Programas de supervisión clínica para enfermeras de cuidados intensivos: protocolo de scoping review / Clinical supervision programs for critical care nurses: scoping review protocol

Introducción: La escasez global de enfermeras trajo consigo una mayor dificultad a la hora de contratar y retener a este tipo de profesionales durante la pandemia provocada por la COVID-19. La supervisión clínica en enfermería, por tratarse de un procedimiento sistemático y estructurado para el desarrollo de la práctica clínica en sus diferentes contextos, parece influir en los indicadores de resultados, en la formación continua y en la trayectoria profesional de las enfermeras. Objetivo: 1) Mapear los programas de supervisión clínica para la incorporación de enfermeras en cuidados intensivos. Método de revisión: método de scoping review definido por el Instituto Joanna Briggs a partir de la siguiente pregunta: ¿cuáles son las características de los programas de supervisión clínica para la incorporación de enfermeras en cuidados intensivos? A la hora de definir los criterios de inclusión, se utilizó la estrategia PCC (población, concepto y contexto), además de artículos escritos en portugués, inglés y castellano; estudios primarios de tipo cuantitativo, cualitativo y mixto; estudios secundarios que responden a la pregunta de la investigación; documentos de textos y de opinión, y estudios encontrados en las referencias bibliográficas secundarias. No se utilizan artículos sin el texto completo, fuera del ámbito de la pregunta de partida y cuyo contexto sean los cuidados intensivos pediátricos y neonatales. La búsqueda se realiza en PubMed/ MEDLINE, SCOPUS, LILACS, OpenGrey, Google Scholar, Web of Science y EBSCOhost, y en las bases de datos asociadas. Presentación e interpretación de los resultados: los dados analizados se presentarán de manera esquemática, tabular y narrativa. (AU)

Background: The global shortage of nurses, considered one of the priority areas of intervention by the World Health Organization, has exposed increased difficulties in recruiting and retaining nurses during the COVID-19 pandemic. Clinical supervision in nursing, as a systematized and structured process for the development of clinical practice in different contexts, seems to contribute to outcomes, in continuous training and in the course of nurses’ professional experience. Aim: 1) To map clinical supervision programmes for the integration of nurses in critical care. Review method: Joanna Briggs Institute method for Scoping review, starting from the question: what are the characteristics of clinical supervision programs for the integration of nurses in critical care? In the inclusion criteria definition, the PCC strategy (population, concept and context) was used; articles written in Portuguese, English and Spanish; quantitative, qualitative, mixed type studies, secondary studies which answer the research question, text and opinion documents and studies found in secondary bibliographic references. Articles without full text, outside the scope of the starting question, and whose context is pediatric and neonatal critical care will be excluded. The search will be carried out in PubMed/ MEDLINE, SCOPUS, LILACS, OpenGrey, Google Scholar, Web of Science and EBSCOhost, with associated databases. Presentation and interpretation of results: The analyzed data will be presented in a diagrammatic, tabular and narrative form. (AU)

La gestión del liderazgo enfermero y la cultura de seguridad del paciente en las organizaciones sanitarias / Nursing leadership management and patient safety culture in healthcare organizations

Objetivo: actualizar el análisis de la relación del liderazgo enfermero con la seguridad del paciente diferenciando entre los distintos tipos de liderazgo. Método: revisión narrativa realizada entre marzo y diciembre de 2021. Se consultaron las bases de datos PubMed, IBECS y CINAHL, utilizando los términos: Leadership, Patient Safety, Risk Management y Nursing, Supervisory, entre otros. Se incluyeron artículos de los últimos cinco años publicados en español o inglés. La selección se llevó a cabo entre tres investigadoras. Resultados: se encontraron 294 registros de los que 13 fueron incluidos finalmente en la revisión. Tres tipos de liderazgo (auténtico, transformacional y ético) tuvieron asociación con la disminución de eventos adversos. El liderazgo auténtico se mostró como predictor del aumento del clima de seguridad. El liderazgo ético se asoció con mayor notificación de errores. Se identificaron aspectos importantes de la persona que lidera para mejorar la seguridad: en la retroalimentación no asigna culpas, es capaz de transmitir los mensajes de forma adecuada, establece un clima de confianza y una comunicación continuada con el personal, es accesible, motivadora, tiene inteligencia emocional, promueve el trabajo en equipo. Conclusiones: distintos tipos de liderazgo se asocian a beneficios en la seguridad del paciente. Que las supervisoras desarrollen un liderazgo eficaz y basado en las relaciones positivas favorece una adecuada cultura de seguridad lo que ha de tenerse en cuenta a la hora de promoverla.(AU)

Objective: to update the analysis of the relationship between nursing leadership and patient safety, differentiating between types of leadership. Method: a narrative review conducted between March and December 2021. The PubMed, IBECS and CINAHL databases were consulted, using the terms Leadership, Patient Safety, Risk Management and Nursing, Supervisory, among others. Articles from the past five years published in Spanish or English were included. Three female researchers were in charge of selection. Results: there were 294 records retrieved, 13 of which were finally included in the review. Three types of leadership (authentic, transformational and ethical) were associated with a reduction in adverse events. Authentic leadership appeared as a predictor for an increase in safety environment. The ethical leadership was associated with a higher report of errors. Important aspects of the leader person were identified in order to improve safety: not assigning blame during feedback, being able to convey messages adequately, establishing a trust environment and continuous communication with staff, being accessible and motivating, having emotional intelligence, and promoting teamwork. Conclusions: different types of leadership are associated with benefits in patient safety. Supervisors developing an effective leadership based on positive relationships will encourage an adequate safety culture, which must be taken into account at the time of promotion.(AU)

