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

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 administration¼ and «direct clinical practice¼ were identified as specific competencies of nursing supervisor and clinical nurse specialist respectively. «Collaboration¼, «leadership¼ and «research¼ 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.

[Competencies and professional profile of the advanced practice nurse]. / Competencias y perfil profesional de la enfermera de práctica avanzada.

INTRODUCTION: The advanced practice nurse can foster the development of innovative approaches in the design of patient, families and community care. This study has aimed to explain the importance of the advanced practice nurse, especially that of the clinical nurse specialist (CNS), within the care setting and to go deeper into the knowledge of this nursing profile. DESIGN: A review of the literature. METHOD: The following databases were used: CINAHL, PubMed and Medline. Search terms were 'clinical nurse specialist,' 'implementation,' and 'advanced practice nursing.' RESULTS: The sample included 24 publications. A synthesis of the findings generated a summary of the competencies of CNS and their definitions, with some examples in their daily practice and the outcome on its 3 spheres of influences: patients and families, staff and organization. CONCLUSION: CNS emerges in the health systems in order to improve the outcomes in the patients, staff and the organization per se because of its competence as an agent of change and transformational leader RELEVANCE TO CLINICAL PRACTICE: National policies and national strategies are needed to implement CNS on the Master's level in the Spanish National Health System given the evidence-based improvement in the care standards.

How nurses perceive the gap between knowledge and practice.

BACKGROUND: Identifying nurses' perceptions of the knowledge-practice gap is a critical step toward developing evidence-based practice. Currently, multiple factors contribute to the gap between nursing education and actual practice. Addressing this gap requires a new perspective, not yet adequately represented in the literature, that includes nurses' perceptions. AIM: This study aims to describe nurses' perceptions of the knowledge-practice gap in the domains of knowledge, practice, environment, and learning. And it analyzes how nurses' professional characteristics are associated with their perceptions of the gap in each of these domains as well as the relationships between the domains themselves. METHODS: The study used a cross-sectional descriptive correlational design. A sample of 513 staff nurses recruited through a convenience sampling technique provided information on professional variables such as education and experience and completed a Likert-scale survey about their perceptions of the knowledge-practice gap. RESULTS: Their answers were found to vary with educational level and history of workshop attendance. Items from the knowledge domain were positively and significantly correlated with items from the environment and learning domains, which were also positively and significantly correlated with each other. However, the knowledge and practice domains were not significantly correlated. In addition to showing correlations among the major domains (or aspects) of the knowledge-practice gap, the study highlights how nurses' professional characteristics contribute to differences in their perceptions of this gap. CONCLUSION: These findings can guide hospital-specific measures for bridging the gap. In addition, the scale can be employed by leaders as a tool for the purpose of conducting assessments.

Professional competencies of oncology nurses: Recognizing advanced practice in nursing.

OBJECTIVE: To identify the competency profile of advanced practice nurses involved in the care process of cancer patients. METHODS: Cross-sectional and descriptive study. The study included all nurses involved in the cancer patient care process in a tertiary hospital in Barcelona. Competence profile data were collected using the instrument for defining the role of the advanced practice nurse (APRD), as well as sociodemographic and occupational variables. Sociodemographic and occupational data were compared against the performance of advanced practice activities. RESULTS: A total of 29 (82.9%) nurses participated with a mean age of 42.6±12.54 years. 9 (31%) nurses were identified as meeting the standard in all 6 domains on the APRD scale to be considered advanced practice nurses. Of these 9 (31%) nurses, 7 (24.1%) met the training standards required by the International Council of Nurses (ICN) with an official master's degree and 2 (6.9%) with a PhD. CONCLUSIONS: There are nurses who carry out their activity in the oncology field of the hospital analyzed with the EPA profile. The identification of advanced practice nurses (APNs) in our health system is essential to be able to recognize the competencies of these professionals and create specific positions that help to address chronicity, patients' quality of life, their survival, and the optimization of health resources. Our study highlights the importance of chronicity and cancer as areas for the development of the APNs.

