Experience of primary care nurses applying nurse-led management of patients with acute minor illnesses.

AIM: The aim of this study is to determine the experience of primary health care nurses regarding the application of nurse-led management in patients with acute minor illnesses. BACKGROUND: Nursing leadership of care for acute minor illnesses is a new challenge faced by nurses in Spain. DESIGN: Qualitative, hermeneutical, interpretive phenomenological approach is used. The Consolidated criteria for reporting qualitative research guidelines were applied. METHODS: Twenty primary care nurses participated; three focus group discussions and nine semi-structured interviews were conducted between November 2019 and October 2020. All the focus group discussions and interviews were recorded, transcribed verbatim and analysed using content analysis. RESULTS: Seven main themes emerged from the focus group discussions and interviews: concept, perception of the other actors, practice, history and social context, competencies, training, and legality. CONCLUSION: The study shows the diversity and complexity of nurses' experience when applying nurse-led management in acute minor illnesses. This work has helped to show the gaps perceived by nurses, including the lack of training in the treatment of conditions historically attended by physicians, the lack of definition of the legal framework and the limitations on nurse prescribing. It also highlighted the power of the nursing profession in terms of autonomy, competencies and role expansion.

El catéter como elemento fundamental en las terapias de depuración renal / The catheter as a fundamental element in renal cleansing therapies

El término “catéter” es muy conocido para las enfermeras, sin embargo, el manejo de las vías para los pacientes con fallo renal es un tema que ofrece cierta dificultad.Las facetas específicas con relación a este tipo de catéteres y el tratamiento depurativo renal son el objetivo de este capítulo. Se analiza cómo hacer el cálculo del flujo de sangre, cómo elegir un buen catéter según su morfología, cuál es la técnica mejor para conservarlo y de qué forma sellarlo cuando se deje en reposo, sin tratamiento depurativo.Estos y otros conocimientos fundamentales se describirán, a partir de la evidencia hallada en la literatura. (AU)

The word catheter is well known to nurses, however, its management for patients with renal failure is a subject that offers some difficulty.The problems with this specific catheter and the renal purifying treatment are the objective of this paper. It analyses how to calculate the blood flow, how to choose a good catheter according to its morphology, what is the best technique to preserve it and how to lock it when it is left at rest, without any purifying treatment.These and other fundamental knowledge will be described, based on the evidence founded in the literature. (AU)

Treatment of minor health problems by primary care nurses: A cross-sectional study.

AIMS: To assess the results of a nursing-led program to treatment of minor health issues from Catalan health institute primary care teams during 2019 and 2020. BACKGROUND: In 2009, the Catalan health institute implemented a nursing program to deal with minor health problems. This nursing-led program includes an algorithm for each of the minor health problems and arose as a strategy to reorganise the flow of demand for care in primary care. DESIGN: A cross-sectional design. METHODS: Multicentric cross-sectional study. 392 primary care teams from the Catalan health institute participated in the study. STROBE guideline was followed in reporting this study. Patients attending any of the participating centres requesting a same-day consultation for minor health issues were registered. RESULTS: A total of 21,215,278 consultations were recorded: 18,284,105 for adult and 2,931,173 for paediatric patients. Minor health issue resolved by the nurse was achieved in 50.9% of adult patients and 55.4% of paediatric patients. The highest rates of resolution in adults (>85%) were as follows: burns, emergency contraception and injuries. The highest resolution rates (>84%) were as follows: burns, breastfeeding difficulties and infant colic. 87.7% of prescriptions issued by nurses were accepted by the family physician. CONCLUSIONS: The nursing-led program to treat minor health issues has been shown to present acceptable resolution for nurses in a large primary care setting. Nurses have been carrying out prescription activities with very favourable results. RELEVANCE TO CLINICAL PRACTICE: This study demonstrates that care provided to patients by nurses for minor health issues requiring preferential resolution is effective. Our results are useful in that they confirm both the effectiveness of the nursing-led program for minor health issues and the pharmacological prescriptions produced during patient appointments. PATIENT OR PUBLIC CONTRIBUTION: Patient's data were obtained through a program records system after the minor health issues appointments.

