[Evolution of adherence to hand hygiene in health care professionals in a third level hospital in relation to the SARS-CoV-2 pandemic]. / Evaluación de la adherencia a la higiene de manos en profesionales sanitarios en un hospital de tercer nivel en relación con la pandemia de SARS-CoV-2.

OBJECTIVE: Proper hand hygiene is the main measure in the prevention and control of infection associated with healthcare. It describes how the pandemic period of 2020 has influenced the evolution of the degree of compliance with hand hygiene practices in health professionals at the Hospital Universitario Insular de Gran Canaria with respect to previous years. METHODS: Descriptive cross-sectional study of direct observation on compliance with the five moments of hand hygiene in the 2018-2020 period. Adherence is described with the frequency distribution of the different moments in which it was indicated. RESULTS: Total adherence has increased from 42.5% in 2018, to 47.6% in 2019, and 59.2% in 2020 (p <0.05). Total adherence was greater in the moments after contact with the patient (67%) than in the moments before contact (48%). The area with the highest adherence was dialysis (83%). There is a greater adherence in open areas than in hospitalization areas (65% vs 56%). Higher adherence was determined in physicians (73%) and nurses (74%), than in nursing assistants (50%) (p<0.05). CONCLUSIONS: In 2020 there was an increase in adherence to hand hygiene compared to previous years. A higher percentage of adherence was determined in physicians and nurses than in nursing assistants. We consider that the current SARS-CoV-2 pandemic has played a relevant role in this increase in adherence.

Trends and risk factors for infant mortality in the Lao People's Democratic Republic.

A high infant mortality rate (IMR) indicates a failure to meet people's healthcare needs. The IMR in Lao People's Democratic Republic has been decreasing but still remains high. This study aimed to identify the factors involved in the high IMR by analyzing data from 53,727 live births and 2189 women from the 2017 Lao Social Indicator Survey. The estimated IMR decreased from 191 per 1000 live births in 1978-1987 to 39 in 2017. The difference between the IMR and the neonatal mortality rate had declined since 1978 but did not change after 2009. Factors associated with the high IMR in all three models (forced-entry, forward-selection, and backward-selection) of multivariate logistic regression analyses were auxiliary nurses as birth attendants compared to doctors, male infants, and small birth size compared to average in all 2189 women; and 1-3 antenatal care visits compared to four visits, auxiliary nurses as birth attendants compared to doctors, male infants, postnatal baby checks, and being pregnant at the interview in 1950 women whose infants' birth size was average or large. Maternal and child healthcare and family planning should be strengthened including upgrading auxiliary nurses to mid-level nurses and improving antenatal care quality.

Tecnologías Avanzadas e Inteligencia Artificial: reflexión sobre desarrollo, tendencias e implicaciones para la Enfermería / Advanced Technologies and Artificial Intelligence: reflexión about development, tendencies and implications for Nursing

El objeto del presente artículo constituye una reflexión respecto al desarrollo y tendencias de las Tecnologías Avanzadas y la Inteligencia Artificial y su impacto en la enfermería en su esencia de cuidar. Plantea ante todo el debate para preparar a las nuevas generaciones de estudiantes de enfermería. Es un ensayo en el que hemos tratado de realizar un abordaje general a la luz de algunos autores en artículos, libros, e incluso artículos de divulgación de periódicos relacionadas con la temática. Se propone que se inicie un amplio debate acerca de los posibles beneficios, perjuicios e incógnitas que se plantean para las próximas generaciones en enfermería

The purpose of this article is a reflection on the development and trends of Advanced Technologies and Artificial Intelligence and its impact on nursing in its essence of care. Above all, it raises the debate to prepare the new generations of nursing students. It is an essay in which we have tried to make a general approach in the light of some authors in articles, books, and even newspaper articles related to the subject. Benefits and risks of the technological advances for the future are pointed out and makes a suggestion to discuss the subject considering the next generations in nursing

Relationship between nurses' perceptions of nursing assistant roles and information-sharing behaviors: A cross-sectional study.

