Análisis de las prácticas clínicas en el Grado en Enfermería: visión de tutores y estudiantes / Analysis of clinical practices in the Nursing Degree: Vision of tutors and students

Objetivo: Conocer las opiniones de los tutores y de los estudiantes del Grado en Enfermería sobre las prácticas clínicas e identificar estrategias y propuestas de mejora para el desempeño de la labor docente. Método: Estudio cualitativo con perspectiva fenomenológica mediante grupos focales con enfermeros tutores de prácticas clínicas y estudiantes de Enfermería. Los participantes se segmentaron en 3 grupos: estudiantes, tutores del área médica y tutores del área quirúrgica. El número de grupos lo determinó la saturación de la información. Se transcribieron los discursos y se realizó un análisis manual sintáctico y semántico de los discursos para extraer las variables de análisis. Se obtuvieron los permisos del Comité de Ética de la Investigación Provincial y del centro correspondiente. Resultados: Tanto los tutores como los estudiantes destacan la necesidad de capacitar a los tutores en las habilidades formativas y proporcionarles herramientas que faciliten su labor, así como el reconocimiento formal de su función docente. En sus discursos, ambos colectivos proponen un cambio de visión y, sobre todo, de actitudes en el desarrollo de la enseñanza-aprendizaje. Y, por último, se manifiesta la necesidad de un cambio en el modelo de relaciones entre la Universidad y los servicios sanitarios. Conclusiones: Con base en lo anteriormente expuesto, se identifica la necesidad de incentivar y formar a los profesionales clínicos para la función tutorial y de plantear un cambio de modelo que propicie un acercamiento entre la Universidad y el sistema sanitario

Objective: To discover the opinions of the tutors and students of the Degree in Nursing on clinical practices and identify strategies and improvement proposals for teacher performance. Method: A qualitative study with a phenomenological perspective through focus groups with clinical nurse tutors and nursing students. The participants were divided into 3 groups: students, tutors from the medical area and tutors from the surgical area. The number of groups was determined by saturation of the information. The discourse was transcribed and a syntactic and semantic manual analysis of the discourse was made to extract the analysis variables. Permission was obtained from the Provincial Research Ethics Committee and the corresponding centre. Results: Both the tutors and the students emphasized the need to train tutors in teaching skills and provide them with tools that facilitate their work, as well as the need for formal recognition of their teaching function. In their discourse, both groups proposed a change of vision, and above all of attitudes, in the development of teaching-learning. Finally, there is a need for a change in the model of relations between the University and health services. Conclusions: Based on the above, the need to encourage and train clinical professionals as tutors is identified and a change of model proposed to bring the University and the health system closer together

Analysis of clinical practices in the Nursing Degree: Vision of tutors and students. / Análisis de las prácticas clínicas en el Grado en Enfermería: visión de tutores y estudiantes.

OBJECTIVE: To discover the opinions of the tutors and students of the Degree in Nursing on clinical practices and identify strategies and improvement proposals for teacher performance. METHOD: A qualitative study with a phenomenological perspective through focus groups with clinical nurse tutors and nursing students. The participants were divided into 3 groups: students, tutors from the medical area and tutors from the surgical area. The number of groups was determined by saturation of the information. The discourse was transcribed and a syntactic and semantic manual analysis of the discourse was made to extract the analysis variables. Permission was obtained from the Provincial Research Ethics Committee and the corresponding centre. RESULTS: Both the tutors and the students emphasized the need to train tutors in teaching skills and provide them with tools that facilitate their work, as well as the need for formal recognition of their teaching function. In their discourse, both groups proposed a change of vision, and above all of attitudes, in the development of teaching-learning. Finally, there is a need for a change in the model of relations between the University and health services. CONCLUSIONS: Based on the above, the need to encourage and train clinical professionals as tutors is identified and a change of model proposed to bring the University and the health system closer together.

