Including audience response systems in debriefing. A mixed study during nursing simulation-based learning.

BACKGROUND: The audience response systems are being implemented to support active learning in nursing degree programs. The benefits of audience response systems have been studied in lecture-based classes and seminars, but their advantages or inconveniences when included in the debriefing phase of a high-fidelity clinical simulation have not been explored. The study aim was to discover student´s experience about using of interactive questions during debriefing, and the self-perceived effects on attention, participation and motivation. METHODS: A Mixed-methods study was used exploratory sequential design in a university. The participants were 4th-year students enrolled in the Nursing Degree in a university in Southern Spain. (1) Qualitative phase: a phenomenological approach was utilized, and focus groups were used for data-collection. (2) Quantitative phase: cross-sectional descriptive study using a questionnaire designed "ad hoc", on the experiences on the use of interactive questions in the debriefing phase and the Debriefing Experience Scale. RESULTS: (1) Qualitative phase: the students highlighted the facilitating role of the interactive questions during the reflection part of the debriefing, and mentioned that the interactive questions helped with stimulating attention, participation, and motivation during the analytical part of the debriefing; (2) Quantitative phase: it was observed that the best evaluated dimension was "Motivation", with a mean of 4.7 (SD = 0.480), followed by the dimension "Participation", with a mean of 4.66 (SD = 0.461), and lastly, the dimension "Attention", with a mean of 4.64 (SD = 0.418). CONCLUSIONS: The use of interactive questions contributed the attention, participation, and motivation of the students during the debriefing, contributing towards a highly satisfactory experience of high-fidelity clinical simulation.

Effects of a Clinical Simulation-Based Training Program for Nursing Students to Address Social Isolation and Loneliness in the Elderly: A Quasi-Experimental Study.

INTRODUCTION: The population of older adults is rapidly increasing worldwide, presenting both prospects and complexities for society and healthcare professionals to maximize the functional capacity of this age group. Social isolation and loneliness significantly affect this population. The objective was to determine the effectiveness, satisfaction, and perceptions of the simulation-based education practices of a training program for nursing students, which was created to palliate the social isolation and loneliness of older adults. METHOD: A quasi-experimental study was conducted with nursing students who participated in an online training program using teleservice based on high-fidelity clinical simulation. The program included asynchronous theoretical training and synchronous practical training using an online platform. Five scenarios were designed using simulated phone calls to address the social isolation and loneliness of older adults. RESULTS: Twenty-five nursing students participated in the program, and they had a mean age of 27.44, with 76% of them being women. After the training program, the participants showed statistically significant improvements (p < 0.05) with respect to their knowledge and attitudes towards older adults, and the program was adapted to the best educational practices in simulations. CONCLUSIONS: Simulation-based online training efficiently improved the knowledge and attitudes of nursing students towards older adults, improving their ability to address social isolation and loneliness. The high satisfaction and adhesion to the best educational practices underline the usefulness of high-fidelity online simulations, especially in situations in which face-to-face training is not feasible, and accessibility and equilibrium could be guaranteed between work and personal life.

Effectiveness of the flipped classroom methodology on the learning of evidence-based practice of nursing students: Quasi-experimental design.

BACKGROUND: International organizations recognize the importance of evidence-based practice (EBP) for nurses. The objective of teaching EBP in the Nursing degree is to train future nurses on this subject. Different teaching models exist for this, from less active traditional models to more active ones such as the flipped classroom. OBJECTIVE: To compare the degree of EBP competence of undergraduate nursing students after an EBP course, through the application of a traditional methodology versus a flipped classroom methodology. DESIGN: Quasi-experimental study of non-equivalent groups. SETTING: The study was composed by a group of students who received training on EBP with the traditional model (face-to-face), and another intervention group with whom the flipped classroom model was utilized, using the online teaching platform EBP-eToolkit. PARTICIPANTS: The study was conducted with 4th-year Nursing degree students enrolled in the course evidence-based practice, in academic years 2019/20 and 2021/2022. METHODS: Before and after the course, the students completed a questionnaire about EBP competence (EBP-COQ), and an objective test was given at the end of the year. RESULTS: A sample of 152 students in the face-to-face group (control), and 143 students in the flipped classroom group (intervention) participated. The intervention group significantly improved its competence on attitude (p = 0.01, η2 = 0.022), skills (p = 0.019, η2 = 0.018), and global competence in EBP (p = 0.003, η2 = 0.030), with respect to those who were taught using the traditional method. However, there were no significant differences in the impact on knowledge, neither through the self-report dimension of the EBP-COQ (p = 0.188) nor the final test score, control group 6.89 (SD: 1.35) and flipped classroom group 7.12 (SD: 1.53) (p = 0.206). CONCLUSIONS: The flipped classroom model is adequate for the teaching of EBP to undergraduate nursing students. It produced a slight increase in attitude, as well as in skills and global competence in EBP. Nevertheless, this increase was not significantly different from face-to-face learning in terms of impact on EBP knowledge.