Empleo y resolución de la Gestión Enfermera de la Demanda en Cataluña / Use and resolution of Nurse Demand Management in Catalonia

Introducción: la gestión enfermera de la demanda (GED) es la atención a los problemas agudos leves liderada por la enfermera y llevada a cabo en los centros de atención primaria de Cataluña desde el 2009. El objetivo del estudio es evaluar el grado de implantación y resolución de la GED en los centros del Institut Català de la Salut. Métodos: estudio observacional descriptivo transversal. El ámbito de estudio ha sido el de atención primaria del Institut Català de la Salut de Cataluña. Análisis de datos secundarios. Los datos han sido extraídos de la plataforma Longview. Las variables de estudio han sido en cuanto a la GED: el número de visitas, la resolución, los motivos de consulta y protocolos implantados en los equipos. Resultados: la GED en el territorio catalán presenta variabilidad en los porcentajes de resolución entre las diferentes gerencias territoriales. Los protocolos pediátricos presentan mayor resolución que los de adultos. Los protocolos con mayor resolución son los relacionados con la práctica usual de la enfermera, y los menos, los que históricamente resolvía el médico. Por último, existe correlación positiva entre los protocolos implementados y el número de usuarios visitados por la enfermera. Conclusiones: el liderazgo enfermero en la atención a enfermedades agudas leves es una práctica afianzada por las enfermeras de atención primaria; aunque existe heterogeneidad en la resolución de los motivos de consulta especialmente entre los que habitualmente atendía la enfermera y los que históricamente resolvía el médico. (AU)

Introduction: Nursing leadership in users with acute minor illnesses (NLAMI) is the attention given by nurse to people with acute problems carried out in primary care centers in Catalonia since 2009. The aim of the study is to evaluate the degree of resolution of the NLAMI in the centers of the Institut Català de la Salut. Methods: cross-sectional descriptive observational study. The scope of the study was the primary care of the Institut Català de la Salut in Catalonia. Secondary data analysis. The data were extracted from the Longview platform. The study variables were related with NLAMI: number of visits, resolution, reasons for consultation and protocols implemented in the health centers. Results: The NLAMI is implemented in the Catalonia and there is variability in the percentages of resolution between territories. Pediatric protocols have higher resolution than adult protocols. The most resolved protocols are those related to the usual practice of the nurse, and the least resolved protocols are those historically resolved by the physician. Finally, there is a positive correlation between the protocols implemented and the number of users visited by the nurse. Conclusions: the leadership in the care of acute minor illnesses is an established practice of primary care nurses and there is heterogeneity in the resolution of the reasons for consultation, especially between those usually attended by the nurse and those historically resolved by the physician. (AU)

Impacto de la formación y aspectos legales en la aplicación de la gestión enfermera de la demanda por parte de las enfermeras de atención primaria de Cataluña / Impact of training and legal aspects on the application of nurse demand management by primary care nurses in Catalonia

Objetivo: Conocer la experiencia de las enfermeras de atención primaria en la aplicación de la gestión enfermera de la demanda (GED). Diseño: Estudio observacional, descriptivo y transversal. Emplazamiento: Atención primaria de Cataluña. Participantes: Enfermeras de atención primaria de Cataluña. Se estimó una muestra de 394 participantes alcanzando 405. La obtención de datos fue desde octubre de 2021 hasta enero de 2022. Mediciones principales: Se realizó un cuestionario ad hoc, el cual exploraba aspectos referentes a la experiencia de aplicación de la GED: definición y manejo del programa, formación y aspectos legales del programa. Resultados: Las enfermeras entienden la GED como un triaje. Además, consideran que la implantación de la prescripción enfermera no mejora la aplicación de la GED. Manifiestan una falta de formación especialmente las enfermeras más noveles. La formación ideal en GED, consideran, debería incluir fisiopatología y supuestos prácticos. Siete de cada 10 enfermeras desconocen el marco legal que ampara la GED y les provoca inseguridad no conocerlo. Seis de cada 10 han dejado de ser resolutivas por miedo a las repercusiones legales. Las enfermeras que sí conocen el marco legal son las que han dejado de resolver en menor proporción. Conclusiones: Se constata la necesidad de formación general en la GED y en los aspectos legales que dan cobertura al programa especialmente en las enfermeras más jóvenes y con menos experiencia en atención primaria. De esta manera se mejorará la aplicación y aceptación del rol autónomo enfermero en la gestión de enfermedades agudas leves.(AU)

