Reduction of ventilatory time using the multidisciplinary disconnection protocol. Pilot study.

OBJECTIVE: compare ventilatory time between patients with the application of a disconnection protocol, managed in a coordinated way between doctor and nurse, with patients managed exclusively by the doctor. METHOD: experimental pilot study before and after. Twenty-five patients requiring invasive mechanical ventilation for 24 hours or more were included, and the protocol-guided group was compared with the protocol-free group managed according to usual practice. RESULTS: by means of the multidisciplinary protocol, the time of invasive mechanical ventilation was reduced (141.94 ± 114.50 vs 113.18 ± 55.14; overall decrease of almost 29 hours), the time spent on weaning (24 hours vs 7.40 hours) and the numbers of reintubation (13% vs 0%) in comparison with the group in which the nurse did not participate. The time to weaning was shorter in the retrospective cohort (2 days vs. 5 days), as was the hospital stay (7 days vs. 9 days). CONCLUSION: the use of a multidisciplinary protocol reduces the duration of weaning, the total time of invasive mechanical ventilation and reintubations. The more active role of the nurse is a fundamental tool to obtain better results.

User satisfaction in the spanish health system: trend analysis.

OBJECTIVE: To analyze the trend of opinion and satisfaction indicators of the Spanish national health system from 2005 to 2017. METHODS: Ecological study of time series analyzing the trend of eight indicators of opinion and satisfaction on the Spanish national health system and its autonomous communities from 2005 to 2017. The data was obtained from the Ministry of Health, Social Services and Equality and from the Health Barometer. The Prais-Winsten regression method was used. RESULTS: A static tendency was observed in the perception of users on how the health system works (APC = 1.898, 95%CI -0.954 - 4.751) and decreasing opinion on the improvement of primary care (APC = -0.283; 95%CI -0.335 - -0.121), specialized (APC = -0.241, 95%CI -0.74 - -0.109) and hospitalization (APC = -0.171, 95%CI -0.307 - -0.036). Satisfaction with knowledge and follow-up by the family doctor and pediatrician showed an increasing trend (APC = 7.939, 95%CI 3.965 - 11.914). Satisfaction with medical and nursing professionals was static. No large differences were observed in the trends of the indicators studied in the autonomous communities. CONCLUSIONS: A negative trend was observed in the opinion of the Spanish national health system users. Financing, human resources, quality management systems and differences in the autonomous communities may be some of the causes.

Student nurses at Spanish universities and their attitude toward xenotransplantation.

INTRODUCTION: Recent immunological and transgenic advances are a promising alternative using limited materials of human origin for transplantation. However, it is essential to achieve social acceptance of this therapy. OBJECTIVE: To analyze the attitude of nursing students from Spanish universities toward organ xenotransplantation (XTx) and to determine the factors affecting their attitude. MATERIALS AND METHODS: Type of study: A sociological, multicentre, and observational study. STUDY POPULATION: Nursing students enrolled in Spain (n = 28,000). SAMPLE SIZE: A sample of 10 566 students estimating a proportion of 76% (99% confidence and precision of ±1%), stratified by geographical area and year of study. Instrument of measurement: A validated questionnaire (PCID-XenoTx-RIOS) was handed out to every student in a compulsory session. This survey was self-administered and self-completed voluntarily and anonymously by each student in a period of 5-10 min. STATISTICAL ANALYSIS: descriptive analysis, Student's t test, the chi-square test, and a logistic regression analysis. RESULTS: A completion rate: 84% (n = 8913) was obtained. If the results of XTx were as good as in human donation, 74% (n = 6564) would be in favor and 22% (n = 1946) would have doubts. The following variables affected this attitude: age (P < 0.001); sex (P < 0.001); geographical location (P < 0.001); academic year of study (P < 0.001); attitude toward organ donation (P < 0.001); belief in the possibility of needing a transplant (P < 0.001); discussion of transplantation with one's family (P < 0.001) and friends (P < 0.001); and the opinion of one's partner (P < 0.001). The following variables persisted in the multivariate analysis: being a male (OR = 1.436; P < 0.001); geographical location (OR = 1.937; P < 0.001); an attitude in favor of donation (OR = 1.519; P < 0.001); belief in the possibility of needing a transplant (OR = 1.497; P = 0.036); and having spoken about the issue with family (OR = 1.351; P < 0.001) or friends (OR = 1.240; P = 0.001). CONCLUSIONS: The attitude of nursing students toward organ XTx is favorable and is associated with factors of general knowledge about organ donation and transplantation and social interaction.

