Autonomous competences and quality of professional life of paediatric nurses in primary care, their relationship and associated factors: A cross-sectional study.

AIMS AND OBJECTIVES: To identify the autonomous competences and quality of professional life of paediatric nurses in primary care, their relationship and possible associated factors. BACKGROUND: The autonomous competences of paediatric nurses vary among healthcare providers in Catalonia, Spain. Autonomy is related to quality of professional life, but little is known about autonomous competences and other factors contributing to paediatric nurses' quality of professional life. DESIGN: A cross-sectional study following the STROBE statement. METHODS: Data from 206 paediatric primary care nurses were analysed. A self-administered survey consisting of an ad hoc questionnaire and a validated instrument to measure quality of professional life (QPL-35 questionnaire) was conducted. Descriptive, bivariate and general multivariate regression analyses were used to identify the relationship between autonomous competences and quality of professional life, and its predicting factors. RESULTS: 47.6% nurses reported a medium level of autonomous competences, 46.6% a high level, and 5.8% a low level. Quality of professional life was medium-high for the domains perception of managerial support and global perception of workload and for the item disconnect from work after work shift, and very high and high values for the domain intrinsic motivation and for the item quality of work life, respectively. Autonomous competences and perceived autonomy were factors associated with quality of professional life. Other associated factors were academic background, specific training and being a paediatric nurse specialist. CONCLUSIONS: Paediatric nurses in primary care have a medium-high level of autonomous competences and they perceive a high level of autonomy. Autonomous competences and level of perceived autonomy are predictors of quality of professional life. RELEVANCE TO CLINICAL PRACTICE: Enhancing paediatric nurses' autonomous competences and academic background, receiving specific training and being paediatric nurse specialists might improve their quality of professional life, healthcare quality and outcomes for the child population.

Impact of nursing interventions on adherence to treatment with antituberculosis drugs in children and young people: A nonrandomized controlled trial.

AIM: To evaluate the association of a new nursing intervention on the adherence to antituberculosis treatment in a paediatric cohort (<18 years). BACKGROUND: Tuberculosis remains a public health problem worldwide. The risk of developing tuberculosis after primary infection and its severity are higher in children. Proper adherence to antituberculosis treatment is critical for disease control. DESIGN: Nonrandomized controlled trial; Phase 1, retrospective (2011-2013), compared with Phase 2, prospective with intervention (2015-2016), in a referral centre for paediatric tuberculosis in Spain (NCT03230409). METHODS: A total of 359 patients who received antituberculosis drugs after close contact with a smear-positive patient (primary chemoprophylaxis) or were treated for latent tuberculosis infection or tuberculosis disease were included, 261 in Phase 1 and 98 in Phase 2. In Phase 2, a new nurse-led intervention was implemented in all patients and included two educational steps (written information in the child's native language and follow-up telephone calls) and two monitoring steps (Eidus-Hamilton test and follow-up questionnaire) that were exclusively carried out by nurses. RESULTS: Adherence to antituberculosis treatment increased from 74.7% in Phase 1% to 87.8% in Phase 2 (p = 0.014; Chi-square test), after the implementation of the nurse-led intervention. In Phase 2, nonadherence was only associated with being born abroad (28.6% vs. 7.8%; p = 0.019; Chi-square test) and with foreign origin families (27.3% vs. 0%; p < 0.0001; Chi-square test). CONCLUSION: The nurse-led intervention was associated to an increase in adherence to antituberculosis treatment. Immigrant-related variables remained major risk factors for sub-optimal adherence in a low-endemic setting.

[Integration of Health Information Patient]. / La integración de la información de salud del paciente.

Information and communications technology (ICT) is implemented in health systems. However, the current economic situation raises questions regarding how the health system will evolve in a context of widespread use of ICT, but with sustainability problems. "Beside sustainability and consolidation, now a days, the challenge is the integration of information and in which care level and who among health professionals should lead this step forward in health care. All this represents a major change of mindset for users of health systems, and the need to integrate all health care, working more transversely, with the aim of achieve more health care continuity and provide better quality in health care of the citizen.

Influence of nursing interventions on adherence to treatment with antituberculosis drugs in children and young people: research protocol.