Objective: To evaluate the experience of primary care nurses in the application of nurse demand management (NDM). Design: Observational, cross-sectional descriptive study. Location: Primary care in Catalonia. Participants: Nurses in the field of primary care in Catalonia. A sample of 394 responses was estimated and 405 were finally obtained. Data collection was from October 2021 to January 2022. Main measurements: An ad hoc questionnaire was developed which explored aspects related to the experience of applying NDM: definition and management of the program, training, and legal concerns of the program. Results: Nurses understand NDM as triage. In addition, they consider that the implementation of nurse prescription would not improve the application of NDM. They express a lack of training, especially among the younger nurses. They consider that the ideal training in NDM, should include physiopathology and practical cases. Seven out of ten nurses are unaware of the legal framework that protects NDM and feel insecure about not knowing it. Six out of ten nurses have stopped being resolutive due to fear of legal repercussions. Nurses who are aware of the legal framework are those who have stopped resolving in the lowest proportion. Conclusions: There is a need for general training in NDM and in the legal aspects that cover the program, especially for younger nurses with less experience in primary care. This will improve the application and acceptance of the autonomous nursing role in the management of acute minor illnesses.(AU)

[Impact of training and legal aspects on the application of nurse demand management by primary care nurses in Catalonia]. / Impacto de la formación y aspectos legales en la aplicación de la gestión enfermera de la demanda por parte de las enfermeras de atención primaria de Cataluña.

OBJECTIVE: To evaluate the experience of primary care nurses in the application of nurse demand management (NDM). DESIGN: Observational, cross-sectional descriptive study. LOCATION: Primary care in Catalonia. PARTICIPANTS: Nurses in the field of primary care in Catalonia. A sample of 394 responses was estimated and 405 were finally obtained. Data collection was from October 2021 to January 2022. MAIN MEASUREMENTS: An ad hoc questionnaire was developed which explored aspects related to the experience of applying NDM: definition and management of the program, training, and legal concerns of the program. RESULTS: Nurses understand NDM as triage. In addition, they consider that the implementation of nurse prescription would not improve the application of NDM. They express a lack of training, especially among the younger nurses. They consider that the ideal training in NDM, should include physiopathology and practical cases. Seven out of ten nurses are unaware of the legal framework that protects NDM and feel insecure about not knowing it. Six out of ten nurses have stopped being resolutive due to fear of legal repercussions. Nurses who are aware of the legal framework are those who have stopped resolving in the lowest proportion. CONCLUSIONS: There is a need for general training in NDM and in the legal aspects that cover the program, especially for younger nurses with less experience in primary care. This will improve the application and acceptance of the autonomous nursing role in the management of acute minor illnesses.

Dealing with Emotional Vulnerability and Anxiety in Nurses from High-Risk Units-A Multicenter Study.

Compassion fatigue and anxiety derived from continued exposure to trauma and death greatly impact nurses' quality of care and quality of life, increasing their desire to leave work. The aim of the study is to assess compassion fatigue and anxiety prevalence and their association with secondary variables. A multicenter, cross-sectional study in nurses from four high-risk units, Emergency, Intensive Care, Oncology, and Pediatrics, was carried out in 14 hospitals in Catalonia (Spain) between 2015 and 2016. The primary endpoints were compassion satisfaction and compassion fatigue (burnout and secondary traumatic stress), which were assessed by Professional Quality of Life (ProQOL), and anxiety, assessed with the State-Trait Anxiety Inventory (STAI). Multivariable logistic regression analyzed the association of sociodemographic, training, working, and psychological factors. Of a total of 1302 nurses, 18.6% presented low compassion satisfaction; 19.7%, high burnout; and 36.4%, high secondary traumatic stress. Trait anxiety scored high in 7.2%. Although compassion satisfaction was present, it did not protect sufficiently against the high level of compassion fatigue or anxiety present in nurses in all centers. The working conditions in the units and variables showed a strong association with nurses' desire to leave. This corroborates the global challenge of healthcare professionals' shortage. Participants expressed the need for better training in emotional management.

The usefulness and acceptance of the OSCE in nursing schools.