Perceived Quality in Patients With Gout Treated in a Rheumatology Clinic With a Clinical Nurse Specialist. / Estudio de calidad percibida en pacientes con gota atendidos en una consulta de reumatología con enfermería especializada.

INTRODUCTION: Gout is a crystal arthropathy that is associated with significant loss of quality of life. A treat-to-target approach and proactive monitoring yield superior outcomes to standard care. The Clinical Nurse Specialist enhances follow-up and adherence to treatment in patients with gout, improving their perceived healthcare quality. OBJECTIVE: To determine the factors that affect the perceived quality and satisfaction of patients with gout treated in a rheumatology clinic and to identify areas for improvement, as well as to explore the influence of nurses' work in the care and management of these patients. METHODS: Cross-sectional observational study in patients with gout monitored in a monographic clinic by anonymous survey based on the SERVQUAL quality model, with demographic data and questions about aspects of care. RESULTS: 71 completed surveys were collected from the 80 delivered between August 2019 and January 2020. Most of the participants were males over 45years of age. A total of 39% were satisfied with the care received, and 55% were very satisfied. All the respondents were satisfied with the face-to-face consultation with the Clinical Nurse Specialist and 66% considered the telephone consultation with the nurse to be good. Possible areas for improvement (referral time to consultation, identification, and availability of health providers) were identified. CONCLUSION: We found high overall satisfaction perceived by the patients attended in a gout consultation with the Clinical Nurse Specialist. Understanding and systematizing the patients' opinion is essential to improve clinical care.

Impact of the COVID-19 Pandemic on Rheumatology Nursing Consultation. / Impacto de la COVID-19 en la consulta de enfermería reumatológica.

OBJECTIVE: The COVID-19 pandemic has brought major changes to the model of patient care in Rheumatology. Our aim was to compare the change in the care delivered in a rheumatology nursing consultation before and during the pandemic. MATERIAL AND METHODS: Descriptive and observational study in 254 patients before and in 251 during the pandemic outbreak. RESULTS: The type of scheduled face-to-face visit decreased during COVID-19 (46.5% vs. 1.6%), with the number of scheduled telephone visits increasing (2.8% vs. 52.2%) and spontaneous consultations over the phone or email (28.3% vs. 45%). The functions performed in the programmed ones were the stable patient control (20% vs. 37%) and management (12% vs. 38%). The reason for spontaneous consultation increased during COVID-19, especially doubts regarding prevention measures and treatment optimization (13.8% vs. 31.1%). CONCLUSIONS: The first wave of COVID-19 brought to rheumatology nursing consultation a global increase in all activities in the number of visits per day, in the number of stable patient controls, in monitoring and answering patient concerns.

Prevention and treatment of delirium in intensive care: Hermeneutics of experiences of the nursing team. / Prevenir y tratar delirium en cuidados intensivos: hermenéutica de las vivencias del equipo de enfermería.

OBJECTIVE: To understand the experiences in nursing care in the prevention and treatment of delirium in people hospitalized in intensive care units. METHODOLOGY: Hermeneutic phenomenological qualitative study. The selection of participants was by intentional sampling: seven nursing assistants and eight nurses. Theoretical saturation was achieved. The phenomenological interview was applied to collect data from a central question and the analysis was carried out following the approaches of Heidegger's hermeneutical circle. RESULTS: Four significant themes emerged from the analysis: 1) Delirium prevention, 2) Pharmacological treatment, 3) Non-pharmacological treatment, and 4) Barriers to non-pharmacological treatment. These themes were accompanied by 35 interrelated units of meaning: in the first theme, the most repetitive units were communication, orientation, and family bonding; in the second was the use of pharmacological treatment only in the acute phase; in the third was the modification of the environment according to the patient's preference (where the family is a priority and strategies that provide cognitive and social stimulation can be reinforced), and in the fourth was the work overload for the nursing team. CONCLUSIONS: The experiences of the nursing team in the prevention and treatment of delirium in critically ill patients highlight that communication allows an approach to the patient as a human being immersed in a reality, with a personal history, needs and preferences. Therefore, family members must be involved in these scenarios, as they can complement and support nursing care.

