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BACKGROUND: The audience response systems are being implemented to support active learning in nursing degree programs. The benefits of audience response systems have been studied in lecture-based classes and seminars, but their advantages or inconveniences when included in the debriefing phase of a high-fidelity clinical simulation have not been explored. The study aim was to discover student´s experience about using of interactive questions during debriefing, and the self-perceived effects on attention, participation and motivation. METHODS: A Mixed-methods study was used exploratory sequential design in a university. The participants were 4th-year students enrolled in the Nursing Degree in a university in Southern Spain. (1) Qualitative phase: a phenomenological approach was utilized, and focus groups were used for data-collection. (2) Quantitative phase: cross-sectional descriptive study using a questionnaire designed "ad hoc", on the experiences on the use of interactive questions in the debriefing phase and the Debriefing Experience Scale. RESULTS: (1) Qualitative phase: the students highlighted the facilitating role of the interactive questions during the reflection part of the debriefing, and mentioned that the interactive questions helped with stimulating attention, participation, and motivation during the analytical part of the debriefing; (2) Quantitative phase: it was observed that the best evaluated dimension was "Motivation", with a mean of 4.7 (SD = 0.480), followed by the dimension "Participation", with a mean of 4.66 (SD = 0.461), and lastly, the dimension "Attention", with a mean of 4.64 (SD = 0.418). CONCLUSIONS: The use of interactive questions contributed the attention, participation, and motivation of the students during the debriefing, contributing towards a highly satisfactory experience of high-fidelity clinical simulation.
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INTRODUCTION: The population of older adults is rapidly increasing worldwide, presenting both prospects and complexities for society and healthcare professionals to maximize the functional capacity of this age group. Social isolation and loneliness significantly affect this population. The objective was to determine the effectiveness, satisfaction, and perceptions of the simulation-based education practices of a training program for nursing students, which was created to palliate the social isolation and loneliness of older adults. METHOD: A quasi-experimental study was conducted with nursing students who participated in an online training program using teleservice based on high-fidelity clinical simulation. The program included asynchronous theoretical training and synchronous practical training using an online platform. Five scenarios were designed using simulated phone calls to address the social isolation and loneliness of older adults. RESULTS: Twenty-five nursing students participated in the program, and they had a mean age of 27.44, with 76% of them being women. After the training program, the participants showed statistically significant improvements (p < 0.05) with respect to their knowledge and attitudes towards older adults, and the program was adapted to the best educational practices in simulations. CONCLUSIONS: Simulation-based online training efficiently improved the knowledge and attitudes of nursing students towards older adults, improving their ability to address social isolation and loneliness. The high satisfaction and adhesion to the best educational practices underline the usefulness of high-fidelity online simulations, especially in situations in which face-to-face training is not feasible, and accessibility and equilibrium could be guaranteed between work and personal life.
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BACKGROUND: International organizations recognize the importance of evidence-based practice (EBP) for nurses. The objective of teaching EBP in the Nursing degree is to train future nurses on this subject. Different teaching models exist for this, from less active traditional models to more active ones such as the flipped classroom. OBJECTIVE: To compare the degree of EBP competence of undergraduate nursing students after an EBP course, through the application of a traditional methodology versus a flipped classroom methodology. DESIGN: Quasi-experimental study of non-equivalent groups. SETTING: The study was composed by a group of students who received training on EBP with the traditional model (face-to-face), and another intervention group with whom the flipped classroom model was utilized, using the online teaching platform EBP-eToolkit. PARTICIPANTS: The study was conducted with 4th-year Nursing degree students enrolled in the course evidence-based practice, in academic years 2019/20 and 2021/2022. METHODS: Before and after the course, the students completed a questionnaire about EBP competence (EBP-COQ), and an objective test was given at the end of the year. RESULTS: A sample of 152 students in the face-to-face group (control), and 143 students in the flipped classroom group (intervention) participated. The intervention group significantly improved its competence on attitude (p = 0.01, η2 = 0.022), skills (p = 0.019, η2 = 0.018), and global competence in EBP (p = 0.003, η2 = 0.030), with respect to those who were taught using the traditional method. However, there were no significant differences in the impact on knowledge, neither through the self-report dimension of the EBP-COQ (p = 0.188) nor the final test score, control group 6.89 (SD: 1.35) and flipped classroom group 7.12 (SD: 1.53) (p = 0.206). CONCLUSIONS: The flipped classroom model is adequate for the teaching of EBP to undergraduate nursing students. It produced a slight increase in attitude, as well as in skills and global competence in EBP. Nevertheless, this increase was not significantly different from face-to-face learning in terms of impact on EBP knowledge.