Modelo de competencias para la gestora enfermera de nivel operativo / Competency-based model for the Nurse Manager at Operational Level

Objetivo: evaluar la validez estructural del modelo de competencias para la gestora enfermera de nivel operativo en el sistema sanitario español. Método: la investigación llevó a cabo un análisis de componentes principales (ACP) para determinar la validez de constructo, reduciendo la dimensionalidad del conjunto de datos. Para este propósito se siguió la teoría de Thurstone en tres fases. La idoneidad de los datos se realizó a través de la prueba de Kaiser-Meyer-Olkin. Resultados: las 51 competencias que integran el modelo de competencias para la gestora enfermera de nivel operativo fueron sometidas al análisis de componentes principales. Los resultados indican la validez estructural del modelo propuesto por saturación de los componentes principales y de cada una de las dimensiones que se compone: Gestión (α Cronbach > 0,631), Comunicación y tecnología (α Cronbach > 0,6), Liderazgo y equipos de trabajo (α Cronbach > 0,876), Conocimiento del sistema sanitario (α Cronbach > 0,749), Conocimiento enfermero (α Cronbach > 0,808), Personalidad (α Cronbach > 0,809). Conclusiones: del análisis de los componentes principales del modelo de competencias para la gestora enfermera de nivel operativo se concluye la validez del constructo del modelo. La toma de decisiones emerge como factor crítico, dada su elevada carga factorial. Analizada la varianza explicada puede concluirse que los factores liderazgo, esencia, calidad y proyección personal deben estar presentes en el perfil de la gestora enfermera de nivel operativo. Las gestoras enfermeras pueden utilizarlo para planificar su carrera profesional. Las organizaciones sanitarias podrían para establecer procesos de selección de las gestoras enfermeras a nivel operativo en España.(AU)

Objective: to evaluate the structural validity of the competency model for the Nurse Manager at Operational Level in the Spanish Health System. Method: the research consisted in a principal component analysis (PCA) to determine the validity of the construct and reduce the dimensionality of the data set. Thurstone’s theory was followed for this purpose in three stages. Data adequacy was conducted through the Kaiser-Meyer-Olkin Test. Results: the 51 skills included in the Competency model for the Nurse Manager at Operational Level were submitted to the principal component analysis. Results showed the structural validity of the model proposed by saturation of the principal components and of each of the dimensions included: Management (α Cronbach > 0.631), Communication and Technology (α Cronbach > 0-6), Leadership and Work Teams (α Cronbach > 0.876), Knowledge of the Health System (α Cronbach > 0.749), Nursing Knowledge (α Cronbach > 0.808), Personality (α Cronbach > 0.809). Conclusions: the analysis of the principal components of the competency model for the Nurse Manager at Operational Level showed the validity of the model construct. Decision-making appeared as a critical factor, due to its high factor loading. The analysis of the explained variance led to the conclusion that the leadership, essence, quality and personal projection factors must be present in the profile of the Nurse Manager at Operational Level. It can be used by Nurse managers in order to plan their professional career. Healthcare organizations could develop selection processes for the Nurse Managers at Operational Level in Spain.(AU)

Impacto del tamaño del ámbito de control de las jefas de unidad en los comportamientos laborales de las enfermeras / Impact of charge nurses’ span of control on the work attitudes of nurses

Fundamento: Conocer el número de enfermeras a cargode las jefas de unidades de Enfermería de los hospitalespúblicos generales aragoneses y analizar cómo afecta alos comportamientos organizacionales de la enfermera ya la calidad de las relaciones que se establecen con lajefa de unidad. Método: Estudio descriptivo transversal realizado ennueve hospitales públicos. Se evaluó mediante cuestionarios validados los comportamientos laborales de lasenfermeras y la calidad de las relaciones de la enfermeracon la jefa de unidad y de esta con la enfermera y consu inmediato superior. Se analizó si existía relación entreestas variables y el número de enfermeras por unidad. Resultados: La muestra se compuso de 2541 enfermeras y192 jefas de unidad. La media del ámbito de control fue de29 enfermeras (DE = 22,4). Se obtuvieron puntaciones menores al aumentar el ámbito de control en: empoderamiento (p<0,001), satisfacción (p = 0,027), apoyo organizacionalpercibido (p<0,001) y calidad de las relaciones entre lasenfermeras y las jefas de unidad (p<0,001) y de la jefa deunidad con su inmediato superior (p<0,001). No se observaron asociaciones significativas respecto a la intenciónde rotación, los comportamientos cívicos organizacionales y el compromiso organizacional. Conclusiones: El tamaño del ámbito de control se relaciona con la percepción de los comportamientos organizacionales de las enfermeras, así como con la calidad delas relaciones interpersonales que establecen con la jefade unidad, indicando la necesidad ajustar el ámbito decontrol por unidad con el objetivo mejorar la calidad dela gestión de las unidades de Enfermería.(AU)