Intervenciones enfermeras NIC como herramienta de evaluación de las competencias del Prácticum de estudiantes de Enfermería en las unidades quirúrgicas / NIC as a tool for assessing competences of nursing students in clinical placement at surgical units

INTRODUCCIÓN: Mostramos la utilidad del lenguaje estandarizado NIC para evaluar el alcance de las competencias del Prácticum de los estudiantes de enfermería en las unidades quirúrgicas. OBJETIVO: Conocer las intervenciones de enfermería de la clasificación NIC que los estudiantes pueden aprender a realizar en las unidades quirúrgicas y el grado de dificultad para el aprendizaje de las intervenciones, según las semanas de rotación del alumno en las prácticas clínicas. MÉTODO: Estudio cualitativo mediante técnica de consenso Delphi, con la participación de enfermeros con experiencia docentes que trabajan en unidades quirúrgicas hospitalarias donde los estudiantes realizan el Prácticum. Se triangularon los resultados mediante cuestionario a los tutores sobre el grado de conformidad con los mismos. RESULTADOS: Se consensuan las intervenciones que los alumnos pueden realizar en las unidades quirúrgicas y la frecuencia con que las realizan, también se determina el grado de dificultad de cada intervención y las semanas de prácticas que los alumnos necesitan para alcanzar el grado de aprendizaje esperado para alcanzar las competencias. CONCLUSIÓN: Los resultados nos permitirán diseñar rotaciones más ajustadas a las necesidades del alumnado. Conocer la frecuencia con la que una intervención se realiza en cada unidad determina las posibilidades de su aprendizaje y los indicadores para su evaluación

BACKGROUND: This paper shows the utility of a NIC standardized language to assess the extent of nursing student skills at Practicum in surgical units OBJECTIVE: To identify the nursing interventions classification (NIC) that students can learn to perform in surgical units. To determine the level of difficulty in learning interventions, depending on which week of rotation in clinical placement the student is. Method: Qualitative study using Delphi consensus technique, involving nurses with teaching experience who work in hospital surgical units, where students undertake the Practicum. The results were triangulated through a questionnaire to tutors about the degree of conformity. RESULTS: A consensus was reached about the interventions that students can achieve in surgical units and the frequency in which they can be performed. The level of difficulty of each intervention, and the amount of weeks of practice that students need to reach the expected level of competence was also determined. CONCLUSIONS: The results should enable us to design better rotations matched to student needs. Knowing the frequency of each intervention that is performed in each unit determines the chances of learning it, as well as the indicators for its assessment

[NIC as a tool for assessing competences of nursing students in clinical placement at surgical units]. / Intervenciones enfermeras NIC como herramienta de evaluación de las competencias del Prácticum de estudiantes de Enfermería en las unidades quirúrgicas.

BACKGROUND: This paper shows the utility of a NIC standardized language to assess the extent of nursing student skills at Practicum in surgical units OBJECTIVE: To identify the nursing interventions classification (NIC) that students can learn to perform in surgical units. To determine the level of difficulty in learning interventions, depending on which week of rotation in clinical placement the student is. METHOD: Qualitative study using Delphi consensus technique, involving nurses with teaching experience who work in hospital surgical units, where students undertake the Practicum. The results were triangulated through a questionnaire to tutors about the degree of conformity. RESULTS: A consensus was reached about the interventions that students can achieve in surgical units and the frequency in which they can be performed. The level of difficulty of each intervention, and the amount of weeks of practice that students need to reach the expected level of competence was also determined. CONCLUSION: The results should enable us to design better rotations matched to student needs. Knowing the frequency of each intervention that is performed in each unit determines the chances of learning it, as well as the indicators for its assessment.

[Medication safety in surgery. Error risk areas and improvements proposed by the nurses]. / MedicaSeguirdad de la medicacíon en quirófano áreas de riesgo de errores y propuestas de mejora de las enfermeras.

UNLABELLED: We describe the process of implementation of improvements for patient safety in the administration of medication in the operating room. OBJECTIVES: To know the weaknesses of the operating room that can contribute to an incident related to the medication and the administration of intravenous fluids in the operating room, and to place improvement strategies to reduce or prevent errors based on the experiences of the nurses. METHOD: Qualitative consensus by expert nurses group and questionnaire about the levels of risk that they attribute to each of the categories of analysis. We explore their experiences about safety in the operating room and their proposals for controlling medication errors. RESULTS: We identified as areas of greatest risk the providers, the prescription and the processing, as well as the weaknesses of the professional culture of patient safety and improvement proposals.