Nursing care to address community health of the indigenous population in the Peruvian Amazon. / Cuidados enfermeros para el abordaje de la salud comunitaria en población indígena de la Amazonia peruana.

The native community Shonori is made up of Ashaninka families of the Peruvian Amazon. This paper addresses community health through an assessment and nursing care plan based on the Purnell cultural competency model and the standardized nurse taxonomy (NANDA, NIC, NOC). The assessment is based on 12 domains related to inheritance and biocultural ecology, communication, roles and family organization, risk behaviours, nutrition, pregnancy, death and spirituality rituals, and health care providers and practices. A diagnosis of «Poor health of the community r /t insufficient resources m/b health problems suffered by the community¼ is detected. The expected results criteria in the care plan are: social competence, community health status and control of social risk related to communicable diseases. The interventions consist of promoting community health, analyzing and identifying the health situation and risks, and controlling and protecting from communicable diseases and environmental risks. Interventions of the public water supply network and subsidies for agricultural and housing support, allowed vectors to be reduced, costs of safe water supply to be covered, and food to be bought to improve child nutrition. The use of traditional medicine was enhanced and health and sexual education campaigns were carried out in coordination with the official health system. A follow-up was carried out for 40 days, corroborating the improvement of community health, and the need for a group approach with all actors.

Perspectives of intensive care nurses on open visits in an ICU. / Perspectivas de los profesionales de enfermería de cuidados intensivos sobre las visitas abiertas en una UCI.

OBJECTIVE: To determine the attitude of the nursing professionals of an Intensive Care Unit regarding the effects of open visiting on the daily activities of the patient, their family and professionals, and also to determine their contribution to the current open visiting policy. METHOD: A cross-sectional descriptive study was performed, with a non-probabilistic discretionary sampling. The sample comprised nursing professionals of the aforementioned Unit. They were given a questionnaire with 26 items and an open question to evaluate their suggestions. RESULTS: 101 nursing professionals took part in the study, of the 120 working in the Unit under study. Seventy-five point two percent state that the nursing team has to postpone or modify their work due to the presence of the family and 89.9% that their presence produces a physical and psychological burden on the staff. Eighty percent think that the visit exhausts the family and 84.2% that the family feels obliged to remain with the patient. Ninety-four percent think that the effect of the presence of the family depends on the patient and the family. CONCLUSIONS: Most of professionals have a negative opinion about the policy of open visits, showing some reluctance when it comes to flexible visiting hours, although they admit that an unrestricted schedule in this type of units implies some benefit for the patient and the family.

Moral distress among healthcare professionals working in intensive care units in Spain.

OBJECTIVE: To assess moral distress (MD) among Spanish critical care healthcare professionals (HCPs). DESIGN: Cross-sectional, prospective study. SETTING: ICUs in Spain. PARTICIPANTS: HCPs currently working in Spanish ICUs. INTERVENTIONS: A 55-item questionnaire was electronically distributed. MAIN VARIABLES: The questionnaire included work-related and socio-demographic characteristics, the Spanish version of the Measure of Moral Distress for Health Care Professionals (MMD-HP-SPA), and the Hospital Ethical Climate Survey (HECS). RESULTS: In total, 1065 intensive care providers completed the questionnaire. Three out of four validity hypotheses were supported. MD was significantly higher for physicians (80, IQR 40-135) than for nurses (61, IQR 35-133, p=0.026). MD was significantly higher for those clinicians considering leaving their position (78, IQR 46-163 vs. 61, IQR 32-117; p<0.001). The MMD-HP-SPA was inversely correlated with the HECS (r=-0.277, p<0.001). An exploratory factor analysis revealed a four-factor structure, evidencing the patient, team, and system levels of MD. CONCLUSIONS: In the study sample, Spanish intensivists report higher MD than nurses. Strategies to improve ICU ethical climate and to correct other related factors in order to mitigate MD at a patient, team, and system level should be implemented. Both groups of HCPs manifest a relevant intention to leave their position due to MD. Further studies are needed to determine the extent to which MD influences their desire to leave the job.

