Indicators and predictors modifiable by the nursing department during the preoperative period: A scoping review.

AIM AND OBJECTIVES: The aim of this study is to identify preoperative indicators and/or predictors of complications or inefficiencies in the surgical process that can be modified within nursing practice. BACKGROUND: Due to rapid sociodemographic and technological change, the global demand for surgical attention is rising exponentially, requiring new strategies for optimisation and sustainability in perioperative care. DESIGN: We conduced the scoping review using the methodology recommended by the Joanna Briggs Institute supported with The PAGER framework and guided by the PRISMA-ScR Checklist. METHODS: Four databases (CINAHL, MEDLINE, SCOPUS and PUBMED) were examined to extract relevant published results for elective surgery on adult patients during the period 2011-2021. This process identified 609 records. Exclusion criteria were applied, and the sample was then evaluated with the Quality Assessment Tool for Studies with Diverse Designs (QATSDD), after which 15 studies remained. RESULTS: The following preoperative indicators and/or predictors were considered: (1) Anxiety; (2) Pain; (3) Health education, knowledge and training; (4) Satisfaction; (5) Management/organisation (including costs, resources used/available, organisational issues, hospital stay (preoperative), standardisation and protocolisation. CONCLUSION: The identification of five indicators and/or predictors of complications or inefficiencies in the surgical process, which can be modified by nursing, allows the effective application of interventions in the preoperative phase, optimising care and improving health outcomes. RELEVANCE TO CLINICAL PRACTICE: The development and implementation of specific nursing skills in the preoperative phase are essential to optimise the surgical process.

Professional grief among nurses in Spanish public health centers after caring for COVID-19 patients.

AIMS AND OBJECTIVES: The aim of the present study is to investigate the professional grief suffered by nurses in various medical units, after coping with the COVID-19 pandemic for the last 18 months. BACKGROUND: Addressing and acknowledging the reality of professional grief is of fundamental importance to nurses' mental health, as this condition has both professional and personal consequences. DESIGN: A qualitative, content analysis approach was taken. METHODS: Based on 25 interviews with nursing professionals working in different health centers units were performed. The following sampling schemes were used: first, convenience sampling, then nominated sampling, and finally theoretical sampling. RESULTS: From our analysis of the data obtained, three main themes were identified: the impact on nurses of COVID-19 outcomes; the symptoms of professional grief; and cognitive reactions. These core elements interacted with 12 subtopics, including symptoms of grief and the cognitive impact produced. CONCLUSIONS: A large proportion of the nurses consulted in this study have suffered and suffered professional grief and report many related symptoms. In response to the present pandemic and any future occurrence, the question of professional grief needs to be addressed. RELEVANCE TO CLINICAL PRACTICE: To help them cope better with this type of situation, nurses should receive appropriate training. Moreover, healthcare institutions should be made aware of the problem and be encouraged to offer assistance to address the impact produced on nurses by the deaths of their patients. CLINICAL RELEVANCE: This study shows the impact of professional grief on nurses in the context of the COVID-19 pandemic. Nurses are affected personally by the deaths of patients and by alterations to their working conditions. In many cases, this grief remains unresolved and its various symptoms persist.

Continuing education programme on vaccines for primary healthcare professionals: mixed-method protocol.

INTRODUCTION: Vaccination is a fundamental intervention in disease prevention; therefore, the advice and recommendations of health professionals have a major influence on the population's decision to be vaccinated or not. Professionals must have sufficient competencies to carry out their work and recommend vaccination with evidence-based knowledge. The aim is to design and validate a strategy to improve professional competencies in vaccination to positively influence adherence and increase vaccination rates in the population. METHODS AND ANALYSIS: Training will be designed based on evidence and previous studies and piloted with healthcare providers. To test changes in knowledge, a pretest and post-test will be conducted. To test feasibility, a think-aloud method will be used with participants and triangulated with focus groups using SWOT (strengths, weaknesses, opportunities and threats) analysis. Transfer will be measured using the questionnaire 'factors for the indirect evaluation of transfer' and an efficacy questionnaire 1½ months later; for satisfaction, an ad hoc questionnaire will be used. A summative approach will be used for the analysis of the focus groups and descriptive and bivariate statistics for the questionnaires. ETHICS AND DISSEMINATION: This study was approved by the Andalusian Research Ethics Committee, Spain (approval number: 0524-N-20). The results will be made available to the public at journal publications and scientific conferences.