AIM: To evaluate the efficacy of nursing interventions on adherence to antituberculosis medication in a paediatric cohort (aged 0-18 years) and to identify the risk factors for non-compliance. BACKGROUND: After primary infection, children have a higher risk of developing tuberculosis and the severity of the disease is worse in children. Adherence to treatment is essential to control both latent infection and tuberculosis disease. DESIGN: Phase 1: retrospective descriptive analysis (n = 270) in children and young people receiving antituberculosis treatment. Phase 2: quasi-experimental, longitudinal, prospective study (n = 100). The results of the two phases will be compared. METHODS: Phase 1: in children followed up during the period 2011-2013 (non-intervention group), the level of adherence and its associated epidemiological, sociocultural and clinical risk factors will be analysed. Phase 2: educational (written information in the child's mother tongue and follow-up telephone calls) and monitoring (Eidus-Hamilton test and follow-up questionnaire) nursing interventions will be implemented. The results of the two phases will be compared. The definitive Nurse-led Follow-up Programme will then be designed. This project was funded in October 2013. DISCUSSION: The risk factors for poor adherence to antituberculosis therapy need to be identified to optimize treatment success in latent tuberculosis infection and disease in children and young people. Simultaneous application of several educational and monitoring methods in nurse-led follow-up shall improve adherence in children and adolescents in our setting. These results may also be applicable in other settings, where tuberculosis is more prevalent and directly observed treatment strategies are not available.

[The nurse in the surgical area: prevention of complications and implemention of intervention in patient care]. / La enfermera en el área quirúrgica: prevención de complicaciones e implementación de intervenciones.

The contribution made by the surgical nurse is essential to ensure the security of the patient who is subjected to surgery as well as accompany this specialized professional work to ensure that the patient is in the best physical and mental condition to deal with procedures of these characteristics. Nurse care in the surgical area is frequently described from a biomedical approach as it focuses on the type of surgery or the surgical technique, a perspective that might be inadequate and obsolete in identifying the areas of professional intervention and in clarifying the objectives of the nursing staff in the surgical area. In this paper nursing interventions such as emotional support, enhanced security and the prevention of infection are described as well as the identification of potential complications more prevalent in the different stages of surgical procedure, such as bleeding, hypoxia or hypothermia, among others, all these different points are developed, from a rationalistic nursing approach with emphasis on a humanistic vision of patient care. The specificity of the surgical area demands a prepared and competent professional nurse in the emotional support of the patient and his or her family, as well as the demons- tration of knowledge and skills in technical management and instruments associated with each type of surgery. It also requires competence in the diagnosis of potential com- plications and the development of activities designed to the prevention, early detection and treatment of potential health problems.

Reliability and validity study of the Spanish adaptation of the "Creighton Simulation Evaluation Instrument (C-SEI)".

There are multiple advantages to using human patient simulation (HPS) as a teaching method for clinical nursing education. Valid, reliable tools that can be used when applying this teaching method are needed to evaluate nursing student skill acquisition. The aim of this study was to translate the Creighton Simulation Evaluation Instrument (C-SEI) into Spanish and to analyse the reliability and validity of the Spanish C-SEI version with nursing students. The study was conducted in two phases: (1) Adaptation of the instrument into Spanish. (2) Cross-sectional study in a sample of 249 nursing students who were evaluated by two observers. The psychometric properties were analysed in terms of reliability (internal consistency and inter-observer consistency) and construct validity using an exploratory factor analysis. Questionnaire internal consistency was 0.839 for the tool as a whole. Inter-observer concordance for the tool as a whole was 0.936 and greater than 0.80 for the majority of the items. The exploratory factor analysis showed a four-factor structure that explains 49.5% of the total variance. The results of this study show that the C-SEI-sp tool is a valid and reliable tool that is easy to apply in the monitoring of student performance in clinical simulation scenarios.

The Oncology Nurse Prescribing: A Catalonian Survey.

