Felicidad en enfermeras durante su actividad profesional / Happiness in nurses during their professional activity

Objetivo: conocer la visión de enfermeras de la Comunidad de Madrid sobre la vivencia de la profesión y el impacto que esta tiene en su felicidad. Método: estudio cualitativo fenomenológico realizado en enfermeras de la Comunidad de Madrid, las cuales fueron seleccionadas de manera intencional, buscando profesionales en activo de las principales áreas de ejercicio profesional. La recogida de la información se efectuó a través de entrevista semiestructurada. Tras la transcripción literal se procedió al análisis (codificación y generación de categorías y subcategorías). Fueron utilizados los criterios de credibilidad, transferencia, consistencia y confirmabilidad de Lincoln para garantizar la calidad del estudio. Resultados: los y las enfermeras participantes manifestaron que iniciaron sus estudios por vocación, siendo el acto de cuidar a los demás el motor de su felicidad laboral. Por otra parte, uno de los factores que impactan de manera directa en desarrollar sentimientos de frustración, insatisfacción e infelicidad en el trabajo es la falta de tiempo suficiente para brindar unos cuidados de calidad a sus pacientes, ya sea por falta de personal o por exceso de carga de trabajo. Conclusión: si bien en el ámbito individual, los y las profesionales de Enfermería son felices en el cuidado íntimo y cercano a los pacientes y sus familiares, en el ámbito colectivo, la profesión parece estar viviendo un momento de desafección e infelicidad, principalmente motivadas por aspectos externos a la propia prestación de estos cuidados, como son la gestión que se efectúa de su ejercicio diario y la imagen que existe sobre la profesión.(AU)

Objective: to understand the point of view of nurses in the Community of Madrid about their professional experience and its impact on their happiness. Method: a qualitative phenomenological study conducted in nurses from the Community of Madrid, who were purposively selected, looking for professionals currently working in the main areas of professional activity. Data collection was conducted through semistructured interviews. After verbatim transcription, there was subsequent analysis (coding and generation of categories and subcategories). Lincoln’s credibility, transferability, dependability, and confirmability criteria were used to guarantee the quality of the study. Results: the participating nurses claimed that they started studying by vocation, and the act of caring for others was the driver for their happiness at work. On the other hand, one of the factors with direct impact on the development of feelings of frustration, dissatisfaction and unhappiness at work was the lack of enough time to offer quality care to their patients, either due to lack of staff or excessive workload. Conclusion: although nursing professionals in their individual setting are happy in terms of personal and close care for patients and relatives, the profession seems to be going through a moment of disaffection and unhappiness in the collective setting, and this is mainly caused by aspects external to this provision of care, such as the management of their daily practice and the existing image of the profession.(AU)

Utilidad del modelo 5MPB-Toledo para predecir bacteriemia en el paciente anciano / Usefulness of the 5MPB-Toledo model to predict bacteremia in the elderly patient

Resumen Objetivo: Analizar la utilidad del modelo predictivo de bacteriemia (5MPB-Toledo) en los mayores de 65 años atendidos por infección en el servicio de urgencias (SU). Material y Método: Estudio observacional prospectivo y multicéntrico de los hemocultivos (HC) obtenidos en pacientes mayores de 65 años atendidos por infección en 66 SU españoles desde el 1 de diciembre de 2019 hasta el 30 de abril de 2020. Se analizó la capacidad predictiva del modelo con el área bajo la curva (ABC) de la característica operativa del receptor (COR) y se calculó el rendimiento diagnóstico de los puntos de corte (PC) del modelo elegido con los cálculos de la sensibilidad, la especificidad, el valor predictivo positivo y el valor predictivo negativo. Resultados: Se incluyeron 2.401 episodios de HC extraídos. De ellos, se consideró como bacteriemia verdadera a 579 (24,11%) y como HC negativo a 1.822 (75,89%). Entre los negativos, 138 (5,74%) se consideraron contaminados. Se categorizó a los pacientes en bajo (0-2 puntos), moderado (3-5 puntos) y alto (6-8 puntos) riesgo, con una probabilidad de bacteriemia de 1,2%, 18,1% y 80,7%, respectivamente. El ABC-COR del modelo tras remuestreo fue de 0,908 (IC 95%: 0,897-0,924). El rendimiento diagnóstico del modelo, considerando un PC ≥ 5 puntos, obtiene una sensibilidad de 94% (IC 95%:92-96), especificidad de 77% (IC 95%:76-79) y un valor predictivo negativo de 97% (IC 95%:96-98). Conclusión: El modelo 5MPB-Toledo es de utilidad para predecir bacteriemia en los mayores de 65 años atendidos en el SU por un episodio de infección.