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Bachillerato en Enfermería , Estudiantes de Enfermería , Humanos , Curriculum , Proyectos de Investigación , Práctica Clínica Basada en la Evidencia , Aprendizaje Basado en Problemas/métodosRESUMEN
OBJECTIVE: To develop and validate a tool to assess the non-technical skills of medical and surgical hospital units undergraduate nursing students. BACKGROUND: In the area of healthcare, non-technical skills complement technical ones, and contribute to patient safety. High-fidelity simulation is an ideal resource for working on these skills. Thus, evaluation instruments are needed to understand the efficiency of this methodology. Although many evaluation instruments already exist, none measure non-technical skills of undergraduate nursing students in medical and surgical hospital units. DESIGN: An instrumental study design was employed. METHODS: Two-phases were used to develop and validate the scale: 1) Scale development. A group of experts defined the dimensions and components. Afterwards, the content was validated by experts, and a pilot study was conducted with undergraduate Nursing students. 2) Analysis of the psychometric properties of the scale. A total of 393 students were evaluated in high-fidelity simulation scenarios by three evaluators, through the use of the Non-Technical Skills in Medical and Surgical Hospital Units (NTS-Nursing) Scale. RESULTS: The content validity indexes were adequate for the total of the items and the total of the scale. The statistical descriptors of the items, the internal structure, and the reliability (internal consistency and inter-evaluator reliability) were analyzed, as well as the external evidence of validity, with adequate values obtained. CONCLUSION: The NTS-Nursing scale is a valid and reliable instrument. Its structure of 10 items makes its use fast and easy.
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Bachillerato en Enfermería , Estudiantes de Enfermería , Humanos , Bachillerato en Enfermería/métodos , Psicometría , Reproducibilidad de los Resultados , Proyectos Piloto , Competencia Clínica , Unidades Hospitalarias , Encuestas y CuestionariosRESUMEN
BACKGROUND: The restrictions imposed during the management of the pandemic led to lack of care of other health problems. PURPOSE: To assess changes in the health status of complex multimorbidity elderly, functional and cognitive capacities, perception of the social surroundings, care provided by the nurses, including nursing diagnosis and interventions, use of health services, adverse events, and use of devices and technical help during the first 6 months of the Covid-19 pandemic. DESIGN: A 1-year longitudinal cohort study was conducted. METHODS: Ninety-seven complex multimorbid elderly attended in primary care were evaluated every 3 months in a health area of the Spanish National Health System (SNHS). The research was called "SAMAC3 study". RESULTS: Significant negative changes were observed in the functional and cognitive capacity of the elderly, and in several nursing diagnoses. A decrease was observed in the frequency of visit to the nurses, hospital admittance, length of hospital stays, and falls. CONCLUSIONS: The functional and cognitive capacities of the cohort became worse. However, a significant decrease in the frequency of use of health services was observed. The nurses detected significant changes in activity-exercise, cognitive-perception, and roles-relationships, but their interventions were mostly centered on resolving clinical matters that required immediate attention. CLINICAL RELEVANCE: The present study allowed us to observe that a situation of social and health stress has worsened the health indicators of multimorbid elderly, and the clinical care of community nurses was insufficient to providing care for the deterioration of the physical and cognitive domains.
