A Scoping Review of Strategies Used to Implement the Surgical Safety Checklist.

In 2007, the World Health Organization initiated the Surgical Safety Checklist (SSC) as part of an initiative to improve patient outcomes. After publication of the SSC, perioperative nurses identified challenges with implementing it and questioned its effectiveness. We desired to summarize the state of the science on the effectiveness of strategies that perioperative personnel have used to implement and assess the SSC; therefore, we conducted a scoping review. We searched several databases and identified 28 articles that described the three key stages of SSC implementation (ie, before, during, and after). Half of the identified articles addressed intervention strategies and most articles provided strategies for SSC implementation. The literature also indicated that effective implementation occurred when there was adequate planning. Perioperative leaders should work with nurses when implementing the SSC and monitor its use after implementation to verify compliance and help prevent negative patient outcomes.

Characteristics and Circumstances of Falls in the Community-Dwelling Older Adult Population.

Objective: The study aimed to describe the characteristics and circumstances of falls in the community-dwelling older adult population. Design: This was a cross-sectional observational and descriptive study involving primary health care centers in Lleida and Castellón de la Plana, Spain. Randomized sampling was used to include 966 individuals aged 75 years or older residing in single-family homes and in possession of a health care card. Data were obtained using the Survey on Fragility in Older People in Lleida (FRALLE survey). Study variables included the occurrence of falls in the past year and fall characteristics such as whether it was a first or successive fall, cause, season, and time of the day the fall occurred, whether the respondent fell flat on the ground, and time the participant remained on the floor. Other variables involved the circumstances of the fall, including the general location of the fall and specific location within the home if applicable, lighting/weather conditions, objects which may have precipitated the fall, floor conditions, and type of footwear. Results: The prevalence of falls was 25.9% with regard to the previous year, with 70% of these participants reporting having fallen previously. Falls most often occurred by accident, during the daytime, and in the winter. Variables that showed statistical significance with regard to age group were: falling flat on the ground (P = .031), fall location (P = .000), presence of an object favoring the fall (P = .039), floor conditions (P = .011), and type of footwear (P = .029). By sex, variables that showed statistical significance included the need for assistance to get up (P = .045) and type of footwear (P = .028). Conclusions: The prevalence of falls was found to be similar in the studied cities. The results show the most common characteristics and circumstances of falls in older adults in the community, making it possible to guide future preventive strategies.

Análisis de los factores contribuyentes a la desnutrición en ancianos no institucionalizados / Analysis of the factors contributing to malnutrition in non-institutionalized elderly

INTRODUCCIÓN: La detección precoz del riesgo de desnutrición es un factor clave para actuar de forma efectiva y minimizar los efectos negativos asociados a la malnutrición en el anciano. OBJETIVO: Identificar los factores relacionados con el riesgo de desnutrición en personas mayores no institucionalizas. METODOLOGÍA: Estudio observacional de corte transversal analítico, realizado mediante cuestionario sobre una muestra (n=400) de población mayor de 75 años no institucionalizada en Castellón durante 2015. Las variables estudiadas son: sociodemográficas, riesgo de desnutrición medida mediante el MNA-SF, la fragilidad mediante los criterios de Fried, comorbilidad medida con el índice de Chalson, discapacidad básica e instrumental, valoradas con el índice de Katz y el índice de Lawton & Brody respectivamente, síntomas depresivos medidos con la escala CES-D y hábitos de vida. RESULTADOS: el 28,2% de individuos presentaban riesgo de desnutrición, Se relaciona con mayor riesgo de desnutrición ser mujer (62,2%) (p= 0,027), tener ingresos más bajos (43,5%) (p = 0,030), consumo de alcohol (29,1%) (p = 0,039), discapacidad básica (42,1%) (P=0,013), síntomas depresivos (50%) (p=<0,001) y la polimedicación (83,8%) (p = 0,015). CONCLUSIÓN: El riesgo de desnutrición se asocia a ser mujer, al nivel de ingresos y a la discapacidad básica e instrumental y a la presencia de síntomas depresivos

INTRODUCTION: Early detection of malnutrition risk is a key factor to act effectively and minimize the negative effects associated with malnutrition in the elderly. OBJECTIVE: To know the factors that contribute to the risk of malnutrition in the elderly living in the community. METHODOLOGY: Observational cross-sectional analytical study, carried out by means of a questionnaire on a sample (n = 400) of a population over 75 years old that was not institutionalized in Castellón during 2015. RESULTS: 28.2% of individuals were at risk of malnutrition, being related to a higher risk of malnutrition being a woman (62.2%) (p = 0.027), having lower income (43.5%) (p = 0.030), alcohol consumption (29.1%) (p = 0.039), basic disability (42.1%) (P = 0.013), depressive symptoms (50%) (p = <0.001) and polypharmacy (83.8%) (p = 0.015). CONCLUSION: The risk of malnutrition is associated with being a woman, at the level of income, basic and instrumental disability, and the presence of depressive symptoms

Effectiveness of an Evidence-Based Practice educational intervention with second-year nursing students.