Background: To determine the number of nurses whoare supervised by a charge nurse in the Nursing Unitsof Aragonese general public hospitals and to analyzehow this affects the organizational behaviors of nursesand the quality of the relationships established with thecharge nurses. Methods: Cross-sectional study carried out in nine publichospitals. Validated questionnaires were used to assessthe working behavior of nurses and the quality of theirrelationships with charge nurses, and the charge nurse’srelationship with their immediate superior and nursingstaff. We analyzed whether there was an association between these variables and the number of nurses per unit. Results: The study included 2,541 nurses and 192 super-visors. The mean span of control was 29 (SD = 22.4). Statistically significant differences were observed with re-spect to empowerment (p<0.001), satisfaction (p = 0.027),perceived organizational support (p<0.001) and thequality of the nurse’s relationships with the supervisor(p<0.001) and the supervisor with her immediate superior (p<0.001), obtaining lower scores as the span of con-trol increased. No significant associations were observedwith respect to turnover intention, organizational citizenship behavior and organizational commitment. Conclusions: The span of control is related to the perception of nurses’ organizational behaviors and with thequality of interpersonal relationships with the chargenurse, indicating a need to adjust the span of of controlper unit in order to improve the quality of the management of the units.(AU)

Percepción de enfermeras/os de atención hospitalaria y primaria de salud, sobre el liderazgo de Enfermería / Perception of nurses in hospital and primary health care, on nursing leadership / Percepção de enfermeiros em hospital e atenção primária à saúde, sobre liderança em Enfermagem

INTRODUCCIÓN: La legislación chilena atribuye a enfermería la Gestión de Cuidados, implica autonomía, requiriendo enfermeras/os capaces de practicar "liderazgo efectivo" contribuyendo a la óptima salud de la población. Sin embargo, se ha instalado la percepción de que enfermería a nivel nacional ha perdido espacios de opinión y toma de decisiones, lo que hace relevante indagar apreciaciones desde las/os protagonistas respecto al ejercicio de liderazgo en sus prácticas. MATERIAL Y MÉTODO: Investigación cualitativa, descriptiva, tipo estudio de caso, utiliza análisis de contenido. RESULTADOS Y DISCUSIÓN. En la percepción del liderazgo de enfermería predominan características del liderazgo transformacional. Reconocen una directa relación entre ejercicio de liderazgo y la calidad del cuidado brindado a las personas. Se identificó como facilitadores del liderazgo habilidades personales, la formación profesional y trayectoria del ejercicio laboral. Emergen obstaculizadores como dificultades comunicativas, relaciones de subordinación asociada al género femenino y profesión no médica, déficit estructural de centros de salud y diferencias generacionales. CONCLUSIÓN: Develan brechas que viven enfermeras/os en ejercicio de liderazgo, junto a favorecedores. Esto permitirá nutrir planes de estudios de pre y post-grado de enfermería, para propiciar el desarrollo de competencias atingentes a los desafíos actuales, contribuyendo al fortalecimiento del rol sociopolítico de enfermería

INTRODUCTION: Chilean legislation attributes to Nursing Care Management, it implies autonomy, requiring nurses capable of practicing "effective leadership" contributing to the optimal health of the population. However, the perception that nursing at the national level has lost spaces of opinion and decision-making has been installed, which makes it relevant to inquire from the protagonists regarding the exercise of leadership in their practices. MATERIAL AND METHOD: Qualitative, descriptive research, case study type, uses content analysis. RESULTS AND DISCUSSION: In the perception of nursing leadership, characteristics of transformational leadership predominate. They recognize a direct relationship between leadership exercise and the quality of care provided to people. Personal skills, professional training and career path were identified as leadership facilitators. Obstaculizers emerge communicative difficulties, relations of subordination associated with the female gender and non-medical profession, structural deficit of health centers and generational differences. CONCLUSION: They reveal gaps that nurses live in the leadership exercise, together with supporters. This will allow to nurture pre and post-graduate nursing curricula, in order to promote the development of competencies at the current challenges, contributing to the strengthening of the sociopolitical role of nursing

INTRODUÇÃO: A legislação chilena atribui à gerência do cuidado de enfermagem, implica autonomia, exigindo enfermeiros capazes de praticar "liderança efetiva", contribuindo para a saúde ideal da população. No entanto, instalou-se a percepção de que a enfermagem em nível nacional perdeu espaços de opinião e tomada de decisão, o que torna relevante a indagação dos protagonistas sobre o exercício da liderança em suas práticas. MATERIAL E MÉTODO: Pesquisa qualitativa, descritiva, tipo estudo de caso, utiliza análise de conteúdo RESULTADOS E DISCUSSÃO: Na percepção da liderança de enfermagem, predominam as características da liderança transformacional. Eles reconhecem uma relação direta entre o exercício da liderança e a qualidade do atendimento prestado às pessoas. Habilidades pessoais, treinamento profissional e plano de carreira foram identificados como facilitadores da liderança. Os obstáculos emergem como dificuldades comunicativas, relações de subordinação associadas ao gênero feminino e à profissão não médica, déficit estrutural dos centros de saúde e diferenças geracionais. CONCLUSÃO: Revelam lacunas que os enfermeiros vivem no exercício de liderança, junto com os apoiadores. Isso permitirá nutrir currículos de enfermagem pré e pós-graduação, a fim de promover o desenvolvimento de competências para os desafios atuais, contribuindo para o fortalecimento do papel sociopolítico da enfermagem

