Incorporación urgente de estudiantes de Enfermería durante la pandemia por COVID-19: análisis de competencias / Emergency incorporation of Nursing students during the COVID-19 pandemic: an analysis of competences

Objetivo: describir el nivel de competencia de los y las estudiantes del Grado en Enfermería contratadas como refuerzo en el Hospital Universitario Vall d’Hebron (Barcelona) durante la primera ola de la pandemia por COVID-19 y determinar su satis-facción con el entorno clínico. Método: estudio descriptivo transversal. Se incluyó a todas las personas contratadas (n= 39) entre febrero y mayo de 2020. Al mes de la incorporación se recogieron variables demográficas académicas, laborables y se midió el nivel de competencia (Cuestionario COM_VAT© de 21 ítems puntuados entre 1: ejecución insuficiente y 4 ejecución autónoma y correcta) y la satisfacción con el entorno clínico (cuestionario diseñado ad hoc de tres dimensiones -orientación, integración con el equipo y adaptación al entorno laboral- evaluadas con 15 ítems puntuados de 1 muy en desacuerdo a 5 muy de acuerdo). Se realizó estadística descriptiva y bivariante. Resultados: participaron las 39 personas. La puntuación global mediana de la evaluación competencial fue de 3,9 sobre 4 pun-tos [RIC 3,7-4]. La competencia de valorar, diagnosticar y abordar situaciones de salud cambiantes obtuvo 3,85 puntos [RIC 3,4-4]. La competencia de ayudar al paciente a cumplir el tratamiento y hacerlo partícipe de 4 [RIC 4-4] y la competencia de contribuir a garantizar la seguridad y el proceso asistencial de 3,8 [RIC 3,6 – 4]. La mediana de satisfacción con el entorno clínico fue de 69 sobre 75 [RIC 63-74] sin diferencias estadísticamente significativas en ella en función del resto de características. Conclusión: las personas participantes mostraron un nivel de competencia que representa una correcta ejecución, pero que puede requerir ayuda ocasional. Reportaron una alta satisfacción con el entorno clínico.(AU)

Objective: to describe the level of competence among Nursing Degree students hired as support at the Hospital Universitario Vall d’Hebron (Barcelona) during the first wave of the COVID-19 pandemic, and to determine their satisfaction with the clinical environment. Method: a descriptive cross-sectional study, including all persons hired (n= 39) between February and March 2020. Demographic, academic and occupational variables were collected at one month of their incorporation, and their level of competence was measured (COM_VAT© questionnaire with 21 items scored from 1: insufficient performance, to 4: autonomous and correct performance), as well as the satisfaction with their clinical environment (questionnaire designed ad hoc with three dimensions: orientation, integration with the team, and adaptation to the work environment, evaluated through 15 items scored from 1: high disagreement, to 5: high agreement). Descriptive and bivariate statistics was used. Results: all 39 persons were included. The overall median score of the evaluation of skills was 3.9 out of 4 scores [IQR 3.7-4]. The competence of assessing, diagnosing and addressing ever-changing health situations obtained a score of 3.85 [IQR 3.4-4]. The competence of helping patients to comply with treatment and getting them involved obtained a 4 [IQR 4-4], and the competence of contributing to guarantee safety and care process obtained 3.8 [IQR 3.6 – 4]. The median satisfaction with the clinical environment was 69 out of 75 [IQR 63-74] without statistically significant differences according to the other characteristics .Conclusion: the participants showed a level of competence ensuring correct performance, but that might require occasional help. They reported high satisfaction with the clinical environment.Keywords:care; coronavirus infections; volunteers; clinical competence; nursing students; job satisfaction; working conditions; cross-sectional studies.(AU)

Perfil de los pacientes hospitalizados en dispositivos asistenciales habilitados durante la pandemia por SARS-CoV-2 / Profile of the patients hospitalized in healthcare resources provided during the SARS-CoV-2 pandemic

OBJETIVO: describir el perfil demográfico, clínico y los indicadores de progresión de los pacientes hospitalizados en dispositivos asistenciales habilitados durante la pandemia por SARS-CoV-2. MÉTODO: estudio observacional retrospectivo. Se incluyeron todos pacientes atendidos en el Pabellón Salud Vall d'Hebron (Barcelona) durante el periodo de su apertura (29 marzo al 18 abril de 2020). Se analizaron variables demográficas, clínicas y de progresión. Se llevó a cabo análisis descriptivo. RESULTADOS: 63 pacientes. El 55,6% (n= 35) era hombre, la media de edad fue de 76,5 (11,88) años. Al ingreso, el 79,3% (n= 50) no presentaba antecedentes de deterioro cognitivo; el 61,9% (n= 39) deambulaba de forma libre o controlada; el 74,6% (n= 47) no presentaba problemas de continencia; el 39,7% (n= 25) fue valorado sin riesgo de lesión por presión. La estancia media (DE) fue de 8,1 (3,8) días. En relación a la presencia de eventos adversos durante su estancia hospitalaria, el 12,7% (n= 8) presentó una lesión por presión, el 6,3% (n= 4) algún episodio de desorientación y fueron declaradas dos caídas. Un 67% (n= 42) tenía el diagnóstico principal de Enfermería de Riesgo de sepsis y el 41,3% (n= 26) precisaron continuidad de cuidados. CONCLUSIONES: el perfil del paciente atendido en estos dispositivos asistenciales correspondió a una persona anciana, sin indicadores de fragilidad evidentes y sin eventos adversos destacables durante su estancia. Las unidades de hospitalización habilitadas durante la pandemia por COVID-19 representan un recurso adecuado y seguro para la atención a los pacientes en situación de emergencia