Seguridad de la medicación en quirófano. Áreas de riesgo de errores y propuestas de mejora de las enfermeras / Medication safety in surgery. error risk areas and improvements proposed by the nurses

Se describe el proceso de implantación de mejoras para la seguridad del paciente en la administración de medicamentos, en quirófano. Objetivos. Conocer los puntos débiles del quirófano que pueden contribuir a que se produzca un incidente en torno a la medicación y la administración de líquidos intravenosos en aquel, y establecer estrategias de mejora para reducir o prevenir los errores a partir de las experiencias de las enfermeras. Método. Cualitativo de consenso mediante grupo de enfermeras expertas y cuestionario sobre los niveles de riesgo que estas atribuyen a cada una de las categorías de análisis. Se exploran sus experiencias sobre la seguridad en quirófano y sus propuestas para el control de los errores de medicación. Resultados. Se identifican como áreas de mayor riesgo los proveedores y la prescripción y el procesamiento, los puntos débiles de la cultura profesional sobre la seguridad del paciente y las propuestas de mejora (AU)

This bibliographic study describes the aspects of bonding that a pediatric nurse must know to foster the emotional attachment between a mother and her baby in the maternity hospital setting. It describes the theoretical models of bonding based on a review of the literature and research on this subject. It also discusses the origins of the bonding theory and the characteristics, types, benefits and consequences that this attachment has on the child’s physical, emotional and social development. Finally, it summarizes the nurse’s role in strengthening mother-child duality, assisting with baby care and supporting the family environment. The qualitative protocol of Kitchenham (2005) was used to extract the relevant information. Conclusion: The results of this review highlight the key role of nurses in promoting mother-child bonding despite political structures in maternity and pediatric centres (AU)

[Patient safety in the operating room. Checklist implementation of general surgery]. / Seguridad del paciente en el quirófano: implantación del checklist en cirugía general.

OBJECTIVES: To plan, implement and evaluate strategies for implementation of Checklist in a general surgery operating rooms and preliminary evaluation of the experience in view of the nurses. METHODOLOGY: Implementation and evaluation of technological application of a checklist format similar to that published by WHO. The process was conducted in three phases using strategies for planning, implementation and evaluation. After training the professionals, design the checklist at each stage, assign the responsibility of screening and determine how registration was applied for 10 months in 68% of planned interventions and 30% urgent. Preliminary evaluation using qualitative methods, discourse analysis of operating room nurses who participated in its implementation and monitoring during implementation. CONCLUSIONS: The qualitative assessment is useful to know the attitudes, opinions and problems of nurses for the implementation of innovations that require interdisciplinary collaboration The application workload increases, but makes visible some activities. The broad participation of nurses reveal their involvement to promote patient safety, but also their training needs. It is essential to the awareness of all professionals to carry out the checklist, which can only be imposed if there is a culture change, innovation and safety and teamwork. For the test does not fall into the routine, it would be wise to do a periodic evaluation. The list should be clear, concise and reliable.

Seguridad del paciente en el quirófano. Implantación del checklist en cirugía general / Patient safety in the operating room. Checklist implementation of general surgery