User satisfaction in the spanish health system: trend analysis / Satisfacción de los usuarios en el sistema de salud español: análisis de tendencias

ABSTRACT OBJECTIVE To analyze the trend of opinion and satisfaction indicators of the Spanish national health system from 2005 to 2017. METHODS Ecological study of time series analyzing the trend of eight indicators of opinion and satisfaction on the Spanish national health system and its autonomous communities from 2005 to 2017. The data was obtained from the Ministry of Health, Social Services and Equality and from the Health Barometer. The Prais-Winsten regression method was used. RESULTS A static tendency was observed in the perception of users on how the health system works (APC = 1.898, 95%CI -0.954 - 4.751) and decreasing opinion on the improvement of primary care (APC = -0.283; 95%CI -0.335 - -0.121), specialized (APC = -0.241, 95%CI -0.74 - -0.109) and hospitalization (APC = -0.171, 95%CI -0.307 - -0.036). Satisfaction with knowledge and follow-up by the family doctor and pediatrician showed an increasing trend (APC = 7.939, 95%CI 3.965 - 11.914). Satisfaction with medical and nursing professionals was static. No large differences were observed in the trends of the indicators studied in the autonomous communities. CONCLUSIONS A negative trend was observed in the opinion of the Spanish national health system users. Financing, human resources, quality management systems and differences in the autonomous communities may be some of the causes.

RESUMEN OBJETIVO Analizar la tendencia de indicadores de opinión y satisfacción del sistema nacional de salud español de 2005 a 2017. MÉTODOS Estudio ecológico de series temporales analizando la tendencia de ocho indicadores de opinión y satisfacción sobre el sistema nacional de salud y sus comunidades autónomas de 2005 a 2017. Los datos se obtuvieron del Ministerio de Sanidad, Servicios Sociales e Igualdad y del Barómetro Sanitario. Se utilizó el método de autoregresión de Prais-Winsten. RESULTADOS Se observó una tendencia estática en la percepción de los usuarios sobre el funcionamiento del sistema sanitario (APC = 1,898; IC95% -0,954-4,751) y decreciente sobre la opinión en la mejora de la atención primaria (APC = -0.283; IC95% -0,335- -0.121), especializada (APC = -0,241; IC95% -0.74- -0.109) y hospitalización (APC = -0.171; IC95% -0,307- -0,036). La satisfacción con el conocimiento y seguimiento por el médico de familia y pediatra mostró una tendencia creciente (APC = 7,939; IC95% 3,965-11,914). La satisfacción con los profesionales de medicina y enfermería fue estática. No se observaron grandes diferencias en las tendencias de los indicadores estudiados en las comunidades autónomas. CONCLUSIONES Se observó una tendencia negativa en la opinión de los usuarios del sistema nacional de salud español. Financiación, recursos humanos, sistemas de gestión de calidad y diferencias en las comunidades autónomas pueden ser algunas de las causas.

Comparative analysis of the psychometric parameters of two quality-of-life questionnaires, the SGRQ and CAT, in the assessment of patients with COPD exacerbations during hospitalization: A multicenter study.

