RESUMEN
BACKGROUND AND AIM OF THE WORK: Greater evaluations are needed to identify barriers or facilitators in nurses' guidelines adherence. The current review aims to explore extrinsic and intrinsic factors impacting nurses' compliance. METHODS: Mixed-method systematic review with a convergent approach, following the PRISMA checklist and the JBI Mixed Methods Review Methodological Guidance was conducted. MEDLINE, Embase, CINAHL were systematically searched, to find studies published between 2010 and 2021, including qualitative, quantitative or mixed-methods articles. RESULTS: Sixty studies were included, and the major findings were analysed by aggregating them in two main themes: intrinsic and extrinsic factors. The intrinsic factors were: a) knowledge and skills; b) attitudes of health personnel; c) sense of belonging towards guidelines. The extrinsic factors were: a) organizational and environmental factors; b) workload; c) guidelines structure; d) patients and caregivers' attitude. CONCLUSIONS: The included studies report lack of resources, among environmental factors, as the main barrier perceived. Nurses, who are at the forefront in addressing the direct application of knowledge and skills to ensure patient safety, have a higher perception of this kind of barriers than other healthcare personnel. Potential facilitators emerged in the review are positive feedback and reinforcements at the workplace, either from the members of the team or from the leaders. Moreover, the level of active participation of the patient and caregiver could have a positive impact on nurses' guidelines adherence. Guidelines implementation remains a complex process, resulting in a strong recommendation to support health policymakers and nursing leaders in implementing continuing education programs.
Asunto(s)
Personal de Salud , Enfermeras y Enfermeros , Actitud del Personal de Salud , Humanos , Guías de Práctica Clínica como Asunto , Carga de Trabajo , Lugar de TrabajoRESUMEN
. The development of a hospital service for planning and organizing the care of cancer patients in the staging phase: the example of Novara hospital. INTRODUCTION: Any disease, but specifically cancer, creates anxiety and patients enter a new path where they need to be accompanied. AIMS: To describe the organisation of a reception and service centre (CAS) for cancer patients at the Novara Hospital. METHODS: The Piedmont Oncology Network has set up the CAS, but each hospital, following common principles, has organised its own CAS, based on the collaborations and resources made available. RESULTS: Since 2015 the following services have been activated in the CAS of Novara: a nursing assessment chart (available in the computerised patient documentation system); the regular monitoring of cancer patients that access to the hospital and the times needed to carry out examinations and to organize exams and visits; a nursing clinic for the insertion of central venous catheters; a counter under the responsibility of the local patronages for support in bureaucratic procedures; an app has been created to make information available and allow patients direct contact with the service. CONCLUSIONS: There is still room for improvement but our experience shows that it is possible to create and operate services to accompany the patient through the path of illness and guarantee the right to be cared for.