This qualitative study explores the usefulness and acceptance attributed by students and faculty members to an Objective Structured Clinical Evaluation (OSCE) administered to nursing undergraduates in Catalonia (Spain) for 10 years. Seventy undergraduate nursing students and twelve faculty members participated in the study. The data collection techniques included an open-ended questionnaire, a student focus group, and individualized faculty interviews. The students experienced the OSCE positively as a learning event that offered an opportunity for feedback that could help them master the required competencies. The OSCE increased students' responsibility by presenting them with a set of challenges that they had to tackle individually. Moreover, it reaffirmed their confidence in situations that closely resembled professional practice. Faculty members valued the ability of the OSCE to integrate and assess competencies, its objectivity, and the indirect information it provided on the effectiveness of the curriculum. The educational impact attributed to the OSCE and its acceptance among faculty and students suggest that it would be useful to re-implement it in the Bachelor's of Nursing in Catalan universities. Our findings may be of use to other nursing programs considering how to assess competency-based education, especially in the context of the European Higher Education Area.

Juego de roles: enfermeras o antropólogos / Game of roles: nurses or anthropologists

Justificación. Una doble formación profesional de los etnógrafos condiciona el trabajo de campo, ya que cuando enfermería y antropología forman parte de la formación de una misma persona, resulta difícil conseguir una separación entre ambos roles. Objetivo. Demostrar que el rol adoptado por los investigadores puede afectar los resultados del trabajo de campo. Metodología. Estudio cualitativo de tipo etnográfico. Muestra intencional o propositiva. Resultados. Un total de 30 mujeres fueron incluidas en el estudio. En ningún caso se consensuó el rol a utilizar; cada etnógrafo adoptó el rol con el que se sintió más cómodo. Se han observado diferencias entre las informaciones recibidas por los etnógrafos, dependiendo del rol adoptado. Conclusiones. Según el rol adoptado por los investigadores se consiguen informaciones distintas

Justification. A double professional training of ethnographers conditions the field work, since when nursing and anthropology are part of formation of the same person, it is difficult to achieve a separation between both roles. Aim. To demonstrate if the role adopted by the researchers could affect the results. Methodology. Qualitative study of ethnographic type. Intentional or purposive sample. Main results. A total of 30 women were included in the study. Each ethnographer adopted the role with which they felt more comfortable. It is difficult to achieve a separation between different roles. Differences have been observed between the information received by ethnographers, depending on the role adopted. Conclusion. Different information is obtained according to the role adopted by the researchers

Influencia de las TIC en la educación para la salud / No disponible

No disponible

Análisis de concepto: gestión enfermera de la demanda / Concept analysis: Nurse demand management

La gestión enfermera de la demanda (GED) es un concepto emergente que requiere una clarificación útil no solo para los profesionales y usuarios sino también para gestores. La GED nació en 2009 tras la necesidad de reorganizar los flujos de la demanda, pero se ha convertido en algo más que en eso. Se entiende la GED como un programa liderado por la enfermera de Atención Primaria para atender a personas con enfermedades agudas leves. La enfermera, bajo un protocolo consensuado y dentro de su ámbito competencial, puede ser autónoma en la atención al paciente y en la resolución de problemas agudos leves. Por tanto, siguiendo la filosofía de Atención Primaria, tanto el médico como la enfermera son los profesionales que darán continuidad en el proceso salud-enfermedad del usuario a lo largo de su vida. Este artículo ha sido escrito según la metodología descrita por Wilson

Nurse demand management (NDM) is an emerging concept that requires some useful clarification, not only for professionals and users but also for managers. The NDM was born in 2009 after the need to reorganize the flow of demand, but it has become more than this. NDM is understood as a program led by the primary care nurse to take care of people with acute minor illnesses. Nurses, under a consensual protocol and within their competence area, can be autonomous in patient care and in the resolution of acute minor illnesses. Therefore, following Primary Care's philosophy, both the doctor and the nurse are the professionals that will follow up the health-disease process throughout the user's life. This article was written according to the methodology described by Wilson

Prescripción enfermera: análisis de concepto / Nurse prescription: A concept analysis