Abstract Objective: To analyse a risk score to predict bacteremia (MPB5-Toledo) in the patients aged older 65 years seen in the emergency departments (ED) due to infections. Patients and Methods: Prospective and multicenter observational cohort study of the blood cultures (BC) ordered in 66 Spanish ED for patients aged older 65 years seen from December 1, 2019, to April 30, 2020. The predictive ability of the model was analyzed with the area under the Receiver Operating Characteristic curve (AUC-ROC). The prognostic performance for true bacteremia was calculated with the cut-off values chosen for getting the sensitivity, specificity, positive predictive value and negative predictive value. Results: A total of 2.401 blood samples wered cultured. True cases of bacteremia were confirmed in 579 (24.11%). The remaining 1.822 cultures (75.89%) wered negative. And, 138 (5.74%) were judged to be contaminated. Low risk for bacteremia was indicated by a score of 0 to 2 points, intermediate risk by 3 to 5 points, and high risk by 6 to 8 points. Bacteremia in these 3 risk groups was predicted for 1.2%, 18.1%, and 80.7%, respectively. The model´s area under the receiver ope rating characteristic curve was 0.908 (95% CI, 0.897-0.924). The prognostic performance with a model´s cut-off value of ≥ 5 points achieved 94% (95% CI: 92-96) sensitivity, 77% (95% CI: 76-79) specificity, and negative predictive value of 97% (95% CI: 96-98). Conclusion: The 5MPB-Toledo score is useful for predicting bacteremia in the patients aged older 65 years seen in the emergency departments due to infections.

A bacteraemia risk prediction model: development and validation in an emergency medicine population.

OBJECTIVE: Design a risk model to predict bacteraemia in patients attended in emergency departments (ED) for an episode of infection. METHODS: This was a national, prospective, multicentre, observational cohort study of blood cultures (BC) collected from adult patients (≥ 18 years) attended in 71 Spanish EDs from October 1 2019 to March 31, 2020. Variables with a p value < 0.05 were introduced in the univariate analysis together with those of clinical significance. The final selection of variables for the scoring scale was made by logistic regression with selection by introduction. The results obtained were internally validated by dividing the sample in a derivation and a validation cohort. RESULTS: A total of 4,439 infectious episodes were included. Of these, 899 (20.25%) were considered as true bacteraemia. A predictive model for bacteraemia was defined with seven variables according to the Bacteraemia Prediction Model of the INFURG-SEMES group (MPB-INFURG-SEMES). The model achieved an area under the curve-receiver operating curve of 0.924 (CI 95%:0.914-0.934) in the derivation cohort, and 0.926 (CI 95%: 0.910-0.942) in the validation cohort. Patients were then split into ten risk categories, and had the following rates of risk: 0.2%(0 points), 0.4%(1 point), 0.9%(2 points), 1.8%(3 points), 4.7%(4 points), 19.1% (5 points), 39.1% (6 points), 56.8% (7 points), 71.1% (8 points), 82.7% (9 points) and 90.1% (10 points). Findings were similar in the validation cohort. The cut-off point of five points provided the best precision with a sensitivity of 95.94%, specificity of 76.28%, positive predictive value of 53.63% and negative predictive value of 98.50%. CONCLUSION: The MPB-INFURG-SEMES model may be useful for the stratification of risk of bacteraemia in adult patients with infection in EDs, together with clinical judgement and other variables independent of the process and the patient.