The emotional experience of nurses in the Home Hospitalization Unit in palliative care: A qualitative exploratory study. / La experiencia emocional de enfermeras de la Unidad de Hospitalización a Domicilio en cuidados paliativos: un estudio cualitativo exploratorio.

OBJECTIVE: To explore the emotions experienced by the nurses of a Home Hospitalization Unit as a result of their work role. METHOD: A qualitative exploratory study was carried out with a phenomenology approach to explore people's experiences and inner-life experiences. The participants were 9nurses working in the home hospitalization unit. An analysis of qualitative content was undertaken. Units of meaning were grouped into 13 codes that, in turn, were classified into 4 categories, emotional dimension, beneficial and distressing aspects, daily working life and personal life. RESULTS: Nursing professionals working in palliative care suffer continuous exposure to traumatic situations, although they also report feeling satisfactory emotions that compensate for moments of distress. Having resources such as training in self-care and emotional regulation, as well as social support seems to be key to providing quality care and avoiding the onset of compassion fatigue. CONCLUSIONS: Maintaining psychosocial well-being in the workplace is crucial for palliative care nurses to be able to undertake their work in the best possible way.

Experience on implementing and consolidating the Best practice guidelines of the Registered Nurses' Association of Ontario (RNAO) in clinical and academic scenarios in Colombia. / Experiencia en la implantación y consolidación de las Guías de buenas prácticas de la Registered Nurses' Association of Ontario (RNAO) en el ámbito clínico y académico en Colombia.

This paper describes the results of the implementation, consolidation and future projection of the Best practice guidelines of the Registered Nurses' Association of Ontario (RNAO) in clinical and academic scenarios in Santander, Colombia. The tool proposed by the RNAO was used for the implementation of the guidelines in both clinical and academic settings. Preliminary results on the implementation of the guidelines are presented in this paper. In the clinical setting, the implementation of the guidelines has made it possible to start the process of standardizing care across the institution, with systematic follow-up based on indicators. This has allowed decision-making and visualization of the quality of nursing care provided by nurses in their different roles. In the academic scenario, implementing the guidelines has strengthened teaching and research functions, and, to a lesser extent, continuing education and social projection processes. In the consolidation phase, advances were achieved in 10 components, relevant to teachers, students, and practice scenarios of public / private health institutions, users (patients/caregivers), health personnel and other nursing programmes at a national and international level. Implementing the clinical practice guidelines has reduced the gap between the clinical and the academic scenarios, where collaborative and inter-institutional work is enhanced to obtain better patient outcomes, based on the available evidence.

The efficacy of an integrated care training program for primary care nurses for the secondary prevention of cardiovascular risk. / Efectividad de un programa de capacitación en cuidados integrales para la prevención secundaria cardiovascular en enfermeras de atención primaria.

OBJECTIVE: To assess the effect of the "Program of Training in Integral Care for Secondary Cardiovascular Prevention in Primary Care Nursing" on the level of knowledge, the degree of application of comprehensive cardiovascular care, and on the continuity of care between the cardiac rehabilitation and primary care units, in relation to post-infarction patients. METHODS: Quasi-experimental before-after study without control group. Comprised an ad-hoc survey prior to training via the Internet and a post-training survey; both the pre- and post-course surveys were anonymous. The program consisted of secondary cardiovascular prevention training, chronicity in the cardiovascular patient and adherence to the therapeutic plan, and follow-up protocol. RESULTS: Over one third of the respondents did not know the control objectives of the different cardiovascular risk factors, more marked regarding lipid control. The program significantly improved the knowledge of the objectives of blood pressure, total cholesterol and LDL cholesterol, and the self-perception of better monitoring of lipid parameters and waist circumference. In centers with a cardiac rehabilitation unit, 73% of respondents indicated that there was "no" communication with the unit before the course, reducing to 55% in the post-course survey. CONCLUSION: There are clear training needs of nurses for their involvement in these secondary prevention programs. A specific continuous training in secondary cardiovascular prevention for nurses in the field of primary care, improves and facilitates the acquisition of knowledge at this level, can improve the approach of patients with cardiovascular events during the first months of said event and communication with the reference cardiac rehabilitation units.