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COVID-19 , Humanos , Anciano , COVID-19/epidemiología , Pandemias , Multimorbilidad , Estudios Longitudinales , Estudios de SeguimientoRESUMEN
OBJECTIVE: Adaptation and validation of the BTI-St© to assess the level of competence in brief tobacco intervention in general practitioners and nurses in Primary Health Care. DESIGN: Cross-sectional study of adaptation and psychometric validation of a criterion-referenced test. SETTING: Primary Health Care. PARTICIPANTS: One hundred fifty-five general practitioners and nurses working at Primary Health Care. INTERVENTIONS: Three clinical scenarios were designed. Using an online platform, participants first viewed each scenario in which brief tobacco intervention was given. Health professional had to assess whether or not the scenarios were carried out in accordance with the 5A+5R model. MAIN MEASURES: Competence in brief tobacco intervention measured by the BTI-Prof©. RESULTS: Results related to reliability were obtained through Kuder-Richardson coefficient, being for scenario 1, 0.880, for scenario 2, 0.829, and for scenario 3, 0.826. The test-retest shows adequate temporal stability: intraclass correlation coefficient for scenario 1 0.857 (95% CI 0.734-0.923), p<0.0001, for scenario 2 0.829 (95% CI 0.676-0.909), p<0.001, and for scenario 3 0.869 (95% CI 0.76-0.928), p<0.0001. CONCLUSIONS: The BTI-Prof© is a robust tool with adequate psychometric properties to assess competence in brief tobacco intervention in Primary Health Care general practitioners and nurses.
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Médicos Generales , Nicotiana , Humanos , Reproducibilidad de los Resultados , Estudios Transversales , PsicometríaRESUMEN
(1) The COVID-19 pandemic has had many consequences on health systems worldwide. In the Spanish health system, telephone-based consultations were coupled to in-person consultations. This type of consultation was mainly a challenge for the primary care teams, who had to assume the greatest load of care provision. The objective of the present study was to discover the satisfaction and perception of health professionals related to a training program on efficient communication based on high-fidelity simulation. (2) Methods: A cross-sectional descriptive study based on a convergent and parallel mixed method. The satisfaction and perception of 275 health professionals associated with COVID-19 training based on the structured communication model CERCAR© was analyzed. (3) Results: The assessment of the satisfaction with the training and methodology was high. With respect to the transfer of information, the participants gave a high score to the categories of consolidation of learning, applicability to their work, and benefits for the institution. The qualitative results supported these findings. (4) Conclusions: The training program and its virtual modality were well received, and had a high degree of transference. The application of active, online learning methodologies is a relevant format for continuous education.
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COVID-19 , COVID-19/epidemiología , Comunicación , Estudios Transversales , Estudios de Seguimiento , Humanos , Pandemias/prevención & control , Atención Primaria de Salud , TeléfonoRESUMEN
BACKGROUND: Most gender-based violence victims who sought help in Spain did so through health services. Training on gender-based violence with active learning methodologies promotes the management of knowledge, reflection, and adaptation to change. Nurses, along with an educator, can construct knowledge with the same strategies they will use professionally. PURPOSE: To evaluate the knowledge, skills, and attitudes associated of postgraduate nurses on gender-based violence before and after a reflection-based training program with dramatized problem-videos. The secondary objectives were to evaluate the knowledge in the activation of protocols, skills, and attitudes in the management of women who are victims of gender-based violence, the consolidation of learning, and the applicability to the workplace. METHODS: Pre-post quasi-experimental study without a control group. A specifically validated and designed instrument was utilized to evaluate the dimensions of knowledge, skills, and attitudes when facing gender-based violence, before and after the training sessions, along with additional questions to assess if the participants possessed better tools to address gender-based violence. RESULTS: The difference between the pre and post-tests was statistically significant for the dimensions knowledge, skills, and attitude (p < 0.05), with a smaller effect size in the dimensions skills and attitude. Also, high scores were observed in the consolidation of learning and applicability to the workplace. CONCLUSION: Reflection-based training with dramatized problem-videos improved the acquisition of tools necessary for the detection and management of gender-based violence of nurses.
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Violencia de Género , Escolaridad , Femenino , Humanos , Capacitación en Servicio , Violencia , Lugar de TrabajoRESUMEN
The objective of this study is to evaluate the differential efficacy between Mindfulness-Based Cognitive Therapy (MBCT) and Cognitive Behavioral Therapy (CBT). A quasi-experimental design of repeated measures before and after the test (n = 57) was used with a non-equivalent control group from a previous cohort treated with CBT (n = 105). The t-test revealed significant differences in subjective quality of life for the MBCT group, and in quantity, optimum, and adequate sleep for the CBT group. The pre-post effect size comparison mostly showed slightly larger effect sizes in the MBCT group. CBT and MBCT had comparable efficacies, although a slight trend towards larger effect sizes in MBCT was found. Likewise, CBT seemed to improve sleep-related variables, while MBCT was associated with improvements in pain and quality of life.