The aim of this study was to assess health-related quality of life (HRQL) in patients with chronic obstructive pulmonary disease (COPD) and to discuss the different tools available for its assessment. The most widely used assessments are the St. George respiratory questionnaire (SGRQ) and the COPD assessment test (CAT) questionnaire. Both have a different difficulty in exam completion, calculation, and scoring. No studies exist that analyze the validity and internal consistency of using both questionnaires on patients admitted to the hospital for a COPD exacerbation. A multicenter, cross-sectional analytic observational study of patients admitted to the hospital due to a COPD exacerbation (CIE 491.2). During their hospital stay, they were administered the SGRQ and the CAT questionnaire within the framework of a therapeutic education program (APRENDEPOC). Descriptive and comparative analysis, correlations between the scales (Pearson's correlation index), consistency and reliability calculations (Cronbach's α), and a forward stepwise multiple linear regression were performed, with significant correlations in both questionnaires considered p < 0.01 with the total scores. A statistical significance of p < 0.05 was assumed. Altogether, 231 patients were admitted for a COPD exacerbation ( n = 77) at Hospital Clínic of Barcelona (HCB) and ( n = 154) at Hospital Universitario General of Castellón (HUGC). The sample profile was not homogeneous between both centers, with significant differences in HRQL between hospitals. Correlation were noted between both scales ( p < 0.01), along with high levels of internal consistency and reliability (CAT 0.836 vs. SGRQ 0.827). The HRQL is related to dyspnea, wheezing, daytime drowsiness, and edema, as well as to the need to sleep in a sitting position, anxiety, depression, and dependence on others in the execution of daily activities. Our regression analysis showed that the SGRQ questionnaire could predict more changes in HRQL with a higher number of variables.

Predictors of nurses' level of participation in student care: A multivariable analysis.

OBJECTIVE: To determine the association and predictive nature of certain socio-demographic, education, work and research variables on nurses' participation level in the clinical care of students. DESIGN: A cross-sectional analytical study using a validated questionnaire between February and June 2014. SETTING AND PARTICIPANTS: A consecutive sample of 117 nurses who worked in public health centres in the province of Castellón (Spain) in 2014. The nurses who had never mentored students and the questionnaires that were <50% complete were excluded. METHODS: A descriptive analysis of the sample and an association analysis between variables were performed. The questionnaire and its dimensions were performed with a logistic regression and the maximum likelihood method, which used a complementary log-log link method. The concordance index was calculated using contingency tables. RESULTS: The mean age was 42.56 years, and the overall mean questionnaire score was 122.84 (SD = 18.69; 95% CI: 119.415-126.26). Across the sample, 58.1% (n = 68) of the nurses obtained an Excellent score, followed by Adequate in 41% (n = 48). Overall, the predictive variables were age, mentoring of students in the last 5 years and previous training to mentor students. CONCLUSION: The main predictive variable for greater participation in the mentorship of students was previous training in mentoring. This study also reflected on other variables that could influence nurses' participation in student mentoring.

Participation of clinical nurses in the practical education of undergraduate nursing students. / Participación de las enfermeras clínicas en la formación práctica de estudiantes de Grado en Enfermería.

OBJECTIVE: To evaluate the level of participation of clinical nurses from Castellón where Universitat JaumeI nursing students do their clinical clerkship. To identify the variables that may influence clinical nurses' participation in students' clinical mentorship. METHOD: This observational, cross-sectional and descriptive study was conducted by applying the validated Involvement, Motivation, Satisfaction, Obstacles and Commitment (IMSOC) questionnaire. The variables collected were: age, work environment and previous training. The study was conducted between January and December 2014. RESULTS: The sample included 117 nurses. The overall mean questionnaire score was 122.838 (standard deviation: ±18.692; interquartile range 95%: 119.415-126.26). The variable "previous training for mentorship students" was statistically significant in the overall score and for all dimensions (P<.05). Primary care nurses obtained better scores in the dimension Implication than professionals working at other care levels. CONCLUSIONS: The level of participation of the clinical nurses from Castellón is adequate. The previous training that professionals receive for mentoring students improves both their level of participation and primary care level. Extending this research to other national and international environments is recommended.