Factors Related to Gender Violence and Sex Education in Adolescents: A Cross-Sectional Study.

BACKGROUND: For school medical services and the staff responsible for sex education for adolescents, it is important to understand the factors that may influence gender violence. The aim of this study is to determine whether the presence of sexist attitudes, double standards and/or romantic myths contributes to the risk of gender violence. METHODS: This cross-sectional study was carried out at five secondary schools in the province of Malaga (Spain). In total, 879 adolescents aged 12-18 years were included, studying years 1-4 of compulsory secondary education. Their attitudes were measured on the following scales: Ambivalent Sexism Inventory (ASI), Double Standard Scale (DSS) and Romantic Love Myths Scale (EMA). RESULTS: Significant differences were observed among the age/year groups for the mean scores obtained on each of the above scales (DSS, p < 0.01; EMA, p < 0.01; ASI, p < 0.01). By gender, the boys recorded higher scores for ASI and lower ones for DSS (p < 0.01). The Spearman's rho value revealed significant relationships between the presence of sexual double standards and that of romantic myths and ambivalent attitudes (p < 0.01). CONCLUSIONS: Adolescents commonly express romantic love myths, sexist attitudes and sexual double standards. These three factors, which are significantly correlated, influence the presence of violence in dating relationships.

Perinatal Grief and Post-Traumatic Stress Disorder in Pregnancy after Perinatal Loss: A Longitudinal Study Protocol.

BACKGROUND: Pregnancies that follow perinatal loss are often associated with mental health disorders, which are not usually treated or even identified. OBJECTIVES: The main study aim is to identify the prevalence of symptoms of post-traumatic stress disorder and complicated perinatal grief at different stages of pregnancy following a prior gestational loss. METHODS: This descriptive longitudinal study will be conducted with a twelve-month follow-up. The study variables addressed will include sociodemographic data (age, sex, education, marital status, employment status and obstetric history) together with clinical data on complicated perinatal grief and post-traumatic stress disorder scores. RESULTS: The results obtained are expected to provide a new perspective on the healthcare approach to perinatal loss and subsequent pregnancy. CONCLUSIONS: We seek to optimise comprehensive healthcare in cases of pregnancy following previous perinatal loss and to evaluate options to minimise possible risks.

Adverse events encountered during clinical placements by undergraduate nursing students in Spain.

BACKGROUND: During clinical placements, nursing students are exposed to adverse events generated by the clinical tasks they must perform. OBJECTIVES: To describe the profile of adverse events encountered and the risks facing nursing students in clinical practice, as well as the severity and incidence of these events. DESIGN: Observational retrospective longitudinal study. SETTING: Clinical placements of undergraduate nursing students from the University of Málaga, in hospitals and primary health care. PARTICIPANTS: A total of 4284 undergraduate nursing students, enrolled during seven consecutive years (2011-2018). METHODS: Study data were obtained from students' notifications of adverse events during their clinical placements. The form for making this notification is available online, in the virtual campus for the practicum and notification is mandatory. RESULTS: A total of 1638 reports of adverse events were made during the study period. The adverse events most commonly reported were clinical accidents, followed by sharp and needle-stick injuries, and medication errors. By clinical settings, adverse events occurring in critical care were most frequently reported (35.9%). By the severity of the event, the largest proportion (32.4%) were classified as serious. By the risk of recurrence, 49.8% of the events reported were classified as accidents that "could happen again at some time". In this respect, there were significant differences among the respondents, with fourth-year students reporting up to four times more events of this type than second and third-year students (p < 0.001). CONCLUSIONS: Nursing students are subject to clinical safety-related events during their practices, mostly concerning medication errors and sharps and needlestick injuries. The pattern of these events changes over time, as students evolve in their competences. To improve clinical safety competencies among student nurses, priority attention should be paid to medication management, dose calculations and reactions to situations of aggression and violence in healthcare settings.