Information-sharing between nurses and nursing assistants is necessary for appropriate inpatient care. Nurses who perceive nursing assistant roles highly may display positive behaviors related to information-sharing with nursing assistants. This study aims to examine the relationship between nurses' perceptions of nursing assistant roles and the frequency of their sharing information with nursing assistants. Using a self-administered, cross-sectional survey questionnaire, data from 2,642 nurses in 182 hospitals were collected. Nurses' perceptions of nursing assistant roles were measured with a scale containing four factors: (i) improving patients' abilities through daily care; (ii) caring for various patients using broad perspectives; (iii) facilitating co-ordination and co-operation among team members; and (iv) increasing the amount of information on patients among team members. Information-sharing behaviors included "expressing," "asking," "linguistic response," and "feedback." Multiple regression analyses for each nurse's information-sharing behaviors were conducted. Nurses' perceptions of nursing assistant roles were positively correlated with the frequency of sharing information with nursing assistants. The degree of the correlations differed, depending on the type of information-sharing behavior. Therefore, improving nurses' understanding of nursing assistant roles might increase their information-sharing behaviors.

Analysis of the guiding rules of the nurse technician's practice in Brazil.

OBJECTIVES: to analyze the normative bases that guide the nurse technician's practice, clarifying how the performance of this category happens. METHODS: this is a qualitative study of exploratory and descriptive nature and of documentary type, held on the basis of the resolutions of the Brazilian Federal Nursing Council (Cofen). From a total of 364 resolutions published from 1975 to 2018, 15 accounted for the objective of the study and were therefore selected. RESULTS: this study systematized two analytical categories: areas of practice of the nurse technician, according to Cofen resolutions; and description of the professional's activities based on the resolutions. FINAL CONSIDERATIONS: the analysis of the normative bases that guide the nurse technician's practice leads to the conclusion of a possible frailty of theoretical and normative content to justify the practice of these professionals.

Analysis of the guiding rules of the nurse technician's practice in Brazil / Análisis de las normativas que guían la práctica del técnico de enfermería en Brasil / Análise das normativas orientadoras da prática do técnico de enfermagem no Brasil

ABSTRACT Objectives: to analyze the normative bases that guide the nurse technician's practice, clarifying how the performance of this category happens. Methods: this is a qualitative study of exploratory and descriptive nature and of documentary type, held on the basis of the resolutions of the Brazilian Federal Nursing Council (Cofen). From a total of 364 resolutions published from 1975 to 2018, 15 accounted for the objective of the study and were therefore selected. Results: this study systematized two analytical categories: areas of practice of the nurse technician, according to Cofen resolutions; and description of the professional's activities based on the resolutions. Final Considerations: the analysis of the normative bases that guide the nurse technician's practice leads to the conclusion of a possible frailty of theoretical and normative content to justify the practice of these professionals.

RESUMEN Objetivos: evaluar los fundamentos de las normativas que guían la práctica del profesional técnico de enfermería para aclarar cómo ocurre la actuación de esa categoría. Métodos: se trata de un estudio de enfoque cualitativo, de naturaleza exploratoria y descriptiva, de tipo documental, realizado con base en las resoluciones del Consejo Federal de Enfermería. De un total de 364 resoluciones publicadas en el período de 1975 a 2018, se seleccionaron 15 que cumplían con el objetivo del estudio. Resultados: se sistematizaron dos categorías analíticas: el nivel de actuación del técnico de enfermería, según exponen las resoluciones del Consejo Federal de Enfermería, y la descripción de las actividades del profesional con base en estas resoluciones. Consideraciones Finales: el análisis de los fundamentos de las normativas que guían la práctica del técnico de enfermería apunta a una posible debilidad de contenido teórico y normativo para fundamentar la práctica de estos profesionales.

RESUMO Objetivos: analisar os fundamentos normativos que orientam a prática do profissional técnico de enfermagem, esclarecendo como se dá a atuação dessa categoria. Métodos: trata-se de um estudo de abordagem qualitativa, de natureza exploratório-descritiva, do tipo documental, realizado com base nas resoluções do Conselho Federal de Enfermagem. De um total de 364 resoluções publicadas no período de 1975 a 2018, foram selecionadas 15 que atenderam ao objetivo do estudo. Resultados: foram sistematizadas duas categorias analíticas: âmbitos de atuação do técnico de enfermagem, segundo as resoluções do Conselho Federal de Enfermagem, e descrição das atividades do profissional com base nas resoluções. Considerações Finais: a análise dos fundamentos normativos que orientam a prática do técnico de enfermagem guia para a conclusão de possível fragilidade de conteúdo teórico e normativo para fundamentar a prática desses profissionais.

Nurse researchers and nursing assistants: construction and projection of polymorphous identities.