Fatores associados à qualidade de vida dos idosos / Factores asociados a la calidad de vida de las personas mayores / Factors associated with the quality of life of older people

Resumo Objetivo: Examinar as relações entre qualidade de vida, nutrição e fragilidade em indivíduos não institucionalizados com idade acima de 75 anos. Método: Estudo observacional, transversal e analítico realizado através da aplicação de um questionário com uma amostra de indivíduos com mais de 75 anos de idade residentes na comunidade e selecionados através de amostragem por conveniência durante o ano de 2015. Resultados: Uma proporção maior de mulheres apresentou baixa qualidade de vida em relação aos homens: 20,9% contra 9% (p<0,01). O risco de desnutrição foi associado a baixa qualidade de vida (35%) (23,4%) (p<0,000). Uma proporção maior de indivíduos fragilizados apresentou baixa qualidade de vida: 55,7% contra 17,4% (p<0.000). Conclusão: A qualidade de vida dos idosos é influenciada pela presença de sintomas de depressão, estado nutricional, sexo, fragilidade e incapacidade básica e instrumental.

Resumen Objetivo: Examinar las relaciones entre calidad de vida, nutrición y fragilidad en individuos no institucionalizados con edad superior a 75 años. Método: Estudio observacional, transversal y analítico realizado durante el año 2015, a través de la aplicación de un cuestionario con una muestra de individuos con más de 75 años de edad residentes en la comunidad y seleccionados a través de muestreo por conveniencia. Resultados: Una proporción mayor de mujeres presentó baja calidad de vida en relación con los hombres: 20,9% contra 9% (p <0,01). El riesgo de desnutrición se asoció a una baja calidad de vida (35%) (23,4%) (p <0,000). Una proporción mayor de individuos fragilizados presentó baja calidad de vida: 55,7% contra 17,4% (p <0.000). Conclusión: La calidad de vida de los ancianos es influenciada por la presencia de síntomas de depresión, estado nutricional, sexo, fragilidad e incapacidad básica e instrumental.

Abstract Objective: Examine the relationships between quality of life, nutrition and frailty in non-institutionalized people older than 75 years of age. Methods: Observational, cross-sectional, analytical study conducted using a questionnaire with a sample of individuals older than 75 years of age residing in the community, who were selected via convenience sampling during 2015. Results: A larger proportion of women had poor quality of life than men: 20.9% as opposed to 9% (p<0.01). Malnutrition risk was associated with low quality of life (35%) (23.4%) (p<0.000). A larger proportion of frail individuals had poor quality of life: 55.7% against 17.4% (p<0.000). Conclusion: Quality of life of older people is influenced by the presence of depression symptoms, nutritional status, sex, frailty and basic and instrumental disability.

Cuestionario para medir la participación de los profesionales de enfermería en la tutela de estudiantes / Questionário para medir a participação dos profissionais de enfermagem na tutela de estudantes / Questionnaire to Measure the Participation of Nursing Professionals in Mentoring Students

Objective. The aim herein was to validate a questionnaire to measure the level of participation of clinical nursing professionals in the mentorship of nursing students during clinical practices. Methods. Design and validation of a questionnaire. The psychometric properties of the tool were determined through four phases: 1- literature review; 2- evaluation of content validity; 3- pilot test, cognitive pretest and intra-observer reliability study; 4- construct validity study through an exploratory factor analysis of main components with varimax rotation in a sample of 249 nursing professionals from primary care and hospital care from different Spanish provinces. The internal consistency was studied with Cronbach's alpha coefficient. Results. The global content validity was above 0.8. The final version of the questionnaire had 33 items, with a global intraclass correlation coefficient of 0.852 and Cronbach's alpha of 0.837. Factor analysis explained 55.4% of the total variance, with a solution of five factors that made up the dimensions: Implication, Motivation, Satisfaction, Obstacles, and Commitment. Conclusion. The questionnaire evaluated has adequate validity and reliability to permit determining the level of nurse participation in the mentorship of students. (AU)