Objetivos: planificar, implementar y evaluar estrategias de implantación de Checklist en unos quirófanos de cirugía general y evaluación preliminar de la experiencia en opinión de los profesionales de enfermería. Metodología: implementación tecnológica y evaluación de la aplicación de un Checklist de formato similar al publicado por la OMS. El proceso se realizó en tres fases mediante estrategias de planificación, implementación y evaluación. Tras formar a los profesionales, diseñar la lista de comprobaciones en cada una de las fases, asignar a los responsables del chequeo y determinar la forma de registro, se aplicó durante 10 meses en un 68% de las intervenciones programadas y un 30% de las urgentes. Evaluación preliminar mediante técnicas cualitativas: análisis de los discursos de las enfermeras de quirófano que participaron en su aplicación y observación durante la misma. Conclusiones: la evaluación cualitativa es útil para conocer las actitudes, opiniones y dificultades de las enfermeras para la implantación de innovaciones que requieren la colaboración interdisciplinaria. La aplicación incrementa cargas de trabajo pero hace visibles algunas actividades. La amplia participación de las enfermeras revela su implicación para favorecer la seguridad del paciente, pero también las necesidades en su formación. Resulta imprescindible la concienciación de todos los profesionales para llevar a cabo el Checklist, que solo se podrá imponer si existe una cultura del cambio, innovación y seguridad y trabajo en equipo. Para que la comprobación no caiga en la rutina, sería recomendable efectuar una evaluación periódica. La lista debe ser clara, concisa y fiable(AU)

Objectives: To plan, implement and evaluate strategies for implementation of Checklist in a general surgery operating rooms and preliminary evaluation of the experience in view of the nurses. Methodology: Implementation and evaluation of technological application of a checklist format similar to that published by WHO. The process was conducted in three phases using strategies for planning, implementation and evaluation. After training the professionals, design the checklist at each stage, assign the responsibility of screening and determine how registration was applied for 10 months in 68% of planned interventions and 30% urgent. Preliminary evaluation using qualitative methods, discourse analysis of operating room nurses who participated in its implementation and monitoring during implementation. Conclusions: The qualitative assessment is useful to know the attitudes, opinions and problems of nurses for the implementation of innovations that require interdisciplinary collaboration The application workload increases, but makes visible some activities. The broad participation of nurses reveal their involvement to promote patient safety, but also their training needs. It is essential to the awareness of all professionals to carry out the checklist, which can only be imposed if there is a culture change, innovation and safety and teamwork. For the test does not fall into the routine, it would be wise to do a periodic evaluation. The list should be clear, concise and reliable(AU)

Docencia universitaria semipresencial. Experiencia en el uso de la plataforma virtual SWAD / Semi-presential university teaching. An experience in the use of SWAD virtual platform

Introducción. La innovación en la metodología docente universitaria es una exigencia del nuevo Espacio Europeo de Educación Superior. La utilización de las tecnologías de la información y la comunicación es una realidad de la sociedad actual, y especialmente del alumnado universitario. Materiales y métodos. Este artículo muestra la experiencia en el uso de la plataforma virtual de apoyo a la docencia, en la asignatura de Salud y Medio Ambiente en la Universidad de Granada. Resultados y conclusiones. La opinión de los alumnos es muy favorable hacia su uso. Su nivel de satisfacción es muy alto, aunque les supone una dedicación y esfuerzo mayores a los esperados. La plataforma virtual ofrece unas posibilidades académicas que permiten el acercamiento y adaptación a los nuevos perfiles de alumnado. Para el profesorado supone un cambio en sus principales actividades: la preparación y diseño de contenidos, las tutorías virtuales y la gestión de foros (AU)

Introduction. The new European Space of higher education demands innovation in the university teaching methodology. The use of the new information and communication technologies is a reality in our current society, especially among university students. The use of virtual platforms for teaching is more developed in post graduate lifelong learning than in university education. Materials and methods. This articles narrates an experience in the use of SWAD virtual platform, teaching aid, in the subject course Health and Environment, in the University of Granada. Results and conclusions. The students have a positive opinion about the use of this platform. Their satisfaction level is very high, although it means more dedication and effort than expected. This virtual platform offers academic possibilities that allows us to get close and adapt to the new student profiles. To professors, it means a change in their main activities: preparing and designing contents, virtual tutorials, and forums managing (AU)

[Educational innovation on the practices for the subjects of community nursing, mental health nursing and geriatric nursing]. / Innovación docente en las prácticas de enfermería comunitaria, salud mental y geriatría.