OBJECTIVE: To understand the meanings that nurse researchers and nursing assistants attribute to one another, and to the development of research produced by Nursing. METHOD: Qualitative research. The Grounded Theory and the Complexity Theory were used as theoretical and methodological frameworks, respectively. Ten nursing assistants and six research nurses participated in the research. The semi-structured interview was used as a data collection technique. The results were categorized by comparative analysis and validated by ten judges. RESULTS: The valuation of nursing care research as well as interactions between research development and nursing care may be related to the way nursing assistants and nurse researchers perceive themselves. These perceptions are multifaceted. CONCLUSION: The meanings nurse researchers and nursing assistants attribute to each other reveal mechanisms of closeness and distance between these actors, as well as between research and nursing care.

Nurse researchers and nursing assistants: construction and projection of polymorphous identities / Enfermero investigador y enfermero asistencial: construcción y proyección de identidades polimorfas / Enfermeiro pesquisador e enfermeiro assistencial: construção e projeção de identidades polimorfas

ABSTRACT Objective: To understand the meanings that nurse researchers and nursing assistants attribute to one another, and to the development of research produced by Nursing. Method: Qualitative research. The Grounded Theory and the Complexity Theory were used as theoretical and methodological frameworks, respectively. Ten nursing assistants and six research nurses participated in the research. The semi-structured interview was used as a data collection technique. The results were categorized by comparative analysis and validated by ten judges. Results: The valuation of nursing care research as well as interactions between research development and nursing care may be related to the way nursing assistants and nurse researchers perceive themselves. These perceptions are multifaceted. Conclusion: The meanings nurse researchers and nursing assistants attribute to each other reveal mechanisms of closeness and distance between these actors, as well as between research and nursing care.

RESUMEN Objetivo: Comprender los significados que enfermeros investigadores y enfermeros asistenciales atribuyen el uno al otro, y al desarrollo de la investigación producida por la enfermería. Método: Investigación cualitativa. La Teoría Fundamentada en los Datos y el Paradigma de la Complejidad se utilizaron como referenciales teóricos y metodológicos, respectivamente. Participaron de la investigación diez enfermeros asistenciales y seis enfermeros investigadores. La entrevista semiestructurada fue utilizada como técnica de recolección de datos. Los resultados fueron categorizados por análisis comparativos y validados por diez jueces. Resultados: La valoración de la investigación por enfermeros asistenciales, así como interacciones entre el desarrollo de la investigación y asistencia de enfermería puede estar relacionado a la forma como enfermeros asistenciales y enfermeros investigadores se perciben. Estas percepciones se presentan de forma multifacética. Conclusión: Los significados que enfermeros encuestados y enfermeros asistenciales atribuyen uno al otro revelan mecanismos de aproximación y distanciamiento entre esos actores, así como entre la investigación y la asistencia de enfermería.

RESUMO Objetivo: Compreender os significados que enfermeiros pesquisadores e enfermeiros assistenciais atribuem um ao outro, e ao desenvolvimento da pesquisa produzida pela Enfermagem. Método: Pesquisa qualitativa. A Teoria Fundamentada nos Dados e o Teoria da Complexidade foram utilizados como referenciais teóricos e metodológicos, respectivamente. Participaram da pesquisa dez enfermeiros assistenciais e seis enfermeiros pesquisadores. A entrevista semiestruturada foi utilizada como técnica de coleta de dados. Os resultados foram categorizados por análise comparativa e validados por dez juízes. Resultados: A valorização da pesquisa por enfermeiros assistenciais, bem como interações entre o desenvolvimento da pesquisa e assistência de enfermagem pode estar relacionado à forma como enfermeiros assistenciais e enfermeiros pesquisadores se percebem. Essas percepções se apresentam de forma multifacetada. Conclusão: Os significados que enfermeiros pesquisados e enfermeiros assistenciais atribuem um ao outro revelam mecanismos de aproximação e distanciamento entre esses atores, bem como entre a pesquisa e a assistência de enfermagem.

If nursing associates are here to stay, get involved.

Like the idea or not - and professional opinion appears to be divided - nursing associates are coming. It was announced last week that about 1,000 students will be enrolled on courses next year, before starting work at a selection of test sites that are yet to be identified.

Is the nursing associate role an innovation or a step backwards?

A new support role is designed to open up the profession, but some say it will undermine nurses and assistant practitioners. Petra Kendall-Raynor reports.

Applying a palliative care approach in residential care: effects on nurse assistants' work situation.

