Professional profile and work conditions of nurses working in intensive care units: A multicentre study.

AIM: To determine the professional profile and the work conditions of nurses working in intensive care units (ICU) in Colombia, Argentina, Peru and Brazil. BACKGROUND: ICUs require a differentiated professional profile to provide quality care, and appropriate working conditions, leading to a transformation of care and management practices. DESIGN: Descriptive multicentre cross-sectional observational study. METHODS: An online survey was applied to identify both the characteristics of the professional profile and the working conditions. 1,427 ICU nursing professionals were included. RStudio statistical software was used for the analysis of the information. Descriptive statistics were used for the presentation of the results. The STROBE checklist for cross-sectional studies was used in this study. RESULTS: Only 33.6% of the professionals had a specialisation degree in intensive care. The skills that were most frequently put into practice were communication (68.5%) and care management (78.5%). The most predominant nurse-to-patient ratios were 1:2, and greater than 1:6. 59.1% of the nurses had an indefinite term contract, 38.8% worked 48 hours per week and 49.8% had rotating shifts. Only 50.4% of them received incentives. The average salary ranged between 348 and 1,500 USD. 64.5% of the participants were satisfied with their job. CONCLUSION: It is necessary to strengthen nurses' professional profile by promoting both postgraduate education and the development of troubleshooting and teamwork skills. It is necessary to standardise the nurse-to-patient ratio, improve wages and increase incentives to achieve greater job satisfaction. RELEVANCE TO PRACTICE: The knowledge and the improvement of both the professional profile and the work conditions of nurses working in intensive care units will improve the quality of the care given to critical patients and, therefore, the quality of health outcomes.

Efecto de un plan de alta de enfermería para mejorar el autocuidado en los pacientes con falla cardiaca / Effect of a Nursing Discharge Plan to Improve Self-care in Patients with Heart Failure / Efeito de um plano de alta de enfermagem para melhorar o autocuidado em pacientes com insuficiência cardíaca

Introducción: la falla cardiaca (FC) es una enfermedad de alto impacto en la calidad de vida de las personas. Por lo que es necesario el desarrollo de estrategias que promuevan el autocuidado desde la hospitalización y que apoyen el proceso de transición. Objetivo: determinar el efecto que tiene un plan de alta de enfermería en el nivel de autocuidado de los pacientes con FC que se encuentran hospitalizados de enero a noviembre de 2019. Metodología: ensayo clínico controlado con una muestra de 64 pacientes. Se aleatorizaron al plan de alta o al seguimiento usual. Para la medición del nivel de autocuidado se utilizó la escala europea de autocuidado con una alfa de Cronbach de 0,7. Se realizó un análisis descriptivo con tablas de frecuencias y de distribución porcentual y la prueba no paramétrica U de Mann Whitney. Resultados: antes de aplicar el plan de alta, se determinó que el 90,2 % de los pacientes del grupo control e intervención tenían un nivel bajo de autocuidado. Posterior a la aplicación del plan de alta se observó una mejoría estadísticamente significativa (p: 0,000) en el nivel de autocuidado. Conclusiones: el plan de alta tuvo un efecto beneficioso en el nivel de autocuidado gracias a sus componentes educativos, motivacionales, de refuerzo de conductas y gestión de síntomas. Este permitió que los pacientes asumieran un rol activo en la modificación de sus conductas para promover la salud.

Introduction: Heart failure (HF) is a disease with a high impact on people's quality of life. Therefore, it is necessary to develop strategies that promote self-care from hospitalization and support the transition process. Objective: To determine the effect of a nursing discharge plan on the level of self-care of patients with HF who are hospitalized from January to November 2019. Methodology: Controlled clinical trial with a sample of 64 patients. They were randomized to discharge plan or usual follow-up. To measure the level of self-care, the European Self-Care Scale was used with a Cronbach's alpha of 0.7. A descriptive analysis was performed with tables of frequencies and percentage distribution and the non-parametric Mann Whitney U test. Results: Before applying the discharge plan, it was determined that 90.2 % of the patients in the control and intervention groups had a low level of self-care. After applying the discharge plan, a statistically significant improvement (p: 0.000) was observed in the level of self-care. Conclusions: The discharge plan had a beneficial effect on the level of self-care thanks to its educational, motivational, behavioral reinforcement and symptom management components, allowing patients to assume an active role in modifying their behaviors to promote health.

