Publications by authors named "Alberto Giannini"

This paper examines the ethical issues surrounding a specific case of patient refusal of medical treatment: refusal stemming from irrational beliefs or misinformation. While respecting patient autonomy is a foundational principle of contemporary medical ethics, its application becomes challenging when patients reject life-saving treatments based on irrational beliefs (e.g.

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Background: The aim of the study is to investigate doctors' and nurses' beliefs and attitudes towards family presence and open visiting policies in Pediatric Intensive Care Units (PICUs) in Italy.

Methods: A multicentric nationwide study was carried out in all 30 Italian PICUs. All doctors and nurses were asked to complete the Italian version of the Beliefs and Attitudes toward Visitation in ICU Questionnaire (BAVIQ).

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Background: In the pediatric setting, the procurement of vascular access can be particularly difficult. Surgical venolysis was the first technique described but, in recent years, the literature has shown that ultrasound-guided implantation has fewer complications. The principal aim of this paper is to state how after a structured training to place ultrasound-guided central lines, venolysis was definitively abandoned in our hospital.

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Article Synopsis
  • Italy currently lacks a pediatric organ donation program following cardiocirculatory determination of death (pDCDD), prompting a need for research on healthcare staff attitudes before implementation.
  • An anonymous survey was conducted with pediatric intensive care unit (PICU) staff across eight Italian centers to gauge their demographics, personal views on donation, and comfort level with pDCDD practices.
  • Results showed a majority supported organ donation, with 78.2% in favor of pDCDD; however, many felt their understanding of the process was inadequate, highlighting a need for improved education on the topic.
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Background: Dissemination of medical practice and scientific information through social media (SoMe) by clinicians and researchers is increasing. Broad exposure of information can promote connectivity within the scientific community, overcome barriers to access to sources, increase debate, and reveal layperson perspectives and preferences. On the other hand, practices lacking scientific evidence may also be promoted, laypeople may misunderstand the professional message, and clinician may suffer erosion of professional status.

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Article Synopsis
  • The study examined how individual and organizational factors contribute to moral distress among clinicians in Pediatric Intensive Care Units (PICUs) in Italy, based on a survey of 612 healthcare professionals.
  • Results indicated that nurses and those without spiritual beliefs experienced more moral distress, while organizational factors like a medium number of admissions, a low nurse-to-patient ratio, and the exclusion of parents during examinations notably heightened moral distress levels.
  • Ultimately, the research concluded that organizational factors significantly impact moral distress more than individual characteristics like resilience or profession.
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Background: During the first coronavirus disease 2019 (COVID-19) pandemic wave, an unprecedented number of patients with respiratory failure due to a new, highly contagious virus needed hospitalization and intensive care unit (ICU) admission. The aim of the present study was to describe the communication and visiting policies of Italian intensive care units (ICUs) during the first COVID-19 pandemic wave and national lockdown and compare these data with prepandemic conditions.

Methods: A national web-based survey was conducted among 290 Italian hospitals.

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The COVID-19 pandemic has confronted emergency and critical care physicians with unprecedented ethically challenging situations. The aim of this paper was to explore physicians' experience of moral distress during the pandemic. A qualitative multicenter study was conducted using grounded theory.

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Background: End-of-life practices vary among intensive care units (ICUs) worldwide. Differences can result in variable use of disproportionate or non-beneficial life-sustaining interventions across diverse world regions. This study investigated global disparities in end-of-life practices.

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Objectives: To investigate how life-sustaining treatment (LST) decisions are made and identify problematic ethical concerns confronted by physicians and nurses in pediatric intensive care within Italy.

Methods: An 88-question online survey was created, based on a previous qualitative study conducted by this team. The survey was designed to identify how LST decisions were managed; contrasting actual practices with what participants think practices should be.

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Since the lockdown because of the pandemic, family members have been prohibited from visiting their loved ones in hospital. While it is clearly complicated to implement protocols for the admission of family members, we believe precise strategic goals are essential and operational guidance is needed on how to achieve them. Even during the pandemic, we consider it a priority to share strategies adapted to every local setting to allow family members to enter intensive care units and all the other hospital wards.

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The handover among healthcare professionals has been a topic of increasing interest over recent years. Many studies have shown that ineffective communication during handover can be critical, particularly for anaesthesiologists and intensivists because of the highly complex needs of patients under their care. Numerous studies have identified the information transfer process as the greatest risk of errors and adverse events (AEs), which results in harm to patients, increases legal issues and damages relations between health professionals.

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With 63,098 confirmed cases on 17 April 2020 and 11,384 deaths, Lombardy has been the most affected region in Italy by coronavirus disease 2019 (COVID-19). To cope with this emergency, the COVID-19 Lombardy intensive care units (ICU) network was created. The network identified the need of defining a list of clinical recommendations to standardize treatment of patients with COVID-19 admitted to Intensive Care Unit (ICU).

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Importance: During the SARS-CoV-2 pandemic, a complete physical isolation has been worldwide introduced. The impossibility of visiting their loved ones during the hospital stay causes additional distress for families: in addition to the worries about clinical recovery, they may feel exclusion and powerlessness, anxiety, depression, mistrust in the care team and post-traumatic stress disorder. The impossibility of conducting the daily meetings with families poses a challenge for healthcare professionals.

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