Standardized language systems for the design of high-fidelity simulation scenarios: A Delphi study.

PURPOSE: This study aimed to identify which of the standardised Nursing Interventions Classification (NIC) activities should be used in the design of clinical cases with high fidelity simulation for educational preparation of undergraduate nursing students in non-technical skills. DESIGN AND METHODS: A three-round Delphi study was carried out: the first round with taxonomy experts, the second round with academic and clinical lecturers with limited experience in the simulation-based learning methodology, and the third round with academic and clinical lecturers having at least two years of simulation experience. The NIC interventions were grouped into two levels of competence in accordance with the undergraduate nursing degree curriculum (1st- and 2nd-year students, the "novice" level; 3rd- and 4th-year students, the "advanced" level). The NIC allows the description of nurse student competencies in multiple clinical scenarios and throughout various contexts: theory, clinical practice and simulation. FINDINGS: The experts identified 163 interventions in 8 areas as relevant and feasible, selecting 42 for the "novice" students, in Nursing Fundamentals (13) and Adult Nursing Care 1 (29), and 97 for the "advanced" students: Maternity Care and Child Health Nursing (18), Mental Health (13), Nursing Care of Older People (12), Community Health Nursing (20) and Adult Nursing Care 2 (34). In addition, 24 interventions were identified as cross-cutting, with training to be provided across all four years of the degree. CONCLUSION: A total of 163 interventions of the NIC list were selected by experts as being both relevant and feasible to nursing undergraduate education. This creates the favourable framework to design high-fidelity scenarios for the training of non-technical skills according to the competences required and in line with the health care reality. Therefore, enabling an optimal combination of theoretical education by academic lecturers with practical training by clinical lecturers and staff nurses.

[Validation of the Communication Skills Scale in nursing professionals]. / Validación de la Escala sobre Habilidades de Comunicación.

BACKGROUND: The Communication Skills Scale (CSS) is an instrument for evaluating communication skills in different health professionals; however, a differential analysis of their psychometric properties by professions and specific scales has not been performed. Therefore, the aim of the present study was to analyze the psychometric properties of the CSS and develop T-scores for the scale for nursing professionals. MATERIAL AND METHODS: We developed an instrumental study to analyze the psychometric properties of the CSS, evaluating its items, reliability, evidence of validity and its internal structure. For this purpose, a battery of questionnaires was administered, which included the CSS, the General Self-efficacy Scale and the Specific Self-efficacy Scale for communication in difficult situations. RESULTS: The questionnaires were applied to 692 nurses. Discrimination indices >0,30 were obtained in all items. The confirmatory factor analysis of the two models (with four oblique factors and adding a second-order factor) revealed that all items had adequate factor loadings and the fit indices of both models were good. The internal consistency was 0,88 for the total scale and between 0,70 and 0,77 for the dimensions. A positive relationship between communication skills and general and specific self-efficacy was obtained. CONCLUSION: The CSS displayed appropriate psychometric properties (item analysis, internal structure, reliability and evidence of validity), relating the communication skills of nurses with their general and specific self-efficacy in communication in difficult situations.

Acquired neuromuscular dysfunction in the intensive care unit. / Disfunción neuromuscular adquirida en la unidad de cuidados intensivos.

INTRODUCTION: Polyneuropathy and myopathy, grouped under the term «intensive care unit-acquired weakness¼ (ICUAW), are neuromuscular pathologies to which patients in the intensive care unit (ICU) are susceptible. They are multifactorial pathologies, prolonged connection to a ventilator is one of the most common. The objective of this review was to identify the efficacy of different rehabilitative treatments in patients with ICUAW, and the relationship between ICUAW and a series of indicators. METHODS: A systematic review of the primary studies selected from the Medline, Scielo, Web of Science, Cochrane, Cuiden and Science Direct databases was carried out, following the guidelines of the PRISMA statement, by which the search protocol was established. RESULTS AND CONCLUSIONS: Of 161 articles, only 10 were selected to be part of this review, in which a total of 717 patients admitted to the ICU were studied. A statistically significant relationship was observed between ICUAW and failure in ventilator disconnection, mortality, increase in ICU stay and the time that the patients required mechanical ventilation. Moreover, all this improved in this type of patients with the application of a rehabilitation therapy. The use of corticosteroids, was not shown to be related to neuromuscular alteration.

Discovering mental models and frames in learning of nursing ethics through simulations.

The acquisition of ethical competence is necessary in nursing. The aims of the study were to analyse students' perceptions of the process of learning ethics through simulations and to describe the underlying frames that inform the decision making process of nursing students. A qualitative study based on the analysis of simulated experiences and debriefings of six simulated scenarios with ethical content in three different groups of fourth-year nursing students (n = 30), was performed. The simulated situations were designed to contain ethical dilemmas. The students' perspective regarding their learning and acquisition of ethical competence through simulations was positive. A total of 15 mental models were identified that underlie the ethical decision making of the students. The student's opinions reinforce the use of simulations as a tool for learning ethics. Thus, the putting into practice the knowledge regarding the frames that guide ethical actions is a suitable pedagogical strategy.

[Communication skills: a preventive factor in Burnout syndrome in health professionals]. / Las habilidades de comunicación como factor preventivo del síndrome de Burnout en los profesionales de la salud.

BACKGROUND: Health professionals are a group that suffers high levels of job stress and burnout. The aim of this study is to demonstrate empirically that the healthcare count on communication skills helps prevent Burnout Syndrome. METHOD: An observational, analytical, cross-sectional study was proposed, involving a sample of 927 health professionals (197 doctors, 450 nurses and 280 auxiliary nurses). Participants completed questionnaires measuring communication skills in health care (EHC-PS) and the Maslach Burnout Inventory Human Services Survey (MBI-HSS). RESULTS: A negative and statistically significant correlation between the different dimensions of communication skills and emotional exhaustion and depersonalization dimensions of burnout was obtained. On the other hand, a positive and statistically significant correlation between the dimensions of communication skills and the personal accomplishment dimension of burnout was observed. CONCLUSIONS: It was shown that the communication skills of health professionals provide protection from and cushion Burnout Syndrome.