Objetivo. Validar un cuestionario para medir el nivel de participación de los profesionales de enfermería clínicos en la tutela de estudiantes de enfermería durante las prácticas clínicas. Métodos. Diseño y validación de un cuestionario. Se determinaron las propiedades psicométricas de la herramienta mediante cuatro fases: 1- revisión de la literatura; 2- evaluación de la validez de contenido; 3- prueba piloto, pretest cognitivo y estudio de la fiabilidad intraobservador; 4-, estudio de validez de constructo mediante un análisis factorial exploratorio de componentes principales con rotación varimax en una muestra de 249 profesionales de enfermería de atención primaria y de atención hospitalaria de diferentes provincias españolas. La consistencia interna se estudió con el coeficiente Alfa de Cronbach. Resultados. La validez de contenido global fue superior a 0.8. La versión final del cuestionario fue de 33 ítems, con un CCI global de 0.852 y un alfa de Cronbach de 0.837. El análisis factorial explicó el 55.4% de varianza total, con una solución de cinco factores que formaron las dimensiones Implicación, Motivación, Satisfacción, Obstáculos y Compromiso. Conclusión. El cuestionario evaluado tiene validez y fiabilidad adecuadas que permite determinar el nivel de participación de las enfermeras en la tutela de estudiantes. (AU)

Objetivo. Validar um questionário para medir o nível de participação dos profissionais de enfermagem clínicos na tutela de estudantes de enfermagem durante as práticas clínicas. Métodos. Desenho e validação de um questionário. Se determinaram as propriedades psicométricas da ferramenta mediante quatro fases: 1- revisão da literatura; 2- avaliação da validez de conteúdo; 3- prova piloto, pré-teste cognitivo e estudo da fiabilidade intra-observador; 4-, estudo de validez de construto mediante uma análise fatorial exploratório de componentes principais com rotação varimax numa amostra de 249 profissionais de enfermagem de atenção primária e de atenção hospitalar de diferentes províncias espanholas. A consistência interna se estudou com o coeficiente Alfa de Cronbach. Resultados. A validez de conteúdo global foi superior a 0.8. A versão final do questionário foi de 33 itens, com um CCI global de 0.852 e um alfa de Cronbach de 0.837. A análise fatorial explicou que 55.4% de variância total, com uma solução de cinco fatores que formaram as dimensões; Implicação, Motivação, Satisfação, Obstáculos e Compromisso. Conclusão. O questionário avaliado tem validez e fiabilidade adequadas que permite determinar o nível de participação das enfermeiras na tutela de estudantes. (AU)

Questionnaire to Measure the Participation of Nursing Professionals in Mentoring Students.

OBJECTIVES: The aim herein was to validate a questionnaire to measure the level of participation of clinical nursing professionals in the mentorship of nursing students during clinical practices. METHODS: Design and validation of a questionnaire. The psychometric properties of the tool were determined through four phases: 1- literature review; 2- evaluation of content validity; 3- pilot test, cognitive pretest and intra-observer reliability study; 4- construct validity study through an exploratory factor analysis of main components with varimax rotation in a sample of 249 nursing professionals from primary care and hospital care from different Spanish provinces. The internal consistency was studied with Cronbach's alpha coefficient. RESULTS: The global content validity was above 0.8. The final version of the questionnaire had 33 items, with a global intraclass correlation coefficient of 0.852 and Cronbach's alpha of 0.837. Factor analysis explained 55.4% of the total variance, with a solution of five factors that made up the dimensions: Implication, Motivation, Satisfaction, Obstacles, and Commitment. CONCLUSIONS: The questionnaire evaluated has adequate validity and reliability to permit determining the level of nurse participation in the mentorship of students.

Cultural analysis of surgical safety checklist items in Spain and Argentina. / Análisis cultural de los ítems de dos listas de verificación quirúrgica de España y Argentina.

OBJECTIVE: To compare the agreement between two surgical checklists implanted in two hospitals in Spain and Argentina, using the international classification for patient safety as a framework. METHOD: This was an expert opinion study carried out using an ad hoc questionnaire in electronic format, which included 7 of the 13 categories of the international classification for patient safety. Fifteen surgical security experts from each country participated in this study by classifying the items on the checklists into the selected ICPS categories. The data were analyzed with SPSS V20 software. RESULTS: There was a greater percentage of classifications in fields related to the prevention of critical events. The category "clinical processes and procedures" was mentioned most frequently in both lists. CONCLUSION: The implementation of the surgical safety checklist is variable. Experts considered that the Argentinian list was clearer in every dimension.

Obesity, knee osteoarthritis, and polypathology: factors favoring weight loss in older people.