Implementação de um modelo de supervisão clínica em enfermagem - modelo safecare / Implementation of a nursing clinical supervision model - SAFECARE model

The actual context, marked by the high cost of health care associated with technological advances, the increase in the workload of health professionals and the aging of the population with multiple chronic diseases. There are concerns raised by health organizations regarding the quality of care, with emphasis on actions aimed to the continuous quality improvement. The effects of clinical supervision on quality of care defined as a target area by the World Health Organization are a key aspect in improving quality. The literature shows that there is no model of nursing clinical supervision capable to respond to the actual context needs. The objective of this exploratory, descriptive and longitudinal study was to implement a contextualized nursing clinical supervision model, SafeCare model, in order to identify the contributions of its implementation in the indicators sensitive to nursing clinical supervision. The study was conducted in the surgery department of a health care institution and the nurses of the surgery department composed the sample. With this article we intend to disseminate the results of the implementation of the SafeCare model and to prove that the implementation of a contextualized Nursing clinical supervision model based on nurses' needs, SafeCare Model, has contributed to obtaining higher quality and safer care for clients

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Evidence based practice as an indicator of clinical supervision in nursing in context of ambulatory surgery / A prática baseada na evidência como indicador da supervisão clínica em enfermagem no contexto de cirurgia de ambulatório

Clinical supervision and evidence-based practice in nursing should be understood as complementary and indissociable as they go hand in hand towards the same objectives. Therefore, the supervising process, should boost the evidence-based practice in order to promote better nursing care. The purpose of this study is to evaluate nurse's predisposition to incorporate evidence-based practice into their care and to identify barriers to its application with the purpose of propose contributions for the implementation of a nursing clinical supervision model that encourages the use of the best evidence available into the daily practice. The study is integrated into the research project "SAFECARE - Supervisão Clínica para a segurança e qualidade dos cuidados". It was developed an exploratory-descriptive study in an ambulatory surgery unit of a University Hospital in Porto, Portugal. It had a target population of 59 nurses, and it was used the "Evidence-Based Practice Questionnaire" as a method of collecting data. From the 49 questionnaires collected, we find that the subscale "Practices" has an average score of 4.89, the subscale "Attitudes" 5.36 and the subscale "knowledge/skills and competences" 5.08. These results showed that nurses have a low use of evidence-based practice when compared with the level of knowledge, skills and competences shown, although they seem to have a positive attitude towards this subject. These results can be partially explained by the overburden felt by the nurses, which identified the lack of time and motivation, but also inappropriate training and scarcity of team meetings and proper tools in the workplace as barriers

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Clinical supervision: analysis of postoperative pain evaluation in the ambulatory surgery setting / Supervisão clínica: análise da avaliação da dor pós-operatória em cirurgia de ambulatório

Clinical supervision, as a formal process of monitoring professional practice, aims to improve decision-making to contribute to safety and quality of care through reflection processes and analysis of clinical practice. This study aimed to compare the postoperative pain evaluation and clinical recording procedures performed by nursing staff and clinical supervisors in ambulatory surgery patients.The study was integrated into the research project "SAFECARE". It was developed a descriptive cross-sectional quantitative study in an ambulatory surgery unit of a University Hospital in Oporto, Portugal. The study population was the nursing staff with an intentional non-probabilistic sampling method. A questionnaire was constructed and evaluation of postoperative pain, patient clinical and demographic variables was included. This instrument was applied in 116 patients matched by 12 surgical specialties. Results were compared between nursing staff, clinical supervisors and electronic nursing records. Patients had an average age of 48.6 years, being mostly female. Regarding pain evaluation, the scale most used by nurses (62.1%) and clinical supervisors (67.2%) was the "Numerical Scale". Postoperative pain evaluation scores ranged from 0 to 7, with score 0 (no pain) presenting more frequently by nurses, electronic nursing records and clinical supervisors. 34.5% of results were not documented in electronic nursing records. These findings support the importance of an intervention of clinical supervision in the indicator "pain" for the outpatient surgery setting. Local protocols of clinical supervision practice would contribute to improve postoperative pain evaluation, as well as standardization and optimization of nursing records, thus ensuring quality care

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Modelo de competencias para la gestora enfermera / Competency model for the Nurse Manager

