Adaptation and validation of the Physical Restraint-Theory of Planned Behaviour Questionnaire to the paediatric context.

OBJECTIVE: To create and test psychometrically a paediatric version of the Physical Restraint-Theory of Planned Behaviour Questionnaire to assess paediatric critical care nurses' intention to use physical restraint. DESIGN: A psychometric study. SETTING: Five medical-surgical Paeditric Intensive care Units from five hospitals in Spain. METHODS: The study took place in three phases. In phase 1, the questionnaire was adapted. In phase 2, the content validity of each item was determined, and a pilot test was conducted. In phase 3, we administered the questionnaire and determined its psychometric properties. RESULTS: The assessment of the intention to use physical restraint was extended to all critical paediatric patients, two items were eliminated from the initial questionnaire, four new items were included, and the clinical scenarios of the intention subscale were expanded from three to six. Overall content validity index for the full instrument of 0.96 out of 1. The Paediatric Physical Restraint-Theory of Planned Behaviour Questionnaire is made up of four subscales (attitude, subjective norms (SN), perceived behavioural control (PBC), and intention) subdivided into 7 factors and 51 items. The internal consistency for the attitude subscale obtained a Cronbach's Alpha of 0.80 to 0.73, for the SN it was 0.72 to 0.89, for the PBC it was from 0.80 to 0.73 and for the intention subscale it was 0.75. CONCLUSIONS: The Paediatric Physical Restraint-Theory of Planned Behaviour Questionnaire is an instrument composed of seven factors and 51 items that validly and reliably assesses the intention of paediatric nurses to apply PR in PICUs. RELEVANCE FOR CLINICAL PRACTICE: Having this instrument will help health centres move towards restraint-free care by allowing managers to assess professionals' attitudes, beliefs, and intentions around the use of PR in PICUs.

Risk factors of catheter- associated bloodstream infection: Systematic review and meta-analysis.

INTRODUCTION: The prevalence of catheter-associated bloodstream infections (CLABSI) is high and is a severe health problem associated with an increase in mortality and elevated economic costs. There are discrepancies related to the risk factors of CLABSI since the results published are very heterogeneous and there is no synthesis in the description of all the predisposing factors. OBJECTIVE: We aimed to perform a systematic review and meta-analysis to synthesize and establish the risk factors predisposing to CLABSI reported in the literature. METHOD: This is a systematic review of observational studies following the PRISMA recommendations. MEDLINE and CINAHL databases were searched for primary studies from 2007 to 2021. The protocol was registered in PROSPERO CRD42018083564. RESULTS: A total of 654 studies were identified, 23 of which were included in this systematic review. The meta-analysis included 17 studies and 9 risk factors were analyzed (total parenteral nutrition (TPN), chemotherapy, monolumen and bilumen catheters, days of catheterization, immunosuppression, kidney disease and diabetes mellitus) due to the homogeneity of their definitions and measurements. The risk factors found to increase the probability of developing CLABSI were TPN, multilumen devices, chemotherapy treatment, immunosuppression and the number of days of catheterization. On the other hand, monolumen devices presented a lower likelihood of triggering this infection.

La colaboración interdisciplinar en las unidades de cuidados intensivos / Interdisciplinary collaboration in intensive care units from the experience of nurses