The new European space for higher education requires changes in education manners as well as execution. One of the main challenges is for the students to acquire competence in their professional life. For that purpose they require knowledge, but also skills and a proactive attitude towards learning. In this paper we tell the experience of the Virgen de las Nieves School of Nursing in Granada, with regards to the integration of the practices for the subjects of Community Nursing III, Psychiatric and Mental Health Nursing, and Geriatric Nursing, which are taken in the third year of the Diplomatura en Enfermería degree. Said practices, which were previously being offered separately within different contexts, will be merged in the same program whose scope will be Primary Care. We believe that the experience has been very positive by looking both at the results and the satisfaction of the students and the professional lecturers. It has been achieved an increase in the number of community care practice hours, and students have managed to acquire more autonomy in their learning and to incorporate critical reasoning in their education. In the methodology used, they have been the main evaluators and protagonists in their learning process, seeking the implication of professionals and teaching tutors in this change. The consensus on the objectives and methods, along with the obstacles which had to be overcome, constitutes one of the most interesting aspects of this experience.

Innovación docente en las prácticas de enfermería comunitaria, salud mental y geriatría / Educational innovation on the practices for the subjects of community nursing. Mental health nursing and geriatric nursing

El nuevo espacio europeo de educación superior exige cambios tanto en el fondo como en la forma de enseñar. Uno de los principales retos es que el alumnado adquiera competencias para su vida profesional. Para ello requiere, además de conocimientos, habilidades y actitudes proactivas para el aprendizaje. En este artículo se explica la experiencia de la Escuela Universitaria de Enfermería (EUE) Virgen de las Nieves de Granada, a propósito de la integración de las prácticas de las asignaturas de Enfermería Comunitaria III, Enfermería Psiquiátrica y de Salud Mental y Enfermería Geriátrica, las cuales se cursan en tercer año de la Diplomatura de Enfermería. Dichas prácticas, que anteriormente se realizaban en distintos contextos de forma inconexa, se unen en un mismo programa que tiene como ámbito la atención primaria. Creemos que la experiencia ha sido muy positiva tanto por los resultados como por la satisfacción del alumnado y las profesionales docentes. Se ha conseguido incrementar el número de horas de prácticas extrahospitalarias, que el alumnado adquiriera mayor autonomía en su aprendizaje y que, además, incorporase el razonamiento crítico en su formación. Se ha utilizado una metodología donde han sido los principales evaluadores y dinamizadores de su proceso de aprendizaje, buscando la implicación de profesionales y tutores docentes en dicho cambio. El consenso en los objetivos y en los métodos, así como las barreras que se han tenido que superar constituye una de las partes más interesantes de esta experiencia(AU)

The new European space for higher education requires changes in education manners as well as execution. One of the main challenges is for the students to acquire competence in their professional life. For that purpose they require knowledge, but also skills and a proactive attitude towards learning. In this paper we tell the experience of the Virgen de las Nieves School of Nursing in Granada, with regards to the integration of the practices for the subjects of Community Nursing III, Psychiatric and Mental Health Nursing, and Geriatric Nursing, which are taken in the third year of the Diplomatura en Enfermería degree. Said practices, which were previously being offered separately within different contexts, will be merged in the same program whose scope will be Primary Care. We believe that the experience has been very positive by looking both at the results and the satisfaction of the students and the professional lecturers. It has been achieved an increase in the number of community care practice hours, and students have managed to acquire more autonomy in their learning and to incorporate critical reasoning in their education. In the methodology used, they have been the main evaluators and protagonists in their learning process, seeking the implication of professionals and teaching tutors in this change. The consensus on the objectives and methods, along with the obstacles which had to be overcome, constitutes one of the most interesting aspects of this experience(AU)

Importancia de un ambiente libre de interrupciones durante el proceso de preparación y administración de medicamentos para la seguridad del paciente / Importance of an interruption-free environment for the safety of the patient while preparing and administering medications

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Proceso de mejorade la enseñanza teóricoprácticade Enfermería MédicoQuirúrgica / Improvement process of theory-practice teaching of Medical-Surgical Nursing