AIM: We aimed to explore the meaning of obesity in elderly persons with knee osteoarthritis (KO) and to determine the factors that encourage or discourage weight loss. BACKGROUND: Various studies have demonstrated that body mass index is related to KO and that weight loss improves symptoms and functional capacity. However, dietary habits are difficult to modify and most education programs are ineffective. DESIGN: A phenomenological qualitative study was conducted. Intentional sampling was performed in ten older persons with KO who had lost weight and improved their health-related quality of life after participating in a health education program. A thematic content analysis was conducted following the stages proposed by Miles and Huberman. FINDINGS: Participants understood obesity as a risk factor for health problems and stigma. They believed that the cause of obesity was multifactorial and criticized health professionals for labeling them as "obese" and for assigning a moral value to slimness and diet. The factors identified as contributing to the effectiveness of the program were a tolerant attitude among health professionals, group education that encouraged motivation, quantitative dietary recommendations, and a meaningful learning model based on social learning theories. CONCLUSION: Dietary self-management without prohibitions helped participants to make changes in the quantity and timing of some food intake and to lose weight without sacrificing some foods that were deeply rooted in their culture and preferences. Dietary education programs should focus on health-related quality of life and include scientific knowledge but should also consider affective factors and the problems perceived as priorities by patients.

Assessment of bachelor's theses in a nursing degree with a rubrics system: Development and validation study.

BACKGROUND: Writing a bachelor thesis (BT) is the last step to obtain a nursing degree. In order to perform an effective assessment of a nursing BT, certain reliable and valid tools are required. OBJECTIVES: To develop and validate a 3-rubric system (drafting process, dissertation, and viva) to assess final year nursing students' BT. DESIGN: A multi-disciplinary study of content validity and psychometric properties. The study was carried out between December 2014 and July 2015. SETTINGS: Nursing Degree at Universitat Jaume I. Spain. PARTICIPANTS: Eleven experts (9 nursing professors and 2 education professors from 6 different universities) took part in the development and content validity stages. Fifty-two theses presented during the 2014-2015 academic year were included by consecutive sampling of cases in order to study the psychometric properties. METHODS: First, a group of experts was created to validate the content of the assessment system based on three rubrics (drafting process, dissertation, and viva). Subsequently, a reliability and validity study of the rubrics was carried out on the 52 theses presented during the 2014-2015 academic year. RESULTS: The BT drafting process rubric has 8 criteria (S-CVI=0.93; α=0.837; ICC=0.614), the dissertation rubric has 7 criteria (S-CVI=0.9; α=0.893; ICC=0.74), and the viva rubric has 4 criteria (S-CVI=0.86; α=8.16; ICC=0.895). CONCLUSION: A nursing BT assessment system based on three rubrics (drafting process, dissertation, and viva) has been validated. This system may be transferred to other nursing degrees or degrees from other academic areas. It is necessary to continue with the validation process taking into account factors that may affect the results obtained.

Análisis cultural de los ítems de dos listas de verificación quirúrgica de España y Argentina / Análise cultural dos itens de duas listas de verificação cirúrgica de Espanha e Argentina / Cultural analysis of surgical safety checklist items in Spain and Argentina

RESUMEN Objetivo Comparar la concordancia entre dos listas de verificación quirúrgica implantadas en dos hospitales en España y Argentina utilizando como marco de referencia la Clasificación Internacional para la Seguridad de Pacientes. Método Estudio basado en el juicio de expertos realizado con un cuestionario ad hoc en soporte electrónico que abarca 7 de las 13 categorías de la Clasificación Internacional para la Seguridad de Pacientes. Participaron 15 expertos en seguridad quirúrgica de cada país, asociando cada ítem de las listas de verificación con las dimensiones seleccionadas. Los datos se analizaron con el programa SPSS V20. Resultados Se evidencia un mayor porcentaje de coincidencias con campos relacionados con prevención de eventos críticos. La dimensión Procesos clínicos y procedimientos obtuvo una mayor frecuencia de asignación en ambas listas. Conclusión Existe variabilidad en la implantación de las listas de verificación quirúrgica. Los expertos consideran la lista argentina más clara en cada dimensión.