Objetivo: identificar las competencias necesarias para desempeñar el rol de gestora enfermera en España en cada uno de los niveles funcionales. Metodología: partiendo de la realización de una revisión bibliográfica de la literatura especializada se diseñó un estudio Delphi estructurado en cuatro rondas para consensuar las competencias necesarias para la gestora enfermera. Resultados: se obtuvo el consenso de 51 competencias, distribuidas en seis dominios. El nivel de experto se alcanza mediante estudios de máster y doctorado. La gestora enfermera tiene que desarrollar sus competencias al nivel de competente, muy competente y experto. El 96% de los integrantes del panel manifestó que para alcanzar el nivel de experto es necesario desarrollar estudios de máster o doctorado. El 60,78% de las competencias de la gestora enfermera de alta dirección debe ser desarrollada al nivel de experto mediante el desarrollo de estudios de máster, experto universitario y especialización universitaria, frente al 9,8% de la dirección logística y al 21,57% de las competencias requeridas para la dirección operativa. Para el nivel de competente serán necesarios estudios de experto, especialista universitario y formación continuada. Conclusiones: el modelo de competencias para la gestora enfermera en España se compone de 51 competencias, de las cuales ocho son básicas. De los resultados se evidencia el grado de desarrollo para cada competencia, y la formación requerida para alcanzar este grado

Objective: to identify the skills needed to play the role of Nurse Manager in Spain at each function level. Methodology: based on a bibliographic review conducted in specialized literature, a Delphi study was designed, structured into four rounds, in order to reach a consensus about the skills needed by the Nurse Manager. Results: a consensus was reached about 51 skills, classified into six domains. The level expert is achieved through master and doctorate courses. Nurse Managers must develop their skills at the following levels: Competent, Very Competent and Expert. Out of the panel members, 96% declared that in order to reach the expert level it is necessary to acquire master or doctorate degrees; 60.78% of the skills of the High Management Nurse Manager must be developed at Expert level, through Master, University Expert and University Specialty degrees, vs. 9.8% of logistical management and 21.57% of skills required for operational management. The Competent level requires Expert, University Specialist and Continuous Education degrees. Conclusions: the competency model for the Nurse Manager in Spain consists of 51 skills, including eight basic skills. The level of development for each skill is shown in results, as well as the training required to achieve said degree

Importancia de las habilidades comunicativas de las supervisoras de Enfermería / Importance of the communication skills in Nurse Managers

OBJETIVO: describir aspectos relevantes relacionados con las habilidades comunicativas de las supervisoras de Enfermería. MÉTODO: revisión narrativa. Se llevó a cabo una búsqueda bibliográfica de la literatura publicada desde el año 2013 al 2017. Para ello se han empleado como fuentes de información las siguientes bases de datos: Pubmed, Cinahl, Scopus, Cochrane Library y Cochrane Plus. La búsqueda se efectuó usando los términos en inglés "nurse manager", "nursing" y "communication skills". Se aceptaron los artículos que hablaran de la influenciade la comunicación de las supervisoras de Enfermería, tanto en el ámbito hospitalario como de Atención Primaria y/o psiquiatría. RESULTADOS: se encontraron un total de 150 artículos en las diferentes bases de datos consultadas. Se seleccionaron para la revisión narrativa un total de 15 artículos. Los principales aspectos relacionados con las habilidades de comunicación de las supervisoras enfermeras incluyen: el clima y satisfacción laboral, la resolución de conflictos,liderazgo, formación y seguridad del paciente. CONCLUSIONES: tanto para enfermeras como para las propias gestoras es muy importante disponer de habilidades comunicativas, puesto que ello puede mejorar el clima laboral y la eficaciade los equipos repercutiendo directamente en los pacientes

OBJECTIVE: to describe relevant aspects associated with the communication skills of Nurse Managers. METHOD: a narrative review. A bibliographic search was conducted in literature published between the years 2013 and 2017. To this aim, the following databases were used as information sources: Pubmed, CINAHL, SCOPUS, Cochrane Library and Cochrane Plus. The search was conducted using the following terms in English: "nurse manager", "nursing" and "communication skills". All articles accepted should discuss the influence of communication by Nurse Managers both in the hospital setting and in Primary Care and/or Psychiatry. RESULTS: in total, 150 articles were found in the different databases consulted; 15 articles were selected for the narrative review. The main aspects associated with the communication skills by Nurse Managers included: work environment and satisfaction, solution of conflicts, leadership, training, and patient safety. CONCLUSIONS: having communication skills is very important for nurses as well as for managers, because this can improve the work environment and team efficacy, with a direct impact on patients

Percepción de los estudiantes de enfermería sobre la supervisión y entorno de aprendizaje clínico: un estudio de investigación fenomenológico / Student nurse perceptions of supervision and clinical learning environment: a phenomenological research study

Objetivo: Analizar las percepciones de los estudiantes de enfermería sobre la relación de supervisión y ambiente de aprendizaje clínico durante sus prácticas clínicas. Metodología: Se utilizó un diseño cualitativo con un enfoque fenomenológico. Los datos se recogieron a través de entrevistas semiestructuradas de grupos focales. Se realizó un muestro intencionado y se conformó una muestra de 48 estudiantes de Enfermería de la Universidad de Alicante (España). Las entrevistas fueron transcritas textualmente y analizadas utilizando el método 'Stage by stage'. A partir del análisis surgió una estructura en forma de árbol con cuatro categorías: individualización, innovación en enseñanza clínica, participación de los estudiantes y relación entre enfermera tutora-estudiante de enfermería. Resultados: El estudio muestra que no hay individualización en el proceso de aprendizaje clínico. La participación de los estudiantes en las actividades de la unidad depende de su experiencia, de las características de la unidad, del equipo de enfermería y del tutor. Los estudiantes sienten que el papel del tutor de prácticas no está claramente definido. La ansiedad, la vulnerabilidad y los sentimientos de ser 'trabajadores temporales' son comunes entre los estudiantes de enfermería. Conclusiones: Estos resultados deben conducir a reflexiones más profundas sobre los elementos estudiados del proceso de supervisión y del entorno de aprendizaje clínico. Más concretamente en los aspectos de individualización, participación de los estudiantes, sentimientos y la elucidación del papel del enfermero tutor