OBJECTIVES: to evaluate the effectiveness of an educational intervention on the knowledge, skills and attitudes of evidence-based practice among second-year nursing students. METHOD: a quasi-experimental before-and-after study. The study population consisted of 120 students enrolled in the Nursing Care in Healthcare Processes course. The educational intervention was based on theoretical and practical classes about the evidence-based practice process and the use of the critical incident technique during the clinical clerkship. Effectiveness was measured with the Evidence-Based Practice Competence Questionnaire in three paired measures using repeated-measures analysis of variance. RESULTS: the mean scores of the Evidence-Based Practice Competence Questionnaire were 79.83 (CI 95% 78.63-81.03) for the basal measurement, 84.53 (CI 95% 83.23-85.83) for the intermediate measurement, and 84.91 (CI 95% 83.26-86.55) for the final measurement, with a statistically significant difference among the three paired measurements (p<0.001). There were statistically significant differences in Attitudes (p = 0.034) and Knowledge (p <0.001) but not in Skills (p = 0.137). CONCLUSION: this educational intervention based on theoretical and practical classes about the evidence-based practice process and the use of the critical incident technique during the clinical clerkship enhances evidence-based practice competence among second-year nursing degree students.

Effectiveness of an Evidence-Based Practice educational intervention with second-year nursing students / Eficácia de uma intervenção educativa de Prática Baseada em Evidências com estudantes do segundo ano de enfermagem / Eficacia de una intervención educativa de Práctica Basada en la Evidencia en estudiantes de segundo año de enfermería

ABSTRACT Objectives: to evaluate the effectiveness of an educational intervention on the knowledge, skills and attitudes of evidence-based practice among second-year nursing students. Method: a quasi-experimental before-and-after study. The study population consisted of 120 students enrolled in the Nursing Care in Healthcare Processes course. The educational intervention was based on theoretical and practical classes about the evidence-based practice process and the use of the critical incident technique during the clinical clerkship. Effectiveness was measured with the Evidence-Based Practice Competence Questionnaire in three paired measures using repeated-measures analysis of variance. Results: the mean scores of the Evidence-Based Practice Competence Questionnaire were 79.83 (CI 95% 78.63-81.03) for the basal measurement, 84.53 (CI 95% 83.23-85.83) for the intermediate measurement, and 84.91 (CI 95% 83.26-86.55) for the final measurement, with a statistically significant difference among the three paired measurements (p<0.001). There were statistically significant differences in Attitudes (p = 0.034) and Knowledge (p <0.001) but not in Skills (p = 0.137). Conclusion: this educational intervention based on theoretical and practical classes about the evidence-based practice process and the use of the critical incident technique during the clinical clerkship enhances evidence-based practice competence among second-year nursing degree students.

RESUMO Objetivos: avaliar a eficácia de uma intervenção educativa sobre os conhecimentos, competências e atitudes da prática baseada em evidências em estudantes do segundo ano do curso de enfermagem. Método: estudo quase-experimental, antes e depois. A população do estudo foi composta por 120 estudantes matriculados na cadeira de Cuidados de Enfermagem em Processos de Assistência Médica. A intervenção educativa foi baseada em aulas teóricas e práticas sobre o processo da prática baseada em evidências e o uso da técnica do incidente crítico durante o estágio clínico. A eficácia foi medida com o Questionário de Competências de Práticas Baseadas em Evidências em três medidas pareadas usando análise de variância de medidas repetidas. Resultados: os escores médios do Questionário de Competências da Prática Baseada em Evidências foram 79,83 (IC95% 78,63-81,03) para a medição basal, 84,53 (IC95% 83,23-85,83) para a medição intermédia e 84,91 (IC95% 83,26-86,55) para a medição final, com uma diferença estatisticamente significante entre as três medidas pareadas (p<0,001). Houve diferenças estatisticamente significantes em Atitudes (p = 0,034) e Conhecimento (p <0,001), mas não em Competências (p = 0,137). Conclusão: esta intervenção educativa baseada em aulas teóricas e práticas sobre o processo de prática baseada em evidências e o uso da técnica do incidente crítico durante o estágio clínico aumenta a competência de prática baseada em evidências em estudantes do segundo ano do curso de enfermagem.