OBJECTIVES: The aim was to investigate the effects of an intervention that applies a palliative care approach in residential care upon nurse assistants' level of strain, job satisfaction, and view of leadership. METHOD: A quasi-experimental, pretest and posttest design was used. Study circles with workshops involving nurse assistants (n = 75) and their superiors (n = 9) focusing on emotional and existential issues in palliative care were evaluated using a questionnaire answered by the nurse assistants at baseline (November 2009), post-intervention (May 2010), and six-month follow-up (November 2010) in comparison with controls (n = 110). RESULTS: Directly after the intervention, the job satisfaction of the nurse assistants decreased and they perceived the leadership more negatively than before the intervention. Six months later, strain as a result of criticism from residents and their superiors and having difficulty in balancing emotional involvement had decreased. SIGNIFICANCE OF RESULTS: The intervention initially seemed to decrease the well-being of the nurse assistants, which could be the result of their increased awareness of the residents' and relatives' needs, in combination with limited support. More emphasis should be placed on the role of leadership when implementing changes in practice.

Pacientes por enfermera-auxiliar y presencia de eventos adversos en unidades de cuidados intensivos de Ibague-Colombia / Nurse-patient ratios or nurse assistant patient ratios and its relationship with the presence of adverse events in intensive care units of Ibague-Colombia

El personal necesario para atender pacientes influye en la calidad del servicio y es un indicador de resultados positivos o de eventos adversos durante la atención de pacientes en ambientes hospitalarios. Objetivo: Establecer la relación existente entre el número de pacientes por enfermero(a)s y auxiliares de enfermería y la probabilidad de ocurrencia de eventos adversos durante un turno en tres unidades de cuidado intensivo de la ciudad de Ibague, Colombia. Método: Estudio ecológico, longitudinal, en tres unidades de cuidado intensivo de Ibague-Colombia en 1656 turnos observados. Resultados: Hubo asociación entre la distribución de enfermero(a)s / paciente E/P y la probabilidad de incidencia de mortalidad 1/5. (OR:1.1) IC 95%, paro cardiorrespiratorio.1/5 (OR 1.38) IC 95% Infecciones derivadas de la atención en salud 1/5 (OR: 1.10) IC 95%. Las dos primeras variables se estudiaron como generales debido a la limitación que impuso el subregistro evidenciado durante el tiempo del estudio. Se evidenció como única variable, de las analizadas en el estudio, sensiblemente relacionada con la razón de auxiliares de enfermería / paciente AE/P la incidencia de escaras por decúbito 1/4 (OR:1.272) IC:95% Conclusiones: La razón enfermero(a) / paciente y auxiliar de enfermería / paciente se relacionan con eventos adversos sin significancia estadística, se hace necesario aumentar el número de observaciones y estudios para tener conclusiones sobre el número de pacientes por enfermera disminuyendo el riesgo de EA (AU)

The staff required to serve patients influences the quality of the service and is an indicator of positive or adverse events during patient care in hospital settings. Objective: To establish the relationship between the Nurse-patient ratios and nurse assistants patient ratios and the probability of occurrence of adverse events during a shift of three intensive care units in Ibague, Colombia. Methods: An ecological study, longitudinal, three intensive care units in 1656 Ibague-Colombia shifts observed. Results: There was an association between the Nurse-patient ratios and the probability of mortality incidence 1/5. (OR: 1.1) 95%, unemployment cardiorrespiratorio.1 / 5 (OR 1.38) 95% infections resulting from health care fifth (OR: 1.10) 95%. The first two variables were studied as general because the limitation imposed by the underreporting demonstrated during the study period. It was shown that only variable, of those analyzed in the study, significantly related to the ratio of nurse assistants-patient ratio the incidence of pressure sores fourth (OR: 1.272) CI: 95% Conclusions: The Nurse-patient ratio and nurse assistants-patient ratio adverse events are associated with no statistical significance, it is necessary to increase the number of observations and studies to draw strong conclusions about the number of patients per nurse decreasing the risk of AD (AU)

Opportunity for progress.

The Cavendish review into HCAs and support workers highlighted the contribution such staff make to patient care, and called for them to be supported with improved training, career opportunities and status. This article shows how some enlightened employers are leading the way in developing their HCA workforce.