Validation of a predictive model for bacteraemia (MPB5-Toledo) in the patients seen in emergency departments due to infections. / Validación del modelo predictivo de bacteriemia (5MPB-Toledo) en los pacientes atendidos en el servicio de urgencias por infección.

OBJECTIVE: To validate a simple risk score to predict bacteremia (MPB5-Toledo) in patients seen in the emergency departments (ED) due to infections. METHODS: Prospective and multicenter observational cohort study of the blood cultures (BC) ordered in 74 Spanish ED for adults (aged 18 or older) seen from from October 1, 2019, to February 29, 2020. The predictive ability of the model was analyzed with the area under the Receiver Operating Characteristic curve (AUC-ROC). The prognostic performance for true bacteremia was calculated with the cut-off values chosen for getting the sensitivity, specificity, positive predictive value and negative predictive value. RESULTS: A total of 3.843 blood samples wered cultured. True cases of bacteremia were confirmed in 839 (21.83%). The remaining 3.004 cultures (78.17%) were negative. Among the negative, 172 (4.47%) were judged to be contaminated. Low risk for bacteremia was indicated by a score of 0 to 2 points, intermediate risk by 3 to 5 points, and high risk by 6 to 8 points. Bacteremia in these 3 risk groups was predicted for 1.5%, 16.8%, and 81.6%, respectively. The model's area under the receiver operating characteristic curve was 0.930 (95% CI, 0.916-0.948). The prognostic performance with a model's cut-off value of ≥ 5 points achieved 94.76% (95% CI: 92.97-96.12) sensitivity, 81.56% (95% CI: 80.11-82.92) specificity, and negative predictive value of 98.24% (95% CI: 97.62-98.70). CONCLUSION: The 5MPB-Toledo score is useful for predicting bacteremia in patients attended in hospital emergency departments for infection.

Visión de la felicidad de profesionales de Enfermería en el desarrollo de su práctica profesional / View of happiness among nurses in the development of their professional practice

Objetivo: explorar la vivencia de la profesión enfermera y el impacto que esta tiene en la felicidad. Método: estudio cualitativo desarrollado a través de un grupo de discusión. Se realizó un muestreo intencional buscando perfiles representativos de la realidad enfermera en función del ámbito profesional, género, edad y años de experiencia, estableciendo como criterios de inclusión que los participantes fueran trabajadores en activo y desempeñaran su actividad profesional en la Comunidad de Madrid. Resultados: se encontraron cuatro categorías: definición de felicidad, felicidad con la profesión, factores relacionados con la felicidad en la profesión enfermera y perspectivas de futuro. Los participantes describen que lo que hace felices a las enfermeras es el cuidado del otro, el trato cercano y directo con los pacientes, sin influir el ámbito de trabajo o servicio donde desarrollan su labor, siempre que haya sido elegido por ellas. Finalmente, destacan que en el ámbito colectivo hay una situación de desafección profesional, principalmente motivada por la estructura donde trabajan y la gestión que se realiza de su trabajo. Conclusión: en el ámbito individual, el acto de cuidar a otro se ve como el factor fundamental que genera felicidad en las enfermeras, no presentando influencia el ámbito donde se desarrolla, siempre y cuando sean estas las que tengan el control de su vida profesional y el ambiente sea el adecuado. Sin embargo, desde un punto de vista colectivo, la profesión enfermera parece estar viviendo un momento de infelicidad, principalmente motivado por aspectos estructurales y de gestión de su actividad laboral