Objetivo: Examinar críticamente el concepto de prescripción enfermera mediante el estudio de los antecedentes y una revisión de la literatura científica con el fin de desarrollar una concepción precisa de esta actuación enfermera e identificar los elementos esenciales que envuelven este concepto. Método: Aplicación del procedimiento de análisis de concepto descrito por Wilson y adaptado por Avant. Resultados: El concepto de prescripción enfermera implica prescribir por parte de la enfermera el mejor régimen terapéutico frente a un problema de salud. Esta prescripción estará guiada por la valoración del problema de salud, por el criterio de la buena práctica clínica del profesional enfermero y estará dirigida a satisfacer las necesidades de salud del usuario y la población. Conclusiones: Los resultados aclaran el significado del concepto de estudio para ayudar a los profesionales a comprender y abordar esta actuación en todas sus dimensiones y promover el reconocimiento social de la profesión enfermera

Objective: To critically analyse the concept of nursing prescription through the study of its background and a review of the scientific literature, in order to develop an accurate conception of this nursing activity and to identify the essential elements surrounding this concept. Method: Application of the concept analysis method described by Wilson, and adapted by Avant. Results: The concept of nurse prescription implies prescribing, by the nurse, the best therapeutic regimen for a health problem. This prescription will be guided by the assessment of the health problem, by the criterion of the good clinical practice of the nurse, and will be focused to satisfy the health needs of the patient and the population. Conclusions: The results clarify the meaning of the study's concept to help professionals understand and address this nursing activity in all its dimensions, and promote social recognition of the nursing profession

[Nurse prescription: A concept analysis]. / Prescripción enfermera: análisis de concepto.

OBJECTIVE: To critically analyse the concept of nursing prescription through the study of its background and a review of the scientific literature, in order to develop an accurate conception of this nursing activity and to identify the essential elements surrounding this concept. METHOD: Application of the concept analysis method described by Wilson, and adapted by Avant. RESULTS: The concept of nurse prescription implies prescribing, by the nurse, the best therapeutic regimen for a health problem. This prescription will be guided by the assessment of the health problem, by the criterion of the good clinical practice of the nurse, and will be focused to satisfy the health needs of the patient and the population. CONCLUSIONS: The results clarify the meaning of the study's concept to help professionals understand and address this nursing activity in all its dimensions, and promote social recognition of the nursing profession.

[Concept analysis: Nurse demand management]. / Análisis de concepto: gestión enfermera de la demanda.

Nurse demand management (NDM) is an emerging concept that requires some useful clarification, not only for professionals and users but also for managers. The NDM was born in 2009 after the need to reorganize the flow of demand, but it has become more than this. NDM is understood as a program led by the primary care nurse to take care of people with acute minor illnesses. Nurses, under a consensual protocol and within their competence area, can be autonomous in patient care and in the resolution of acute minor illnesses. Therefore, following Primary Care's philosophy, both the doctor and the nurse are the professionals that will follow up the health-disease process throughout the user's life. This article was written according to the methodology described by Wilson.

Creando una aplicación móvil en salud / Creating a mobile health application

La aparición de Internet y de las nuevas tecnologías de la información y comunicación han generado una profunda transformación que afecta al cuidado de la salud, y que ha dado lugar a la llamada eHealth. La disponibilidad de mejoras tecnológicas, tanto en las redes de los operadores como en los dispositivos móviles por parte de la población ha favorecido la generación de nuevos escenarios en los diferentes sectores de la sociedad. En el ámbito de la salud, el uso de dispositivos móviles para el cuidado de la salud se denomina mHealth. El auge de la tecnología móvil va en aumento y con ello las aplicaciones móviles, lo que produce una demanda más creciente de esta tecnología por parte de la ciudadanía, profesionales e instituciones. Este artículo pretende describir las distintas etapas del proceso y desarrollo de estas aplicaciones móviles, así como todos aquellos aspectos que considerar hasta su distribución y actualización (AU)

Internet and the new technologies of information and communication (TICs) have deeply transformed health care, leading to the eHealth concept. The availability of technological improvements in networks and mobile devices has favored the development of new societal scenarios. Within the health field, the use of mobile devices for health care is called mHealth. The rise of mobile technology keeps increasing and so do mobile applications, leading to a growing demand for this kind of technology from citizens, professionals and institutions. This article intends to describe the different stages within the process and development of mobile applications, as well as all those aspects which must be considered until distribution and update (AU)