RESUMO Objetivo Comparar a concordância entre duas listas cirúrgicas, implantadas em dois hospitais na Espanha e na Argentina, usando como quadro de referência a classificação internacional para a segurança do paciente. Método Estudo baseado na opinião de especialistas, realizado através de um questionário ad hoc em formato eletrônico, que inclui 7 das 13 categorias da classificação internacional para a segurança do paciente. Participaram 15 especialistas em segurança cirúrgica de cada país, associando cada item das listas de verificação nas dimensões selecionadas. Os dados foram analisados com o programa SPSS V20. Resultados Uma porcentagem mais elevada de coincidências é evidente com domínios relacionados à prevenção de eventos críticos. A dimensão Processos clínicos e procedimentos apresentou uma maior frequência de atribuição em ambas as listas. Conclusão Há variabilidade na implantação das listas cirúrgicas de verificação. Especialistas acreditam que a lista da Argentina é mais clara em todas as dimensões.

ABSTRACT Objective To compare the agreement between two surgical checklists implanted in two hospitals in Spain and Argentina, using the international classification for patient safety as a framework. Method This was an expert opinion study carried out using an ad hoc questionnaire in electronic format, which included 7 of the 13 categories of the international classification for patient safety. Fifteen surgical security experts from each country participated in this study by classifying the items on the checklists into the selected ICPS categories. The data were analyzed with SPSS V20 software. Results There was a greater percentage of classifications in fields related to the prevention of critical events. The category “clinical processes and procedures” was mentioned most frequently in both lists. Conclusion The implementation of the surgical safety checklist is variable. Experts considered that the Argentinian list was clearer in every dimension.

Doctorate nursing degree in Spain.

UNLABELLED: Analytical and descriptive study of the process of change being experienced in the Spanish university system over the last decade (2005-2014). OBJECTIVE: To describe the structural changes occurring in Nursing Education in Spain, reaching access to doctoral studies from the European Convergence Process and the subsequent legislative development. METHODOLOGY: Bibliographical review of royal decrees and reference literature on the subject of study and descriptive analysis of the situation. RESULTS: Carries various changes suffered in the curricula of nursing education in the last decade, the legislation of the European Higher Education sets the guidelines for current studies of Masters and Doctorates. CONCLUSIONS: The implementation of the Master and Doctorate stages after a basic degree, which is now possible with the new legislation. A formal beginning made of scientific nursing in order to generate their own lines of research led by Doctors of nursing who can integrate in research groups under the same condition as other researcher, yet now, from the nursing discipline itself.

Doctorate nursing degree in Spain / Doutorado de Enfermagem na Espanha / Doctorado de Enfermería en España

Analytical and descriptive study of the process of change being experienced in the Spanish university system over the last decade (2005-2014).

Estudo analítico e descritivo, do processo de mudança do sistema universitário espanhol na última década (2005-2014).

Estudio analítico y descriptivo del proceso de cambio que durante la última década (2005-2014) está experimentando el Sistema Universitario Español.

[Nursing professionals and health care assistants' perception of patient safety culture in the operating room]. / Percepción de los profesionales de enfermería y auxiliares de enfermería sobre cultura de seguridad del paciente en el área quirúrgica.

OBJECTIVES: To assess nursing professionals and health care assistants' perceptions, opinions and behaviours on patient safety culture in the operating room of a public hospital of the Spanish National Health Service. To describe strengths and weaknesses or opportunities for improvement according to the Agency for Healthcare Research and Quality criteria, as well as to determine the number of events reported. METHOD: A descriptive, cross-sectional study was conducted using the Spanish version of the questionnaire Hospital Survey on Patient Safety Culture. The sample consisted of nursing professionals, who agreed to participate voluntarily in this study and met the selection criteria. A descriptive and inferential analysis was performed depending on the nature of the variables and the application conditions of statistical tests. Significance if p < .05. RESULTS: In total, 74 nursing professionals responded (63.2%). No strengths were found in the operating theatre, and improvements are needed concerning staffing (64.0%), and hospital management support for patient safety (52.9%). A total of 52.3% (n = 65) gave patient safety a score from 7 to 8.99 (on a 10 point scale); 79.7% (n = 72) reported no events last year. The total variance explained by the regression model was 0.56 for "Frequency of incident reporting" and 0.26 for "Overall perception of safety". CONCLUSIONS: There was a more positive perception of patient safety culture at unit level. Weaknesses have been identified, and they can be used to design specific intervention activities to improve patient safety culture in other nearby operating theatres.