Management of acute stroke. Specific nursing care and treatments in the stroke unit. / Manejo del ictus agudo. Tratamientos y cuidados específicos de enfermería en la Unidad de Ictus.

OBJECTIVE: This study provides a series of updated, evidence-based recommendations for the management of acute stroke. We aim to lay a foundation for the development of individual centres' internal protocols, serving as a reference for nursing care. METHODS: We review the available evidence on acute stroke care. The most recent national and international guidelines were consulted. Levels of evidence and degrees of recommendation are based on the Oxford Centre for Evidence-Based Medicine classification. RESULTS: The study describes prehospital acute stroke care, the operation of the code stroke protocol, care provided by the stroke team upon the patient's arrival at hospital, reperfusion treatments and their limitations, admission to the stroke unit, nursing care in the stroke unit, and discharge from hospital. CONCLUSIONS: These guidelines provide general, evidence-based recommendations to guide professionals who care for patients with acute stroke. However, limited data are available on some aspects, showing the need for continued research on acute stroke management.

Mapeamento das ações do enfermeiro de prática avançada em uma instituição de ensino superior / Mapping the actions of advanced practice nurses in a higher education institution

Mapear as ações do Enfermeiro de Prática Avançada nos campos de ensino clínico e estágio curricular supervisionado de um curso de graduação em enfermagem. Métodos: estudo transversal, descritivo, incluindo 21 enfermeiros. A coleta de dados deu-se por questionário sócio-profissiográfico, alinhado às competências do Conselho Internacional de Enfermeiros no tocante à Prática Avançada de Enfermagem. Resultados: Os enfermeiros demonstraram médio conhecimento em Prática Avançada de Enfermagem, e ações de prática avançada mapeadas como prescrição de agentes terapêuticos para lesões, procedimento de catéter central de inserção periférica, solicitação de exames de imagem e swab peri-anal, pareceres em lesão, manejo e consulta de enfermagem no pré-parto, assistência no parto. Competências no domínio do cuidado e no domínio da gestão/educação foram evidenciadas. Conclusão: evidenciou-se potenciais de ação de Prática Avançada na Instituição de Ensino.(AU)

To map the actions of Advanced Practice Nurses in the clinical teaching and supervised curricular internship fields of an undergraduate nursing course. Methods: A cross-sectional, descriptive study including 21 nurses. Data was collected using a socio-professional questionnaire, aligned with the International Council of Nurses' competencies regarding Advanced Nursing Practice. Results: The nurses demonstrated medium knowledge of Advanced Nursing Practice, and mapped advanced practice actions such as prescribing therapeutic agents for injuries, peripherally inserted central catheter procedures, requesting imaging tests and peri-anal swabs, injury opinions, management and nursing consultation in the prepartum period, and assistance in childbirth. Skills in the care domain and the management/education domain were highlighted. Conclusion: There was potential for action in Advanced Practice at the Teaching Institution.(AU)

Mapear las acciones de las Enfermeras de Práctica Avanzada en los campos de la enseñanza clínica y de las prácticas curriculares supervisadas de un curso de enfermería de pregrado. Métodos: Se trató de un estudio transversal, descriptivo, en el que participaron 21 enfermeras. Los datos fueron recogidos a través de un cuestionario socio-profesional, alineado con las competencias del Consejo Internacional de Enfermería en relación a la Práctica Avanzada de Enfermería. Resultados: Las enfermeras demostraron conocimiento medio de la Práctica Avanzada de Enfermería, y mapearon acciones de práctica avanzada como prescripción de agentes terapéuticos para lesiones, procedimientos de catéter central de inserción periférica, solicitud de pruebas de imagen e hisopos perianales, emisión de dictámenes sobre lesiones, manejo y consulta de enfermería en el período preparto, asistencia al parto. Se destacaron las competencias en el ámbito de los cuidados y en el de la gestión/educación. Conclusión: Hubo potencial de actuación en la Práctica Avanzada en la Institución de Enseñanza.(AU)

EXPERIENCIAS Y PROCESO DE DUELO ENTRE PROFESIONALES DE ENFERMERÍA ONCOLÓGICA PEDIÁTRICA: EXPERIENCES AND GRIEVING PROCESS AMONG PEDIATRIC CANCER NURSES.