Objetivo: Comprender la experiencia vivida por las enfermeras que trabajan en las UCI polivalentes de un hospital de tercer nivel de la ciudad de Barcelona en relación con la colaboración interprofesional. Metodología: Diseño cualitativo exploratorio, multicéntrico de tipo descripción interpretativa. El ámbito de estudio fue cuatro UCI polivalentes de cuatro hospitales públicos y universitarios de tercer nivel. La muestra estuvo formada por 8 enfermeras. El muestreo teórico de variación máxima. La técnica de obtención de información fue el grupo de discusión con grabación de audio. Se realizó un análisis temático de contenido. Se siguieron los criterios de confiabilidad y autenticidad, así como el proceso de reflexividad durante todo el estudio. El estudio fue aprobado por el Comité de Ética de Investigación Clínica (CEIC). Resultados: Emergieron 2 grandes temas: la definición de colaboración interprofesional y propuestas de futuro. Las enfermeras consideran que la confianza y el respeto son la base de la colaboración interprofesional y aseguran la continuidad de los objetivos planificados. La comunicación y la relación entre iguales son dos de los factores que intervienen en la colaboración interprofesional. Es necesario cambiar de una jerarquía convencional a una visión compartida que mejoraría la participación de las enfermeras. Conclusiones: Los grandes pilares de la colaboración interdisciplinar son la comunicación efectiva y el trabajo en equipo, basado en la confianza y el respeto. Las líneas futuras de trabajo van enfocadas a la formación interdisciplinar de los futuros profesionales, la implantación real del pase conjunto y la mejora del clima laboral. (AU)

Purpose: Understanding the nurses experience who work in the ICUs of a high complexity hospital in Barcelona in relation to interprofessional collaboration. Methodology: Interpretative description by a qualitative exploratory and multicenter design. The study area was four ICUs from four high complexity, public and universitary hospitals. The sample consisted of 8 nurses. Theoretical sampling of maximum variation was used. The information gathering technique was the discussion group with audio recording. A thematic content analysis was carried out. The criteria of reliability and authenticity, as well as the process of reflexivity, were followed throughout the study. The study was approved by the Clinical Research Ethics Committee (CEIC). Results: Two major themes emerged: the definition of interprofessional collaboration and proposals for the future. Nurses consider that trust and respect are the basis of interprofessional collaboration and ensure the continuity of planned objectives. Communication and the relationship between equals are two of the factors involved in interprofessional collaboration. It is necessary to change from a conventional hierarchy to a shared vision that would improve the participation of nurses. Conclusions: The great pillars of interdisciplinary collaboration are effective communication and teamwork, based on trust and respect. Future lines of work are focused on the interdisciplinary training of future professionals, the actual implementation of the clinical sessions and the improvement of the work environment. (AU)

Influencia de la accesibilidad y distancia en el consum de productos sanitarios en una Unidad de Hemodiálisis / Influence of accessibility and distance in the use of healthcare products in a Hemodialysis Unit

OBJETIVO: determinar si la distancia que deben recorrer las enfermeras para acceder a tres productos sanitarios (gasas, apósitos y sueros fisiológicos) influye en la cantidad consumida en el Gabinete de Hemodiálisis de la Fundació Puigvert (2013-2014).MÉTODO: estudio cuasi experimental en el total de las enfermeras del Gabinete de Hemodiálisis (n= 30). Variable principal: consumo de unidades de tres productos sanitarios (gasas, apósitos y sueros fisiológicos).Variable de intervención: distancia a donde se encontraban los productos sanitarios (5, 7 y 9 m), que fue modificada cada dos meses. En el análisis bivariante se utilizó el coeficiente de correlación de Spearman, el test de Wilcoxon y la prueba U Mann Whitney. RESULTADOS: existía una correlación lineal inversa, de manera que a mayor edad o años de profesión, menor consumo de los productos sanitarios estudiados. Al comparar el consumo a los 7 y 9 m versus los 5 m, se vio que era inferior para todos los productos (p< 0,05). El consumo de gasas y apósitos fue mayor (p< 0,05) en el turno de tarde en todas las distancias exploradas. CONCLUSIONES: a mayor distancia de los productos sanitarios suero fisiológico, gasas y apósitos, menor es el consumo de los mismos por parte de las enfermeras. Existe una asociación estadísticamente significativa entre el consumo, la edad y la experiencia, de manera que las enfermeras más jóvenes y con menos experiencia consumen más