Post-traumatic stress disorder after subsequent birth to a gestational loss: An observational study / Trastorno de estrés postraumático tras una gestación posterior a una pérdida gestacional: Un estudio observacional

Abstract Introduction The loss of a pregnancy puts women at risk of suffering post-traumatic stress disorder. This circumstance can influence a subsequent pregnancy, and the link with the future baby. Objective The main objective of this work was to identify the prevalence of post-traumatic stress disorder (PTSD) among post-partum women who give birth after having suffered a previous gestational loss and to identify possible relationships between PTSD and the variables studied. Method An observational, descriptive, and cross-sectional study. A total of 115 puerperal women who had suffered a previous gestational loss completed questionnaires containing sociodemographic variables, obstetric history, and responses to the Davidson Trauma Scale. Results A score of 40 was established as a cut-off point in the Davidson Trauma Scale for the identification of PTSD. 21.7% of the participants scored 40 or above. Significant differences were found related to age (p = .030), number of pregnancies (p = .033), and number of gestational losses (p = .001). The probability of PTSD increases significantly in relation to the number of losses. Respondents are 2.55 times (β = .94 p = .027) more likely to suffer PTSD the higher the number of gestational losses suffered. Discussion and conclusion There are significant differences in the presence of PTSD among puerperal women in terms of age, number of pregnancies, and number of gestational losses. Post-partum women are more likely to suffer PTSD after a gestational loss the higher the number of gestational losses suffered.

Resumen Introducción La pérdida de un embarazo sitúa a las mujeres en riesgo de padecer un trastorno por estrés postraumático. Esta circunstancia puede influir en un embarazo posterior, y el vínculo con el futuro bebé. Objetivo El objetivo principal de este trabajo fue identificar la prevalencia de trastorno por estrés postraumático entre puérperas que dan a luz tras haber sufrido una pérdida gestacional previa e identificar posibles relaciones entre el trastorno por estrés postraumático y las variables estudiadas. Método Se trata de un estudio observacional, descriptivo y transversal. Un total de 115 puérperas que habían sufrido una pérdida gestacional anterior llenaron cuestionarios que contenían variables sociodemográficas, de la historia obstétrica y la Escala de Trauma de Davidson. Resultados Se estableció 40 como punto de corte en la Escala de Trauma de Davidson para identificar el trastorno por estrés postraumático. Se identificó en un 21.7% de las participantes. Se encontraron diferencias significativas relacionadas con la edad (p = .030), el número de embarazos (p = .033) y el número de pérdidas gestacionales (p = .001). La probabilidad de trastorno por estrés postraumático aumenta significativamente en relación con el número de pérdidas. Es 2.55 veces (β = .94 p = .027) más probable padecer un trastorno por estrés postraumático cuanto mayor sea el número de pérdidas gestacionales sufridas. Discusión y conclusión Existen diferencias significativas en la prevalencia de trastorno por estrés postraumático entre las puérperas en cuanto a la edad, el número de embarazos y el número de pérdidas gestacionales. Es más probable padecer trastorno por estrés postraumático tras una gestación posterior a una pérdida gestacional cuanto mayor sea el número de pérdidas gestacionales sufridas.

A scoping review of safety management during clinical placements of undergraduate nursing students.