Afrontamiento de docentes de enfermería ante la muerte del paciente en unidades de cuidado crítico / Coping with Nursing Teachers in the Front of Patient Death in Critical Care Units / Enfrentamento de docentes de enfermagem frente à morte do paciente em unidades de cuidado crítico

Introducción. La muerte es un fenómeno que preocupa a la humanidad, por tanto, es objeto de cuidado por enfermería como parte de las competencias inherentes a la disciplina. Objetivo. Describir el nivel de afrontamiento de las enfermeras frente a la muerte de pacientes en unidades de cuidado crítico. Método. Estudio piloto observacional, de tipo descriptivo transversal, con método de muestreo probabilístico, teniendo en cuenta el número de enfermeras que se desempañaban como docentes de enfermería en el área de cuidado crítico de cuatro universidades de Pereira y Manizales (n = 30). Se aplicó encuesta autoadministrada, elaborada por las investigadoras, con datos sociodemográficos, curriculares y del perfil docente. Para evaluar el nivel de afrontamiento, se utilizó la escala de Bugen de afrontamiento de la muerte, validada al castellano. Resultados. El 100% de docentes de enfermería tuvo una experiencia cercana a la muerte con algún ser querido, y el 73,3% no había tenido ninguna preparación como enfermera acerca de la muerte, lo que se puso de manifiesto según la escala de Bugen, donde el 36,8% (n = 11) de la población puntuó por debajo del percentil 33, el 33,4% (n = 10) de la población por encima del percentil 66, y el 29,9% (n = 9) puntuó en la zona intermedia. Conclusión. Las enfermeras necesitan mejorar su nivel de afrontamiento ante la muerte, mediante una formación sólida en cuidados integrales al final de la vida y el buen morir, para lograr competencias específicas que puedan ser enseñadas en los actos docentes de manera consciente.

Introduction. The death is a phenomenon, it has always worried humanity, so it is the object of nursing care as part of the inherent competencies of the discipline. Objective. To describe the nurses' level of coping with the death of patients in critical care units. Method. Pilot study observational, descriptive transversal study, the sampling method was probabilistic, taking into account the number of nurses who performed as Nursing teachers in the critical care area of ​​four universities in Pereira and Manizales (n = 30). A self-administered survey was applied, prepared by the researchers, with sociodemographic, curricular and teaching profile data, and to assess the level of coping, the Bugen scale of coping with death, validated in Spanish, was used. Results. The 100% teachers had near-death experience with a family member and the 73,3% had not preparation about the death, which was revelated by the Bugen scale. The 36,8% (1) of the population scored below the percentile 33 and 33,4% (2) of the population scored upper the percentile 66 and 29,9% (3) in the average zone. Conclusion. The nurses need to improve their level of coping with death, through solid training in comprehensive care at the right to die, to achieve specific competencies that can be consciously teach.

Introdução. A morte é um fenômeno que preocupa a humanidade, portanto, é objeto dos cuidados de enfermagem no âmbito das competências inerentes à disciplina. Objetivo. Descrever o nível de enfrentamento do enfermeiro frente à morte de pacientes em unidades de cuidado crítico. Método. Estudo piloto observacional, de tipo descritivo transversal, com método de amostragem probabilística, considerando o número de enfermeiros que atuavam como docentes de enfermagem na área de cuidado crítico de quatro universidades de Pereira e Manizales (n= 30). Inquérito autoaplicado elaborado pelas pesquisadoras foi aplicado, com dados sociodemográficos, curriculares e do perfil docente. Para avaliar o nível de enfrentamento foi utilizada a escala de Bugen de enfrentamento da morte, validada em espanhol. Resultados. 100% de docentes de enfermagem teve uma experiência de quase morte com um ente querido e 73.3% não teve preparo nenhum como enfermeira de quase morte, o que foi revelado de acordo com a escala de Bugen, onde 36.8% (n = 11) da população pontuou por abaixo do percentil 33, 33.4% (n = 10) da população acima do percentil 66 e 29.9% (n= 9) pontuou na zona intermediaria. Conclusão. O enfermeiro precisa melhorar o seu nível de enfrentamento à morte, por meio de uma sólida formação no cuidado integral no final da vida e o bom morrer para alcançar competências específicas que possam ser ensinadas nos atos docentes de maneira consciente.