OBJECTIVE: This study identifies the capability, knowledge, and satisfaction of oncology nurses in Spain after approval of the nurse prescribing law in 2006. METHODS: A descriptive cross-sectional study was conducted among 140 nurses in three cancer centers in Catalonia, Spain, by using convenience sampling method. The principal variables of this study were nurse satisfaction, knowledge about what products nurses are allowed to prescribe, the nurses' perception of their own prescribing ability, and their opinion on education and training needs with regard to the new approved law. The secondary variables included years of professional experience, place of work, and sociodemographic variables. Data were collected during a 3 months period by using a piloted 29-item self-assessment questionnaire. RESULTS: Analyses of univariate and bivariate data showed that 82.2% of the nurses were aware of the approved law, but 94.2% indicated that they lack information about it. The mean satisfaction with the approval of the law was 6.64 ± 1.76 (numerical scale 0-10). In addition, 68.1% and 55.1% of the nurses were prepared to prescribe medical devices and drugs, respectively. To date, 61.1% of the nurses prescribe medical devices and 66% prescribe pharmacological products daily. CONCLUSIONS: Nurses expressed general satisfaction with the approval of the Law 29/2006. Nurses currently provide prescriptions, but widespread knowledge of the allowed prescriptions is lacking.

Analysis of University Postgraduate Nursing Education in Spain.

BACKGROUND: The nursing education program framework in Spain has recently been adapted and modified. This study aimed to analyze university postgraduate master'slevel nursing education during the past 21 years in Spain in terms of educational supply and demand. METHOD: A retrospective, longitudinal, descriptive, and observational design was used. The educational offerings at 15 university nursing schools in Spain were examined. The target population was 7,871 registered and licensed nurses who had completed postgraduate education. RESULTS: Among the 211 programs offered, public universities' educational offerings focused on two areas-public health and emergency care-whereas most courses in private universities were in surgery. Regarding demand, 1,235 nurses were enrolled. The most frequently requested educational areas were surgery, emergency and urgent care, and public health. CONCLUSION: Although the postgraduate nursing education situation has changed, supply and demand for this type of education in Spain are well balanced at both public and private universities. [J Nurs Educ. 2016;55(11):615-622.].

[Randomised clinical trial on pain control in intertrochanteric fractures of the femur with and without skin traction]. / Ensayo clínico aleatorizado sobre el control del dolor en las fracturas pertrocantéreas de fémur mediante el uso o no de tracción cutánea.

AIM: To evaluate the level of pain control among patients with intertrochanteric fracture of the femur with and without the application of skin traction. METHODS: A randomised, single centre, parallel, controlled and open, clinical trial performed in a hospital environment. The study subjects were patients with an intertrochanteric femur fracture seen in the Emergency Department. A non-probabilistic and consecutive sample of 40 patients (power 80% CI: 95%), was used. The patients were randomly assigned (1:1) to treatment with or without skin traction. The assignment was made by means of sealed envelopes. The principal variable of study was the evaluation of the pain at 48 hours after admission. Data was collected during February to October 2008 using an ad hoc questionnaire. Data was collected at baseline, 2 h, 24 h and 48 h after admission. RESULTS: At 48 hours after admission, the mean baseline pain improved by 4.4 points (SD: 1.8) (P<.001), the differential effect of the level of pain between both study groups was 0.7 points of the VAS scale (95% CI, -0.7 to 0.6), while the effect of traction showed no statistically significant differences (P=.721). One patient was withdrawn due skin reaction to the traction adhesive. CONCLUSIONS: The treatment with skin traction in the patients with intertrochanteric fracture of femur does not produce changes in the progression of the pain in comparison with the patients without skin traction.

[Knowledge of and satisfaction with the approval of the nurse prescription of nurses studying a masters degree and specialty in the University of Barcelona]. / Conocimiento y satisfacción de la aprobación de la prescripción enfermera (Ley 28/2009) en enfermeras de formación máster y especialidad de la Universidad de Barcelona.

OBJECTIVE: To identify the knowledge, satisfaction and capabilities of nurses regarding nurse prescribing after the approval of the Nurse Prescription Law. METHODS: A cross-sectional study carried out in the School of Nursing at the University of Barcelona (UB). The participants included 485 nurses taking a Masters or Specialist degree and teaching staff in these courses. The main variables were: satisfaction, information and knowledge about the recently approved Law, knowledge about the current skills on the prescribed products, nurse perception of their own prescribing ability, and opinion on information and training as regards the new law. The secondary variables included: years of professional experience, area and job position, postgraduate course and socio-demographic data. The study was conducted from March to April 2010 using a self-administered ad hoc questionnaire with 29 items on the topic and previously piloted on site. RESULTS: A total of 345 nurses participated, of whom 87.2% (301) taking a Masters degree. Of these, 72.3% (238) were aware and stated to have knowledge of the Law passed, although 95.9% (303) of them said they lacked information on it. The mean score on satisfaction with the approval of the Prescription Law was 6.24±2.08. Of all the nurses, 57.6% (189) of them said they were currently able to prescribe health products and 41.3% were capable of prescribing drugs (134). CONCLUSIONS: Nurses showed a high level of satisfaction with the Nurse Prescription law. Currently, many nurses are independently prescribing pharmacological and health products.