Uso de aplicaciones móviles de salud en usuarios de Atención / Use of mobile health applications in primary care users

Introducción: Existen más de 165 000 aplicaciones móviles (apps) relacionadas con la salud (mHealth) a disposición de los pacientes, que favorecen su empoderamiento y disminuyen costes sanitarios. Sin embargo, no todas son fiables, seguras y de calidad. Objetivo: Analizar el uso de la mHealth por pacientes de un Centro de Atención Primaria (CAP). Material y métodos: Estudio descriptivo transversal basado en 274 encuestas realizadas a pacientes, de 16 a 65 años, que acudían a consulta de enfermería del CAP Santa Eulàlia Sud (L’Hospitalet de Llobregat) que tuvieran un dispositivo móvil con Internet. Resultados: La mayoría de encuestados (68 %) utiliza apps de salud: ejercicio físico (63.4 %), alimentación (41.4 %) e información de servicios de salud (26.3 %); descargadas siguiendo recomendaciones de amigos/familiares (71 %), Internet (45.9 %), redes sociales (40.3 %), medios de comunicación (31.7 %) y profesionales sanitarios (12.9 %). Perciben como inconvenientes en su descarga: idoneidad de la app (61.3 %), fiabilidad de la información (58.1 %) y error al interpretar la información (30,1 %). Los usuarios (89 %) y no usuarios (70 %) de mHealth están interesados en la información proporcionada por un profesional sanitario sobre ello. Conclusiones: Cada vez hay más usuarios de mHealth y los criterios en la selección de las apps ponen en duda que las descargadas sean fiables y de calidad. Las dificultades manifestadas y el deseo de información indican la necesidad de que los profesionales sanitarios guíen y asesoren sobre este tipo de app, indicando al paciente la más idónea, la más fiable, la más sencilla de interpretar y manejar, para evitar errores, y proporcionarles conocimientos sobre cómo utilizarlas (AU)

Introduction: There are more than 165,000 mobile aplications (apps) related to health (mHealth) available to patients, promoting their empowerment and reducing healthcare costs; but not all are reliable, safe and quality. Objective: To analyze the use of mHealth for patients in a Primary Care Center (CAP). Methods: Cross-sectional study based on surveys of 274 patients, aged 16 to 65 years attending nursing consultation CAP Santa Eulalia Sud (L'Hospitalet de Llobregat) that have a mobile device with Internet. Results: Most respondents (68 %) use my health: physical exercise (63.4 %), food (41.4 %) and information about health services (26.3 %); discharged following recommendations from family/ friends (71 %), Internet (45.9 %), social networks (40.3 %), media (31.7 %) and health professionals (12.9 %). Perceived drawbacks download: suitability of the apps (61.3 %), reliability of information (58.1 %) and error in interpreting the information (30.1 %). Users (89 %) and non-users (70 %) of mHealth are interested in the information provided by a health professional about it. Conclusions: More and more users of mHealth and criteria in selecting there apps that cast doubt discharged reliable and quality. The difficulties expressed and desire information demonstrate the need for health professionals to guide and advise on such apps, indicating the patient the most appropriate, the most reliable, the easiest to interpret and manage to avoid mistakes, and provide them with knowledge on how to use them (AU)

Surveillance nursing diagnoses, ongoing assessment and outcomes on in-patients who suffered a cardiorespiratory arrest.

Objective The purposes of this study were to examine the frequency of surveillance-oriented nursing diagnoses and interventions documented in the electronic care plans of patients who experienced a cardiac arrest during hospitalization, and to observe whether differences exist in terms of patients' profiles, surveillance measurements and outcomes. Method A descriptive, observational, retrospective, cross-sectional design, randomly including data from electronic documentation of patients who experienced a cardiac arrest during hospitalization in any of the 107 adult wards of eight acute care facilities. Descriptive statistics were used for data analysis. Two-tailed p-values are reported. Results Almost 60% of the analyzed patients' e-charts had surveillance nursing diagnoses charted in the electronic care plans. Significant differences were found for patients who had these diagnoses documented and those who had not in terms of frequency of vital signs measurements and final outcomes. Conclusion Surveillance nursing diagnoses may play a significant role in preventing acute deterioration of adult in-patients in the acute care setting.