BACKGROUND: The abundant knowledge on nursing students' competencies in clinical safety, and the multiple approaches adopted make it difficult to obtain an overview of the current status of this question. PURPOSE: To review the literature on undergraduate nursing students' safety competencies during their clinical placements. METHOD: A scoping review was carried out. Searches were executed in PubMed, CINAHL, WOS, MEDES, and websites of relevant organizations. The framework proposed by the Joanna Briggs Institute was adopted. FINDINGS: A total of 43 studies were selected for the final sample. The review identified four major topics: the presence of adverse events in clinical placements, the acquisition of competencies in clinical safety, student experiences regarding clinical safety, and pedagogical approaches for clinical safety. DISCUSSION: Nursing students encounter adverse events and clinical safety incidents throughout their clinical training. Faculties should assign the highest priority to this question, due to its importance in the creation of a culture of safety.

Post-traumatic stress and related symptoms in a gestation after a gestational loss: narrative review / Estrés postraumático y síntomas relacionados en un embarazo posterior a una pérdida gestacional: revisión narrativa

Abstract Background Around 30% of pregnancies conclude in a gestational loss. Most women who suffer a gestational loss become pregnant again. However, mothers who have experienced this situation live the new pregnancy with fear and anxiety. Objective To perform an update of the main works done in the study of post-traumatic stress and related symptoms during pregnancy after a gestational loss. Method The Medline database was consulted. Articles published from 2007 to date were selected. Key words related to the topic of study were used. Results The studies reviewed showed five entities that deserve attention during a pregnancy achieved after a gestational loss: post-traumatic stress, depression, anxiety, relationship, and relationship with the future child. There is a relationship between the presence of post-traumatic stress and the risk of developing depression and anxiety. Discussion and conclusion Women who experience perinatal loss, regardless of the type of loss and the gestational age in which it occurs, are at risk of continuing grief, symptoms of depression, anxiety, and post-traumatic stress in later pregnancy. The gestational age and the time elapsed between the perinatal loss and the next pregnancy seem to be the most influential factors in the development of post-traumatic stress sindrome, and symptoms of dysfunctional grief, anxiety, and depression.

Resumen Antecedentes Alrededor de un 30% de los embarazos concluyen en una pérdida gestacional; de este porcentaje, la mayoría de las mujeres vuelve a quedar embarazada. Sin embargo quienes han experimentado esta situación viven con miedo y ansiedad su nuevo embarazo. Objetivo Realizar una actualización de los principales trabajos realizados en cuanto al estudio del estrés postraumático y los síntomas relacionados con el embarazo posterior a una pérdida gestacional. Método Se consultó la base de datos Medline y se seleccionaron artículos publicados desde 2007 hasta la fecha. Se emplearon palabras clave relacionadas con el tema de estudio. Resultados Los estudios revisados mostraron cinco entidades que merecen atención durante un embarazo experimentado tras una pérdida gestacional: estrés postraumático, depresión, ansiedad, relación de pareja y vínculo con el futuro infante. Se encontró que existe una relación entre la presencia de estrés postraumático y el riesgo de desarrollar depresión y ansiedad. Discusión y conclusión Las mujeres que experimentan pérdida perinatal, independientemente del tipo de pérdida y de la edad gestacional en la que se produce, corren el riesgo de continuar el duelo, los síntomas de depresión, la ansiedad y el estrés postraumático durante el embarazo posterior. La edad gestacional y el tiempo transcurrido entre la pérdida perinatal y el siguiente embarazo parecen ser los factores más influyentes en el desarrollo del síndrome de estrés postraumático, así como de síntomas de duelo disfuncional, ansiedad y depresión.

Fecundación in vitro postmortem / In vitro fertilizationpostmortem / Postmortem fertilização in vitro

