[NURSE PEDIATRIC EMERGENCY VALUATION IN PRIMARY CARE: QUALITY RECORD AND PATIENTS AND NURSES SATISFACTION WITH TOOL VEUPAP]. / Valoración enfermera de las Urgencias Pediátricas en Atención Primaria.

OBJECTIVE: To value the degree of completion of VEUPAP record, the level of satisfaction of the accompanists otcrilaren witn nursing care and nurse satisfaction. DESIGN: Descriptive study. There was valued the cumplimentation of record of global and specific form by nurse according to defined quality criteria. The satisfaction of the accompanists was valued by the AMABLE questionnaire, the nurses satisfaction with the use of VEUPAP by the CSLPS-EAP and the personal accomplishment in the work by the MBI in his validated Spanish version. RESULTS: 266 VEUPAP cases were evaluated. The general compliance of the items exceeds 95 (92-98) %, except for three items. Completion of protocols fever, respiratory distress, gastrointestinal, and abdominal pain is 95 (92-98) %, 93(90-96) %, 90 (86-94) %--and 67 (61-73) % respectively. More than 95 (93-97) % users referring to be satisfied with the nurses attention. The 100 (100-100) % of the nurses are very satisfied with their tasks and activities and personal accomplishment they get, 88(84-92) % with the quality of patient care and achievement of objectives. All feel quite satisfied with their degree of autonomy. Job instability represents 50(44-56) % of dissatisfaction. The EE is low for 94% of nurses and a medium for 6%, the DP high for 17% and low for 13% and the PA low for 53% and medium for 47%. CONCLUSIONS: Quality of registration, user satisfaction and the nurse who provides care satisfaction are three cornerstones of pediatric emeraency care. VEUPAP impacts positively on these three aspects.

Valoración enfermera de las Urgencias Pediátricas en Atención Primaria. Calidad del registro y satisfacción de usuarios y profesionales con el sistema VEUPAP / Nurse pediatric emergency valuation in primary care: quality record and patients and nurses satisfaction with tool VEUPAP

Objetivo. Valorar el grado de cumplimentación del registro VEUPAP y el nivel de satisfacción de los acompañantes de los niños y de las enfermeras con este sistema. Diseño. Estudio transversal descriptivo. Se valoró la cumplimentación del registro de forma global y específica por la enfermera según criterios de calidad definidos. La satisfacción de los acompañantes se valoró con el cuestionario AMABLE, la de las enfermeras con el CSLPS-EAP y la realización personal en el trabajo con el Maslach Bornout Inventory (MBI) en su versión validada en castellano. Resultados. Se evaluaron 266 casos registrados con VEUPAP. El cumplimiento general de los ítems supera el 95 % (92-98%), excepto en dificultad respiratoria, gastrointestinal y dolor abdominal, con 93 % (90-96 %), 90 % (86-94 %) y 67 % (61-73 %), respectivamente. Supera el 95 % (93-97 %) los usuarios que refieren estar satisfechos con la atención enfermera. El cien por cien de las enfermeras están muy satisfechas con sus tareas y actividades y la realización personal que consiguen; el 88 % (84-92 %) con la calidad de atención a los pacientes y logro de objetivos. Todas se sienten bastantes satisfechas con su grado de autonomía. La inestabilidad laboral supone un 50 % (44-56 %) de insatisfacción. El agotamiento emocional (AE) es bajo para el 94 % de las enfermeras y medio para el 6 %, la despersonalización (DP) alta para 17 % y baja para el 13 %, y la realización personal (RP) baja para el 53 % y media para el 47 %. Conclusiones. Calidad de registro, satisfacción del usuario y de la enfermera son tres piedras angulares de la atención pediátrica de Urgencias. VEUPAP incide de manera positiva sobre estos tres aspectos (AU)

Objective. To value the degree of completion of VEUPAP record, the level of satisfaction of the accompanists of children with nursing care and nurse satisfaction. Design. Descriptive study. There was valued the cumplimentation of record of global and specific form by nurse according to defined quality criteria. The satisfaction of the accompanists was valued by the AMABLE questionnaire, the nurses satisfaction with the use of VEUPAP by the CSLPS-EAP and the personal accomplishment in the work by the MBI in his validated spanish version. Results. 266 VEUPAP cases were evaluated. The general compliance of the items exceeds 95(92-98) %, except for three items. Completion of protocols fever, respiratory distress, gastrointestinal, and abdominal pain is 95(92-98) %, 93(90-96) %, 90(86-94) % and 67(61-73) % respectively. More than 95(93-97) % users referring to be satisfied with the nurses attention. The 100(100-100) % of the nurses are very satisfied with their tasks and activities and personal accomplishment they get, 88(84-92) % with the quality of patient care and achievement of objectives. All feel quite satisfied with their degree of autonomy. Job instability represents 50(44-56) % of dissatisfaction. The EE is low for 94% of nurses and a medium for 6 %, the DP high for 17 % and low for 13 % and the PA low for 53 % and medium for 47 %. Conclusions. Quality of registration, user satisfaction and the nurse who provides care satisfaction are three cornerstones of pediatric emergency care. VEUPAP impacts positively on these three aspects (AU)

[Identification of finalist nursing care in a pediatric emergency department of primary care]. / Cuidados enfermeros finalistas. Identificación en un servicio de urgencias pediátrico de atención primaria.