Objective: to explore the experience of the Nursing profession and its impact on happiness. Method: a qualitative study conducted through a discussion group. Intentional sampling was conducted, looking for profiles representative of the Nursing reality, based on their professional setting, gender, age, and years of experience. The inclusion criteria established were: participants should be currently working, and conducting their professional activity in the Community of Madrid. Results: four categories were found: definition of happiness, happiness with the profession, factors associated with happiness in the Nursing profession, and future prospects. The participants described that what makes nurses happy is caring for others, the close and direct contact with patients, without any influence by the setting of work or unit where they conducted their work, as long as it had been chosen by them. Finally, they pointed out that in the collective setting there is a situation of professional disaffection, mainly motivated by the structure where they work and the management of their work. Conclusion: in the individual setting, the act of caring for others is seen as the essential factor that generates happiness in nurses, without any influence by the setting where this is conducted, as long as nurses have control over their professional life and the environment is adequate. However, from a collective point of view, the nursing profession seems to be going through a moment of unhappiness, mainly motivated by structural and management aspects regarding their work activity

60 años de la aprobación del título de fisioterapia y de la primera escuela de fisioterapia reconocida, la de Salus Infirmorum en el centro infantil "Casa del Niño" de Madrid / 60 years since approval of the physiotherapy degree and the first recognized physiotherapy school, Salus Infirmorum ubicated in the children's center "Casa del Niño" in Madrid

Se acaban de cumplir 60 años de la aprobación de la especialidad de Fisioterapia para los Ayudantes Técnicos Sanitarios, así como la creación de las primeras escuelas de Fisioterapia. El presente artículo justificará cómo el conjunto de brotes epidémicos de poliomielitis en España, influyeron de forma decisiva en el nacimiento de profesiones sanitarias como la Fisioterapia. Por otro lado, se reconstruirá el proceso de institucionalización, nacimiento y desarrollo en sus primeros años de la Escuela de Fisioterapia Salus Infirmorum, la primera en ser aprobada por el Ministerio de Educación. Salus Infirmorum, con la creación del centro infantil "Casa del Niño" consiguió aunar la formación de fisioterapeutas y el tratamiento de niños con problemas motóricos como consecuencia de la poliomielitis. En el centro se atendió a más de 680 niños y se formaron en ella 373 enfermeras fisioterapeutas, siendo reconocido como Obra de interés social, por la Comisaría de Asistencia Social del Ministerio de Educación Nacional, en orden 6 de junio de 1958

Sixty years have passed since approval of the Physiotherapy specialty for licensed practical nurses, as well as the establishment of the first Physiotherapy Schools. This paper will explain how the set of epidemic outbreaks of poliomyelitis in Spain, had a decisive influence on the birth of health professions such as Physiotherapy. On the other hand, throughout it, the process of institutionalization of Salus Infirmorum, the first Physiotherapy College recognized by the Ministry of Education, its birth and its first year’s early development will be reconstructed. Salus Infirmorum, with the creation of the children’s center "Casa del Niño" managed to combine the physiotherapists training with the treatment of children with motor disorders as a result of poliomyelitis. In the healthcare center, more than 680 children were attended and 373 physiotherapist-nurses were trained, being recognized as a Social Interest Group, by the Social Assistance Commission of the Ministry of National Education, in order June 6, 1958

Nursing care in postwar Madrid / Atención enfermera en el Madrid de la posguerra / Atenção enfermeira em Madrid da pós-guerra

Objective.To describe the work of the Salus Infirmorum Sisterhood in caring for the most underprivileged individuals from the postwar outskirts of Madrid, through the voluntary service of the nurses who were part of that Institution. Methods. A historical study based on the analysis of primary sources from the Sisterhood's archives. Results. Salus Infirmorum once relied on more than 100 volunteer nurses who treated over 425-thousand people in 21 parish dispensaries located within the neediest neighborhoods of Madrid, providing both preventative and curative medical care. Nurses were offered adequate training in exchange for the care provided. Conclusion. Salus Infirmorum took healthcare to the streets of Madrid, treating patients in improvised medical clinics set up in parishes or in the patient's own home, as the situation required, in addition to training women who otherwise would not have had access to it.

