AIMS: The goal of the present study was to quantify the perceived aggression towards nurses working in two Italian health care institutions and to verify the hypothesis of an association between the characteristics of aggressors and the type of aggression. BACKGROUND: Violence and aggressiveness, particularly aimed at nurses, are a common, but inadequately investigated phenomenon in Italian health care institutions. DESIGN: A cross-sectional study. METHODS: The study was performed, studying a sample of 700 nurses (37% of the personnel in 94 units) in two health care institutions in northeast Italy using an anonymous multiple-choice questionnaire. RESULTS: Forty-nine percent of the nurses responded that they had experienced aggression in the previous year, 82% of that was only verbal. This happened more often to female nurses working in the emergency department and in geriatric and psychiatric units. A statistically significant association (p < 0.001) was found between the perception of fatigue, stress and work dissatisfaction and the frequency of aggression. Aggressors were usually patients or their relatives (57%) and were mainly men (66%). Fifty-three percent of assaulted nurses did not ask for help after the event. CONCLUSIONS: This study confirms the high incidence of perceived, mainly verbal aggression towards nurses. RELEVANCE TO CLINICAL PRACTICE: Action to prevent aggressive episodes may include concentrating on job motivation, encouraging participatory leadership and promoting the best possible working conditions. The absence of any systematic event reporting and documentation makes the assaulted workers feel defenceless

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Surgical site infections are the most common nosocomial infections in surgical patients. The preventable and the unmodifiable risk factors for deep sternal wound infections (DSWI) have been amply assessed in the literature. The aim of this review was to describe the results of the numerous published studies to describe all the DSWI risk factors and the scales devised to predict SWI, with a view to providing an update on this issue. A comprehensive search of the Medline and Embase databases was performed (considering studies from January 1995 to April 2011); and a manual search was also conducted using references cited in original publications and relevant review articles. There are several risk factors associated with DSWI, which could be classified in four categories as demographic (e.g. sex and age), behavioural (e.g. smoking and obesity), baseline clinical conditions (e.g. diabetes, hypertension and COPD) and surgical operative risk factors (e.g. duration of operation and emergency operation). Six scales for predicting the risk of DSWI are described in the literature: they vary not only in accuracy but also in ease of application and they are applied at different times (some only preoperatively and others also postoperatively). This study provides a broad update on our knowledge of the risk factors for DSWI and the scales for prediction with a view to improving the management of infections at cardiosurgery units.

Severe thirst distress is frequent in haemodialysis (HD) patients, and some studies have noted a positive relationship between thirst and an increased interdialytic weight gain (IDWG). The goal of this explorative study was to describe the perception of thirst and correlated symptoms in HD patients, and verify the correlation between thirst intensity and the IDWG. The study was performed on an opportunistic sample of patients treated in the dialysis unit of a city hospital in the North-East of Italy. Data were collected using a questionnaire containing a demographic and a clinical part, the Thirst Distress Scale, and a Visual Analogue Scale (VAS) 0-10 about thirst intensity. The sample of 107 patients was composed of 71 males (66%). The average age was 68 years (SD 12, median 70 years). Fluid restriction causes severe physical discomfort and xerostomy. 66% of the respondents declared a thirst level of more than 7 on the VAS scale. The average IDWG was 2.47 kg. The chi2 test did not show a significant difference when correlated with thirst intensity (p = 0.88).