Explore how nursing professionals handle the death of a pediatric patient with cancer under their care and identify needs that they face in the workplace. An exploratory qualitative design was used, under the phenomenological framework and the Model of Information, Motivation and Behavioral Skills (IMHB). The data was obtained through semi-structured interviews with a sample of ten pediatric oncology nursing professionals. Each interview was transcribed and analyzed to identify thematic axes in the narrative of the participants. The findings revealed four categories that alluded to professional experiences in the face of the death of a patient and their handling of the grieving process. These were: Perception of nursing professionals about cancer; management of the pediatric patient in the terminal phase, coping strategies and areas of professional need. According to the findings, limitations were identified in knowledge about the subject of death and the grieving process of these health professionals. These limitations reflect being an obstacle in their clinical skills and in their capacity for assertive management. It is essential to educate these professionals about Thanatology and its benefits; as well as, to enable them access to psychological interventions for emotional management.

Explorar cómo los profesionales de enfermería manejan el fallecimiento de un paciente pediátrico con cáncer bajo su cuidado e identificar necesidades que enfrentan en el área laboral. Se utilizó un diseño exploratorio de corte cualitativo, bajo el marco fenomenológico y el Modelo de Información, Motivación y Habilidades Conductuales (IMHB). Los datos se obtuvieron a través de entrevistas semi-estructuradas a una muestra de diez profesionales de enfermería de oncología pediátrica. Cada entrevista fue transcrita y analizada para identificar ejes temáticos en la narrativa de las personas participantes. Los hallazgos revelaron cuatro categorías que aludían a las experiencias profesionales ante la muerte de un paciente y su manejo ante el proceso de duelo. Estas fueron: Percepción de los profesionales de enfermería sobre el cáncer; manejo del paciente pediátrico en fase terminal, estrategias de afrontamiento y, áreas de necesidad profesional. Según los hallazgos, se identificó limitaciones en conocimiento sobre el tema de la muerte y el proceso de duelo de estos profesionales de la salud. Estas limitaciones reflejan ser un obstáculo en sus destrezas clínicas y en su capacidad de manejo asertivo. Resulta fundamental educar a estos profesionales sobre la tanatología y sus beneficios; como también así, posibilitarles el acceso a intervenciones psicológicas para el manejo emocional.

Competential development of nurses in the public health system of Andalucía. / Desarrollo competencial de las enfermeras en el sistema sanitario público de Andalucía.

The socio-demographic and epidemiological changes of our environment are characterized by an increase in aging, chronic illness, comorbidities and with it, a progressive escalation of the demand for care. These new demands and expectations of citizenship are accompanied by an evolution of health systems (technological advances, complexity of the healthcare network, limited resources), the need to develop new roles and competence in care, together with the opportunity that full academic development implies: Nursing undergraduate and posgraduate degrees. This is why, at present, it is necessary to reorient care models in order to achieve health care for more agile, efficient and better quality care processes, adapted to the needs and expectations of citizens and to the sustainability of health systems. The Public Health System of Andalusia (SSPA) has developed, in recent decades, different nursing roles that include new competences, with the aim of responding to the needs of citizens. The objective of this article is to present how the competences development framework of nurses has been configured in the SSPA, which also integrates advanced skills in care and advanced practice profiles (Clinical Nurse Specialists and Advanced practice nurses).

Desenvolvimento da Intervenção de Enfermagem "Ultrassonografia: bexiga" segundo a Nursing Interventions Classification / Desarrollo de la intervención de enfermería "ecografía de vejiga" de acuerdo con la Nursing Interventions Classification / Development of the "Ultrasound: bladder" nursing intervention according to the Nursing Interventions Classification