La integración de la información de salud del paciente / Integration of health information patient

Las tecnologías de la información y la comunicación (TIC) están implementadas en los sistemas de salud. Sin embargo, la actual situación socioeconómica plantea algunos interrogantes respecto a cómo evolucionará el sistema de salud en un contexto de uso generalizado de las TIC, pero con dificultades de sostenibilidad. Además de la sostenibilidad y la consolidación, ahora el reto planteado es la integración de la información y en qué ámbito asistencial y qué profesionales de la salud deberán liderar este paso adelante en la atención de salud de las personas de la comunidad. Todo ello supone un importante cambio de mentalidad para los usuarios de los sistemas de salud, y la necesidad de integrar todos los cuidados de salud, trabajando de manera más transversal, con el objetivo de dar continuidad asistencial y propiciando más calidad en la atención de salud del ciudadano (AU)

Information and communications technology (ICT) is implemented in health systems. However, the current economic situation raises questions regarding how the health system will evolve in a context of widespread use of ICT, but with sustainability problems. Beside sustainability and consolidation, now a days, the challenge is the integration of information and in which care level and who among health professionals should lead this step forward in health care. All this represents a major change of mindset for users of health systems, and the need to integrate all health care, working more transversely, with the aim of achieve more health care continuity and provide better quality in health care of citizen (AU)

Ensayo clínico aleatorizado sobre el control del dolor en las fracturas pertrocantéreas de fémur mediante el uso o no de tracción cutánea / Randomised clinical trial on pain control in intertrochanteric fractures of the femur with and without skin traction

Objetivo. Evaluar el grado de control del dolor de los pacientes afectos de fracturas pertrocantéreas de fémur en función de la aplicación o no de tracción cutánea. Método. Ensayo clínico aleatorizado unicéntrico, paralelo, controlado y abierto realizado en el ámbito hospitalario. Los sujetos a estudio fueron pacientes que acudieron al servicio de urgencias por fractura pertrocantérea de fémur. Muestra de 40 pacientes (potencia 80% IC: 95%). Muestreo no probabilístico consecutivo. Pacientes asignados de manera aleatoria (1:1) a tratamiento con tracción cutánea o sin tracción. La asignación fue realizada mediante sobres cerrados. La variable principal de estudio fue la evaluación del dolor a las 48 horas de ingreso. La recogida de datos se realizó durante febrero a octubre de 2008 mediante cuaderno de registro de datos ad hoc, siendo evaluadas basalmente, a las 2h, 24h y 48h del ingreso del paciente. Resultados. A la 48 horas del ingreso el dolor basal medio de la muestra mejoró en 4,4 puntos (DE: 1,8) (p<0,001), el efecto diferencial del nivel de dolor entre los dos grupos de estudio fue de 0,7 puntos de la escala EVA (IC: 95% -0,7 a 0,6), el efecto de la tracción no demostró diferencias estadísticamente significativas (p=0,721). Fue retirado un paciente por reacción cutánea al adhesivo de la tracción. Conclusiones. El tratamiento con tracción cutánea en los pacientes con fractura pertrocantérea de fémur no produce cambios en la evolución del dolor en comparación con los pacientes sin tracción cutánea (AU)