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BACKGROUND: The self-learning Methodology in Simulated Environments (Spanish acronym: MAES©, (Murcia, Spain) is a type of self-directed and collaborative training in health sciences. The objective of the present study was to compare the level of competence of postgraduate surgical nursing students in the clinical safety of surgical patients, after training with the MAES© methodology versus traditional theoretical-practical workshops, at different points in time (post-intervention, after three months, six months post-intervention, and at the end of the clinical training period, specifically nine months post-intervention). METHODS: We conducted a prospective study with an experimental group of surgical nursing postgraduate students who participated in MAES© high-fidelity simulation sessions, and a control group of postgraduate nursing students who attended traditional theoretical-practical sessions at two universities in Catalonia (Spain). The levels of competence were compared between the two groups and at different time points of the study. RESULTS: The score was higher and statistically significantly different in the experimental group for all the competencies, with a large effect size at every measurement point previously mentioned. CONCLUSIONS: The postgraduate nurses were the most competent in the clinical safety of surgical patients when they trained with the MAES© methodology than when they learned through traditional theoretical-practical workshops. The learning of surgical safety competencies was more stable and superior in the experimental group who trained with MAES©, as compared to the control group.
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Bachillerato en Enfermería , Estudiantes de Enfermería , Competencia Clínica , Práctica Clínica Basada en la Evidencia , Humanos , Enfermería Perioperatoria , Estudios ProspectivosRESUMEN
BACKGROUND: Self-reported scales and objective measurement tools are used to assess Evidence-based Practice (EBP) learning. An agreement between these measures has not been widely investigated among nursing students. OBJECTIVE: The aim of the present study was to examine the relationship between EBP competency in undergraduate nursing students, defined as the capability to choose and use an integrated combination of EBP knowledge, skills and attitudes, evaluated with the self-reported EBP-COQ questionnaire and the final test score of an EBP course included in a Nursing Degree Program. DESIGN: A cross-sectional study was carried out. SETTINGS: University of Murcia (Spain), Nursing Degree, academic year 2019/2020. PARTICIPANTS: The study population was comprised by 210 4th-year undergraduate nursing students enrolled in the Clinical Practice and Evidence-based Nursing course. All the students were invited to participate. METHODS: A validated EBP-COQ questionnaire (1 "lowest score" to 5 "highest score") and an objective test (score from 0 to 10) were used to assess EBP competency. The SPSS 26.0 program was used to perform descriptive, bivariate and multivariate analyses. RESULTS: 152 students participated (response rate 72.4%), the sample was 81.4% female, and the median age was 20 years old; 76.3% attended more than 75% of the class hours. After the EBP course, the students obtained a high overall EBP competency score (mean = 4.21; SD = 0.26). The mean score on the objective test was 6.86 (SD = 1.36). A moderate positive correlation was found between the subjective and objective EBP competency measurements (Pearson's correlation coefficient 0.5; p < 0.0001). CONCLUSIONS: Our findings contribute with new and significant evidence of the convergent validity of the EBP-COQ questionnaire, which increases the value of this instrument for evaluating the EBP competency of Nursing Degree students.
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Bachillerato en Enfermería , Estudiantes de Enfermería , Adulto , Competencia Clínica , Estudios Transversales , Enfermería Basada en la Evidencia , Práctica Clínica Basada en la Evidencia , Femenino , Humanos , Masculino , Autoinforme , Encuestas y Cuestionarios , Adulto JovenRESUMEN
The prevalence of chronic pain in Spain is 15%. The objective of this study was to evaluate the efficacy of mindfulness-based cognitive therapy on patients with chronic pain. A quasi-experimental design of repeated measures pre- and post-test (N = 57) was carried out at three hospitals from the province of Alicante. Self-reported assessment measurements of pain intensity, anxiety-depression symptoms, perception of health status, interference of pain on sleep, self-efficacy in pain, acceptance, and mindfulness attitude were included. The T-test indicates significant differences in intensity of present pain, mental quality of life, and depression (medium effect sizes), as well as in self-efficacy: total score, symptom management and pain control (medium effect sizes), sleep disturbances and quantity of sleep (large effect sizes). MBCT is effective in reducing many symptoms in patients with chronic pain, although its maintenance needs to be further investigated.