OBJECTIVE: to determine if the distance that nurses must walk in order to have access to three healthcare products (gauze, dressings and saline solutions) has any impact on the amount used at the Hemodialysis Unit in the Fundació Puigvert (2013-2014).METHOD: a quasi-experimental study including all nurses from the Hemodialysis Unit (n= 30). Primary variable: use of units of three healthcare products (gauze, dressings and saline solutions).Intervention variable: the distance at which the healthcare products were located (5, 7 and 9 metres), which was modified every two months. The Spearman Correlation Coefficient, Wilcoxon Test and Mann Whitney U Test were used for bivariate analysis. RESULTS: there was a reverse linear correlation, so that at higher age or years in the profession, there was a lower use of the healthcare products studied. When comparing this use at 7 and 9 metres versus 5 metres, it was observed that it was lower for all products (p< 0.05). The use of gauze and dressings was higher (p < 0.05) during the afternoon shift for all distances explored. CONCLUSIONS: when healthcare products such as saline solutions, gauze and dressings at placed at a longer distance, their use by nurses is lower. There is a statistically significant association between use, age and experience; thus, younger nurses with less experience will use these products to a higher extent

Impacto de la ubicación-lateralidad en el consumo de productos sanitarios en una unidad de hemodiálisis / Impact of laterality-location in the consumption of health products in a hemodialysis unit

Introducción. El objetivo es determinar si la ubicación-lateralidad dentro del carro de curas de tres recursos sanitarios (gasas, apósitos y sueros fisiológicos [SF] de 10 cc) influye en la cantidad de material consumido en el Gabinete de Hemodiálisis de la Fundació Puigvert. Metodología. Estudio cuasi experimental, sin grupo control tipo postest. Muestra formada por treinta enfermeras expertas (muestreo no probabilístico de conveniencia). El estudio se realizó entre marzo y agosto de 2014. Durante dos meses, los tres productos sanitarios permanecieron en el lado derecho del carro de curas, durante dos meses en el centro y, finalmente, dos meses en el lado izquierdo. El análisis se realizó mediante el software estadístico SPSS. Para todas las pruebas se utilizó un nivel de significación < .005. Resultados. Edad media de 40.4 años y una antigüedad media en el Gabinete de 14 años. Se observa un incremento de consumo de SF y gasas cuando los productos se colocan en el lado derecho respecto al centro, pero no es significativo (p > .005). El consumo de apósitos es mayor en el lado derecho que en el centro (p < .001). El consumo de los tres productos sanitarios es inferior cuando se colocan en el lado izquierdo del carro en comparación con su ubicación en el centro (p < .001) o en el lado derecho (p < .001). Conclusiones. La ubicación-lateralidad tiene una influencia directa en el consumo de material sanitario. El consumo en el lado izquierdo es inferior que en el centro y en el lado derecho. La ubicación-lateralidad es una buena estrategia de gestión (AU)

Introduction. The objective is to determine whether lateralitylocation inside shopping cures three health resources (gauze, bandages and physiological sera [PS] from 10 cc) influences the amount of material consumed in the Cabinet of Hemodialysis of the Fundació Puigvert. Methodology. Quasi-experimental study with no control group post test type. The sample consisted of thirty expert nurses (nonprobability convenience sampling). The study was conducted between March and August 2014. For two months, the three medical devices remained on the right side of the carriage cures for two months in the middle and finally two months on the left side. The analysis was performed using SPSS statistical software, for all tests a significance level < .005 was used. Results. Average age of 40.4 years and a mean old in the Cabinet of 14 years. Increased consumption and gauze PS is observed when the products are placed on the right side of center but is not significant (p > .005). Dressings consumption is higher on the right than in the center (p < .001). The consumption of the three health products is lower on the left side of the truck when placed in the center (p < .001) or right side (p < .001). Conclusions. The laterality-location has a direct influence on the consumption of medical supplies. Consumption on the left side is less than in the center and on the right side (AU)

[IMPACT OF LATERALITY-LOCATION IN THE CONSUMPTION OF HEALTH PRODUCTS IN A HEMODIALYSIS UNIT]. / Impacto de La ubicación-lateralidad: EN EL CONSUMO DE PRODUCTOS SANITARIOS EN UNA UNIDAD DE HEMODIÁLISIS.

