Impact of hospitalization on nutritional status in persons aged 65 years and over (NUTRIFRAG Study): Protocol for a prospective observational study.

BACKGROUND: Malnutrition is a recurring problem that has become more relevant in recent years. The aim of this study is to assess the risk of malnutrition and nutritional status on admission and its evolution until discharge in patients aged 65 and over admitted to medical and surgical hospitalization units in hospitals of the Spanish National Health System. METHODS: Prospective observational study to be carried out in the medical-surgical hospitalization units of 9 public hospitals between 01/09/2022 and 31/12/2024. Using consecutive sampling, a total of 4077 patients will be included (453 in each hospital). Variables included are related to the care process, functionality, cognition and comorbidity, risk profile, nutritional status and dysphagia; as well as frailty, dietary quality and contextual variables. The incidence of risk of malnutrition, undernutrition and dysphagia during the care process and at discharge will be calculated. The association with risk factors will be studied with logistic regression models and multivariate Cox regression models. In addition, an analysis of participants' satisfaction with food services will be carried out. The study was approved by the Ethics and Research Committee on 30/09/2020, approved for funding on 02/12/2021 and with registration number RBR-5jnbyhk in the Brazilian clinical trials database (ReBEC) for observational studies. DISCUSSION: Some studies address nutritional status or dysphagia in older people in various care settings. However, there is a lack of large sample studies including both processes of the impact of hospitalization. The results of the project will provide information on the incidence and prevalence of both pathologies in the study subjects, their associated factors and their relationship with the average length of stay, mortality and early readmission. In addition, early detection of a problem such as malnutrition related to the disease and/or dysphagia during a hospital stay will favor the action of professionals to resolve both pathologies and improve the health status of patients.

Impact of the implementation of best practice guidelines on nurse's evidence-based practice and on nurses' work environment: Research protocol.

AIM: To determine the impact of the Best Practice Spotlight Organization® initiative on nurses' perception of their work environment and their attitudes to evidence-based practice. DESIGN: Quasi-experimental, multicentre study. The intervention is the participation in Best Prectice Spotilight Organizations to implement Best Practice Guidelines. METHODS: The study will include seven centres in the interventional group and 10 in the non-equivalent control group, all of them belonging to the Spanish national health system. The Practice Environment Scale of the Nursing Work Index, and the Health Sciences Evidence-Based Practice Questionnaire will be administered to a sample of 1,572 nurses at the beginning of the programme and at 1 year. This 3-year study started in April 2018 and will continue until December 2021. Statistical analyses will be carried out using the SPSS 25.0. This project was approved by the Drug Research Ethics Committee of the Parc de Salut Mar and registered in Clinical Trials. DISCUSSION: The study findings will show the current state of nurses' perception of their work environment and attitudes to evidence-based practice, and possible changes in these parameters due to the programme. IMPACT: The findings could provide a strong argument for health policymakers to scale up the Best Practice Spotlight Organization® initiative in the Spanish national health system.

Del cuidado registrado al diagnóstico enfermero / From nursing care sheets to nursing diagnoses

Objetivos. Los objetivos de este estudio de tipo descriptivo y analítico son: a) clasificar las expresiones utilizadas por las enfermeras en la hoja de cuidados del paciente en el Hospital General Universitario de Alicante (HGUA) en un sistema de categorías teóricas establecido por el equipo investigador en un estudio piloto; b) analizar las expresiones prediagnósticas que registran las enfermeras del HGUA, y c) inducir los diagnósticos enfermeros más frecuentes en el HGUA a través de las actividades registradas en la hoja de cuidados. Método. Hojas de cuidados: 401. Variables: 22 categorías teóricas y expresiones prediagnósticas registradas. Análisis de contenido: expresiones agrupadas en el sistema de categorías. Resultados. Unidades de texto: 5.589. Categorías más frecuentes: control de constantes, administración de medicación, bienestar general, pruebas diagnósticas. Se inducen 33 etiquetas diagnósticas (de 656 expresiones prediagnósticas). Más frecuentes: riesgo de infección (26,07%), dolor agudo (19,97%) y deterioro de la integridad tisular/cutánea (13,11%). El análisis de las anotaciones refleja la cultura y los valores de la profesión, considerables para el cambio de la organización de trabajo en el HGUA

Objective. The aims of this descriptive analytical study were: aa) to classify the expressions used by nurses in their care plans at the Alicante General Hospital (HGUA) in a theoretical categories system designed for a pilot study by a research group; b) to analyze the pre-diagnosis expressions used by nurses in their nursing records, and c) to identify the most frequent nursing diagnoses in the HGUA through the activities recorded in care plans. Method. There were 401 nursing care sheets. Regarding the study variables, 22 theoretical categories and pre-diagnosis expressions were recorded by nurses. The contents of care plans were analyzed and expressions were grouped within the categories system. Results. There were 5,589 entries. The most frequent categories were monitoring of vital signs, drug administration, general well-being, and diagnostic tests. Thirty-three diagnostic expressions were identified from 656 pre-diagnosis expressions analyzed. The most frequent were: risk of infection (26.07%), acute pain (19.97%), and deterioration of tissue/skin integrity (13.11%). The analysis of entries reflected the culture and values of the profession, which should be taken into consideration when implementing changes in organization of work in the HGUA

El concepto de Necesidad Humanda Básica. Como aproximación a la definición del cuidado / Analysis of the concept of basic necessity as an approach to caring definition

El objetivo de este trabajo es presentar una revisión teórica del concepto de necesidad humana básica para determinar a través de los modelos de Enfermería que utilizan este concepto en sus supuestos teóricos (Orom, Watson, King, Addellah, Henderson, Levine, Roy, Gordon, NANDA, NIC y NOC) la esencia de la noción del cuidado. Al acercarse a los elementos constitutivos de las teorías y taxonomías citadas encontramos siete elementos presentes en todos los casos: (1) Respiración, (2) Mantenimiento de la energía: alimentación e hidratación, equilibrio líquidos y electrólitos, (3) Movimiento/ actividad (..) (AU)

The aim of this work is to introdice a theoretical revisión of the concept of basic human necessity in order to settle, through main Nursing models and theoretical taxonomics which use this concept in the is theoretical statements, the core of caring notion. On approaching the constituent elements of the models and taxonomics before mentioned, we find 7 elements present en ALL cases: (1) Breathing, (2) Maintaining energy (..) (AU)