OBJECTIVE: To describe the characteristics of care in a pediatric emergency service to identify potential finalist nursing areas. METHOD: Cross-sectional study in 385 randomly selected patients. Sex, age, municipality of residence, kinship companion, reasons for consultation, level of urgency, care and treatment protocols prior to medical care, observation, health education, delay in care, complications during the wait, duration of care and referral needs is assesed. The calculations were performed using SPSS 17.0. RESULTS: The sample included 380 children, 63% male, ages 3 (0.5-11) years. Delay in triage was 4 (0-15) minutes and the duration of 5 (2-7). The reasons for consultation were fever 54 (49-59)%, cough 45(40-50)%, pain 14 (11-17)%, skin/mucous lesions 13 (10-16)%, vomiting 10 (7-13)%. The level distribution was for 2th triage level 5 (3-7)%, 3th level 23 (19-27)%, 4th level 28 (26-30)% and 5th level 44 (39-49)%. Care protocols were fever 20 (16-24)%, respiratory distress and vomiting/diarrhea, 7 (4-10)% and pain 3 (1-5)%. In 20% the nurse start treatment prior to consultation. 22% remained under observation. 20% received health education. There were 3% of complications. The 2% accurate referral. The 53% of the reasons for non-serious inquiries are classified as susceptible finalist care by nurse. DISCUSSION: The results expand the perspectives of finalist nursing areas. Three finalists areas are identified: with minimal protocols, previous protocol development and decision algorithms and, with limitations by actual legal framework.

Veupap (valoración enfermera de la urgencia pediátrica en atención primaria). Diseño y validación preliminar / Design and preliminary validation of a tool for nursing assessment and classification for pediatric patients in primary health care emergency. «Veupap»

Objetivo: Diseño de un instrumento de valoración y clasificación enfermera para pacientes pediátricos en urgencias de atención primaria. Diseño: Revisión bibliográfica exhaustiva de sistemas de valoración y clasificación de pacientes urgentes, trabajo en grupos de expertos, creación del instrumento y prueba de su validez, fiabilidad y facilidad de uso en condiciones habituales de funcionamiento del servicio. Emplazamiento: Servicio de urgencias pediátrico Dr. Jaime Chaves. Tenerife. Islas Canarias. Participantes: Nueve enfermeras y nueve pediatras con formación y experiencia en la atención pediátrica de urgencias. Las pruebas de validez y fiabilidad se realizan sobre una muestra de 200 pacientes pediátricos que acudían solicitando atención al Servicio de Urgencias, previa solicitud de consentimiento informado. Intervenciones: Sesiones formativas, motivacionales y de consenso del grupo experto. Con los pacientes, las enfermeras aplican el instrumento de clasificación a prueba y los pediatras su método habitual de clasificación experta. Mediciones principales: Motivos de consulta, nivel de clasificación obtenido con el instrumento por dos enfermeras de forma independiente al ingreso, nivel de clasificación otorgado por el pediatra especialista al alta. Resultados: Versión definitiva del instrumento con los campos de valoración y documentos anexos. Las pruebas de validez arrojan una sensibilidad del 100% y una especificidad del 94% y una concordancia entre enfermera y pediatra del 83%, y las de fiabilidad un acuerdo entre enfermeras del 76% (p<0,001 en general). Conclusiones: El instrumento, denominado VEUPAP (Valoración Enfermera de la Urgencia Pediátrica en Atención Primaria), resulta válido, fiable, sencillo y útil para su aplicación en atención primaria (AU)

Objective: Design a tool for nursing assessment and classification for pediatric patients in primary care emergency. Design: Comprehensive literature review of systems of evaluation and classification of urgent patients, work in groups of experts, creation of the instrument and test its validity, reliability and ease of use in normal operation conditions of service. Location: Pediatric Emergency Department Dr. Jaime Chaves. Tenerife. Canary Islands. Participants: Nine nurses and nine pediatricians with training and experience in emergency pediatric care. The validity and reliability tests are performed on a sample of 200 pediatric patients who came calling attention to the emergency service alter request informed consent. Interventions: Training sessions, motivational and expert group consensus. Nurses apply the classification tool to test at patient entry and level of classification given by the pediatrician at discharge. Results: Final version of the instrument with the fields of assessment and related documents. Validity tests show a sensitivity of 100% and a specificity of 94% and a concordance between nurse and pediatric of 83% and reliability agreement among nurses of 76% (p <0.001 in all cases). Conclusions: The instrument, called VEUPAP (Nurse Pediatric Emergency Valuation in Primary Care), is valid, reliable, simple and useful for application in primary care (AU)