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Dolor Crónico , Terapia Cognitivo-Conductual , Atención Plena , Dolor Crónico/terapia , Humanos , Calidad de Vida , España , Resultado del TratamientoRESUMEN
BACKGROUND: Consensus on evidence-based practice (EBP) competencies and associated learning outcomes for registered nurses has not yet been achieved in the European context. AIMS: To establish a set of core EBP competencies for nurses and the most important EBP learning outcomes encompassing attitudes, knowledge, and skills dimensions for implementation into nursing education in European countries. METHODS: A multi-phase modified Delphi survey was conducted: Phase 1, a literature review; Phase 2, a two-round consensus of experts; and Phase 3, a Delphi survey. Experts from six European countries participated. RESULTS: In Phase 1, 88 records were selected and 835 statements extracted, which were grouped according to the seven steps of EBP. After removing 157 duplicates, the remaining competencies (n = 678) were evaluated in Phase 2. Then, a two-round expert consensus was reached, with 24 competencies and 120 learning outcomes identified and divided into affective, cognitive, and skills domains. In Phase 3, based on a Delphi survey expert consensus, all evaluated statements were included in a final set of competencies and learning outcomes. Only two learning outcomes were recommended for allocation to a different domain, and four were reformulated as suggested, with no further changes to the others. LINKING EVIDENCE TO ACTION: The set of EBP competencies and learning outcomes can guide nurse educators, managers, and EBP stakeholders in the development of content that incorporates EBP knowledge, skills, and attitudes into educational programs. Prioritizing the EBP competencies and learning outcomes that are most necessary and adapting them to every context will provide healthcare organizations with guidelines for enhancing the continuing education of nurses. These results could facilitate the development of effective tools for assessing nursing students' and nurses' perception of competencies required for EBP processes.
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Competencia Clínica/normas , Enfermeras y Enfermeros/psicología , Enseñanza/normas , Consenso , Técnica Delphi , Europa (Continente) , Práctica Clínica Basada en la Evidencia/métodos , Humanos , Enfermeras y Enfermeros/estadística & datos numéricos , Encuestas y Cuestionarios , Enseñanza/psicologíaRESUMEN
OBJECTIVE: To describe the Evidence-Based Practice (EBP) competency level in Primary Care (PC) nurses in Spain and to determine the associated factors. DESIGN: Cross-sectional, national survey design, carried out between January and March 2020. SETTING: PC in Spain. PARTICIPANTS: Seven hundred eighty PC active nurses in the National Health Service with at least one year of professional experience. MAIN MEASUREMENTS: (1) Sociodemographic, professional and access to scientific information variables; (2) outcome variable: EBP competency (attitude, knowledge, skills and utilization) assessed through the EBP-COQ Prof© questionnaire. Bivariate and multiple lineal regression analyses were carried out. RESULTS: The mean score for the EBP competency of the PC nurses was 131.5 (standard deviation [SD] 17.0), according to dimensions: attitude 36.8 (SD 3.6); knowledge 38.2 (SD 8.9); skills 23.0 (SD 3.5); and utilization 33.3 (SD 6.1). The number of articles read in the last month has showed the most influence on all the EBP-COQ Prof© dimensions, followed by EBP training (more than 150h) and nursing students mentoring. The education level (master, specialist and doctorate) is associated with knowledge and skills dimensions, meanwhile belonging to a BPSO® center is associated with the EBP utilization. CONCLUSIONS: These findings can guide PC service managers to plan strategies that improve the EBP competency level of the nurses, aimed mainly at achieving real application in clinical practice. However, it is necessary to consider the possible impact of selection bias on the results.