Objetivo.Describir la labor realizada por la Hermandad Salus Infirmorum en la atención a los más desfavorecidos de los suburbios de la posguerra madrileña, por intermedio del voluntariado de las enfermeras de dicha institución. Metodología. Estudio histórico en el que se han analizado fuentes primarias del archivo de la entidad. Resultados. Salus Infirmorum llegó a contar con más de cien enfermeras quienes atendieron a más de 425 mil personas de forma altruista, en 21 dispensarios parroquiales de los barrios más necesitados de Madrid. En este contexto, llevaron a cabo una asistencia sanitaria de tipo preventivo y curativo a las que, además, se les ofertaba una formación adecuada para esta atención. Conclusión. Salus Infirmorum llevó el cuidado a las calles, mediante improvisados centros asistenciales en las parroquias o en el propio domicilio si la situación del enfermo lo requería; además se preocupó de preparó a mujeres que de otra manera no hubieran podido acceder a una formación académica.

Objetivo.Descrever o trabalho realizada pela Irmandade Salus Infirmorum na atenção aos mais desfavorecidos dos subúrbios da pós-guerra madrilena, através do voluntariado das enfermeiras que integravam dita instituição. Metodologia. Estudo histórico no qual se analisou fontes primárias do arquivo da entidade. Resultados. Salus Infirmorum chegou a contar com mais de cem enfermeiras que atenderam a mais de 425 mil pessoas de forma altruísta, em 21 dispensários paroquiais dos bairros mais necessitados de Madrid, levando a cabo uma assistência sanitária, de tipo preventiva e curativa, às que, ademais, se lhes ofertava uma formação adequada para esta atenção. Conclusão. Salus Infirmorum levou o cuidado às ruas, através de improvisados centros assistenciais nas paroquias ou no próprio domicílio se a situação do doente o requeresse, ademais de formar a mulheres que de outra maneira não houvesse podido acessar.

Nursing care in postwar Madrid.

OBJECTIVE: To describe the work of the Salus Infirmorum Sisterhood in caring for the most underprivileged individuals from the postwar outskirts of Madrid, through the voluntary service of the nurses who were part of that Institution. METHODS: A historical study based on the analysis of primary sources from the Sisterhood's archives. RESULTS: Salus Infirmorum once relied on more than 100 volunteer nurses who treated over 425-thousand people in 21 parish dispensaries located within the neediest neighborhoods of Madrid, providing both preventative and curative medical care. Nurses were offered adequate training in exchange for the care provided. CONCLUSION: Salus Infirmorum took healthcare to the streets of Madrid, treating patients in improvised medical clinics set up in parishes or in the patient's own home, as the situation required, in addition to training women who otherwise would not have had access to it.

Idoneidad del baremo de valoración de la situación de dependencia para determinar el ingreso en una residencia pública de la Comunidad de Madrid / Suitability of assessment degree of care dependency to determine admission to a public Nursing Home of the Region of Madrid

Objetivo: valorar el nivel de dependencia de los usuarios ingresados en una residencia pública del Servicio Regional de Bienestar Social, comparando los resultados obtenidos a través del Baremo de Valoración propuesto por la Ley, el Índice de Barthel y el Instrumento de Clasificación Funcional del Residente (basado en el RAI-NH 2.0). Método: descriptivo observacional, incluyendo todos los ingresos que se produjeron en el centro el primer año de estudio, y reevaluando los casos discordantes al año. Conclusiones: el baremo oficial ha clasificado con mayores niveles de dependencia a un porcentaje elevado de usuarios

Objective: To assess the dependency's level of users admitted to a Public Residence of the Regional Welfare Service, comparing the results obtained with the Official Rating Scale, the Barthel Index and the Functional Classification Instrument Resident (based in the RAI-NH 2.0). Method: Descriptive, observational, including all the incomes that occurred in the Center's first year of study, and reassessing the discordant cases annually. Conclusions: The Official Scale ranked higher levels of dependence on a high percentage of users