Birth of Cardiac Massage

Knickerbocker, assistant in surgery, who conducted studies on defibrillation in dogs, found that placement of electrodes alone caused an increase in femoral arterial pressure. This observation made the idea that the circulation could be maintained artificially with cardiac massage. 
It was a revolutionary discovery: no need to “open the chest” for a direct cardiac massage! Be wrote in the article of 1960, “… anyone and everywhere can initiate resuscitation procedures. We need two hands. ”

Two hands can save life!

See more here:
Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed-chest cardiac massage. JAMA, 1960; 173, 1064-1067
Eisenberg MS, Psaty BM. Cardiopulmonary resuscitation. Celebration and challenges. JAMA 2010; 304, 87-88


Nurses and health promotion more than thirty years from Ottawa’s card

More than thirty years after the Ottawa Charter was drafted, nurses strongly emphasize the importance of promoting health through their activities.Health is an essential asset for social, economic and personal development, and is a key aspect of quality of life. Health promotion, theorized concept in various historical epochs, was coded in 1986 by the Ottawa Charter.

It is not possible to gain maximum health potential if you are unable to control the determinants of health. Nurses’ commitment is focused on the development of policies aimed at promoting and preserving the health of citizens.

(Federica Putzu)

Gli infermieri e la promozione della salute a distanza di più di trent’anni dalla carta di Ottawa

A distanza di più di trent’anni dalla stesura della Carta di Ottawa gli infermieri sottolineano con forza attraverso le loro attività l’importanza della promozione della salute.
La salute è un bene essenziale per lo sviluppo sociale, economico e personale, ed è aspetto fondamentale della qualità della vita. La promozione della salute, concetto teorizzato in varie epoche storiche, è stato codificato nel 1986 dalla Carta di Ottawa.
Non è possibile conquistare il massimo potenziale di salute se non si è in grado di controllare i fattori determinanti della salute. L’ impegno degli infermieri è orientato allo sviluppo di politiche orientate alla promozione e conservazione della salute dei cittadini.

(Federica Putzu)

Outputs, Outcomes, Impact

Theese are the basic components of a result chain, how actions can lead to a desired result. Construct an initial result chain based on a conceptual model than start analising the indicators of the process that lead to goals on a target.

Input ~ Strategy ~ Output ~ Outcome ~ Impact can be the chain.

Outputs, outcomes and impact are terms that are used to describe changes at different levels.

Output means the result of a trial, results which are achieved immediately after implementing an activity. 

Outcome is not seen immediately after the end of the activity, after some time appear this kind of result, it seem to be better described as some change at the ground level after a training. 

Impact is a long term result, not achievable  during the project activities. 

The external effectiveness is the indicator that shows the relationship between the product (output) and the result (outcome). 

Look here for more external concept description.

Who takes care of the nurses?

Burnout is associated with professions that combine stress and idealism. Many nurses suffer from work-related stress. To be frequent are also depressive states and the so-called burn-out syndrome, ie the work exhaustion.

Data presented in Rome at the Policlinico Gemelli during the conference which was held in 2011 entitled “The work stress-related Health Care Workers Emergency” (dell’AcEMC, prof. Ivo Casagranda) says that  54.7% of nurses of a sample population suffers from a mental fatigue. For nurses, the most critical work si in the first 4 hours, while at least 8% of them has made use of psychotropic drugs. 

In the nursing profession you have manifestations of stress, burn-out and emotional overload that lead to an inevitable comunication difficulties, not infrequently, also it manifested by conflicts within the working group. Nurses must learn to manage conflict to draw a positive evolution of activities. The psychological scenario, resulting from a complex and emotionally strong supportive relationship with the patient and his family is hard to be under control.

Nurses are still in inter-friction, intra and inter-relationships characterized by the defense of their own specific in spite of inter-dependence and collaboration. The team-working skills becomes a requirement to improve performance and reduce work-related stress. 

Don’t stop nurses!

In recent years much has been done to improve the organization and the quality of nursing work and maybe even a lot can be done in the direction of a concrete implementation of new methodologies.

Interruptions in Nurse activity increase the chance of making mistakes. Not only doctors and those working in the structure, but also by those who are external to the structure itself, for example phones, fax, relatives; it is always very difficult to oppose resistance to breaking attempts: it’s a really complicated work and nurse often respond of his or her activities. 

But the question is… how can nurses find a solution?! Communication is one of the activities that characterize Nursing; nurses need to find strategies of containment of the possibility of increasing the risk related to certain processes.

One way would be to guarantee the patient a fixed time for meeting if necessary. Nurses need to find a place where they can guarantee respect for privacy, but above all you can devote all the time necessary in order to reassure him, because much interruptions for questions depend on a low confidence.

Here I am… nurse in surgery during one hour delivery therapy : day one 19 interruptions, day two 22, day three 13. We risk too much! Don’t stop nurses in their acrivities, but nurses must find time and place to a positive communication, with relatives and caregivers.