Exploring nurses' experiences: Abandoning the profession and migrating for improved opportunities.

AIM: This study explores nurses' experiences in migration for employment and professional abandonment in Barcelona (Spain). METHODS: Employing a mixed-design approach comprising 1) a qualitative descriptive phenomenological study, followed by 2) a subsequent cross-sectional study, 20 and 225 nurses participated in each study, respectively. Qualitative data, gathered through 4 focus group discussions, underwent inductive thematic analysis, following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines, while quantitative data were descriptively analyzed. FINDINGS: Three qualitative themes emerged: 1) Migration motives, such as improved job opportunities, permanent contracts, continuous training, and professional recognition; 2) Reasons for leaving or contemplating leaving the profession, including excessive workload, lack of recognition, limited development, and exhaustion; 3) Nurses' needs, encompassing more staffing, improved remuneration, permanent contracts, flexible schedules, greater autonomy, and career growth. The cross-sectional study revealed a 13.5 % professional abandonment rate at some point across all demographics and seniority levels. Migration trends varied by professional experience, with younger nurses seeking better conditions and opportunities elsewhere. CONCLUSIONS: Multifactorial causes underlie job migration and professional abandonment, necessitating comprehensive interventions to improve nurses' working and professional conditions.

[Nursing University Education in a New Healthcare Setting]. / La formación universitaria de las enfermeras en el nuevo contexto asistencial.

Nursing university education has to respond to the challenges of the 21st century. Health conditions are highly complex with associated social problems. The universities should train nurses with a transforming vision, by defining study plans, preventive approach and promoting health, in a context of community health. The information and communication technologies along with the nurse leadership are also essential elements of value for graduated nurses. An innovative response to social needs and transformation of society requires commitment in defining the study plans of degree and also in the master's degree and in the continuing education programs. Investigate is how to acquire the necessary skills to generate knowledge to help ensure the professional development of nurses and contribute to the persons health.

Developing Evidence-Based Practice questionnaire for community health nurses: reliability and validity of a Spanish adaptation.

AIMS AND OBJECTIVES: This study aimed to translate the community nursing version of the Developing Evidence-Based Practice questionnaire, adapt the Spanish translation to the primary care context in Spain, and evaluate its reliability and validity. BACKGROUND: Instruments available in Spanish to date are not designed to rigorously evaluate barriers and incentives associated with evidence-based practice implementation in community health nursing. DESIGN: Classical Test Theory approach. METHODS: The 49-item Developing Evidence-Based Practice questionnaire was translated, back-translated and pilot-tested. Two items were added to assess respondents' ability to read and understand the English language. During the first six months of 2010, 513 nurses from 255 primary health care centres in Catalunya (Spain) voluntarily participated in the study. Internal consistency and test-retest reliability were evaluated. Internal structure was analysed by principal component analysis. A randomized, controlled, parallel-design study was carried out to test scores' sensitivity to change with two groups, intervention and control. The intervention consisted of eight hours of in-person training, provided by experts in evidence-based practice. RESULTS: Of 513 nurses, 445 (86·7%) nurses responded to all 51 items. Factor analysis showed six components that explained 51% of the total variance. Internal consistency and test-retest reliability were satisfactory (Cronbach α and intraclass correlation coefficients >0·70). A total of 93 nurses participated in the sensitivity-to-change tests (42 in the intervention group, 51 controls). After the training session, overall score and the 'skills for evidence-based practice' component score showed a medium (Cohen d = 0·69) and large effect (Cohen d = 0·86), respectively. CONCLUSIONS: The Developing Evidence-Based Practice questionnaire adapted to community health nursing in the primary care setting in Spain has satisfactory psychometric properties. RELEVANCE TO CLINICAL PRACTICE: The Developing Evidence-Based Practice questionnaire is a useful tool for planning and evaluating the implementation of evidence-based practice in community health nursing.

Implementation of Nurse Prescriptions throughout the Public Health System in Catalonia (2021-2022).

BACKGROUND: Nurses in Catalonia have always prescribed health advice, health products, and medication in line with the professional competency of the discipline. Legislation about nurse prescriptions and the implementation of nurse prescribing varies widely among different countries. This article reports data regarding nurse prescribing in Catalonia in 2021 and 2022. METHODS: This retrospective longitudinal study analyzed data from all care-providing units in Catalonia's integrated public health system. RESULTS: The number of nurse prescriptions increased from 139,435 in 2021 to 573,822 in 2022, and the number of nurses issuing prescriptions increased from 3604 in 2021 to 5563 in 2022. The proportion of prescriptions for different products was similar in the two years analyzed. Prescriptions for medication increased by 7.5% in 2022. CONCLUSIONS: Nurse prescribing is a recent advance in Catalonia. Despite some difficulties in rollout, the data indicate that this practice is becoming consolidated, as in other European countries.

Experiences of Spanish nurses in the rollout of nurse prescribing: a qualitative study.

Introduction: Nurse prescribing has legal recognition in Spain, after a long regulatory process, with confusing, changing legislation that does not fully coincide with the reality of nurses' practice. There is currently no research available on how nurses have experienced the rollout of nurse prescribing. The objective of this study is to describe the experiences of nurses in the rollout of nurse prescribing in the province of Barcelona, Spain. Method: A descriptive qualitative study with intentional sampling was carried out between March 2021 and July 2022. The data were collected through semi-structured individual interviews and discussion groups. The participants were 24 nurses working in the province of Barcelona who were accredited in nurse prescribing or involved in the rollout of nurse prescribing. The data were analyzed using thematic analysis, following Braun and Clark. The COREQ checklist was used to report findings. Results: We describe nurses' responses on the following themes: internal and external barriers; strategies to support nurse prescribing in the initial rollout and proposals for improvement; and factors linked to nurses' satisfaction. Discussion: The regulatory process has provided a safety framework for nurse prescribing. Strategies are needed for its comprehensive development and its acceptance among the public. The findings give visibility to nurse prescribing internationally.

Opinion on the benefits of nurse prescribing in Catalonia. Consensus of health professionals and managers.

OBJECTIVE: To study the level of agreement among health professionals and managers in Catalonia on the benefits of nurse prescribing (NP). METHOD: An online Real Time Delphi was conducted to collect the level of agreement of health professionals and managers. Participants voted in a 6-point scale (1 low benefit and 6 high benefit) for 12 items describing benefits of NP. A total of 1332 professionals participated. The level of consensus was calculated applying interquartile ranges of scores and standardized mean differences among subgroups using effect sizes (ES) and their corresponding 95% confidence intervals. RESULTS: The scores indicate a general agreement on the perceived benefits of NP among participants. Standardized differences among scores on the perceived benefits among professionals were small to high (ES range between 0.2 and 1.2) between nurses and medical doctors and high between nurses and pharmacists (ES range: 1.2 and 2.4). Differences between scores of nurses and those of managers or other professionals in the present study were smaller for most voted benefits. CONCLUSIONS: The study shows an agreement on the benefits of NP. Nevertheless, when standardized scores are taken into consideration, differences among professionals' perceptions emerged, and aligned with documented barriers identified in the literature such as corporative aspects, cultural limitations, institutional and organisational inertia, beliefs and unawareness of what NP implies.