Analysis of clinical practices in the Nursing Degree: Vision of tutors and students. / Análisis de las prácticas clínicas en el Grado en Enfermería: visión de tutores y estudiantes.

OBJECTIVE: To discover the opinions of the tutors and students of the Degree in Nursing on clinical practices and identify strategies and improvement proposals for teacher performance. METHOD: A qualitative study with a phenomenological perspective through focus groups with clinical nurse tutors and nursing students. The participants were divided into 3 groups: students, tutors from the medical area and tutors from the surgical area. The number of groups was determined by saturation of the information. The discourse was transcribed and a syntactic and semantic manual analysis of the discourse was made to extract the analysis variables. Permission was obtained from the Provincial Research Ethics Committee and the corresponding centre. RESULTS: Both the tutors and the students emphasized the need to train tutors in teaching skills and provide them with tools that facilitate their work, as well as the need for formal recognition of their teaching function. In their discourse, both groups proposed a change of vision, and above all of attitudes, in the development of teaching-learning. Finally, there is a need for a change in the model of relations between the University and health services. CONCLUSIONS: Based on the above, the need to encourage and train clinical professionals as tutors is identified and a change of model proposed to bring the University and the health system closer together.

[NIC as a tool for assessing competences of nursing students in clinical placement at surgical units]. / Intervenciones enfermeras NIC como herramienta de evaluación de las competencias del Prácticum de estudiantes de Enfermería en las unidades quirúrgicas.

BACKGROUND: This paper shows the utility of a NIC standardized language to assess the extent of nursing student skills at Practicum in surgical units OBJECTIVE: To identify the nursing interventions classification (NIC) that students can learn to perform in surgical units. To determine the level of difficulty in learning interventions, depending on which week of rotation in clinical placement the student is. METHOD: Qualitative study using Delphi consensus technique, involving nurses with teaching experience who work in hospital surgical units, where students undertake the Practicum. The results were triangulated through a questionnaire to tutors about the degree of conformity. RESULTS: A consensus was reached about the interventions that students can achieve in surgical units and the frequency in which they can be performed. The level of difficulty of each intervention, and the amount of weeks of practice that students need to reach the expected level of competence was also determined. CONCLUSION: The results should enable us to design better rotations matched to student needs. Knowing the frequency of each intervention that is performed in each unit determines the chances of learning it, as well as the indicators for its assessment.

[Medication safety in surgery. Error risk areas and improvements proposed by the nurses]. / MedicaSeguirdad de la medicacíon en quirófano áreas de riesgo de errores y propuestas de mejora de las enfermeras.

UNLABELLED: We describe the process of implementation of improvements for patient safety in the administration of medication in the operating room. OBJECTIVES: To know the weaknesses of the operating room that can contribute to an incident related to the medication and the administration of intravenous fluids in the operating room, and to place improvement strategies to reduce or prevent errors based on the experiences of the nurses. METHOD: Qualitative consensus by expert nurses group and questionnaire about the levels of risk that they attribute to each of the categories of analysis. We explore their experiences about safety in the operating room and their proposals for controlling medication errors. RESULTS: We identified as areas of greatest risk the providers, the prescription and the processing, as well as the weaknesses of the professional culture of patient safety and improvement proposals.

[Patient safety in the operating room. Checklist implementation of general surgery]. / Seguridad del paciente en el quirófano: implantación del checklist en cirugía general.

OBJECTIVES: To plan, implement and evaluate strategies for implementation of Checklist in a general surgery operating rooms and preliminary evaluation of the experience in view of the nurses. METHODOLOGY: Implementation and evaluation of technological application of a checklist format similar to that published by WHO. The process was conducted in three phases using strategies for planning, implementation and evaluation. After training the professionals, design the checklist at each stage, assign the responsibility of screening and determine how registration was applied for 10 months in 68% of planned interventions and 30% urgent. Preliminary evaluation using qualitative methods, discourse analysis of operating room nurses who participated in its implementation and monitoring during implementation. CONCLUSIONS: The qualitative assessment is useful to know the attitudes, opinions and problems of nurses for the implementation of innovations that require interdisciplinary collaboration The application workload increases, but makes visible some activities. The broad participation of nurses reveal their involvement to promote patient safety, but also their training needs. It is essential to the awareness of all professionals to carry out the checklist, which can only be imposed if there is a culture change, innovation and safety and teamwork. For the test does not fall into the routine, it would be wise to do a periodic evaluation. The list should be clear, concise and reliable.

