italy
| | - Corrado Lanera
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan, 18, Padova, 35131, Italy
| | - Rosanna Comoretto
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Andrea Francavilla
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan, 18, Padova, 35131, Italy
| | - Paolo Rosi
- Institute of Anaesthesia and Intensive Care, Padua University Hospital, Padua, Italy
- Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Veronica Casotto
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan, 18, Padova, 35131, Italy
| | - Paolo Navalesi
- Institute of Anaesthesia and Intensive Care, Padua University Hospital, Padua, Italy
- Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan, 18, Padova, 35131, Italy.
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Verga M, Viganò GL, Capuzzo M, Duri C, Ignoti LM, Picozzi P, Cimolin V. The digitization process and the evolution of Clinical Risk Management concept: The role of Clinical Engineering in the operational management of biomedical technologies. Front Public Health 2023; 11:1121243. [PMID: 36817927 PMCID: PMC9932586 DOI: 10.3389/fpubh.2023.1121243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 01/17/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Digital transformation and technological innovation which have influenced several areas of social and productive life in recent years, are now also a tangible and concrete reality in the vast and strategic sector of public healthcare. The progressive introduction of digital technologies and their widespread diffusion in many segments of the population undoubtedly represent a driving force both for the evolution of care delivery methods and for the introduction of new organizational and management methods within clinical structures. Methods The CS Clinical Engineering of the "Spedali Civili Hospital in Brescia" decided to design a path that would lead to the development of a software for the management of biomedical technologies within its competence inside the hospital. The ultimate aim of this path stems from the need of Clinical Engineering Department to have up-to-date, realistic, and systematic control of all biomedical technologies present in the company. "Spedali Civili Hospital in Brescia" is not just one of the most important corporate realities in the city, but it is also the largest hospital in Lombardy and one of the largest in Italy. System development has followed the well-established phases: requirement analysis phase, development phase, release phase and evaluating and updating phase. Results Finally, cooperation between the various figures involved in the multidisciplinary working group led to the development of an innovative management software called "SIC Brescia". Discussion The contribution of the present paper is to illustrate the development of a complex implementation model for the digitization of processes, information relating to biomedical technologies and their management throughout the entire life cycle. The purpose of sharing this path is to highlight the methodologies followed for its realization, the results obtained and possible future developments. This may enable other realities in the healthcare context to undertake the same type of pathway inspired by an accomplished model. Furthermore, future implementation and data collection related to the proposed Key Performance Indicators, as well as the consequent development of new operational management models for biomedical technologies and maintenance processes will be possible. In this way, the Clinical Risk Management concept will also be able to evolve into a more controlled, safe, and efficient system for the patient and the user.
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Affiliation(s)
- Matteo Verga
- ASST Spedali Civili di Brescia - SC Ingegneria Clinica, Brescia, Italy
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Gian Luca Viganò
- ASST Spedali Civili di Brescia - SC Ingegneria Clinica, Brescia, Italy
| | - Martina Capuzzo
- ASST Spedali Civili di Brescia - SC Ingegneria Clinica, Brescia, Italy
| | - Claudia Duri
- ASST Spedali Civili di Brescia - SC Ingegneria Clinica, Brescia, Italy
| | | | - Paola Picozzi
- ASST Spedali Civili di Brescia - SC Ingegneria Clinica, Brescia, Italy
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Veronica Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
- S. Giuseppe Hospital, Istituto Auxologico Italiano, IRCCS, Piancavallo, Italy
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