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.

Treatment of minor health problems by primary care nurses: A cross-sectional study.

AIMS: To assess the results of a nursing-led program to treatment of minor health issues from Catalan health institute primary care teams during 2019 and 2020. BACKGROUND: In 2009, the Catalan health institute implemented a nursing program to deal with minor health problems. This nursing-led program includes an algorithm for each of the minor health problems and arose as a strategy to reorganise the flow of demand for care in primary care. DESIGN: A cross-sectional design. METHODS: Multicentric cross-sectional study. 392 primary care teams from the Catalan health institute participated in the study. STROBE guideline was followed in reporting this study. Patients attending any of the participating centres requesting a same-day consultation for minor health issues were registered. RESULTS: A total of 21,215,278 consultations were recorded: 18,284,105 for adult and 2,931,173 for paediatric patients. Minor health issue resolved by the nurse was achieved in 50.9% of adult patients and 55.4% of paediatric patients. The highest rates of resolution in adults (>85%) were as follows: burns, emergency contraception and injuries. The highest resolution rates (>84%) were as follows: burns, breastfeeding difficulties and infant colic. 87.7% of prescriptions issued by nurses were accepted by the family physician. CONCLUSIONS: The nursing-led program to treat minor health issues has been shown to present acceptable resolution for nurses in a large primary care setting. Nurses have been carrying out prescription activities with very favourable results. RELEVANCE TO CLINICAL PRACTICE: This study demonstrates that care provided to patients by nurses for minor health issues requiring preferential resolution is effective. Our results are useful in that they confirm both the effectiveness of the nursing-led program for minor health issues and the pharmacological prescriptions produced during patient appointments. PATIENT OR PUBLIC CONTRIBUTION: Patient's data were obtained through a program records system after the minor health issues appointments.

Quality of professional life of primary healthcare nurses: A systematic review.

AIMS: To identify and critically appraise the available evidence on the overall quality of professional life of primary care nurses worldwide and its main influencing factors. BACKGROUND: Quality of professional life of healthcare workers is a keystone that influences the quality of healthcare services provided by healthcare organisations. Nurses have a key role as healthcare services providers given the growing shortage of doctors in primary care. DESIGN: A systematic review design in accordance with the PRISMA statement. METHODS: The search was conducted through MEDLINE (PubMed), CINAHL, SCOPUS, Scientific Electronic Library Online (SciELO) and Web of Science databases. The grey literature was reviewed at OpenGrey. The search was limited to human studies published from April 2010-April 2020. No limit of original language publication was applied. Three independent reviewers analysed the methodological quality of the studies. RESULTS: Ten studies were included from five countries. Five studies reported nurses were satisfied with their quality of professional life and the influencing factors identified were Workload, Job autonomy, Demographic variables, Management support, Recognition, Intrinsic motivation, Interpersonal relations, Compassion fatigue, Burnout, Turnover intention, and work was reported as a component of Quality of life. CONCLUSION: Primary healthcare nurses reported a high level of quality of professional life, but the scarce studies found do not provide solid consistency to assess the overall quality of professional life. Perception of high workload was the most frequently identified factor to negatively influence the quality of professional life of nurses. RELEVANCE TO CLINICAL PRACTICE: Quality of professional life of primary care nurses is a key issue because of nurses' important relation with patient's care and satisfaction. Healthcare organisations should strive to address primary care nurses' quality of professional life to enhance their well-being and consequently patients' safety and high-quality healthcare services.

Paediatric nursing clinical competences in primary healthcare: A systematic review.