UNLABELLED: INTRODUCTION. The objective is to determine whether laterality-location inside shopping cures three health resources (gauze, bandages and physiological sera [PS] from 10 cc) influences the amount of material consumed in the Cabinet of Hemodialysis of the Fundaci6 Puigvert. METHODOLOGY: Quasi-experimental study with no control group post test type. The sample consisted of thirty expert nurses (non-probability convenience sampling). The study was conducted between March and August 2014. For two months, the three medical devices remained on the right side of the carriage cures for two months in the middle and finally two months on the left side. The analysis was performed using SPSS statistical software, for all tests a significance level < .005 was used. RESULTS: Average age of 40.4 years and a mean old in the Cabinet of 14 years. Increased consumption and gauze PS is observed when the products are placed on the right side of center but is not significant (p > .005). Dressings consumption is higher on the right than in the center (p < .001). The consumption of the three health products is lower on the left side of the truck when placed in the center (p <.001) or right side (p < .001). CONCLUSIONS: The laterality-location has a direct influence on the consumption of medical supplies. Consumption on the left side is less than in the center and on the right side. The laterality-location is a good management strategy.

Tabaquismo. Análisis de la producción científi ca en el Área de Tabaquismo de la SEPAR en el año 2009 / Smoking. Analysis of the Scientifi c Production in the SEPAR Smoking Area in 2009

El Área de Tabaquismo de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) se inició en elaño 1995. Sus principales objetivos fueron incrementar la sensibilización sobre el problema del tabaquismoentre los miembros de nuestra sociedad científi ca, mejorar sus conocimientos científi cos en esta afección,facilitar las intervenciones diagnósticas y terapéuticas en los fumadores y, por último, promover lasintervenciones para la prevención y el tratamiento del tabaquismo por parte de la administración políticosanitaria.Hoy día es una de las áreas más dinámicas de la SEPAR y cuenta con más de 400 miembros.Durante el año 2009, los profesionales sanitarios del Área de Tabaquismo de la SEPAR han desarrollado unaintensa labor de investigación que se ha traducido en una producción científi ca adecuada que ha abarcadodiferentes aspectos de la disciplina del tabaquismo. Entre los más impactantes merecen destacarse los estudiosrealizados para determinar el impacto que la Ley 28/2005 ha tenido en la prevalencia del tabaquismoen España, los estudios que valoran la productividad científi ca de los miembros del área y los numerososartículos que publican los resultados de las diferentes unidades de tabaquismo que lideran losneumólogos españoles(AU)

The SEPAR Smoking Area was started in the year 1995. Its main aims were to increase awareness of theproblem of smoking among the members of our scientifi c society, to improve their scientifi c knowledge onthis problem, to help in diagnostic and therapeutic interventions in smokers, and fi nally, to promoteinterventions for the prevention and treatment of smoking by the health and political administrations.Nowadays, it is the most dynamic areas of SEPAR and has more than 400 members.Throughout the year 2009, the health professionals of the SEPAR smoking area have carried out intenseresearch work that has led to a reasonable scientifi c production that has covered different aspects of thediscipline of smoking. The most impressive studies were those that tried to determine the impact that Law28/2005 has had in the prevalence of smoking in Spain, the studies that assessed the scientifi c productivityof the area members and the numerous articles that published the results from different smoking unitsthat are led by Spanish pneumologists(AU)

[Present and future of the SEPAR Smoking and Health Area]. / Presente y futuro del Area de Tabaquismo de la SEPAR.