Con el presente trabajo se pretende describir el proceso de mejora de laenseñanza teórico-práctica o de simulación en las materias de EnfermeríaMédico-Quirúrgica de segundo curso de la Diplomatura de Enfermería.Se trata de un trabajo de mejora tecnológica que se realizó en la EUEVirgen de las Nieves, adscrita a la Universidad de Granada, a lo largo detres cursos académicos. La enseñanza teórico-práctica o las prácticas desimulación constituyen el primer contacto de los estudiantes de Enfermeríacon los productos o materiales sanitarios, los cuales, mediante unadeterminada forma de usarlos o aplicarlos, a maquetas, robots, maniquíes,etc., constituirán las técnicas o procedimientos de los cuidados quehabrán de dominar y desarrollar en las prácticas clínicas. Esta aproximacióna la realidad ayuda a los estudiantes a reproducir con bastante fidelidadlos escenarios donde van a tener que enfrentarse a los problemas desalud de la población, de ahí, la importancia de establecer un programacomún con criterios y contenidos unificados y consensuados por todoslos profesores implicados. Previa exploración y análisis estratégico de lasituación de partida, el objetivo de este proyecto ha sido mejorar la insercióndel alumno en las unidades donde realiza las prácticas clínicas, así comoprepararle y motivarle para que, posteriormente, aprenda con mayor facilidada actuar en el contexto real y, a partir de esta base, adquiera las competenciascurriculares que tiene como objetivo esta asignatura (AU)

This work aims to describe the process to improve the theory-practiceor simulation teaching of topics relating to second year Medical-SurgicalNursing of the Nursing degree. It is a technological improvementwork that was performed in the Nursing School of Virgen de las Nieves,linked to the University of Granada, over the course of three academicyears. Theory-practice teaching or simulation practice are the firstpoint of contact of Nursing students with health products or materialswhich constitute the techniques or procedures of care that they will haveto master and develop in clinical practice sessions. This approach toreality helps students to reproduce, pretty accurately, the scenarios wherethey will have to face the population’s health problems. Therefore, itis very important to establish a shared programme with unified criteriaand contents that have been agreed upon by all teachers involved. Priorexploration and strategic analysis of the initial situation, the objectiveof this project has been to improve students’ insertion into the units wherethey will carry out clinical practice work, and to prepare them and motivatethem so that they later learn more easily how to act in real situationsand from there acquire the curricular competences that embodythe objective of this course (AU)

[Problem-based learning, a strategy to employ it]. / Aprendizaje basado en problemas: estrategia de implantación.

The Virgen de las Nieves University School of Nursing has adopted the methodology of Problem-Based Learning (ABP in Spanish acronym) as a supplementary method to gain specific transversal competencies. In so doing, all basic required/obligatory subjects necessary for a degree have been partially affected. With the objective of identifying and administering all the structural and cultural barriers which could impede the success or effectiveness of its adoption, a strategic analysis at the School was carried out. This technique was based on a) knowing the strong and weak points the School has for adopting the Problem-Based Learning methodology; b) describing the structural problems and necessities to carry out this teaching innovation; c) to discover the needs professors have regarding knowledge and skills related to Problem-Based Learning; d) to prepare students by informing them about the characteristics of Problem-Based Learning; e) to evaluate the results obtained by means of professor and student opinions, f) to adopt the improvements identified. The stages followed were: strategic analysis, preparation, pilot program, adoption and evaluation.

Aprendizaje basado en problemas. Estrategia de implantación / Problem-based learning, a strategy to employ it

La Escuela Universitaria de Enfermería Virgen de las Nieves ha implantado la metodología del Aprendizaje Basado en Problemas (ABP), como método complementario para el logro de competencias transversales y específicas. Esto ha supuesto implicar de forma parcial a todas las asignaturas troncales y obligatorias de la titulación. Con el fin de identificar y gestionar las barreras estructurales y culturales que pudieran dificultar el éxito o la efectividad de su implantación se realizó un análisis estratégico de la Escuela. Esta técnica se basó en: a) Conocer los puntos fuertes y débiles de la Escuela para la implantación de la metodología ABP. b) Describir los problemas y necesidades de tipo estructural para llevar a cabo la innovación docente. c) Averiguar las necesidades de los profesores en cuanto a conocimientos y habilidades relacionados con el ABP. d) Preparar a los alumnos informándoles sobre las características del ABP. e) Evaluar los resultados mediante la opinión de los alumnos y profesores. f) Implantar las mejoras identificadas. Las etapas seguidas fueron: análisis estratégico, preparación, prueba piloto, implantación y evaluación(AU)