AIMS: To identify and critically appraise the available evidence on paediatric nurses' clinical competencies performed autonomously regarding disease prevention and health promotion activities for children and adolescents in primary healthcare worldwide. DESIGN: A systematic review design in accordance with the Preferred Reporting Items Systematic Reviews and Meta-Analyses statement. DATA SOURCES: The search was conducted through MEDLINE (PubMed), Cumulative Index to Nursing and Allied Health Literature, SCOPUS, The Cochrane Library, Scientific Electronic Library Online, Web of Science and The Joanna Briggs Institute EBP (Ovid) databases. The grey literature was reviewed at OpenGrey. Additional studies were located through a references list of selected studies identified on first search. REVIEW METHODS: Database search employed MeSH terms: (paediatric nursing) AND (primary healthcare) AND ((clinical skills) OR (clinical competences)). Studies published from inception to October 2019 exploring paediatric nurses' clinical competencies in primary healthcare were eligible for inclusion. No language restrictions were applied in the main search. Selection was made by two reviewers independently. Three independent reviewers assessed the methodological quality of included studies. RESULTS: Eighteen studies were included from six countries. The most common nursing competencies independently performed identified and described in studies were Health education and advice, Child and adolescent health and development assessment, Immunizations and Child health checks. CONCLUSION: Studies describe clinical competencies of nurses in children care. No consistent scientific evidence is available about clinical competencies of paediatric nurses performed autonomously in primary care. IMPACT: Few scientific studies identifying and assessing nurses' child primary healthcare skills were found and therefore recorded. Studies describe nurses' clinical skills in childhood, but results do not show firm consistency assessing their practice scope. Health policy-makers should encourage the development of nurses' competencies if they wish to preserve quality and equity of healthcare services to children. Therefore, the first step is to identify the autonomous competencies of paediatric nurses in primary care.

La enfermera de pediatría de atención primaria, referente de salud para los pacientes y las familias en la edad infantojuvenil / Primary care nurse in pediatrics, a reference of health for patients and families in infants-youth age

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El control del asma bronquial en niños atendidos en un centro de Atención Primaria / Control of bronchial asthma in children seen in a Primary Care Centre

Objetivos Los objetivos de este estudio fueron conocer el grado de control del asma bronquial en niños entre 6 y 14 años atendidos en un centro de Atención Primaria. Método Estudio descriptivo transversal que incluyó a niños de entre 6 y 14 años diagnosticados de asma bronquial, atendidos por un equipo de Atención Primaria del área metropolitana de Barcelona. La determinación del control del asma bronquial se realizó mediante el test de control del asma (TCA). Se consideró que tenían un buen control del asma los niños que obtenían una puntuación en el TCA superior a 20. Resultados Se encuestaron un total de 46 pacientes (45% niñas y 55% niños), con una edad media de 8,9 (DE 2,8) años. La prevalencia del asma mal controlada fue del 41,3%. Un 36% de los niños tenían antecedentes familiares de asma y un 43% de los niños refirieron tener dificultades para realizar actividad física. Conclusiones El alto porcentaje de mal control del asma bronquial en niños plantea la necesidad de revisar la efectividad de los protocolos de intervención existentes para mejorar su control (AU)

Objectives: This study aimed to assess the level of asthma control in children aged 6 to 14 years old in a Primary Care Centre. Methodology: A cross-sectional descriptive study was conducted on asthmatic children aged 6 to14 years old followed up in a Primary Health Care Centre in a metropolitan area of Barcelona. The Asthma Control Test (ACT) was the tool used to measure asthma control. Asthma was considered to be well controlled with an ACT score >20. Demographic and disease specific data were also collected. Results: A total of 46 patients (45% girls, 55% boys) completed the ACT. Their mean age was 8,9 years (SD 2.8). The prevalence of poorly controlled asthma was 41.3%. A family history of asthma was found in 36% of the children, and 43% of them declared to have activity limitations. Conclusions: The high percentage of poorly controlled asthma in children raises the need for reviewing the effectiveness in the processes to improve asthma control in these patients (AU)

[Control of bronchial asthma in children seen in a primary care centre]. / El control del asma bronquial en niños atendidos en un centro de Atención Primaria.

OBJECTIVES: This study aimed to assess the level of asthma control in children aged 6 to 14 years old in a Primary Care Centre. METHODOLOGY: A cross-sectional descriptive study was conducted on asthmatic children aged 6 to 14 years old followed up in a Primary Health Care Centre in a metropolitan area of Barcelona. The Asthma Control Test (ACT) was the tool used to measure asthma control. Asthma was considered to be well controlled with an ACT score >20. Demographic and disease specific data were also collected. RESULTS: A total of 46 patients (45% girls, 55% boys) completed the ACT. Their mean age was 8,9 years (SD 2.8). The prevalence of poorly controlled asthma was 41.3%. A family history of asthma was found in 36% of the children, and 43% of them declared to have activity limitations. CONCLUSIONS: The high percentage of poorly controlled asthma in children raises the need for reviewing the effectiveness in the processes to improve asthma control in these patients.