La fecundación in vitro postmortem (FIV postmortem) es una técnica mediante la cual se extrae semen del hombre ya fallecido para fecundar el óvulo de su esposa viva. El objetivo de esta revisión de la literatura es conocer y comparar las distintas opciones de la FIV postmortem en varios países. Metodología: revisión de la literatura en diferentes bases de datos que nos devuelva una búsqueda en inglés o español con alta relevancia con el tema a tratar y disponible en texto completo como criterios de inclusión. Resultado: Actualmente en España se permite realizar esta técnica con una serie de requisitos y bajo unas condiciones legales, sin embargo existen muchas diferen cias entre distintos países, en algunos no se permite el uso de esta técnica bajo ningún concepto, mientras que en otros el acceso a ella es libre para toda mujer viuda que lo desee dentro de las primeras horas del fallecimiento del hombre. Discusión: aún son pocos los países que tienen una legislación específica en cuanto a la FIV postmortem, y muy pocos los que permiten realizar la técnica, incluso teniendo la autorización del varón previa al fallecimiento. Conclusiones: Existe gran controversia en cuanto a la legislación en los diferentes países, por lo que sería necesario una investigación más profunda sobre este tema

Postmortem IVF is a technique by semen is extracted from the deceased man to fertilize the egg of his wife. The objective of this review of the literature is to know and compare the different options of postmortem IVF in several countries. Methodology: literature review in different databases that return a search in English or Spanish with high relevance with the subject to be treated and available in full text as inclusion criteria, being the absence of any of the above exclusion criteria. Outcome: Currently in Spain it is allowed to perform this technique with a number of requirements and under legal conditions, however in other countries there is a lot of discrepancy, some are not allowed to use this technique under any concept, while in others access She is free for every widow woman who wants it within the first hours of the man's death. Discussion: Few countries have a current legislation on postmortem IVF, and very few countries allow the technique to be performed, even with the authorization of the male prior to death. Conclusions: There is a lot of controversy about the legislation in the different countries, so a deeper investigation on this topic would be necessary

IVF postmortem é uma técnica pela qual o sêmen é extraído do homem morto agora para fertilizar o óvulo da esposa viva. O objetivo desta revisão de literatura é determinar e comparar as diferentes opções de IVF postmortem em vários países. Metodologia: revisão da literatura nas bases de dados diferentes que você retornar uma pesquisa em Inglês ou Espanhol com alta relevância para o tema e está disponível em texto completo como critério de inclusão, com a ausência de qualquer um dos critérios de exclusão acima. Resultado: atualmente na Espanha estão autorizados a realizar esta técnica com uma série de requisitos e condições legais, mas em outros países há muito discrepância em algum uso desta técnica de qualquer forma não são permitidos, enquanto no acesso outros é livre para qualquer viúva que deseja dentro das primeiras horas da morte do homem. Discussão: Poucos países têm legislação sobre postmortem fertilização in vitro, e muito poucos que permitem a técnica, mesmo com autorização prévia do sexo masculino até a morte. Conclusões: Há muita controvérsia sobre a legislação em diferentes países, de modo mais pesquisas sobre este assunto seria necessário

Cultural adaptation and validation of the Lasater Clinical Judgment Rubric in nursing students in Spain.

BACKGROUND: The clinical judgment and decision-making abilities of nurses can influence many health outcomes, hence the importance of addressing these qualities in university studies. In this respect, clinical simulation is a commonly employed teaching method. The evaluation of simulation activities requires standardised instruments, such as the Lasater Clinical Judgment Rubric, which is widely used for this purpose, although a culturally adapted and validated version in Spain is not available. AIMS: To obtain a Spanish culturally adapted and validated version of the rubric for undergraduate students of nursing. DESIGN, PARTICIPANTS AND SETTING: Cultural adaptation and psychometric validation study carried out with undergraduate nursing students in the simulation laboratories at the University of Málaga (Spain). METHODS: A process of translation/back-translation and cultural adaptation was carried out in accordance with international standards. The rubric was empirically evaluated in standardised scenarios with high and medium-fidelity simulators. Each student took part in two different simulation sessions, led by two instructors. In each simulation, the data were collected by two independent observers. RESULTS: 152 observations were obtained from 76 students. The interobserver reliability was high, with an intraclass correlation coefficient of 0.93 (95% CI 0.92-0.95) (p = 0.0001) and Cronbach's alpha of 0.93. According to the confirmatory factor analysis, the fit of the model was satisfactory in all indices, with a χ2/df value of 1.08, GFI 0.96, TLI 0.99, NFI 0.97 and RMSEA 0.24 (90% CI 0.000-0.066). CONCLUSIONS: The rubric obtained is culturally adapted to the Spanish educational context, and is valid and reliable for nursing students. Further prospective studies should be undertaken to evaluate the responsiveness, potential for transfer to clinical practice and cost-benefit ratios of different simulation designs.