Cuidados enfermeros finalistas. Identificación en un servicio de urgencias pediátrico de atención primaria / Dentification of finalist nursing care in a pediatric emergency department of primary care

Objetivo. Describir la demanda en cuidados en un servicio de urgencias pediátricas de atención primaria para identificar áreas potenciales de atención finalista enfermera. Método. Estudio descriptivo prospectivo en 385 niños de 0 a 14 años seleccionados al azar. Se valoró sexo, edad, motivos de consulta, nivel de urgencia, protocolos de cuidados y tratamientos previos a la atención médica, observación, educación sanitaria, duración y demora en la atención, complicaciones durante la espera y necesidades de derivación. Los cálculos se realizaron con SPSS 17.0. Resultados. La muestra comprendió 380 niños, 63%varones, en edades de 3 (0,5-11) años. La demora en triaje fue de 4 (0-15) minutos y la duración de 5 (2-7). Los motivos de consulta indicaron fiebre 54 (49-59)%, tos 45 (40-50)%, dolor 14 (11-17)%, lesiones en piel/mucosas 13 (10-16)%, vómitos 10 (7-13)%. La distribución por niveles fue para nivel 2 de triaje 5 (3-7)%, nivel 3, 23 (19-27)%, nivel 4, 28 (26-30)% y nivel 5, 44 (39-49)%. Los protocolos de cuidados fueron fiebre 20 (16-24)%, dificultad respiratoria y vómitos/diarreas 7 (4-10)% y, dolor 3 (1-5) %. En un 20% la enfermera inició tratamiento previo a la consulta. Un 22% permaneció en observación. El 20% recibió educación sanitaria. Se produjo un 3% de complicaciones con bajo impacto clínico. El 2% precisó derivación. El 53% de los motivos de consultas clasificados como no graves resultó susceptible de atención finalista por la enfermera. Discusión. Los resultados amplían las perspectivas de abordaje finalista de la enfermera en resolución de problemas de salud. Se identifican tres áreas finalistas: con protocolización mínima, previo desarrollo de protocolos y algoritmos de decisión, y con limitaciones según marco legal vigente (AU)

Objective: To describe the characteristics of care in a pediatric emergency service to identify potential finalist nursing areas. Method: Cross-sectional study in 385 randomly selected patients. Sex, age, municipality of residence, kinship companion, reasons for consultation, level of urgency, care and treatment protocols prior to medical care, observation, health education, delay in care, complications during the wait, duration of care and referral needs is assesed. The calculations were performed using SPSS 17.0. Results: The sample included 380 children, 63% male, ages 3 (0.5-11) years. Delay in triage was 4 (0-15) minutes and the duration of 5 (2-7). The reasons for consultation were fever 54 (49-59)%, cough 45(40-50)%, pain 14 (11-17)%, skin/mucous lesions 13 (10-16)%, vomiting 10 (7-13)%. The level distribution was for 2th triage level 5 (3-7)%, 3th level 23(19-27)%, 4th level 28 (26-30)% and 5th level 44 (39-49)%. Care protocols were fever 20 (16-24)%, respiratory distress and vomiting/diarrhea, 7 (4-10)% and pain 3 (1-5)%. In 20% the nurse start treatment prior to consultation. 22% remained under observation. 20% received health education. There were 3% of complications. The 2% accurate referral. The 53% of the reasons for non-serious inquiries are classified as susceptible finalist care by nurse. Discussion: The results expand the perspectives of finalist nursing areas. Three finalists areas are identified: with minimal protocols, previous protocol development and decision algorithms and, with limitations by actual legal framework (AU)

[Design and preliminary validation of a tool for nursing assessment and classification for pediatric patients in primary health care emergency. "VEUPAP"]. / Diseño y validación preliminar. VEUPAP. Valoración Enfermera de la Urgencia Pediátrica en Atención Primaria.

OBJECTIVE: Design a tool for nursing assessment and classification for pediatric patients in primary care emergency. DESIGN: Comprehensive literature review of systems of evaluation and classification of urgent patients, work in groups of experts, creation of the instrument and test its validity, reliability and ease of use in normal operation conditions of service. LOCATION: Pediatric Emergency Department Dr. Jaime Chaves. Tenerife. Canary Islands. PARTICIPANTS: Nine nurses and nine pediatricians with training and experience in emergency pediatric care. The validity and reliability tests are performed on a sample of 200 pediatric patients who came calling attention to the emergency service alter request informed consent. INTERVENTIONS: Training sessions, motivational and expert group consensus. Nurses apply the classification tool to test at patient entry and level of classification given by the pediatrician at discharge. RESULTS: Final version of the instrument with the fields of assessment and related documents. Validity tests show a sensitivity of 100% and a specificity of 94% and a concordance between nurse and pediatric of 83% and reliability agreement among nurses of 76% (p < 0.001 in all cases). CONCLUSIONS: The instrument, called VEUPAP (Nurse Pediatric Emergency Valuation in Primary Care), is valid, reliable, simple and useful for application in primary care.