Development and psychometric testing of the non-technical skills scale in medical and surgical hospital units for nursing students.

OBJECTIVE: To develop and validate a tool to assess the non-technical skills of medical and surgical hospital units undergraduate nursing students. BACKGROUND: In the area of healthcare, non-technical skills complement technical ones, and contribute to patient safety. High-fidelity simulation is an ideal resource for working on these skills. Thus, evaluation instruments are needed to understand the efficiency of this methodology. Although many evaluation instruments already exist, none measure non-technical skills of undergraduate nursing students in medical and surgical hospital units. DESIGN: An instrumental study design was employed. METHODS: Two-phases were used to develop and validate the scale: 1) Scale development. A group of experts defined the dimensions and components. Afterwards, the content was validated by experts, and a pilot study was conducted with undergraduate Nursing students. 2) Analysis of the psychometric properties of the scale. A total of 393 students were evaluated in high-fidelity simulation scenarios by three evaluators, through the use of the Non-Technical Skills in Medical and Surgical Hospital Units (NTS-Nursing) Scale. RESULTS: The content validity indexes were adequate for the total of the items and the total of the scale. The statistical descriptors of the items, the internal structure, and the reliability (internal consistency and inter-evaluator reliability) were analyzed, as well as the external evidence of validity, with adequate values obtained. CONCLUSION: The NTS-Nursing scale is a valid and reliable instrument. Its structure of 10 items makes its use fast and easy.

Impact of COVID-19 Restrictions in Childbirth and Puerperium: A Cross-Sectional Study.

Introduction (1): The COVID-19 pandemic led to changes in healthcare during pregnancy, childbirth and puerperium. The objective of this study was to know the impact of visit restrictions, PCR performance and use of masks on delivery and puerperium care. Methods (2): A descriptive cross-sectional study was carried out. A survey was used to assess the impact of COVID-19-related measures on women who had given birth in hospitals in the Region of Murcia, Spain, between March 2020 and February 2022. Results (3): The final sample size was 434 women. The average scores were 4.27 for dimension 1 (Visit restrictions), 4.15 for dimension 2 (PCR testing) and 3.98 for dimension 3 (Mask use). More specifically, we found that the restriction of visits was considered a positive measure for the establishment of the mother-newborn bond (mean score 4.37) and that the use of masks at the time of delivery should have been made more flexible (mean score 4.7). Conclusions (4): The policy of restricting hospital visits during the pandemic caused by COVID-19 has been considered beneficial by mothers, who expressed that they did not feel lonely during their hospital stay.

Consequences of the Covid-19 pandemic on complex multimorbid elderly: Follow-up of a community-based cohort. SAMAC3 Study.

BACKGROUND: The restrictions imposed during the management of the pandemic led to lack of care of other health problems. PURPOSE: To assess changes in the health status of complex multimorbidity elderly, functional and cognitive capacities, perception of the social surroundings, care provided by the nurses, including nursing diagnosis and interventions, use of health services, adverse events, and use of devices and technical help during the first 6 months of the Covid-19 pandemic. DESIGN: A 1-year longitudinal cohort study was conducted. METHODS: Ninety-seven complex multimorbid elderly attended in primary care were evaluated every 3 months in a health area of the Spanish National Health System (SNHS). The research was called "SAMAC3 study". RESULTS: Significant negative changes were observed in the functional and cognitive capacity of the elderly, and in several nursing diagnoses. A decrease was observed in the frequency of visit to the nurses, hospital admittance, length of hospital stays, and falls. CONCLUSIONS: The functional and cognitive capacities of the cohort became worse. However, a significant decrease in the frequency of use of health services was observed. The nurses detected significant changes in activity-exercise, cognitive-perception, and roles-relationships, but their interventions were mostly centered on resolving clinical matters that required immediate attention. CLINICAL RELEVANCE: The present study allowed us to observe that a situation of social and health stress has worsened the health indicators of multimorbid elderly, and the clinical care of community nurses was insufficient to providing care for the deterioration of the physical and cognitive domains.