Formación del personal de ayuda a domicilio y el beneficio generado en el usuario / Training for home care service staff and its benefits to users/patients

El servicio de ayuda a domicilio es básico para el mantenimiento de muchas personas en su domicilio. Debido a la existencia de unas necesidades de atención cualificada a las personas dependientes nos planteamos: por un lado, comprobar el nivel de formación de los auxiliares de ayuda a domicilio de la provincia de Almería, saber las actividades que realizan diariamente en los domicilios y, por último, determinar el beneficio en el usuario que aportan con su cuidado. Se trata de un estudio descriptivo, observacional, transversal en el que se seleccionaron a través de un muestreo aleatorio simple a un total de 66 personas que trabajaban como auxiliares de ayuda a domicilio (AAD) por toda la provincia de Almería. Los resultados muestran las AAD de nuestra muestra no cumplen los mínimos de formación que vienen reflejados en el BOE, pues más del 84% o no tienen cursos relacionados o los tienen por debajo de las 600 horas. Así, creemos que para que los AAD puedan proporcionar unos cuidados de calidad que reporten un beneficio real en los usuarios, es necesario cualificar y supervisar a dicho personal para que puedan cumplir adecuadamente su trabajo conforme a lo dispuesto en la legislación vigente(AU)

Home care service is essential for the care and maintenance of many people in their homes. Aware of the need for qualified home care assistance to dependent persons, we have considered some important points as to check the level of training of home care aides in the province of Almería in terms of daily household support, on the one hand and on the other, to determine how these dependent people are benefited by home care service. This study aims to describe, observe and present a cross-section of a randomly selected sample of a total of 66 professionals working as home care aides (HCAs) throughout the province of Almeria. Results show that the HCAs in our sample do not meet the minimum training requirement published in the BOE. More than 84% of the sample either have not completed any course related to the job or if they have done so, they have only done below the 600 hours required. Thus, we believe that in order for the HCA to be able to provide quality home care and give real benefit to users, personnel qualification and supervision are necessary for them to adequately do their job and comply with the existing legislation(AU)

Effect of increased nursing home hospice use on nursing assistant staffing.

BACKGROUND: Since 1999, there has been a significant increase in hospice providers and hospice use in nursing homes. A 1997 Office of Inspector General (OIG) report warned of possible kickbacks, monetary and otherwise, that might be paid by hospices to nursing homes in exchange for referrals. One possible kickback mentioned in the report was nursing homes receiving additional staff hours at no cost, which could lead to decreases in nursing home staffing. The purpose of this study was to determine if changes in nursing home hospice volume were related to changes in certified nursing assistant (CNA) staffing. METHODS: The study included free-standing nursing homes with at least 3 years of observation between 1999 and 2006, no fewer than five deaths in any year, and between 30 and 500 beds (n=10,759). We examined the longitudinal relationship between changing hospice volume and CNA minutes per resident day (MPRD), utilizing nursing home fixed-effects regression analysis and adjusting for resident case mix and changing organizational characteristics. RESULTS: The introduction of hospice services in a nursing home did not result in statistically significant changes in CNA staffing. Instead, increases in hospice volume resulted in small increases in CNA staffing. Specifically, the addition of 1000 hospice days, in a given year, resulted in an additional 0.79 (95% confidence interval [CI] 0.373-1.211) CNA MPRD. CONCLUSIONS: The proposition that nursing homes may be decreasing their staffing as a result of receiving additional hospice staff was not supported by this study and, in fact, nursing homes were found to only slightly increase CNA staffing with increasing hospice volume.

Stayers, leavers, and switchers among certified nursing assistants in nursing homes: a longitudinal investigation of turnover intent, staff retention, and turnover.

PURPOSE: Studies of certified nursing assistant (CNA) turnover in nursing homes are typically cross-sectional and include full-time and part-time workers. We conducted a longitudinal study to evaluate the job factors and work attitudes associated with just full-time staying or leaving. For those who did not stay, we assessed reasons for leaving and satisfaction following job transition. DESIGN AND METHODS: A random sample of CNAs identified through the Pennsylvania Department of Health's CNA registry, working ≥ 30 hr weekly in a nursing facility was surveyed by telephone at baseline and 1 year later. RESULTS: Of the 620 responding to both surveys, 532 (85.8%) remained (stayers), 52 (8.4%) switched to another facility (switchers), and 36 (5.8%) left the industry (leavers). At baseline, switchers reported higher turnover intentions and fewer benefits compared with stayers and left for new opportunities. Leavers had lower job satisfaction and emotional well-being and left for health reasons. Turnover intentions were predicted by low job satisfaction and low emotional well-being. Actual turnover was predicted only by turnover intentions and by the absence of health insurance. Pay was not a predictor of turnover intent or turnover. IMPLICATIONS: There are two distinct groups of CNAs contributing to turnover. Attitudinal factors, such as job satisfaction and emotional well-being, are mediated via turnover intentions to effect actual turnover. Even accounting for methodological differences, this turnover rate is lower than previous studies, which use alternative methods and include part-time workers. This study should help nursing home administrators better understand the work-related factors associated with staff turnover.