Resumo Objetivo Desenvolver uma intervenção de enfermagem com o uso de ultrassonografia de bexiga segundo a Nursing Interventions Classification. Métodos Estudo metodológico em duas etapas: revisão integrativa de literatura e desenvolvimento da intervenção. Para etapa da revisão integrativa de literatura foram investigadas quatro bases de dados (PubMed, CINAHL, LILACS e SCOPUS), incluindo estudos de acesso gratuito e disponíveis na íntegra, nos idiomas inglês, português e espanhol, sem delimitação temporal. Na etapa de desenvolvimento da intervenção, foram seguidas as Diretrizes para Submissão de uma Intervenção à Nursing Interventions Classification Nova ou Revisada. Resultados Na revisão integrativa de literatura foram encontrados 328 estudos primários nas bases de dados, sendo incluídos 17 na análise final. Destacaram-se estudos com delineamento descritivo, sendo prevalente o nível de evidência VI. Os achados possibilitaram desenvolver cada um dos componentes da intervenção de enfermagem (Título, Definição, 17 atividades, Nível de Formação e o Tempo Estimado para realização). Conclusão A Intervenção de Enfermagem intitulada "Ultrassonografia: bexiga" foi desenvolvida, submetida ao Comitê Editorial da Nursing Interventions Classification e aceita para publicação na oitava edição da Classificação.

Resumen Objetivo Desarrollar una intervención de enfermería con el uso de ecografía de vejiga de acuerdo con la Nursing Interventions Classification. Métodos Estudio metodológico en dos etapas: revisión integradora de la literatura y desarrollo de la intervención. Para la etapa de revisión integradora de la literatura se investigó en cuatro bases de datos (PubMed, CINAHL, LILACS y SCOPUS), con la inclusión de estudios de acceso gratuito y disponibles con texto completo, en idioma inglés, portugués y español, sin límite temporal. En la etapa de desarrollo de la intervención, se siguieron las directrices para el envío de una intervención a Nursing Interventions Classification Nueva o Revisada. Resultados En la revisión integradora de la literatura, se encontraron 328 estudios primarios en las bases de datos, de los cuales se incluyeron 17 en el análisis final. Se destacaron los estudios con diseño descriptivo, con prevalencia de nivel de evidencia VI. Los resultados permitieron desarrollar cada uno de los componentes de la intervención de enfermería (título, definición, 17 actividades, nivel de formación y tiempo estimado para la realización). Conclusión La intervención de enfermería titulada "Ecografía: vejiga" fue desarrollada, enviada al Comité Editorial de la Nursing Interventions Classification y aprobada para publicar en la octava edición de la Clasificación.

Abstract Objective To develop a nursing intervention using bladder ultrasound according to the Nursing Interventions Classification. Methods This is a methodological study in two steps: integrative literature review and intervention development. For the integrative literature review step, four databases were investigated (PubMed, CINAHL, LILACS and Scopus), including free access studies available in full, in English, Portuguese and Spanish, without time limits. In the intervention development step, the Guidelines for Submission of a New or Revised Nursing Interventions Classification Intervention were followed. Results In the integrative literature review, 328 primary studies were found in the databases, 17 of which were included in the final analysis. Studies with a descriptive design stood out, with level of evidence VI being prevalent. The findings made it possible to develop each component of the nursing intervention (title, definition, 17 activities, level of training and estimated time for completion). Conclusion The nursing intervention entitled "Ultrasound: bladder" was developed, submitted the Nursing Interventions Classification Editorial Committee and accepted for publication in the 8th edition of the Classification.

Ações de cuidado e diagnósticos de enfermagem ao paciente com oxigenação por membrana extracorpórea: translação do conhecimento / Acciones de cuidado y diagnósticos de enfermería para pacientes con oxigenación por membrana extracorpórea: traslación del conocimiento / Care actions and nursing diagnoses for patients with extracorporeal membrane oxygenation: knowledge translation