Adaptación y validación de un instrumento de evaluación de la competencia del consejo breve para dejar de fumar. BTI-Prof© / Adaptation and validation of an instrument to evaluate the competence on a Brief Tobacco Intervention. BTI-Prof©

Objetivo: Adaptación y validación del BTI-St© para evaluar el nivel de competencia en consejo breve para dejar de fumar en profesionales de medicina y enfermería de Atención Primaria. Diseño: estudio transversal, de adaptación y validación psicométrica de un test referido a criterio. Emplazamiento: Atención Primaria. Participantes: Ciento cincuenta y cinco profesionales de medicina y enfermería de Atención Primaria en activo. Intervenciones: Se diseñaron 3 escenarios clínicos. A través de una plataforma online, los participantes en primer lugar visualizaban cada escenario donde se desarrollaba un consejo breve para dejar de fumar y posteriormente debían valorar si se había realizado de acuerdo con el modelo de las 5A+5R. Mediciones principales: Competencia en el consejo breve para dejar de fumar medida a través del BTI-Prof©. Resultados: Los resultados vinculados a la fiabilidad se obtuvieron mediante el coeficiente Kuder-Richardson y fueron para el escenario 1: 0,880, para el escenario 2: 0,829 y para el escenario 3: 0,826. El test-retest muestra una adecuada estabilidad temporal, con unos coeficientes de correlación intraclase de 0,857 (IC 95%: 0,734-0,923), p<0,0001 para el escenario 1, 0,829 (IC 95%: 0,676-0,909), p<0,001 para el escenario 2 y 0,869 (IC 95%: 0,76-0,928), p<0,0001 para el escenario 3. Conclusiones: El BTI-Prof© es una herramienta robusta, con adecuadas propiedades psicométricas para evaluar la competencia en consejo breve para dejar de fumar en profesionales de medicina y enfermería de Atención Primaria.(AU)

Objective: Adaptation and validation of the BTI-St© to assess the level of competence in brief tobacco intervention in general practitioners and nurses in Primary Health Care. Design: Cross-sectional study of adaptation and psychometric validation of a criterion-referenced test. Setting:Primary Health Care. Participants: One hundred fifty-five general practitioners and nurses working at Primary Health Care. Interventions: Three clinical scenarios were designed. Using an online platform, participants first viewed each scenario in which brief tobacco intervention was given. Health professional had to assess whether or not the scenarios were carried out in accordance with the 5A+5R model. Main measures: Competence in brief tobacco intervention measured by the BTI-Prof©. Results: Results related to reliability were obtained through Kuder-Richardson coefficient, being for scenario 1, 0.880, for scenario 2, 0.829, and for scenario 3, 0.826. The test–retest shows adequate temporal stability: intraclass correlation coefficient for scenario 1 0.857 (95% CI 0.734–0.923), p<0.0001, for scenario 2 0.829 (95% CI 0.676–0.909), p<0.001, and for scenario 3 0.869 (95% CI 0.76–0.928), p<0.0001. Conclusions: The BTI-Prof© is a robust tool with adequate psychometric properties to assess competence in brief tobacco intervention in Primary Health Care general practitioners and nurses.(AU)

[Adaptation and validation of an instrument to evaluate the competence on a Brief Tobacco Intervention. BTI-Prof©]. / Adaptación y validación de un instrumento de evaluación de la competencia del consejo breve para dejar de fumar. BTI-Prof©.

