The growing complex of organizations and the new demand for people's health care lead to a planned and personalized care solution. Primary nursing (PN), is a new model of care focused on the people to be treated and, at the same time, restores responsibility, autonomy and role to the nursing staff. The study was based on an analysis of the wellbeing climate following the implementation of the PN in emergency surgical ward in the General Hospital in Piacenza. In the emergency surgery ward of the General Hospital Guglielmo Da Saliceto in Piacenzathe results of organization remodulation and model of care are being analyzed. In this job the observations are been focussed on wellbeing of nursing staff. The Mc Closkey Mueller Satisfaction Scale (MMSS) is used for the study before and after the change, The Team Climate Inventory (TCI), used after thepractices changes and the staff satisfaction survey after the implementation of PN. At the beginning, with the MMSS methods, the results show impatience with some contractual and remunerative aspects; instead, after the introduction of the PN, the results show a satisfaction for teamwork, the interaction between the team personnel and with patients. Similarly, it alsoincreases the perception of the degree of autonomy of contribution in decision making and in the authoritativeness of the role covered. The new assistance model also shows good results from TCI and Focus Group to achieve the goals of assistance and organization. The increased satisfactions of the nursing staff show a better quality care.
Ambulance crew's choosing of appropriate destination hospital for trauma patients can affect survival and morbidity outcomes. Aim of the present study is to devise a decision-making algorithm in order to allow the best choice of destination hospital for trauma patients and to apply it on an electronic device able to facilitate the decision made by ambulance staff. The method used was analysis of literature data, context and workload with a retrospective observational study. A comparison between the destination hospitals actually chosen and those that could have been chosen with the Piacenza trauma algorithm has been applied. The data shows a 9.5% (P>0.10) more advantageous change in appropriateness in the choice of medical facility and a 1.4% increase in admissions to the Emergency Department of the provincial hospital. The creation and use of a medical protocol and its consequent installation on an electronic device (tablet) that can be shared over a computer platform could help medical staff make appropriate pre-hospital choices as regards the destination hospital for trauma patients.
The study examined the intubation manoeuvres performed by Piacenza local health authority ambulance service nurses in patients with sudden cardiac arrest of nontraumatic origin. The study has a retrospective observational design and analyzes all the intubation manoeuvres performed by ambulance service nurses in patients with non-traumatic cardiac arrest between January 2010 and December 2013. The success of the procedure with subglottic tubes was 97.7% (P>0.60), while it was 100% (P>0.50) with supraglottic devices. The success rate of the procedures is encouraging and the statistical analysis showed that there are no significant differences between literature data and the experience of Piacenza ambulance system crews. An increase in the use of supraglottic devices was also observed. The results show that the Piacenza ambulance service nursing staff has a good level of skills and competence in advanced airway management. A future development of this ability could involve intubation also in situations other than cardiac arrest using specific medication.
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