[Use of Mobile Health Applications in Primary Care Users]. / Uso de aplicaciones móviles de salud en usuarios de Atención Primaria.

Introduction: There are more than 165,000 mobile applications (apps) related to health (mHealth) available to patients, promoting their empowerment and reducing healthcare costs; but not all are reliable , safe and quality. Objective: To analyze the use of mHealth for patients in a Primary Care Center (CAP). Method: Cross-sectional study based on surveys of 274 patients, aged 16 to 65 years attending nursing consultation CAP Santa Eulalia Sud (L'Hospitalet de LLobregat) that have a mobile device with Internet. Results: Most respondents (68%) use my health: physical exercise (63.4%), food (41.4%) and information about health services (26.3%); discharged following recommendations from family/friends (71%), Internet (45.9%), social networks (40.3%), media (31.7%) and health professionals (12.9%). Perceived drawbacks download: suitability of the apps (61.3%), reliability of information (58.1%) and error in interpreting the information (30.1%). Users (89%) and non-users (70%) of mHealth are interested in the information provided by a health professional about it. Conclusions: More and more users of mHealth and criteria in selecting their apps that cast doubt discharged reliable and quality. The difficulties expressed and desire information demonstrate the need for health professionals to guide and advise on such apps, indicating the patient the most appropriate, the most reliable, the easiest to interpret and manage to avoid mistakes, and provide them with knowledge on how to use them.

Surveillance nursing diagnoses, ongoing assessment and outcomes on in-patients who suffered a cardiorespiratory arrest / Diagnósticos de enfermagem de vigilância, avaliação contínua e resultados em pacientes que sofreram uma parada cardiorrespiratória / Diagnósticos enfermeros de vigilancia, evaluación en curso y resultados en pacientes hospitalizados que sufrieron paro cardiorrespiratorio

ABSTRACT Objective The purposes of this study were to examine the frequency of surveillance-oriented nursing diagnoses and interventions documented in the electronic care plans of patients who experienced a cardiac arrest during hospitalization, and to observe whether differences exist in terms of patients' profiles, surveillance measurements and outcomes. Method A descriptive, observational, retrospective, cross-sectional design, randomly including data from electronic documentation of patients who experienced a cardiac arrest during hospitalization in any of the 107 adult wards of eight acute care facilities. Descriptive statistics were used for data analysis. Two-tailed p-values are reported. Results Almost 60% of the analyzed patients' e-charts had surveillance nursing diagnoses charted in the electronic care plans. Significant differences were found for patients who had these diagnoses documented and those who had not in terms of frequency of vital signs measurements and final outcomes. Conclusion Surveillance nursing diagnoses may play a significant role in preventing acute deterioration of adult in-patients in the acute care setting.

RESUMO Objetivo Determinar a frequência de registro eletrônico de diagnósticos e intervenções de vigilância no plano de cuidados para pacientes que sofreram uma parada cardíaca durante a admissão e avaliar se existem diferenças com base no perfil do paciente, medidas de monitoramento e resultados. Método Estudo descritivo, observacional, retrospectivo, transversal, que incluiu dados dos registros eletrônicos de pacientes internados em uma das 107 unidades de oito hospitais de cuidados agudos. Para análise dos dados foram utilizados estatísticos descritivos. Os valores de p foram relatados em dois ramos. Resultados Foram obtidos dados de 492 documentos de enfermagem de pacientes que sofreram uma parada cardíaca. Quase 60% dos prontuários eletrônicos incluídos na análise continham um ou mais diagnósticos de vigilância. Diferenças significativas foram encontradas entre os pacientes com e sem registro desses diagnósticos, no que se refere à frequência das medições dos sinais vitais e aos resultados finais. Conclusão Os diagnósticos de vigilância podem desempenhar um papel importante na prevenção de deterioração aguda em pacientes adultos hospitalizados.