RESUMEN Objetivos: evaluar la efectividad de una intervención educativa de práctica basada en la evidencia sobre los conocimientos, habilidades y actitudes del estudiantado de segundo año del grado en enfermería. Método: estudio cuasi-experimental (antes-después). La población de estudio consistió en 120 estudiantes inscritos en el curso de Cuidados de Enfermería en los Procesos de Atención Sanitaria. La intervención educativa se basó en clases teóricas y prácticas sobre el proceso de práctica basada en la evidencia y el uso de la técnica de incidentes críticos durante las rotaciones clínicas. La efectividad se midió con el Cuestionario de Competencia en Práctica Basada en la Evidencia por medio de tres medidas pareadas y utilizando el análisis de varianza de medidas repetidas. Resultados: las puntuaciones medias del Cuestionario de Competencia en Práctica Basada en la Evidencia fueron 79,83 (IC 95% 78,63-81,03) para la medición basal, 84,53 (IC 95% 83,23-85,83) para la medición intermedia, y 84,91 (IC 95% 83,26-86,55) para la medición final, con una diferencia estadísticamente significativa entre las tres medidas pareadas (p <0,001). Hubo diferencias estadísticamente significativas en Actitudes (p = 0,034) y Conocimientos (p <0,001), pero no en Habilidades (p = 0,137). Conclusión: la intervención educativa basada en clases teóricas y prácticas sobre el proceso de práctica basada en la evidencia y el uso de la técnica de incidentes críticos durante las rotaciones clínicas mejoran la competencia en práctica basada en la evidencia en estudiantes de segundo año de enfermería.

Evaluation of the quality of the teaching-learning process in undergraduate courses in Nursing.

OBJECTIVE: to identify aspects of improvement of the quality of the teaching-learning process through the analysis of tools that evaluated the acquisition of skills by undergraduate students of Nursing. METHOD: prospective longitudinal study conducted in a population of 60 secondyear Nursing students based on registration data, from which quality indicators that evaluate the acquisition of skills were obtained, with descriptive and inferential analysis. RESULTS: nine items were identified and nine learning activities included in the assessment tools that did not reach the established quality indicators (p<0.05). There are statistically significant differences depending on the hospital and clinical practices unit (p<0.05). CONCLUSION: the analysis of the evaluation tools used in the article "Nursing Care in Welfare Processes" of the analyzed university undergraduate course enabled the detection of the areas for improvement in the teachinglearning process. The challenge of education in nursing is to reach the best clinical research and educational results, in order to provide improvements to the quality of education and health care.

Evaluation of the quality of the teaching-learning process in undergraduate courses in Nursing / Avaliação da qualidade do processo ensino-aprendizagem no curso de graduação em Enfermagem / Evaluación de la calidad del proceso enseñanza-aprendizaje en estudios de grado en Enfermería

AbstractObjective: to identify aspects of improvement of the quality of the teaching-learning process through the analysis of tools that evaluated the acquisition of skills by undergraduate students of Nursing.Method: prospective longitudinal study conducted in a population of 60 secondyear Nursing students based on registration data, from which quality indicators that evaluate the acquisition of skills were obtained, with descriptive and inferential analysis.Results: nine items were identified and nine learning activities included in the assessment tools that did not reach the established quality indicators (p<0.05). There are statistically significant differences depending on the hospital and clinical practices unit (p<0.05).Conclusion: the analysis of the evaluation tools used in the article "Nursing Care in Welfare Processes" of the analyzed university undergraduate course enabled the detection of the areas for improvement in the teachinglearning process. The challenge of education in nursing is to reach the best clinical research and educational results, in order to provide improvements to the quality of education and health care.