The Virgen de las Nieves University School of Nursing has adopted the methodology of Problem-Based Learning (ABP in Spanish acronym) as a supplementary method to gain specific transversal competencies. In so doing, all basic required/obligatory subjects necessary for a degree have been partially affected. With the objective of identifying and administering all the structural and cultural barriers which could impede the success or effectiveness of its adoption, a strategic analysis at the School was carried out. This technique was based on a) knowing the strong and weak points the School has for adopting the Problem-Based Learning methodology; b) describing the structural problems and necessities to carry out this teaching innovation; c) to discover the needs professors have regarding knowledge and skills related to Problem-Based Learning; d) to prepare students by informing them about the characteristics of Problem-Based Lear-ning; e) to evaluate the results obtained by means of professor and student opinions, f) to adopt the improvements identified. The stages followed were: strategic analysis, preparation, pilot program, adoption and evaluation(AU)

Plan de cuidados periquirúrgicos para el paciente trasplantado hepático / Perisurgical Nursing care plan for patients who have undergone liver transplantation

En nuestro hospital, desde el año 2002 se inició el programa de Trasplante Hepático (TH). La complejidad y especificidad de la intervención quirúrgica de TH, nos llevó a plantear la necesidad de elaborar un plan de cuidados periquirúrgico estandarizado que recogiera todas las actuaciones que realizan las/os enfermeras/os. Para ello se llevó a cabo un proceso de mejora de la calidad, que constó de dos etapas: 1ª etapa: se exploraron las actividades perioperatorias que las enfermeras realizan en el paciente trasplantado hepático, se elaboró un protocolo y se pilotó con fines de validación; 2ª etapa: se adecuó el plan de cuidados definitivo según los resultados del pilotaje (AU)

The liver transplantation (LT) programme was started in our hospital in 2002. The complexity and specificity of LT surgery led us to present the need to draw a standardised perisurgical nursing care plan that compiled all the tasks or actions undertaken by professional nursing personnel. To this end, a quality improvement process was undertaken which consisted of two stages: a first stage that explored the perioperative activities undertaken by nurses in patients with a liver transplant and that involved the elaboration of a protocol which as used as a pilot for validation purposes; and a second stage where the final nursing care plan was adapted to meet the results of the pilot phase conducted in the first stage (AU)

Plan de cuidados estandarizado para el postoperatorio de cirugía perianal ambulatoria / Standardised nursing care plan for out-patient postoperative perianal surgery

En la atención ambulatoria adquiere una especial relevancia la consideración de aspectos individuales, sociales y familiares del paciente, debido a que la convalecencia de su proceso se realiza en régimen ambulatorio, lo que hace aún más necesario el autocuidado. El propósito de este trabajo fue la elaboración de un plan de cuidados consensuado para los pacientes operados de sinus pilonidal durante las primeras semanas después de la intervención, siguiendo el modelo de Enfermería de V Henderson y la terminología enfermera de las taxonomías NANDA, NIC, NOC, identificando también los posibles problemas estructurales y las dificultades de su implantación. Metodología: se trata de un trabajo de implementación tecnológica en el que se utilizó la observación y la participación de un grupo de expertos. Se realizó en dos fases: a) fase de elaboración de un plan estándar, por consenso, a partir del análisis de los planes de cuidados realizados por alumnos de Enfermería; y b) fase de pilotaje del mismo aplicándolo a 10 pacientes. Finalmente, se elabora un plan de cuidados adaptado a las características de los pacientes y a la estructura de la unidad. Resultados: la utilización de un modelo enfermero como marco de análisis y reflexión ha servido para orientar la toma de decisiones enfermeras y clasificar los distintos tipos de problemas de salud del paciente. Las taxonomías de lenguaje enfermero han sido útiles para designar las distintas áreas de responsabilidad en el cuidado y para clarificar los criterios de resultados en el paciente