Aim. To evaluate the level of pain control among patients with intertrochanteric fracture of the femur with and without the application of skin traction. Methods. A randomised, single centre, parallel, controlled and open, clinical trial performed in a hospital environment. The study subjects were patients with an intertrochanteric femur fracture seen in the Emergency Department. A non-probabilistic and consecutive sample of 40 patients (power 80% CI: 95%), was used. The patients were randomly assigned (1:1) to treatment with or without skin traction. The assignment was made by means of sealed envelopes. The principal variable of study was the evaluation of the pain at 48 hours after admission. Data was collected during February to October 2008 using an ad hoc questionnaire. Data was collected at baseline, 2h, 24h and 48h after admission. Results. At 48hours after admission, the mean baseline pain improved by 4.4 points (SD: 1.8) (P<.001), the differential effect of the level of pain between both study groups was 0.7 points of the VAS scale (95% CI, -0.7 to 0.6), while the effect of traction showed no statistically significant differences (P=.721). One patient was withdrawn due skin reaction to the traction adhesive. Conclusions. The treatment with skin traction in the patients with intertrochanteric fracture of femur does not produce changes in the progression of the pain in comparison with the patients without skin traction (AU)

Conocimiento y satisfacción de la aprobación de la prescripción enfermera (Ley 28/2009) en enfermeras de formación máster y especialidad de la Universidad de Barcelona / Knowledge of and satisfaction with the approval of the nurse prescription of nurses

Objetivo. Identificar el nivel de conocimiento, satisfacción y capacitación de las enfermeras con relación a la prescripción enfermera tras la aprobación de la Ley 28/2009. Método. Estudio observacional descriptivo transversal realizado en la Escuela de Enfermería de la Universidad de Barcelona. Los sujetos a estudio fueron 485 enfermeras en formación máster o especialización y docentes de dicha escuela. Las variables principales de estudio fueron: satisfacción, conocimiento e información de la aprobación de la Ley, conocimiento de los elementos autorizados a prescribir, percepción de capacidad prescriptora de las enfermeras y opinión de la necesidad formativa e informativa respecto a la Ley. Como secundarias: años de experiencia profesional, ámbito laboral, curso formativo y sociodemográficas. La recogida de datos se realizó entre los meses de marzo y abril de 2010 mediante un cuestionario autoaplicable ad hoc de 29 ítems, probado previamente. Resultados. Participaron 345 enfermeras, el 87,2% (301) alumnas en formación máster. El 72,3% (238) de las enfermeras conocían la aprobación de la ley, pero un 95,9% (303) indicó tener insuficiente información. La satisfacción media con la aprobación de la Ley se situó en 6,24±2,08. El 57,6% (189) de las enfermeras opinaron estar capacitadas para prescribir productos sanitarios y un 41,3% (134), para prescribir fármacos. Conclusiones. Hay satisfacción con la aprobación de la Ley 28/2009. Actualmente muchas enfermeras prescriben productos farmacológicos y sanitarios de forma autónoma (AU)

Objective: To identify the knowledge, satisfaction and capabilities of nurses regarding nurse prescribing after the approval of the Nurse Prescription Law. Methods: A cross-sectional study carried out in the School of Nursing at the University of Barcelona (UB). The participants included 485 nurses taking a Masters or Specialist degree and teaching staff in these courses. The main variables were: satisfaction, information and knowledge about the recently approved Law, knowledge about the current skills on the prescribed products, nurse perception of their own prescribing ability, and opinion on information and training as regards the new law. The secondary variables included: years of professional experience, area and job position, postgraduate course and socio-demographic data. The study was conducted from March to April 2010 using a self-administered ad hoc questionnaire with 29 items on the topic and previously piloted on site. Results: A total of 345 nurses participated, of whom 87.2% (301) taking a Masters degree. Of these, 72.3% (238) were aware and stated to have knowledge of the Law passed, although 95.9% (303) of them said they lacked information on it. The mean score on satisfaction with the approval of the Prescription Law was 6.24±2.08. Of all the nurses, 57.6% (189) of them said they were currently able to prescribe health products and 41.3% were capable of prescribing drugs (134). Conclusions: Nurses showed a high level of satisfaction with the Nurse Prescriptionlaw. Currently, many nurses are independently prescribing pharmacological and health products (AU)

La enfermera en el área quirúrgica. Prevención de complicaciones e implementación de intervenciones / The nurse in the surgical area: prevention of complications and implemention of intervention in patient care