ResumoObjetivo:identificar os aspectos de melhoria da qualidade do processo ensino-aprendizagem através da análise de ferramentas que avaliaram a aquisição de competências pelos alunos do curso de Enfermagem.Método:estudo longitudinal prospectivo realizado em uma população de 60 alunos do segundo ano de Enfermagem com base nos dados de registro dos quais foram obtidos indicadores de qualidade que avaliam a aquisição de competências, com análise descritiva e inferencial.Resultados:foram identificados nove itens e nove atividades de aprendizagem incluídas nas ferramentas de avaliação que não atingiram os indicadores de qualidade estabelecidos (p<0,05). Existem diferenças estatisticamente significativas dependendo do hospital e da unidade de práticas clínicas (p<0,05).Conclusão:a análise das ferramentas de avaliação utilizadas na matéria "Cuidados de Enfermagem em Processos Assistenciais" de tal curso universitário permitiu detectar as áreas de melhoria no processo de ensino-aprendizagem. O desafio da educação em enfermagem é conseguir utilizar os melhores resultados da pesquisa clínica e pedagógica, a fim de proporcionar melhorias para a qualidade do ensino e para a qualidade assistencial.

ResumenObjetivo:detectar aspectos de mejora de la calidad del proceso enseñanza-aprendizaje a través del análisis de herramientas que evaluaron la adquisición de competencias en estudiantes de grado en Enfermería.Método:estudio longitudinal, prospectivo realizado sobre una población de sesenta estudiantes del segundo curso de Enfermería basado en datos de registro de los que se obtienen indicadores de calidad que evalúan la adquisición de competencias, con análisis descriptivo e inferencial.Resultados:se han identificado nueve ítems y nueve actividades de aprendizaje incluidas en las herramientas de evaluación que no alcanzan los indicadores de calidad establecidos (p<0,05). Existen diferencias estadísticamente significativas en función de hospitales y unidades de prácticas clínicas (p<0,05).Conclusión:el análisis de las herramientas de evaluación utilizadas en la materia Cuidados de Enfermería en Procesos Asistenciales de dicha carrera ha permitido detectar áreas de mejora en el proceso de enseñanza-aprendizaje. El reto para la educación en enfermería consiste en utilizar los mejores resultados de investigación clínica y pedagógica para aportar mejoras a la calidad de la docencia y a la calidad asistencial.

Level of involvement of clinical nurses in the evaluation of competence of nursing students.

OBJECTIVE: To determine the level of involvement of clinical nurses accredited by the Universitat Jaume I (Spain) as mentors of practice (Reference Nurses) in the evaluation of competence of nursing students. METHODOLGY: Cross-sectional study, in which the "Clinical Practice Assessment Manual'' (CPAM) reported by reference 41 nurses (n=55) were analyzed. Four quality criteria for completion were established: with information at least 80% of the required data, the presence of the signature and final grade in the right place. Verification of learning activities was also conducted. Data collection was performed concurrently reference for nurses and teachers of the subjects in the formative evaluations of clinical clerkship period in the matter "Nursing Care in Healthcare Processes ", from March to June 2013. RESULTS: 63% of CPAM were completed correctly, without reaching the quality threshold established (80%). The absence of the signature is the main criteria of incorrect completion (21%). Nine learning activities do not meet the quality threshold set (80%) (p < 0.05). There are significant differences according to clinical units p < 0.05. From the 30 learning activities evaluated in the CPAM, it can be stated that nine of them do not reach the verification threshold established (80%), therefore it cannot be assumed that these activities had been completed by students and evaluated by the RefN throughout the clinical clerkship period. CONCLUSION: The level of involvement of Reference Nurse cannot be considered adequate, although strategies to encourage involvement through collaboration and training must be developed.

Nivel de implicación de enfermeras clínicas en la evaluación de estudiantes de grado en enfermería / Nível de envolvimento de enfermeiras clínicas na avaliação de estudantes de graduação em enfermagem / Level of involvement of clinical nurses in the evaluation of competence of nursing students