In out-patient care, the consideration of individual, social and family aspects of the patient acquires a special relevance because the process of convalescence has to be followed on an out-patient basis, hence making self-car even more necessary. The purpose of this paper was to elaborate a consensuated nursing care plan for patients who had undergone dermoid cyst surgery during the first week after the intervention, following the V. Henderson´s nursing model and the nursing terminology of the NANDA, NIC and NOC taxonomies. The paper also identified possible structural problems and the difficulties that were encountered during their implementation. Methodology: this study was carried out based on technological implantation and counted with the observation and participation of a group of experts (peer review). It was conducted in two phases: a) Elaboration phase of a standard plan, by consensus, based on the analysis of care plans carried out by student nurses and, b) pilot phase of the plan by applying such to 10 patients. Lastly, a nursing care plan adapted to the patient characteristics and the structure of the unit was elaborated. Results: the utilisation of a nursing model as a framework for analysis and reflection has served as guidance in the taking of nursing decisions and in the classification of the different health problems of the patients. The taxonomies of the nursing language have been useful to designate the different areas of responsibility in the care and to clarify the results criteria in the patient

[Informal care and nurses. Relations inside the hospital]. / Cuidadoras informales y enfermeras. Relaciones dentro del hospital.

The prolongation of a hospital stay or chronic illness in a family may cause a severe deterioration in the health of informal caretakers; therefore, it is necessary that professionals who work in formal institutions act as consultants and that they optimize informal caretakers' abilities so that they learn not only how to care for their ill relatives but also so that they care for themselves. Nonetheless, health centers, who concentrate on the ill patients, do not always consider informal caretakers as part of a family context which bears direct influence on the well-being and health of these people. In this article, the author proposes to: know the relationship models which the professional nursing team establishes with caretakers in the hospital environment; identify the strengths and weaknesses of caretakers, nursing professionals and institutions in order to establish a model for capacity-collaboration relationship. The methodology used was of a qualitative nature, utilizing discussion groups with professionals and semi-structured interviews with caretakers selected from among those who were found in the hospital. We could conclude that in the majority of the wards in the "HMQ" hospital, the patients are considered passive receptors of professional care and their families are left to the side. A model for capacity-collaboration relationship does not appear viable in HMQ due to the presence of certain weaknesses. However, there are certain strengths which could be fortified; these include the desire of the caretakers and the conviction among professionals of the benefits which such a relationship model would provide.

Cuidadoras informales y enfermeras. Su relación dentro del hospital / Informal caretakers and nurses. Their relationships inside a hospital

La prolongación de un ingreso hospitalario o una enfermedad crónica de un miembro de la familia, puede suponer un gran deterioro de la salud para las cuidadoras informales; por tanto necesitan que los profesionales de los sistemas formales actúen de consultores y potencien sus habilidades personales para que aprendan, no sólo a cuidar a sus enfermos sino también a cuidarse a sí mismas. Sin embargo, los servicios sanitarios, centrados en los pacientes, no siempre consideran a las cuidadoras como parte de un contexto familiar que influye directamente en el bienestar y la salud de éstos. En este artículo se quiere: Conocer los modelos de relación que establecen los profesionales del equipo de enfermería con las cuidadoras, en el medio hospitalario. Identificar los factores que condicionan sus relaciones con los profesionales. Identificar las fortalezas y debilidades de las cuidadoras, profesionales de enfermería e institución, para establecer un modelo de relación de colaboración-capacitación. La metodología empleada fue de tipo cualitativo, utilizando grupos de discusión con profesionales y entrevistas semiestructuradas con cuidadoras seleccionadas entre las que se encontraban en el hospital. Podríamos concluir que en la mayoría de los servicios del HMQ los pacientes son considerados pasivos receptores de la atención profesional y la familia queda al margen. Un modelo de relación de colaboración-capacitación, no parece viable en el HMQ debido a la existencia de ciertas debilidades. Sin embargo existen ciertas fortalezas que podrían ser potenciadas como es el deseo de las cuidadoras y el convencimiento entre los profesionales de los beneficios que supondría este modelo de relación. (AU)