OBJECTIVE: Adaptation and validation of the BTI-St© to assess the level of competence in brief tobacco intervention in general practitioners and nurses in Primary Health Care. DESIGN: Cross-sectional study of adaptation and psychometric validation of a criterion-referenced test. SETTING: Primary Health Care. PARTICIPANTS: One hundred fifty-five general practitioners and nurses working at Primary Health Care. INTERVENTIONS: Three clinical scenarios were designed. Using an online platform, participants first viewed each scenario in which brief tobacco intervention was given. Health professional had to assess whether or not the scenarios were carried out in accordance with the 5A+5R model. MAIN MEASURES: Competence in brief tobacco intervention measured by the BTI-Prof©. RESULTS: Results related to reliability were obtained through Kuder-Richardson coefficient, being for scenario 1, 0.880, for scenario 2, 0.829, and for scenario 3, 0.826. The test-retest shows adequate temporal stability: intraclass correlation coefficient for scenario 1 0.857 (95% CI 0.734-0.923), p<0.0001, for scenario 2 0.829 (95% CI 0.676-0.909), p<0.001, and for scenario 3 0.869 (95% CI 0.76-0.928), p<0.0001. CONCLUSIONS: The BTI-Prof© is a robust tool with adequate psychometric properties to assess competence in brief tobacco intervention in Primary Health Care general practitioners and nurses.

Telephone-Based Structured Communication Simulation Program for the Follow-Up of COVID-19 Cases and Contacts in Primary Care.

(1) The COVID-19 pandemic has had many consequences on health systems worldwide. In the Spanish health system, telephone-based consultations were coupled to in-person consultations. This type of consultation was mainly a challenge for the primary care teams, who had to assume the greatest load of care provision. The objective of the present study was to discover the satisfaction and perception of health professionals related to a training program on efficient communication based on high-fidelity simulation. (2) Methods: A cross-sectional descriptive study based on a convergent and parallel mixed method. The satisfaction and perception of 275 health professionals associated with COVID-19 training based on the structured communication model CERCAR© was analyzed. (3) Results: The assessment of the satisfaction with the training and methodology was high. With respect to the transfer of information, the participants gave a high score to the categories of consolidation of learning, applicability to their work, and benefits for the institution. The qualitative results supported these findings. (4) Conclusions: The training program and its virtual modality were well received, and had a high degree of transference. The application of active, online learning methodologies is a relevant format for continuous education.

Improving learning in the management of gender violence. Educational impact of a training program with reflective analysis of dramatized video problems in postgraduate nurses.

BACKGROUND: Most gender-based violence victims who sought help in Spain did so through health services. Training on gender-based violence with active learning methodologies promotes the management of knowledge, reflection, and adaptation to change. Nurses, along with an educator, can construct knowledge with the same strategies they will use professionally. PURPOSE: To evaluate the knowledge, skills, and attitudes associated of postgraduate nurses on gender-based violence before and after a reflection-based training program with dramatized problem-videos. The secondary objectives were to evaluate the knowledge in the activation of protocols, skills, and attitudes in the management of women who are victims of gender-based violence, the consolidation of learning, and the applicability to the workplace. METHODS: Pre-post quasi-experimental study without a control group. A specifically validated and designed instrument was utilized to evaluate the dimensions of knowledge, skills, and attitudes when facing gender-based violence, before and after the training sessions, along with additional questions to assess if the participants possessed better tools to address gender-based violence. RESULTS: The difference between the pre and post-tests was statistically significant for the dimensions knowledge, skills, and attitude (p < 0.05), with a smaller effect size in the dimensions skills and attitude. Also, high scores were observed in the consolidation of learning and applicability to the workplace. CONCLUSION: Reflection-based training with dramatized problem-videos improved the acquisition of tools necessary for the detection and management of gender-based violence of nurses.

Self-Learning Methodology in Simulated Environments (MAES©) as a Learning Tool in Perioperative Nursing. An Evidence-Based Practice Model for Acquiring Clinical Safety Competencies.

BACKGROUND: The self-learning Methodology in Simulated Environments (Spanish acronym: MAES©, (Murcia, Spain) is a type of self-directed and collaborative training in health sciences. The objective of the present study was to compare the level of competence of postgraduate surgical nursing students in the clinical safety of surgical patients, after training with the MAES© methodology versus traditional theoretical-practical workshops, at different points in time (post-intervention, after three months, six months post-intervention, and at the end of the clinical training period, specifically nine months post-intervention). METHODS: We conducted a prospective study with an experimental group of surgical nursing postgraduate students who participated in MAES© high-fidelity simulation sessions, and a control group of postgraduate nursing students who attended traditional theoretical-practical sessions at two universities in Catalonia (Spain). The levels of competence were compared between the two groups and at different time points of the study. RESULTS: The score was higher and statistically significantly different in the experimental group for all the competencies, with a large effect size at every measurement point previously mentioned. CONCLUSIONS: The postgraduate nurses were the most competent in the clinical safety of surgical patients when they trained with the MAES© methodology than when they learned through traditional theoretical-practical workshops. The learning of surgical safety competencies was more stable and superior in the experimental group who trained with MAES©, as compared to the control group.