Manejo del síndrome de HELLP en una gestación pretérmino / Management of HELLP syndrome in preterm pregnancy

INTRODUCCIÓN: La hipertensión inducida durante el embarazo es una de las principales causas de morbimortalidad maternofetal. Afecta a un 10% de las gestantes en todo el mundo, con una incidencia en España del 1,2%. CASO CLÍNICO: Se expone el caso de una gestante gemelar tras una fecundación in vitro , de 30 + 5 semanas, que ingresa por presentar cifras tensionales límite (140/90 mmHg), junto con edemas maleolares con fóvea y epigastralgia. Tras su valoración, se le diagnosticó una preeclampsia grave que derivó en un síndrome de HELLP (hemolisis, aumento de enzimas hepáticas y plaquetopenia), por lo que, debido al empeoramiento de la gestante y a la pérdida de bienestar fetal, se decidió finalizar la gestación mediante cesárea urgente. CONCLUSIÓN: El manejo del síndrome de HELLP requiere una detección precoz y la participación de un equipo multidisciplinario para disminuir los riesgos de morbimortalidad maternofetales

INTRODUCTION: Hypertension induced by pregnancy is one of principal reasons from morbimortality maternal-fetal, this is affecting around 10% to pregnancy in the world, and 1.2% in Spain. Clinical case: This case about winpregnancy at 30 + 5 gestational weeks that come to emergencies by high blood pressure (140/90 mmHg), and lower extremity with fovea and epigastralgia. She is diagnosed with serious pre-clampsia wich is derived in HELLP syndrome. The patient's condition worse and multidisciplinary team decided an urgent cesarean. CONCLUSION: Management of HELLP syndrome needs an early detection and the participation of multidisciplinary team to minimize morbimortality maternal-fetal

Aplicación del proceso enfermero en gestante hemodializada / Evaluation of complications of arteriovenous fistula for hemodialysis according to the puncture technique

La frecuencia de las gestaciones en mujeres en tratamiento con hemodiálisis está incrementándose en los últimos años. El aumento de fertilidad en estas pacientes se debe a la mejora de la eficacia de la diálisis, junto con el manejo clínico de la insuficiencia renal. Sin embargo, el embarazo de las pacientes hemodializadas sigue siendo un reto, debido a frecuentes complicaciones como la preeclampsia, la prematuridad severa, el polihidramnios, etc. Actualmente, se constata el ascenso de la tasa de supervivencia fetal y la disminución de la morbi-mortalidad materno-fetal. Presentamos el caso de una gestante en tratamiento con hemodiálisis que presenta una amenaza de parto prematuro a la 27+2 semanas de gestación. Se han formulado diagnósticos enfermeros siguiendo la taxonomía NANDA-NOC-NIC, con la finalidad de visibilizar la necesidad de un adecuado plan de cuidados en estas pacientes (AU)

The frequency of pregnancies in women being treated with hemodialys is increasing in recent years. Increasing fertility in these patients is due to improving the efficiency of dialysis, along with the clinical management of renal failure. However, pregnancy in these patients remains a challenge, due to frequent complication ssuch as preeclampsia, severe prematurity, polyhydramnios, etc. Currently, there is an aument of fetal survival and reduced maternal and fetal morbidity and mortality. This case is about pregnancy in hemodyalisis treatment with threat of premature birth in 27+2 weeks. Nursing diagnoses have been made following the NANDA -NOC -NIC taxonomy, in order to visualize the need for an adequate care plan in these patients (AU)