Content validity of the Spanish version of the Practice Environment Scale of the Nursing Work Index.

OBJECTIVE: The objective of this study is to evaluate the content validity of the Iberian Spanish version of the questionnaire The Practice Environment Scale of the Nursing Work Index (PES-NWI) by using the Content Validity Indexing (CVI). METHODS: A descriptive cross-sectional observational study was conducted. The Spanish version of the questionnaire was translated from the American English instrument through forward and back translation processes. Experts evaluated the translated items through content validity indexing. Once the assessments were completed, CVI indicators were calculated: number of agreements, item Content Validity Index and overall content validity and modified kappa coefficient of the instrument. RESULTS: The overall content validity of the instrument was 0.82. The average modified kappa coefficient of the items was 0.80, with a rating of 'excellent'. Only 4 of the items were rated as weak or poor. CONCLUSIONS: The study demonstrates that the content validity of the Spanish version of the PES-NWI is acceptable. Some results indicate that some items have cross-cultural applicability challenges that need to be addressed in future research studies. Use of the instrument in other Spanish language speaking countries should be taken with caution since some words may not reflect the language of the healthcare systems there.

Simultaneous implementation of the Bachelor, Masters and PhD degrees in nursing in the Universidad Jaume I. Castellón de la Plana, Spain / Implantación simultánea de los niveles Grado, Máster y Doctorado en Enfermería en la Universidad Jaume I. Castellón de la Plana, España / Implantação simultânea dos níveis graduação, mestrado e doutorado em enfermagem na universidade Jaume I. Castellón da Plana, Espanha

We present an experience in Nursing Education, accredited and implemented under the Spanish University System Reform in a Public University (Jaume I, Castellón) which had no previous nursing studies. The academics offered included all three educational levels (Bachelor, Master's and Doctorate), with an integrated theoretical-practical-clinical teaching methodology for the Bachelor Degree, competence acquisition in research in the Master's degree, and a doctorate formed by lines of research in the field of Nursing. Studies are accredited by the National Agency for Quality Assessment, which were authorized by the Spanish Ministry of Education and implanted between 2009 and 2011.

Se presenta una experiencia de Educación en Enfermería acreditada e implantada al amparo de la Reforma del Sistema Universitario Español, en una Universidad pública (Jaume I, Castellón) que no tenía los estudios de Enfermería previos. La oferta académica incluye los tres niveles formativos Grado, Máster y Doctorado, con una metodología docente integrada teórico-práctico-clínica en el nivel Grado, por adquisición de competencias en investigación en nivel Máster y un Doctorado, formados por líneas de investigación del ámbito de la Enfermería. Los estudios se acreditaron por la Agencia Nacional de Evaluación de la Calidad, los cuales fueron autorizados por el Ministerio de Educación Español y se implantaron entre los años 2009 y 2011.

Se apresenta uma experiência de Educação em Enfermagem credenciada e implantada ao amparo da Reforma do Sistema Universitário Espanhol, numa Universidade pública (Jaume I, Castellón) que não tinha os estudos de Enfermagem prévios. A oferta acadêmica inclui os três níveis formativos Graduação, Mestrado e Doutorado, com uma metodologia docente integrada teórico-prático-clínica no nível Graduação, por aquisição de concorrências em investigação em nível Mestrado e um Doutorado formado por linhas de investigação do âmbito da Enfermagem. Os estudos se credenciaram pela Agência Nacional de Avaliação da Qualidade, foram autorizados pelo Ministério de Educação Espanhol e se implantaram entre os anos 2009 e 2011.