Resumo Objetivo mapear diagnósticos e ações de enfermagem para o cuidado ao paciente adulto com oxigenação por membrana extracorpórea, considerando um protocolo e um sistema informatizado de prescrição e a inclusão de novas ações de cuidados, em um processo de translação do conhecimento à prática clínica. Métodos estudo descritivo e exploratório, com mapeamento cruzado entre um protocolo assistencial e sistema informatizado de um hospital universitário, no período de 2014 a 2018. Foram realizados dois encontros com a chefia de enfermagem e membros do time de oxigenação por membrana extracorpórea para validar as ações. Resultados diagnósticos mais comuns utilizados nos 45 prontuários dos pacientes com oxigenação por membrana extracorpórea foram: Risco de infecção (100%); Ventilação espontânea prejudicada (93,33%); Síndrome do déficit de autocuidado (93,33%). Conclusão e implicações para a prática o mapeamento incluiu 25 novas ações associadas a 14 diagnósticos de enfermagem no sistema informatizado, visando a disseminação do conhecimento e sua aplicação em cuidados reais a pacientes com oxigenação por membrana extracorpórea.

Resumen Objetivo mapear diagnósticos y acciones de enfermería para el cuidado de pacientes adultos con oxigenación por membrana extracorpórea, considerando un protocolo y un sistema de prescripción computarizado y la inclusión de nuevas acciones de cuidado, en un proceso de traslación del conocimiento a la práctica clínica. Métodos estudio descriptivo, exploratorio, con mapeo cruzado entre un protocolo de atención y un sistema informatizado en un hospital universitario, de 2014 a 2018. Posteriormente se realizaron dos reuniones con la gerente de enfermería y miembros del equipo de oxigenación por membrana extracorpórea para validar acciones. Resultados los diagnósticos más frecuentes utilizados en los 45 prontuarios de pacientes con oxigenación por membrana extracorpórea fueron: Riesgo de infección (100%); Deterioro de la ventilación espontánea (93,33%); Síndrome de déficit de autocuidado (93,33%). Conclusión e implicaciones para la práctica el mapeo incluyó 25 nuevas acciones asociadas a 14 diagnósticos de enfermería en el sistema informatizado, con el objetivo de difundir el conocimiento y su aplicación en la atención real al paciente con oxigenación por membrana extracorpórea.

Abstract Objective to map diagnoses and nursing actions for the care of adult patients with extracorporeal oxygenation membrane, considering a protocol and a computerized prescription system and the inclusion of new care actions, in a process of translating knowledge to clinical practice. Methods descriptive and exploratory study, with cross-mapping between a care protocol and a computerized system of at a university hospital, from 2014 to 2018. Two meetings were held with the nursing manager and members of the extracorporeal oxygenation membrane team to validate the actions. Results most common diagnoses used in the 45 medical records of patients with extracorporeal membrane oxygenation were: Risk of infection (100%); Impaired spontaneous ventilation (93.33%); Self-care deficit syndrome (93.33%). Conclusion and implications for practice The mapping included 25 new actions, associated with 14 nursing diagnoses in the computerized system, aiming to disseminate knowledge and its application in real care for patients with extracorporeal oxygenation membrane.

Family and community nursing, chronology of a specialty. / Enfermería familiar y comunitaria, cronología de una especialidad.

More the 30 years have passed since the first Royal Decree that regulated nursing specialties was published in 1987. It is the Royal Decree published in 2005 that really allowed the training development of part of the specialties recognized in it (family and community nursing, paediatric nursing, geriatric nursing and occupational health nursing) since the obstetric-gynaecological specialist nurses (midwives) and mental health specialists had long since already started their training processes through the resident internal nurse model, today, training in the specialty of family and community nursing has been implemented in all the autonomous communities, but has not had the same development in terms of the incorporation of specialists in the health institutions of the respective health services of the autonomous communities This circumstance is generating a great lack of motivation among community nurses, both specialists and those who hope to obtain the qualification through a specialty exam. Many of the objectives achieved to date have been made possible thanks to the work of the scientific societies of community nursing (Association of Community Nursing [AEC] and Federation of Associations of Community Nursing and Primary Care [FAECAP]), which have allowed progress to be made and the process not to be halted, although there are still many achievements to be made on which the aforementioned scientific societies continue to work. In a society in which nursing care is increasingly necessary and demanded, it must have greater consideration and position in health policies, since it has demonstrated its effectiveness and can be the model that allows the health system to be sustainable. Therefore, nurses who specialize in family and community nursing must cease constituting an opportunity and become a reality.