Psychological Therapy in Chronic Pain: Differential Efficacy between Mindfulness-Based Cognitive Therapy and Cognitive Behavioral Therapy.

The objective of this study is to evaluate the differential efficacy between Mindfulness-Based Cognitive Therapy (MBCT) and Cognitive Behavioral Therapy (CBT). A quasi-experimental design of repeated measures before and after the test (n = 57) was used with a non-equivalent control group from a previous cohort treated with CBT (n = 105). The t-test revealed significant differences in subjective quality of life for the MBCT group, and in quantity, optimum, and adequate sleep for the CBT group. The pre-post effect size comparison mostly showed slightly larger effect sizes in the MBCT group. CBT and MBCT had comparable efficacies, although a slight trend towards larger effect sizes in MBCT was found. Likewise, CBT seemed to improve sleep-related variables, while MBCT was associated with improvements in pain and quality of life.

Competencia en Práctica Basada en la Evidencia y factores asociados en las enfermeras de Atención Primaria en España / Evidence-Based Practice competency and associated factors among Primary Care nurses in Spain

Objetivo: Conocer el nivel de competencia en Práctica Basada en la Evidencia (PBE) de las enfermeras de Atención Primaria (AP) en España y analizar los factores asociados. Diseño: Estudio transversal de carácter nacional, realizado en enero-marzo de 2020. Emplazamiento: AP en España. Participantes: Setecientas ochenta enfermeras de AP en activo en el Sistema Nacional de Salud con experiencia profesional mínima de un año. Mediciones principales: 1) Variables sociodemográficas, profesionales y de acceso a información científica, y 2) variable de resultado: competencia en PBE (actitud, conocimientos, habilidades y utilización), evaluada mediante el cuestionario EBP-COQ Prof©. Se realizaron análisis bivariados y multivariados mediante regresión lineal. Resultados: La puntuación media en el nivel de competencia en PBE de las enfermeras de AP fue de 131,5 (desviación típica [DT] 17,0). Por dimensiones: actitud 36,8 (DT 3,6); conocimientos 38,2 (DT 8,9); habilidades 23,0 (DT 3,5) y utilización 33,3 (DT 6,1). Leer más de 3 artículos en el último mes es la variable que tiene más influencia sobre todas las dimensiones del EBP-COQ Prof©, seguida de la formación en PBE (más de 150h) y la tutorización de alumnos de Enfermería. El nivel educativo (máster, especialista y doctorado) se asocia con las dimensiones conocimientos y habilidades, mientras que trabajar en un centro BPSO® se asocia con la utilización de la PBE. Conclusiones: Estos hallazgos pueden orientar a los gestores en los servicios de AP a planificar estrategias que mejoren el nivel de competencia en PBE de las enfermeras, dirigidas principalmente a lograr una aplicación real en la práctica clínica. No obstante, se hace necesario considerar el posible impacto del sesgo de selección en los resultados.(AU)

Objective: To describe the Evidence-Based Practice (EBP) competency level in Primary Care (PC) nurses in Spain and to determine the associated factors. Design: Cross-sectional, national survey design, carried out between January and March 2020. Setting: PC in Spain. Participants: Seven hundred eighty PC active nurses in the National Health Service with at least one year of professional experience. Main measurements: (1) Sociodemographic, professional and access to scientific information variables; (2) outcome variable: EBP competency (attitude, knowledge, skills and utilization) assessed through the EBP-COQ Prof© questionnaire. Bivariate and multiple lineal regression analyses were carried out. Results: The mean score for the EBP competency of the PC nurses was 131.5 (standard deviation [SD] 17.0), according to dimensions: attitude 36.8 (SD 3.6); knowledge 38.2 (SD 8.9); skills 23.0 (SD 3.5); and utilization 33.3 (SD 6.1). The number of articles read in the last month has showed the most influence on all the EBP-COQ Prof© dimensions, followed by EBP training (more than 150h) and nursing students mentoring. The education level (master, specialist and doctorate) is associated with knowledge and skills dimensions, meanwhile belonging to a BPSO® center is associated with the EBP utilization. Conclusions: These findings can guide PC service managers to plan strategies that improve the EBP competency level of the nurses, aimed mainly at achieving real application in clinical practice. However, it is necessary to consider the possible impact of selection bias on the results.(AU)

Effects of Mindfulness-Based Cognitive Therapy for Chronic Pain: A Multicenter Study.