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Enfermería de Atención Primaria , Actitud del Personal de Salud , Competencia Clínica , Estudios Transversales , Práctica Clínica Basada en la Evidencia , Conocimientos, Actitudes y Práctica en Salud , Humanos , Atención Primaria de Salud , España , Medicina Estatal , Encuestas y CuestionariosRESUMEN
Background: Clinical simulation efficiently complements the training of Nursing Degree students. The debriefing phase is the most important feature of simulation-based learning, where the students are able to acquire the necessary competences. It is at this stage where learning strategies and motivation play a crucial role. The objective of the study was to analyze the relationship between the style of debriefing utilized in the simulation sessions, and the learning strategies of Nursing Degree students who participated in a high-fidelity clinical simulation. Method: This was a quasi-experimental study conducted with a sample of 200 students in their third and fourth years at university. To obtain the data, an evaluation Questionnaire for the Evaluation of Learning Strategies of University Students (CEVEAPEU) was utilized, as well as two different types of structured debriefing styles, namely, with or without a graphical representation of the strengths/weaknesses during the analytical phase. The data analysis was performed with the SPSS® v25 program. Results: Statistically significant differences were found, with higher scores obtained when utilizing debriefing with a graphical representation, on both scales of the questionnaire (affective and cognitive), on the motivational, metacognitive and processing, and use of information subscales, and twelve learning strategies mostly belonging to the subscales of motivation; searching, collecting, and selecting information; and processing and using information. Conclusion: Debriefing with a graphical representation is deemed, a priori, as the most adequate approach for our context, based on the greater number of learning strategies utilized by our students. The use of a written graphical record of the strengths and weaknesses in the analytical phase is recommended.
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Clinical simulation in obstetrics has turned out to be a tool that can reduce the rate of perinatal morbidity and mortality. The objective of this study was to analyze the impact and evaluate the effects of training with high-fidelity simulation of obstetric emergencies on a multidisciplinary group. The quasi-experimental research study was structured in three phases: a first phase where the most important obstetric emergencies were determined, a second phase of design and development of the selected cases for simulation training, and a third and final phase where the abilities and satisfaction of the multidisciplinary team were analyzed. Three scenarios and their respective evaluation tools of obstetric emergencies were selected for simulation training: postpartum hemorrhage, shoulder dystocia, and breech delivery. The health professionals significantly improved their skills after training, and were highly satisfied with the simulation experience (p < 0.05). An inter-observer agreement between good and excellent reliability was obtained. Regarding conclusions, we can state that high-fidelity obstetric emergency simulation training improved the competencies of the health professionals.
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BACKGROUND: Current literature provides poor information about the implementation of health-promoting clinical practice guidelines (CPGs) and their longitudinal monitoring. PURPOSE: The aim of this study was to evaluate the longitudinal impact of a CPG implementation program that promotes breastfeeding, its associated quantitative and qualitative indicators, and direct costs. DESIGN: A mixed-methods design with a longitudinal approach was utilized, with an interrupted time series design and the analysis of reports from the implementation program as the qualitative approach. METHODS: The study setting was maternity and pediatric units of a health area in the Spanish health system. The implementation of a CPG for the promotion of breastfeeding was evaluated, which included a pre-implementation year (2011), 3 years of implementation (2012-2014), and 2 years of post-implementation (2015-2016). The sample was composed of mother-infant dyads. A segmented logistic regression analysis was utilized to evaluate the changes in the most important breastfeeding indicators. A deductive thematic content analysis was performed starting with quality indicators and a descriptive economic analysis. FINDINGS: In the 6 years of monitoring, 7,842 mother-infant dyads were recorded. The results of the quantitative indicators showed the presence of four stages: baseline, gain, adjustment, and sustainability or saturation. The breast milk at the first feeding had an increasing slope in the gain stage (24% per quarter; odds ratio [OR] = 1.24, 95% confidence interval [CI] 1.12-1.37). The exclusive breastfeeding at hospital discharge showed significant changes in the period of gain (OR = 2.45, 95% CI 1.95-3.08), which was maintained in the adjustment period, with an increase of 18% in the slope of the gain stage (OR = 1.18, 95% CI 1.06-1.32). The longitudinal distribution of the qualitative indicators showed a greater concentration of indicators towards the first half of each phase. The total cost was 209,575 ($248,670.17). CONCLUSIONS: The implementation of the breastfeeding CPG showed early, positive, and sustained results in the exclusive breastfeeding rates. The implementation implied the application of a complex intervention, with its qualitative indicators showing a wave-shaped dynamic. CLINICAL RELEVANCE: Our findings contribute to the understanding and evolution of the main indicators of the implementation of a breastfeeding CPG, providing details on the magnitude of the effect, the process of change, and the associated costs.