OBJECTIVE: to describe the demographical and clinical profile and the progression indicators for patients hospitalized in healthcare resources provided during the SARS-COV-2 pandemic. METHOD: an observational retrospective study, which included all patients seen at the Pabellón Salud Vall d'Hebron (Barcelona) during its opening period (March, 29th to April, 18th, 2020). Demographic, clinical and progression variables were analyzed; descriptive analysis was conducted. RESULTS: the study included 63 patients; 55.6% (n= 35) were male, with a mean age of 76.5 (11.88) years. At admission, 79.3% (n= 50) did not present a previous history of cognitive deterioration; 61.9% (n= 39) could walk in a free or controlled way; 74.6% (n= 47) did not present continence issues; 39.7% (n= 25) were evaluated as without risk of pressure injury. The mean stay (SD) was 8.1 (3.8) days. Regarding the presence of adverse events during their hospital stay, 12.7% (n= 8) presented pressure injuries, 6.3% (n= 4) had some disorientation episode, and two falls were reported; while 67% (n= 42) had the primary Nursing diagnosis of Risk of Sepsis, and 41.3% (n= 26) required continuity of care. CONCLUSIONS: the profile of the patient managed in these healthcare resources was an elderly person, without evident frailty indicators, and without any outstanding adverse events during their stay. The hospitalization units provided during the COVID-19 represented an adequate and safe resource for patient care in an emergency situation

Clinical nurses's critical thinking level according to sociodemographic and professional variables (Phase II): A correlational study.

Critical thinking ability is one of the basic competencies of clinical nurse and is widely accepted as being associated with the provision of quality care, however, the few evidence-based data related to the relationship between level of critical thinking ability and nurses' sociodemographic and professional characteristics. The aim of this study was to identify the level of critical thinking among nurses in clinical practice according to sociodemographic and professional variables. Descriptive cross-sectional and correlational study was carried out in a sample of 339 nurses from medical, surgical and critical care units at a tertiary care hospital. This study is related to a previous publication that presents psychometric analysis. Data were compiled using the Nursing Critical Thinking in Clinical Practice Questionnaire and ad hoc form for the recording of sociodemographic and professional characteristics. The statistical analysis of the data was performed using frequency, Mann-Whitney U Test, Kruskal-Wallis Test, and Pearson's correlation coefficients. Nurses reported moderate levels of critical thinking. Older nurses, with 11-15 years of experience in the actual unit, with continuous shift work, a permanent contract and master's degree indicated a higher level of critical thinking. Critical thinking skills are related to certain socio-demographic and professional variables, particularly age, years of experience, shift work, type of contract and educational level.

Critical thinking: A comparative analysis between nurse managers and registered nurses.

AIM: To analyse the levels of critical thinking among nurse managers and registered nurses and to explore the association between these levels and socio-demographic and occupational factors. BACKGROUND: Critical thinking is an essential skill in advanced clinical nursing. However, few studies to date have explored critical thinking levels in nurse managers or compared them with those recorded in registered nurses. METHODS: A randomized sample of 44 nurse managers and 295 registered nurses from a tertiary hospital in Barcelona participated in this study. The Nursing Critical Thinking in Clinical Practice Questionnaire was used to measure the level of critical thinking. The data were analysed using multivariate analysis by logistic regression. RESULTS: Levels of critical thinking were higher in nurse managers than in registered nurses. Age, work shift schedule and educational level were associated with a higher level of critical thinking in nurse managers and were predictor factors. CONCLUSIONS: This study identified age, work shift schedule and educational level as factors that impact on the acquisition of critical thinking skills among nurse managers. IMPLICATIONS FOR NURSING MANAGEMENT: This study provides substantive evidence of the levels of critical thinking among nurse managers. When introducing strategies to enhance these skills, the associated occupational factors should be taken into account.

Development and Psychometric Properties of the Nursing Critical Thinking in Clinical Practice Questionnaire.

BACKGROUND AND AIM: A complex healthcare environment, with greater need for care based on the patient and evidence-based practice, are factors that have contributed to the increased need for critical thinking in professional competence. At the theoretical level, Alfaro-LeFevre () put forward a model of critical thinking made up of four components. And although these explain the construct, instruments for their empirical measurement are lacking. The purpose of the study was to develop and validate the psychometric properties of an instrument, the Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 Practice), designed to evaluate the critical thinking abilities of nurses in the clinical setting. METHODS: A cross-sectional survey design was used. A pool of items was generated for evaluation by a panel of experts who considered their validity for the new instrument, which was finally made up of 109 items. Following this, validation was carried out using a sample of 339 nurses at a hospital in Barcelona, Spain. Reliability was determined by means of internal consistency and test-retest stability over time, although the validity of the construct was assessed by means of confirmatory factor analysis. RESULTS: The content validity index of the N-CT-4 Practice was .85. Cronbach's alpha coefficient for the whole instrument was .96. The intraclass correlation coefficient was .77. Confirmatory factor analysis showed that the instrument was in line with the four-dimensional model proposed by Alfaro-LeFevre (). LINKING EVIDENCE TO ACTION: The psychometric properties of theN-CT-4 Practice uphold its potential for use in measuring critical thinking and in future research related with the examination of critical thinking.