The prevalence of chronic pain in Spain is 15%. The objective of this study was to evaluate the efficacy of mindfulness-based cognitive therapy on patients with chronic pain. A quasi-experimental design of repeated measures pre- and post-test (N = 57) was carried out at three hospitals from the province of Alicante. Self-reported assessment measurements of pain intensity, anxiety-depression symptoms, perception of health status, interference of pain on sleep, self-efficacy in pain, acceptance, and mindfulness attitude were included. The T-test indicates significant differences in intensity of present pain, mental quality of life, and depression (medium effect sizes), as well as in self-efficacy: total score, symptom management and pain control (medium effect sizes), sleep disturbances and quantity of sleep (large effect sizes). MBCT is effective in reducing many symptoms in patients with chronic pain, although its maintenance needs to be further investigated.

Evaluation of evidence-based practice learning among undergraduate nursing students: Relationship between self-reported and objective assessment.

BACKGROUND: Self-reported scales and objective measurement tools are used to assess Evidence-based Practice (EBP) learning. An agreement between these measures has not been widely investigated among nursing students. OBJECTIVE: The aim of the present study was to examine the relationship between EBP competency in undergraduate nursing students, defined as the capability to choose and use an integrated combination of EBP knowledge, skills and attitudes, evaluated with the self-reported EBP-COQ questionnaire and the final test score of an EBP course included in a Nursing Degree Program. DESIGN: A cross-sectional study was carried out. SETTINGS: University of Murcia (Spain), Nursing Degree, academic year 2019/2020. PARTICIPANTS: The study population was comprised by 210 4th-year undergraduate nursing students enrolled in the Clinical Practice and Evidence-based Nursing course. All the students were invited to participate. METHODS: A validated EBP-COQ questionnaire (1 "lowest score" to 5 "highest score") and an objective test (score from 0 to 10) were used to assess EBP competency. The SPSS 26.0 program was used to perform descriptive, bivariate and multivariate analyses. RESULTS: 152 students participated (response rate 72.4%), the sample was 81.4% female, and the median age was 20 years old; 76.3% attended more than 75% of the class hours. After the EBP course, the students obtained a high overall EBP competency score (mean = 4.21; SD = 0.26). The mean score on the objective test was 6.86 (SD = 1.36). A moderate positive correlation was found between the subjective and objective EBP competency measurements (Pearson's correlation coefficient 0.5; p < 0.0001). CONCLUSIONS: Our findings contribute with new and significant evidence of the convergent validity of the EBP-COQ questionnaire, which increases the value of this instrument for evaluating the EBP competency of Nursing Degree students.

Core Evidence-Based Practice Competencies and Learning Outcomes for European Nurses: Consensus Statements.

BACKGROUND: Consensus on evidence-based practice (EBP) competencies and associated learning outcomes for registered nurses has not yet been achieved in the European context. AIMS: To establish a set of core EBP competencies for nurses and the most important EBP learning outcomes encompassing attitudes, knowledge, and skills dimensions for implementation into nursing education in European countries. METHODS: A multi-phase modified Delphi survey was conducted: Phase 1, a literature review; Phase 2, a two-round consensus of experts; and Phase 3, a Delphi survey. Experts from six European countries participated. RESULTS: In Phase 1, 88 records were selected and 835 statements extracted, which were grouped according to the seven steps of EBP. After removing 157 duplicates, the remaining competencies (n = 678) were evaluated in Phase 2. Then, a two-round expert consensus was reached, with 24 competencies and 120 learning outcomes identified and divided into affective, cognitive, and skills domains. In Phase 3, based on a Delphi survey expert consensus, all evaluated statements were included in a final set of competencies and learning outcomes. Only two learning outcomes were recommended for allocation to a different domain, and four were reformulated as suggested, with no further changes to the others. LINKING EVIDENCE TO ACTION: The set of EBP competencies and learning outcomes can guide nurse educators, managers, and EBP stakeholders in the development of content that incorporates EBP knowledge, skills, and attitudes into educational programs. Prioritizing the EBP competencies and learning outcomes that are most necessary and adapting them to every context will provide healthcare organizations with guidelines for enhancing the continuing education of nurses. These results could facilitate the development of effective tools for assessing nursing students' and nurses' perception of competencies required for EBP processes.