Aim: To analyse nursing students' perceptions of the supervision relationship and the clinical learning environment during their clinical practice placements. Methods : A qualitative design was used to conduct this phenomenological study. Data were collected through semi-structured focus group interviews. The purposive sample consisted of 48 nursing students of the University of Alicante (Spain). Semi-structured focus group interviews were transcribed verbatim and then analysed using the stage by stage method. A tree structure with four categories arose: individualization, innovation in clinical teaching, student participation, and nurse tutor-student nurse relationship individual training. Results: This study shows that no individualization is involved in the clinical learning process. Student participation in ward activities depends on the student's experience, the characteristics of the ward, the nursing team and the nurse tutor. Students feel that the role of the nurse tutor is not clearly defined. Anxiety, vulnerability and feelings of being 'temporary workers' are common in nursing students. Conclusion: These results should prompt to deeper reflections on the studied elements of the supervisory process and the clinical learning environment. More specifically on aspects of individualization, student participation, and feelings, but also in the clarification of the tutor role definition

Nurse managers' perspectives on nurses' performance in mentorship program

Objective: The aim of this study was to explore the nurse managers' perspectives on nurses' performance in a mentorship program. Method: A cross-sectional survey was conducted on 51 nurse managers in Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang, by using modified and self-developed questionnaire with the Cronbach's alpha value 0.994. The data were analyzed by using descriptive statistics such as central tendency, frequency and percentage. Results: The gender of respondents was predominantly female (100%). The mean age is 45.41 (SD ± 4.51). In terms of level of education, the majority of the respondents (76.5%) were having a diploma. The majority has been in practice as a staff nurse between 11 to 20 years, and most of them have been practicing as nurse managers for about five years and less. Meanwhile, results showed that the nurse managers had positive perceptions upon newly graduated nurses' performance in the mentorship program, concerning on their effective communication, professional development and creative thinking. Conclusions: It is vital to identify the effectiveness of the mentorship program among nurses; hence, it enhances job satisfaction among new nurses

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Improving the interpersonal competences of head nurses through Peplau's theoretical active learning approach

Background: Effective interpersonal skills are essential for head nurses in governing and managing their work units. Therefore, an active learning strategy could be the key to enhance the interpersonal competences of head nurses. Purpose: This study aimed to investigate the effects of Peplau's theoretical approach of active learning on the improvement of head nurses' interpersonal skills. Method: This study used a pre-experimental design with one group having pretests and posttests, without control group. A total sample of 25 head nurses from inpatient units of a wellknown private hospital in Jakarta was involved in the study. Data were analyzed using the paired t-test. Results: The results showed a significant increase in head nurses' knowledge following the training to strengthen their interpersonal roles (P=.003). The results also revealed significant increases in the head nurses' skills in playing the roles of leader (P=.006), guardian (P=.014), and teacher/speaker (P=.015). Nonetheless, the results showed no significant increases in the head nurses' skills in playing the roles of counselor (P=.092) and stranger (P=.182). Conclusions and recommendations: Training in strengthening the interpersonal roles of head nurses significantly increased the head nurses' knowledge and skills. The results of the study suggested the continuation of active learning strategies to improve the interpersonal abilities of head nurses. Furthermore, these strategies could be used to build the abilities of head nurses in other managerial fields

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Incentivos y motivación en el trabajo de gestión en enfermería / Motivation and incentives at work in nursing management

A partir de la hipótesis de que la utilización exclusiva de incentivos monetarios puede minar la motivación intrínseca de los profesionales sanitarios y producir el efecto contrario al perseguido, este trabajo analiza los factores que se asocian con la motivación intrínseca de los profesionales responsables de gestión en enfermería. Para ello, se elaboró un cuestionario sobre Motivación en el Trabajo de Gestión en Enfermería basado en el Intrinsic Motivation Inventory (IMI), que se distribuyó en las Jornadas Nacionales de Supervisoras de Enfermería (Bilbao, 2010). Tras el análisis de los resultados, se obtiene un perfil motivacional que puede orientar a los gestores sanitarios en el rediseño de un sistema de incentivos que, alineado con los valores profesionales, influya en el comportamiento eficiente de los agentes sanitarios, y a invertir en un nuevo tipo de capital que denominamos 'capital motivaciona'(AU)

From the hypothesis that the exclusive use of monetary incentives may undermine intrinsic motivation of health professionals, causing the opposite effect to that intended, this paper analyzes the factors that are associated with intrinsic motivation of professionals responsible for nursing management. To this end, we designed a questionnaire on Work Motivation in Nursing Management based on Intrinsic Motivation Inventory (IMI), which was distributed at the National Conference of Supervisors of Nursing (Bilbao, 2010). After analyzing the results, we obtained a motivational profile that can guide health managers in the redesign of a system of incentives that, aligned with professional values, influence the efficient performance of health workers, and to invest in a new type of capital that we call 'motivational capital'(AU)