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Lactancia Materna/estadística & datos numéricos , Guías de Práctica Clínica como Asunto , Femenino , Unidades Hospitalarias , Humanos , Lactante , Análisis de Series de Tiempo Interrumpido , Estudios Longitudinales , Evaluación de Programas y Proyectos de Salud , Investigación Cualitativa , EspañaRESUMEN
Disruptive behavior creates a dysfunctional culture that has a negative impact on work relations and influences the quality of care and safety of the patient. The objective of the present work is to provide the best methodological quality scientific evidence available on disruptive behavior at a hospital, the aspect associated with the safety of the patient, and its impact on quality of care. For this, we included studies that addressed the prevalence of disruptive behaviors observed in the area of hospital health and its professionals. The selection, eligibility, data extraction and evaluation of the risk of bias stages were conducted by two researchers, and any discrepancies were solved by a third researcher. The data presented show that disruptive behaviors are frequently observed in the daily life of health professionals, and compromise the quality of care, the safety of the patient, and can lead to adverse effects. The results presented indicate that the appearance of disruptive behaviors compromises the quality of care, the safety of the patient, and the appearance of adverse effects, and can also affect the physical and mental health of the health professionals. PROSPERO registration number: CRD42021248798.
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AIM: To evaluate the changes produced after the application of the Best Practice Spotlight Organization® (BPSO® ) Program on the attitude towards the evidence-based practice, the nurses' perception of the organisational climate and nurse outcomes in a health area of the Spanish National Health System. BACKGROUND: There is limited research that associates strategies of evidence-based practice implementation with changes on the work environment and nurse outcomes. METHODS: Cross-sectional study that compared data on the nurses' perception of the work environment. Five guidelines were implemented between 2012 and 2015 in a health area. Data were collected in 2012 and 2016/2017, using a questionnaire consisting of five previously validated tools. X2 , t test, ANOVA and multivariate analysis were carried out. RESULTS: A total of 451 nurses participated. Compared with the baseline evaluation in 2012, several outcomes changed significantly (p < .001), nurses were younger and were more satisfied with "salary", "annual leaves" and "sick leave". The rest of the nurse outcomes were not modified. CONCLUSIONS: Nurses' perception of the work environment is favourable, although the application of the BPSO® Program has not produced any major changes. IMPLICATIONS FOR NURSING MANAGEMENT: Measures are suggested that are oriented towards the planning of staffing and the increase in the participation of the nursing staff in programmes of implementation of guidelines.
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Satisfacción en el Trabajo , Personal de Enfermería en Hospital , Estudios Transversales , Humanos , Organizaciones , Salarios y Beneficios , Encuestas y Cuestionarios , Lugar de TrabajoRESUMEN
AIMS: To discover the level of evidence-based practice competency of Spanish nurses, to develop a scale of the EBP-COQ-Prof© and to analyse the influence of different variables on the level of competency. BACKGROUND: The evidence-based practice competency has previously been assessed using a wide variety of instruments, although these have methodological limitations and lack associated scales that allow for the interpretation of the score obtained. METHOD: Observational, cross-sectional, national study. Using an online questionnaire, data were obtained between January and March 2020 from nurses working in the National Health System. An ANOVA was performed along with multiple regression analyses. The T-score and percentiles were calculated to obtain the scale of the EBP-COQ-Prof©. RESULTS: 2,942 nurses participated. The score for the evidence-based practice competency was 130.29 (standard deviation 17.55). The multiple regression analysis showed a model comprised of 8 variables that explained 33% of the variance. CONCLUSIONS: The Spanish nurses have a moderate level of evidence-based practice competency. The scale classifies the subjects into 3 levels: low, moderate and high competency. IMPLICATIONS FOR NURSING MANAGEMENT: The scale proposed for the EBP-COQ-Prof© could be utilized to facilitate the diagnosis of evidence-based practice competency, and to monitor and plan individual and collective strategies to improve this competency.