[Evidence-Based Practice competency and associated factors among Primary Care nurses in Spain]. / Competencia en Práctica Basada en la Evidencia y factores asociados en las enfermeras de Atención Primaria en España.

OBJECTIVE: To describe the Evidence-Based Practice (EBP) competency level in Primary Care (PC) nurses in Spain and to determine the associated factors. DESIGN: Cross-sectional, national survey design, carried out between January and March 2020. SETTING: PC in Spain. PARTICIPANTS: Seven hundred eighty PC active nurses in the National Health Service with at least one year of professional experience. MAIN MEASUREMENTS: (1) Sociodemographic, professional and access to scientific information variables; (2) outcome variable: EBP competency (attitude, knowledge, skills and utilization) assessed through the EBP-COQ Prof© questionnaire. Bivariate and multiple lineal regression analyses were carried out. RESULTS: The mean score for the EBP competency of the PC nurses was 131.5 (standard deviation [SD] 17.0), according to dimensions: attitude 36.8 (SD 3.6); knowledge 38.2 (SD 8.9); skills 23.0 (SD 3.5); and utilization 33.3 (SD 6.1). The number of articles read in the last month has showed the most influence on all the EBP-COQ Prof© dimensions, followed by EBP training (more than 150h) and nursing students mentoring. The education level (master, specialist and doctorate) is associated with knowledge and skills dimensions, meanwhile belonging to a BPSO® center is associated with the EBP utilization. CONCLUSIONS: These findings can guide PC service managers to plan strategies that improve the EBP competency level of the nurses, aimed mainly at achieving real application in clinical practice. However, it is necessary to consider the possible impact of selection bias on the results.

Grado de percepción sobre el conocimiento, las habilidades y la seguridad antes y después de un programa de entrenamiento con videolaringoscopia y mecanismo de protección Intubox® en el manejo de la vía aérea de pacientes con COVID-19 / Perception of level of knowledge, skills, and safety before and after training to perform videolaryngoscopy with the Intubox barrier system for airway management in patients with COVID-19

Objetivos. El objetivo principal fue describir el grado de percepción sobre el conocimiento, las habilidades y la seguridad antes y después de un programa de entrenamiento con videolaringoscopia y mecanismo de protección Intubox® en el manejo de la vía aérea de pacientes con COVID-19. El objetivo secundario fue evaluar la seguridad de los dispositivos de barrera en la intubación a través de un análisis visual de dispersión de partículas.Método. Ensayo clínico de un solo brazo basado en simulación. Los participantes fueron médicos que realizaron un programa de formación mediante simulación clínica de baja y alta fidelidad. Se usó un instrumento diseñado y valida-do específico para evaluar la percepción sobre el conocimiento, las habilidades y la seguridad antes y después del programa. Se realizó un análisis visual de la contaminación por gotas.Resultados. La muestra final estuvo compuesta por 27 médicos, con una edad media de 40 (DE 10,8) años y el 63% mujeres. Se obtuvo un incremento estadísticamente significativo en las dimensiones conocimiento, habilidad y seguridad tras el entrenamiento. Se observó una menor contaminación cuando se realizaron las técnicas de manejo de vía aérea con urna protectora.Conclusiones. Los urgenciólogos incrementaron su percepción sobre los conocimientos, habilidades y seguridad en el manejo de la vía aérea en pacientes con COVID-19 tras un programa de formación con simulación. El uso combinado de laringoscopia y dispositivo de barrera Intubox® causó menor dispersión de partículas durante la intubación. (AU)

Objectives. The main objective was to describe physicians’ perception of their knowledge, skill, and safety before and after training to perform videolaryngoscopy while using the Intubox barrier system when managing the airway of a patient with the coronavirus 2019 disease (COVID-19). The secondary objective was to assess the safety afforded by the barrier by means of visually evaluating particle dispersion during intubation.Methods. Single-arm clinical simulation trial. The participants were physicians who received training in both a low-fidelity and a high-fidelity simulation zone. The participants assessed their knowledge, skill, and safety when using the Intubox before and after training using a specially designed and validated questionnaire. Droplet contamination was estimated visually.Results. Twenty-seven physicians with a mean (SD) age of 40 (10.8) years participated; 63% were women. They perceived their knowledge, skill, and safety to be significantly higher after training. Droplet contamination was seen to decrease when airway management maneuvers were done with the barrier in place.Conclusions. After simulation training the emergency physicians judged their knowledge, skill, and safety to be greater when they used the barrier during airway management in patients with COVID-19. The combined use of a laryngoscope and the Intubox barrier resulted in less particle dispersion during intubation. (AU)