La aportación de la enfermera quirúrgica es fundamental para garantizar la seguridad de la persona que se somete a una intervención; además de acompañarla, este profesional especializado trabaja para garantizar que la persona se encuentre en las mejores condiciones físicas y psíquicas para afrontar un procedimiento de estas características. Frecuentemente, el cuidado enfermero en el bloque quirúrgico se halla descrito desde el enfoque biomédico puesto que se centra en el tipo de cirugía o en la técnica quirúrgica, perspectiva que puede ser insuficiente y obsoleta a la hora de identificar las áreas de intervención profesional y de clarificar los objetivos del equipo enfermero en el área quirúrgica. Se describen en este trabajo las intervenciones enfermeras, como el apoyo emocional, la potenciación de la seguridad y la prevención de la infección; y se identifican también las complicaciones potenciales más prevalentes en las diferentes etapas del proceso quirúrgico, como la hemorragia, la hipoxia o la hipotermia, entre otras, desarrollado todo ello a partir de la estructura de razonamiento enfermero y poniendo énfasis, desde una visión humanizadora de los cuidados, en la persona. La especificidad del área quirúrgica demanda a un profesional enfermero preparado y competente en el acompañamiento y el apoyo emocional de la persona y su familia, que demuestre conocimientos y habilidades en el manejo técnico e instrumental asociado a cada tipo de cirugía; y, también, competente en el diagnóstico de las complicaciones potenciales y en el desarrollo de actividades dirigidas a su prevención, detección precoz y tratamiento(AU)

The contribution made by the surgical nurse is essential to ensure the security of the patient who is subjected to surgery, as well as accompany this specialized professional work to ensure that the patient is in the best physical and mental condition to deal with procedures of these characteristics. Nurse care in the surgical area is frequently described from a biomedical approach as it focuses on the type of surgery or the surgical technique, a perspective that might be inadequate and obsolete in identifying the areas of professional intervention and in clarifying the objectives of the nursing staff in the surgical area. In this paper, nursing interventions such as emotional support, enhanced security and the prevention of infection are described as well as the identification of potential complications more prevalent in the different stages of surgical procedure, such as bleeding, hypoxia or hypothermia, among others, all these different points are developed from a rationalistic nursing approach with emphasis on a humanistic vision of patient care. The specificity of the surgical area demands a prepared and competent professional nurse in the emotional support of the patient and his or her family, as well as the demonstration of knowledge and skills in technical management and instruments associated with each type of surgery. It also requires competence in the diagnosis of potential complications and the development of activities designed to the prevention, early detection and treatment of potential health problems(AU)

Actualización sobre la gripedel virus A: experienciade una pandemia desdela perspectiva enfermera / Update on the influenza A virus: a pandemic experience from the nursing perspective

En abril de 2009 la Organización Mundial de la Salud (OMS) emite suprimer comunicado, donde advierte la presencia de un brote epidémicopor un nuevo virus de gripe A (H1N1) en EE.UU y México, declarandouna Emergencia de Salud Pública de importancia internacional. Dos mesesdespués la OMS elevó la alerta por este virus a nivel 6, el máximode la escala que configura una pandemia, tras comprobar la transmisiónelevada y sostenida del virus en el mundo. Actualmente, los Comités ySubcomités de Expertos están trabajando en la elaboración y actualizaciónde protocolos específicos y en la implementación de medidas, tantoclínicas como sociales, que ayuden a gestionar la pandemia.Los objetivos de este trabajo son realizar una revisión de los antecedentesy situación actual de la gripe del virus A, para reflexionar sobre losaspectos más controvertidos que han aparecido en el transcurso de estapandemia y reforzar los conocimientos de los profesionales enfermeros (AU)

In april 2009, the World Health Organisation (WHO) issued its first reportwarning of the presence of an epidemic outbreak of influenza A virus(H1N1 subtype) in the US and Mexico, declaring a public healthemergency of worldwide importance. Two months later, the WHO raisedthis virus alert to level 6, the maximum on the scale for a pandemic, afterchecking the high and sustained transmission rate of the virus in theworld. At present, the Expert Committees and Subcommittees are workingon the elaboration and updating of specific protocols and on the implementationof measures, both clinical and social measures that help managethe pandemic.The objectives of this work are to carry out a review of the backgroundand current situation of the A virus influenza to reflect on the most controversialaspects that have emerged during the course of the outbreakand to reinforce the knowledge of the nursing professional (AU)