Aim This study explored the clinical placement experiences of nursing students during the Covid-19 pandemic. Background The health emergency caused by Covid-19 required a rapid reorganisation of care settings. This reorganisation entailed revisiting the clinical placements settings and learning programs of Italian nursing faculties. Some Italian universities wanted to seize the health emergency as a learning opportunity enabling the nursing student to acquire additional knowledge and skills. Design We conducted a descriptive qualitative study employing a phenomenological approach. The study population was second and third-year nursing students. The students did their clinical placement in 5 Northern Italy hospitals, mainly in infectious diseases wards, intensive care and sub-intensive care units, emergency department, short-stay surgical units and internal medicine wards. In these departments, the inpatient wards were entirely converted into Covid-19 units. Ethical approval was obtained from the local ethics committee. Methods Semi-structured, open-ended interviews were conducted in March-April 2021 and analysed following a phenomenological approach. Results Twenty-one nursing students in their 2 nd and 3 rd academic year participated. Their average age was 24 years. 81% were female and 19% were male. Three main themes were generated: (i) Learning which surpasses technicalities; (ii) Confronting dignity issues; (iii) Feeling treated as an equal in the workspace. Students had to learn how to lower their fear and self-manage the emotional burden to be a caring presence for the patients who were intensely suffering from the disease and isolation. Attending a clinical practice placement in Covid-19 wards led them to focus on human dignity issues: participants realised how dignity was questioned and how they could become patients’ advocates. Students also described that they felt part of the team, with their student role almost fading. Conclusions This study describes that the most unpredictable public health emergency, such as Covid-19, can provide learning opportunities in the practice environment for nursing students. Students described feeling useful and capitalising on new competencies. Designing educational activities for nursing students concerning pandemic emergencies may be strategic for dealing with similar situations in the future.
Background Flushing and locking of totally implantable venous access devices (TIVADs) is recommended to maintain their patency when not in use. Although manufacturers’ recommendations indicate monthly access for TIVAD maintenance, there is a tendency in real life to prolong this interval. Objectives To assess the effectiveness of prolonged versus short flushing and locking intervals to prevent TIVAD occlusions in adults with cancer. Methods A systematic search was carried out in MEDLINE, EMBASE, CINAHL, and Web of Science. Two reviewers independently selected studies, assessed quality, and extracted data. Study findings were summarized, and a meta-analysis conducted. Results Six articles were included in the review, with a total of 1255 participants. Differences in types of cancers, flushing and locking techniques, and volume and concentration of heparin were described. Pooled results from 4 studies showed fewer catheter occlusions in favor of prolonged flushing and locking intervals (relative risk, 0.81), even if not statistically significant (95% confidence interval, 0.41–1.61) with no heterogeneity among studies (I 2 = 0.00%, P = .69). The quality of evidence was very low. Conclusions Very low-quality evidence suggests that prolonged schedule flushing and locking intervals has no effect on catheter patency. However, because of low number and poor quality of evidence derived from the studies analyzed, findings of this meta-analysis should be interpreted with caution. Implications for Practice No statistically significant difference in occlusion rate between short and long timing of flushing was found. However, further studies are necessary to strengthen the safe implementation of longer intervals in clinical practice.
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