Objetivo. Determinar el nivel de implicación de las enfermeras clínicas acreditadas por la Universitat Jaume I (España) como tutoras de prácticas (enfermeras de referencia) en la evaluación de competencias de los estudiantes de enfermería. Metodología.Estudio de corte transversal, en el que se analizaron las “Guías de Evaluación de Prácticas Clínicas” reportadas por 41 enfermeras de referencia (n=55). Se definieron tres criterios de calidad de la cumplimentación: que tenga información al menos del 80% de los datos requeridos, presencia de la firma y calificación final en el lugar adecuado. También se realizó la verificación de las actividades de aprendizaje. La recogida de datos se hizo de forma concurrente por las enfermeras de referencia y el profesorado de las asignaturas en las evaluaciones formativas del periodo de prácticas clínicas tuteladas de la materia “Cuidados de enfermería en procesos asistenciales” de marzo a junio de 2013. Resultados. El 63% de las Guías de Evaluación de Prácticas Clínicas se entregan cumplimentadas correctamente, sin alcanzar el umbral de calidad establecido (80%). La ausencia de la firma es el principal criterio de cumplimentación incorrecta (21%). De las 30 actividades de aprendizaje evaluadas en las guías, puede afirmarse que nueve de ellas no alcanzan el estándar de verificación establecido (80%), de forma que no puede asegurarse que estas actividades hayan sido realizadas por los alumnos y evaluadas por las Enfermeras tutoras a lo largo del periodo de prácticas clínicas. Conclusión. El nivel de implicación de las enfermeras de referencia debe mejorarse y para esto es necesario desarrollar estrategias que fomenten su implicación mediante la colaboración y la formación...

Objective. To determine the level of involvement of clinical nurses accredited by the Universitat Jaume I (Spain) as mentors of practice (Reference Nurses) in the evaluation of competence of nursing students. Methodolgy. Cross-sectional study, in which the "Clinical Practice Assessment Manual” (CPAM) reported by reference 41 nurses (n=55) were analyzed. Four quality criteria for completion were established: with information at least 80% of the required data, the presence of the signature and final grade in the right place. Verification of learning activities was also conducted. Data collection was performed concurrently reference for nurses and teachers of the subjects in the formative evaluations of clinical clerkship period in the matter "Nursing Care in Healthcare Processes ", from March to June 2013. Results. 63% of CPAM were completed correctly, without reaching the quality threshold established (80%). The absence of the signature is the main criteria of incorrect completion (21%). Nine learning activities do not meet the quality threshold set (80%) (p < 0.05). There are significant differences according to clinical units p < 0.05. From the 30 learning activities evaluated in the CPAM, it can be stated that nine of them do not reach the verification threshold established (80%), therefore it cannot be assumed that these activities had been completed by students and evaluated by the RefN throughout the clinical clerkship period. Conclusion. The level of involvement of Reference Nurse cannot be considered adequate, although strategies to encourage involvement through collaboration and training must be developed...

Objetivo. Identificar o nível de envolvimento das enfermeiras clínicas credenciadas pela Universitat Jaume I (Espanha) como tutoras de práticas (enfermeiras de referência) na avaliação de competências dos estudantes de enfermagem. Metodologia. Estudo de corte transversal, no que se analisaram as “Guia de Avaliação de Práticas Clínicas” reportadas por 41 enfermeiras de referência (n=55). Definiram-se quatro critérios de qualidade do preenchimento: que tenha informação pelo menos de 80% dos dados requeridos, presença da assinatura e qualificação final no lugar adequado. Também se realizou a verificação das atividades de aprendizagem. A recolhida de dados se realizou de forma concorrente pelas enfermeiras de referência e o professorado das matérias nas avaliações formativas do período de práticas clínicas tuteladas da matéria “Cuidados de enfermagem em processos assistenciais” de Março a Junho de 2013. Resultados. 63% das Guias de Avaliação se entregam preenchidas corretamente, sem atingir o umbral de qualidade estabelecido (80%). A ausência da assinatura é o principal critério de preenchimento incorreta (21%). Das 30 atividades de aprendizagem avaliadas nas guias, pode afirmar-se que nove delas não atingem o padrão de verificação estabelecido (80%), de forma que não pode assegurar-se que estas atividades tenham sido realizadas pelos alunos e avaliadas pelas Enfermeiras tutoras ao longo do período de práticas clínicas. Conclusão. O nível de envolvimento das enfermeiras de referência deve melhorar-se e para isto é necessário desenvolver estratégias que fomentem seu envolvimento através da colaboração e a formação...

[Intrepid: Second nursing cycle. First step, first desire in European Spain]. / Intrepidos. 2 ciclo de enfermería. Primer paso, primer anhelo en la España Europea.

When we started to write this article for ROL the first question which confronted us was first step? Why? The beginning of second cycle studies in 1998 did not correspond to any European desire, but rather consolidated a real desire which Spanish Nursing had: attain the highest possible academic title through growth inside the nursing discipline itself, having as an objective to place nursing in equal conditions as the majority of titles in the Spanish university system. This meant it was necessary to carry out research and investigation inside one's own scientific field, develop future professionals, administrate under equal conditions, and specifically consolidate a way deserving of one who bears responsibility over health care.