Perception of level of knowledge, skills, and safety before and after training to perform videolaryngoscopy with the Intubox barrier system for airway management in patients with COVID-19. / Grado de percepción sobre el conocimiento, las habilidades y la seguridad antes y después de un programa de entrenamiento con videolaringoscopia y mecanismo de protección Intubox® en el manejo de la vía aérea de pacientes con COVID-19.

OBJECTIVES: The main objective was to describe physicians' perception of their knowledge, skill, and safety before and after training to perform videolaryngoscopy while using the Intubox barrier system when managing the airway of a patient with the coronavirus 2019 disease (COVID-19). The secondary objective was to assess the safety afforded by the barrier by means of visually evaluating particle dispersion during intubation. MATERIAL AND METHODS: Single-arm clinical simulation trial. The participants were physicians who received training in both a lowfidelity and a high-fidelity simulation zone. The participants assessed their knowledge, skill, and safety when using the Intubox before and after training using a specially designed and validated questionnaire. Droplet contamination was estimated visually. RESULTS: Twenty-seven physicians with a mean (SD) age of 40 (10.8) years participated; 63% were women. They perceived their knowledge, skill, and safety to be significantly higher after training. Droplet contamination was seen to decrease when airway management maneuvers were done with the barrier in place. CONCLUSION: After simulation training the emergency physicians judged their knowledge, skill, and safety to be greater when they used the barrier during airway management in patients with COVID-19. The combined use of a laryngoscope and the Intubox barrier resulted in less particle dispersion during intubation.

OBJETIVO: El objetivo principal fue describir el grado de percepción sobre el conocimiento, las habilidades y la seguridad antes y después de un programa de entrenamiento con videolaringoscopia y mecanismo de protección Intubox® en el manejo de la vía aérea de pacientes con COVID-19. El objetivo secundario fue evaluar la seguridad de los dispositivos de barrera en la intubación a través de un análisis visual de dispersión de partículas. METODO: Ensayo clínico de un solo brazo basado en simulación. Los participantes fueron médicos que realizaron un programa de formación mediante simulación clínica de baja y alta fidelidad. Se usó un instrumento diseñado y validado específico para evaluar la percepción sobre el conocimiento, las habilidades y la seguridad antes y después del programa. Se realizó un análisis visual de la contaminación por gotas. RESULTADOS: La muestra final estuvo compuesta por 27 médicos, con una edad media de 40 (DE 10,8) años y el 63% mujeres. Se obtuvo un incremento estadísticamente significativo en las dimensiones conocimiento, habilidad y seguridad tras el entrenamiento. Se observó una menor contaminación cuando se realizaron las técnicas de manejo de vía aérea con urna protectora. CONCLUSIONES: Los urgenciólogos incrementaron su percepción sobre los conocimientos, habilidades y seguridad en el manejo de la vía aérea en pacientes con COVID-19 tras un programa de formación con simulación. El uso combinado de laringoscopia y dispositivo de barrera Intubox® causó menor dispersión de partículas durante la intubación.

Does Multidisciplinary Team Simulation-Based Training Improve Obstetric Emergencies Skills?

Clinical simulation in obstetrics has turned out to be a tool that can reduce the rate of perinatal morbidity and mortality. The objective of this study was to analyze the impact and evaluate the effects of training with high-fidelity simulation of obstetric emergencies on a multidisciplinary group. The quasi-experimental research study was structured in three phases: a first phase where the most important obstetric emergencies were determined, a second phase of design and development of the selected cases for simulation training, and a third and final phase where the abilities and satisfaction of the multidisciplinary team were analyzed. Three scenarios and their respective evaluation tools of obstetric emergencies were selected for simulation training: postpartum hemorrhage, shoulder dystocia, and breech delivery. The health professionals significantly improved their skills after training, and were highly satisfied with the simulation experience (p < 0.05). An inter-observer agreement between good and excellent reliability was obtained. Regarding conclusions, we can state that high-fidelity obstetric emergency simulation training improved the competencies of the health professionals.