RESUMEN Objetivo Los objetivos de este estudio fueron examinar la frecuencia de los diagnósticos enfermeros basados en la vigilancia y las intervenciones documentadas en los planes de asistencia mediante sistema informático de pacientes que pasaron por paro cardiaco durante estancia hospitalaria y observar si existen diferencias en términos de perfil de los pacientes, medidas de vigilancia y resultados. Método Descriptivo, observacional, retrospectivo, transversal, randomizado, incluyendo datos de documentación informática de pacientes que pasaron por paro cardiaco durante estancia hospitalaria en cualquiera de las 107 alas adultas de las ocho instalaciones de cuidados intensivos. Las estadísticas descriptivas fueron utilizadas para los análisis de datos. Valores P bilaterales fueron relatados. Resultados Casi el 60% del los pacientes analizados por la gráfica electrónica tuvieron diagnóticos enfermeros de vigilancia representados en los planes de cuidados informatizados. Fueron encontradas diferencias significativas en pacientes que tuvieron dichos diagnósticos documentados y los que no los tuvieron en términos de frecuencia de mediciones de señales vitales y resultados finales. Conclusión Los diagnósticos enfermeros de vigilancia pueden jugar un rol significativo en la prevención del deterioro agudo de pacientes adultos hospitalizados en las unidades de cuidados intensivos.

El cuidado a las personas y las TIC / The care to the people and the ITC

El avance y consolidación de las Tecnologías de la Información y la Comunicación (TIC) han favorecido que la historia clínica electrónica sea el nexo que vertebra toda la información clínica y sanitaria del paciente. Un uso adecuado de las TIC puede mejorar la gestión del tiempo de los profesionales y asegurar la coordinación, y puede ser una solución para generar un flujo de información continua entre los diferentes profesionales de la salud y entre los diferentes niveles asistenciales. El objetivo de las TIC es facilitar el continuo asistencial y favorecer una asistencia de eficiencia y calidad. Las TIC presentan ventajas e inconvenientes, por lo que los profesionales deberían hacer un uso adecuado basado, principalmente, en la no maleficencia y en la confidencialidad. Las distintas aplicaciones formulan como objetivos: 1. La mejora de la continuidad asistencial entre los diferentes niveles asistenciales. 2. La integración y coordinación entre los niveles asistenciales, para proporcionar unos cuidados personalizados y de excelencia. 3. La reducción de los costes en salud, por ejemplo en pacientes de alta complejidad. Las TIC facilitan la atención no presencial, ya que espacia el tiempo entre visitas. Este hecho conlleva, para muchos pacientes, una gran comodidad al no tener que ausentarse del trabajo y facilita la accesibilidad al sistema sanitario. Los inconvenientes de las TIC están relacionados con la confidencialidad de los datos, la información del paciente y la despersonalización de la atención al paciente. La enfermera, en la utilización de las TIC, tiene un papel protagonista, dado su rol en la promoción de la salud y prevención de la enfermedad. En estos contextos, las TIC pueden ayudar a innovar para mejorar la calidad de la asistencia y los resultados de salud. En este sentido, la enfermera tiene una gran oportunidad para innovar en los cuidados y ser referente en el seguimiento a distancia de los pacientes. Las TIC han generado nuevos desafíos a nivel de los profesionales, pacientes y proveedores que deben estudiarse con la finalidad de minimizar los problemas y buscar soluciones. Las redes sociales y los posts son útiles para la redefinición y profundización en la relación con enfermera-paciente, la difusión de la investigación enfermera entre las enfermeras y la visibilidad enfermera (AU)

The advancement and consolidation of information and communications technologies (ICT) has favored electronic medical records as the link between the clinical and patient health information. Appropriate use of ICT can improve and ensure coordination between different health professionals and levels of care. The aim of ICT is to facilitate the continuum of care and foster care efficiency and quality. However, professionals should make appropriate use of ICT based primarily on non-maleficence and confidentiality. The ICT: 1. Improve care continuity. 2. Facilitate integration and coordination, in order to provide personalized and excellent care between different levels of care. 3. Reduce health costs (in patients of high complexity, for example). The ICT facilitate the non-contact care, spacing the time between visits. The disadvantages of ICT are related to confidentiality and depersonalization of patient care. Nurses, by using ICT, play a leading role, given its role in health promotion and disease prevention. In these contexts, ICT can help innovate and improve the quality of care and health outcomes. In this regard, nurses have a great opportunity to innovate in care and take leadership in remote monitoring of patients. ICT have created new professionals, patients and providers challenges that should be studied in order to minimize problems and seek solutions. Social networks are useful for refining and deepening the relationship between nurses and patients, disseminating nursing research among nurses and nurse visibility (AU)