Nursing clinical teaching supervision: Portuguese students’ perception

BACKGROUND: Clinical training, in the nursing degree, represents half of the initial graduation time, constitutes an important learning period, where supervision plays a crucial role in the nurses' social structuring process. OBJECTIVES: To know the perception that the Portuguese nursing students have about supervision in clinical education. MATERIAL AND METHODS: Integrative review, led by PI[C]OD method, which search engines were Google Scholar, the Virtual Health Library and SciELO Portugal. After application of the Relevance Test, he stood up with a corpus sample of 11 studies. RESULTS: All studies were considered of quality, having obtained a final classification higher than 75%. Students highly value the clinical instruction context and a positive affective and relational atmosphere, for which it is essential that the supervisor leaves the positions of evaluator, authoritarian, intimidating and even verbal and non-verbal aggressiveness, in order to establish with students an informal relationship and proximity. CONCLUSION: The professional knowledge of the supervisors must match the professional act in a contextualized reality, allowing students learn to critically analyze, consolidating the knowledge acquired previously and becoming aware of the different roles and skills you need to develop not only in a cognitive and technical perspective but also in an affective and relational perspective

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Nursing tutors’ perception of clinical supervision Skills

INTRODUCTION: The evolution of science and technology, changes within the healthcare organizations and new healthcare emerging philosophies require an active participation from healthcare professionals in helping in their peers' training. The supervision process is therefore more and more important. OBJECTIVES: To identify specialist nursing instructors' perception of the clinical supervisor skills in child-health area and paediatrics. MATERIAL AND METHODS: Qualitative-descriptive and phenomenological study composed by a sample of ten nursing tutors in the Dr. Nélio Mendonça Hospital's Paediatrics Department. We used a semi-structured interview and recordings of the conversations. We performed a content analysis on the corpus of all the interviews, once we had defined subcategories and indicators. RESULTS: The category "clinical supervisor skills" emerged from our study and the subcategories which were the most commonly referred were "personal characteristics with a 38% record unit" and "professional skills" (25.7%). As far as the relevant aspects in the child-health area and paediatrics are concerned, personal and professional skills stood out once again, with a 40.4% rate each. The main facilitating factor in the supervision process was the fact that it is a structured process (21.6%), and the inhibition factor was the deficit that exists in interpersonal relationships (21.7%). Globally, there were more record units associated with inhibition factors. CONCLUSION: Knowing what supervisors' insights in such a specific area as child-healthcare and paediatrics are, we think that this study can be a contribution to improve the quality of the supervision process in nursing. A joint effort between supervisor and supervised nurse will be needed to improve the processes that link institutions and their actors, processes where knowledge, experiences and professional objectives are commonly shared

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Gestión de recursos humanos por competencias / Human resources management based on competencies

Vivimos una época de cambios en los que las organizaciones sanitarias se enfrentan a nuevos retos. Entre ellos está el reconocer el talento que hay en ellas, para potenciarlo, desarrollarlo y retenerlo. La gestión de recursos humanos por competencias se perfila como una herramienta que contribuye a alcanzar este objetivo. Competencias desde su perspectiva de cualidad o genéricas: rasgos de personalidad, valores y motivaciones, que están profundamente arraigadas en la persona. Mediante la elaboración de un mapa de competencias para la organización y la identificación del perfil de competencias de los puestos, sobre todo los puestos clave, los empleados conocen qué se espera de ellos; posteriormente, a través de la evaluación de competencias, se detectan las necesidades de formación y aprendizaje y, una vez cubiertas, se consigue una mejor adecuación persona-puesto. Un puesto clave en las organizaciones sanitarias es el de jefa de unidad de enfermería, nexo de unión entre el equipo directivo y los profesionales; la forma en que se desempeñe va a repercutir en la calidad de los cuidados proporcionados y en la motivación de su equipo de trabajo. Así, la persona más adecuada para ocupar este puesto es aquella que, además de conocimientos, tiene habilidades, actitudes e intereses compatibles con su función. La gestión por competencias facilita la identificación tanto del potencial como de las necesidades de aprendizaje para desempeñar este puesto (AU)

We are living in a time with a lot of changes in which health organizations have more challenges to face. One of them is to recognize, strengthen, develop and retain the talent they have. Competency-based human resources management is emerging as a tool that contributes to achieve that aim. Competencies from the generic or characteristic perspective: personality traits, values and motivations, which are deeply rooted in the person. Through elaborating a competencies map for the organization, and identifying the job competencies profile, above all in key jobs, the employees know what it is going to expect from them. After, detect and cover the learning needs, it is possible to achieve better adjust between worker-job. The nursing unit manager is a key job because it is a link between management team and nursing team. The way that it is performed, it will have impact on the quality of care and its team motivation. So, the most adequate person who covers this job would have a part of knowledge, skills, attitudes and compatible interests with her job. Competency-based management helps identify both the potential and learning needs to performing this job (AU)