[Educational innovation on the practices for the subjects of community nursing, mental health nursing and geriatric nursing]. / Innovación docente en las prácticas de enfermería comunitaria, salud mental y geriatría.

The new European space for higher education requires changes in education manners as well as execution. One of the main challenges is for the students to acquire competence in their professional life. For that purpose they require knowledge, but also skills and a proactive attitude towards learning. In this paper we tell the experience of the Virgen de las Nieves School of Nursing in Granada, with regards to the integration of the practices for the subjects of Community Nursing III, Psychiatric and Mental Health Nursing, and Geriatric Nursing, which are taken in the third year of the Diplomatura en Enfermería degree. Said practices, which were previously being offered separately within different contexts, will be merged in the same program whose scope will be Primary Care. We believe that the experience has been very positive by looking both at the results and the satisfaction of the students and the professional lecturers. It has been achieved an increase in the number of community care practice hours, and students have managed to acquire more autonomy in their learning and to incorporate critical reasoning in their education. In the methodology used, they have been the main evaluators and protagonists in their learning process, seeking the implication of professionals and teaching tutors in this change. The consensus on the objectives and methods, along with the obstacles which had to be overcome, constitutes one of the most interesting aspects of this experience.

[Problem-based learning, a strategy to employ it]. / Aprendizaje basado en problemas: estrategia de implantación.

The Virgen de las Nieves University School of Nursing has adopted the methodology of Problem-Based Learning (ABP in Spanish acronym) as a supplementary method to gain specific transversal competencies. In so doing, all basic required/obligatory subjects necessary for a degree have been partially affected. With the objective of identifying and administering all the structural and cultural barriers which could impede the success or effectiveness of its adoption, a strategic analysis at the School was carried out. This technique was based on a) knowing the strong and weak points the School has for adopting the Problem-Based Learning methodology; b) describing the structural problems and necessities to carry out this teaching innovation; c) to discover the needs professors have regarding knowledge and skills related to Problem-Based Learning; d) to prepare students by informing them about the characteristics of Problem-Based Learning; e) to evaluate the results obtained by means of professor and student opinions, f) to adopt the improvements identified. The stages followed were: strategic analysis, preparation, pilot program, adoption and evaluation.

[Informal care and nurses. Relations inside the hospital]. / Cuidadoras informales y enfermeras. Relaciones dentro del hospital.

The prolongation of a hospital stay or chronic illness in a family may cause a severe deterioration in the health of informal caretakers; therefore, it is necessary that professionals who work in formal institutions act as consultants and that they optimize informal caretakers' abilities so that they learn not only how to care for their ill relatives but also so that they care for themselves. Nonetheless, health centers, who concentrate on the ill patients, do not always consider informal caretakers as part of a family context which bears direct influence on the well-being and health of these people. In this article, the author proposes to: know the relationship models which the professional nursing team establishes with caretakers in the hospital environment; identify the strengths and weaknesses of caretakers, nursing professionals and institutions in order to establish a model for capacity-collaboration relationship. The methodology used was of a qualitative nature, utilizing discussion groups with professionals and semi-structured interviews with caretakers selected from among those who were found in the hospital. We could conclude that in the majority of the wards in the "HMQ" hospital, the patients are considered passive receptors of professional care and their families are left to the side. A model for capacity-collaboration relationship does not appear viable in HMQ due to the presence of certain weaknesses. However, there are certain strengths which could be fortified; these include the desire of the caretakers and the conviction among professionals of the benefits which such a relationship model would provide.