Smoking is the primary avoidable cause of premature death and morbidity in our country. According to data from the WHO, tobacco costs more than 5 million lives per year, a figure that is assumed to continue increasing and will be 10 million by the year 2030. As health professionals we are obliged to be actively involved in this serious health problem, by correctly identifying, diagnosing and treating all smokers to help them in the process of giving up and help them achieve total abstinence. There is scientific evidence that smoking is the direct cause and reason for the worsening of many respiratory diseases, which due to their nature are basically the responsibility of the pneumologist, who officially, according to the Health Service Administration, is the specialist and expert in this area. The Smoking and Health Area of SEPAR was started in 1995. Its primary objectives were to increase the awareness of the smoking problem among the members of our Scientific Society, improve their scientific knowledge of this diseases, to help in diagnostic and treatment interventions in smokers, and lastly, to promote interventions for the prevention and treatment of smoking by the health and political Administrations. Nowadays it is one of the most dynamic areas of SEPAR and has more than 400 members. There are many unresolved challenges in our area, but the fundamental one which continues to occupy a particular place for the Administration, for our patients, for other health professionals of other specialties and scientific societies, and for all SEPAR professionals, is a key aspect of which there is no doubt: to defend the health and well-being of our population against the main cause of avoidable disease and death, tobacco.

Presente y futuro del Área de Tabaquismo de la SEPAR / Present and Future of the SEPAR Smoking and Health Area

El tabaquismo es la primera causa evitable de mortalidad prematura y morbilidad en nuestro medio. Segúndatos de la Organización Mundial de la Salud, el tabaco se cobra más de 5 millones de vidas al año, cifraque presumiblemente irá en aumento y será de 10 millones para el año 2030.Los profesionales sanitarios estamos obligados a implicarnos activamente en este grave problema sanitarioidentificando, diagnosticando y tratando correctamente a todos los fumadores para ayudarles en el procesode abandono y facilitar el logro de la abstinencia definitiva.Existe evidencia científica que el tabaquismo es causa directa o motivo de empeoramiento de muchas enfermedadesrespiratorias, que por su naturaleza competen básicamente al neumólogo, que oficialmente, deacuerdo con la administración sanitaria, es el especialista y experto en la materia.El Área de Tabaquismo de la SEPAR se inició en el año 1995. Sus principales objetivos fueron incrementar lasensibilización sobre el problema del tabaquismo entre los miembros de nuestra sociedad científica, mejorarsus conocimientos científicos en esta afección, facilitar las intervenciones diagnósticas y terapéuticas enlos fumadores y, por último, promover las intervenciones para la prevención y el tratamiento del tabaquismopor parte de la administración político-sanitaria. Hoy día es una de las áreas más dinámicas de la SEPARy cuenta con más de 400 miembros.Muchos son los retos pendientes de nuestra área, pero el fundamental lo constituye seguir ocupando unlugar referente para la administración, para nuestros pacientes, para otros profesionales sanitarios de otrasespecialidades y sociedades científicas, y para todos los profesionales de la SEPAR en un aspecto clave queno merece dudas: defender el bienestar y la salud de nuestra población frente a la principal causa de enfermedady mortalidad evitable, el tabaco(AU)

Smoking is the primary avoidable cause of premature death and morbidity in our country. According todata from the WHO, tobacco costs more than 5 million lives per year, a figure that is assumed to continueincreasing and will be 10 million by the year 2030.As health professionals we are obliged to be actively involved in this serious health problem, by correctlyidentifying, diagnosing and treating all smokers to help them in the process of giving up and help themachieve total abstinence.There is scientific evidence that smoking is the direct cause and reason for the worsening of many respiratorydiseases, which due to their nature are basically the responsibility of the pneumologist, who officially,according to the Health Service Administration, is the specialist and expert in this area.The Smoking and Health Area of SEPAR was started in 1995. Its primary objectives were to increase theawareness of the smoking problem among the members of our Scientific Society, improve their scientificknowledge of this diseases, to help in diagnostic and treatment interventions in smokers, and lastly, topromote interventions for the prevention and treatment of smoking by the health and political Administrations.Nowadays it is one of the most dynamic areas of SEPAR and has more than 400 members.There are many unresolved challenges in our area, but the fundamental one which continues to occupy aparticular place for the Administration, for our patients, for other health professionals of other specialtiesand scientific societies, and for all SEPAR professionals, is a key aspect of which there is no doubt: to defendthe health and well-being of our population against the main cause of avoidable disease and death,tobacco(AU)