Diferencias y similitudes entre las competencias de una supervisora de enfermería y una enfermera clínica especialista / Differences and similarities between the competencies of a nursing supervisor and an advanced clinical nurse specialist

Introducción: Con el objetivo de contribuir al desarrollo de una regulación profesional más específica, el presente estudio se centró en identificar diferencias y similitudes entre las competencias de la supervisora de enfermería y la enfermera clínica especialista en una unidad de cuidados intensivos. Material y métodos: Se llevó a cabo un análisis crítico de la literatura publicada entre 2003 y 2013, que fue identificada a través de búsquedas sistemáticas en bases de datos electrónicas, revistas de gestión sanitaria y práctica avanzada y listas de referencias de los 17 artículos incluidos. Resultados: «Gestión y administración» y «práctica clínica directa» fueron identificadas como competencias específicas de la supervisora de enfermería y la enfermera clínica especialista respectivamente. «Colaboración», «liderazgo» e «investigación» emergieron como competencias compartidas por ambos perfiles, aunque con operacionalización diferente. Conclusiones: Estos hallazgos implican que la regulación, formación e implantación de estos perfiles debe abordar tanto sus competencias específicas como el enfoque distintivo a adoptar en la operacionalización de las compartidas

Introduction: With the aim of contributing to the development of a more specific professional regulation, the present study was to identify differences and similarities between the competencies of the nursing supervisor and clinical nurse specialist in an intensive care unit. Material and methods: A critical analysis of the literature published between 2003 and 2013 was conducted, identified through systematic searches in electronic databases, health management and practitioner journals and reference lists of the 17 items included. Results: «Management and administration» and «direct clinical practice» were identified as specific competencies of nursing supervisor and clinical nurse specialist respectively. «Collaboration», «leadership» and «research» emerged as competencies shared by both profiles, but with different a operationalization way of conducting it. Conclusions: These findings imply that regulation, education and implementation of these profiles must address their specific skills as the distinctive approach taken in operationalizing shared

Presentismo en Enfermería. Implicaciones en seguridad del paciente. Posibilidades de control y reducción / Nursing presenteeism. Patient safety implications. Possibilities of control and reduction

Cada vez empezamos a encontrar estudios e investigaciones que orientan hacia la idea de que una peor salud y bienestar de los trabajadores sanitarios puede tener importantes repercusiones para lacalidad de los cuidados y la seguridad que los pacientes reciben. El fenómeno emergente del presentismo, referido a aquellos empleados que a pesar de encontrarse enfermos o con alguna lesiónque los obligarían a ausentarse, se presentan a trabajar, nos sirve como ejemplo para tratar de explicar esta realidad. Objetivos: Tratar de responder a las siguientes preguntas: ¿Es enfermería una profesión presentista?, ¿Por qué las enfermeras no cogen la baja por enfermedad?, ¿Qué implicaciones tiene este fenómeno para la Seguridad del Paciente?, ¿Qué posibilidades tienen supervisores de enfermería y gestores de instituciones sanitarias de controlar y reducir el presentismo en sus organizaciones? Metodología: Se ha realizado una revisión bibliográfica de la evidencia científica disponible en castellano e inglés entre los años 1995 y 2011. Las bases de datos utilizadas han sido Medline, Pubmed, Scopus, Cuiden, CSIC- ISOC y PsycINFO. Esta revisión se completó con búsqueda referencial y búsqueda intuitiva en Google. Encontramos 57 artículos de los que se seleccionaron finalmente 48. Resultados: La profesión de enfermería, junto con las cuidadoras y la enseñanza a nivel primario son uno de los grupos profesionales con tasas significativamente más altas de presentismo en comparación con otras profesiones. Un gran número de variables, tanto organizacionales como individuales, han sido descritas como predictores del presentismo, es decir, facilitan y aumentan la probabilidad de que una enfermera acuda enferma a trabajar (AU)

We begin to find studies and research oriented towards the idea that poorer health and welfare of health care workers may have important implications for quality of care and safety that patients receive. The emerging phenomenon of presenteeism, referred to those employees who despite being sick or injury that would force them to absent, report to work, serves as an example to try to explain this reality. Objectives: Try to answer the following questions: Is nursing a presentist profession?, Why nurses do not call in sick? What implications does have this behaviour for Patient Safety? What chance have nursing supervisors and managers of health institutions to control and reduce presenteeism in their organizations? Methodology: A review of the available scientific evidence literature in Castilian and English between 1995 and 2011 was conducted in order to try to answer the following questions: Database used were Medline, Pubmed, Scopus, Cuiden, CSIC- ISOC y PsycINFO. Search was completed with references and intuitive search in Google. We found 57 items of which 48 were selected. Results: The nursing profession, with care-and-welfare and education sector at the primary level are one of the professional groups with significantly higher rates of presenteeism compared with other professions. A large number of variables, both organizational and individual have been described as presenteeism predictors, i.e. facilitate and increase the likelihood that a sick nurse go to work. Conclusions: There is still a small number of research focused on presenteeism in the field of health institutions. Experts in occupational health, health management or quality or care should include this new phenomenon in their agendas, designing research to try to find a better scientific evidence (AU)