The Influence of the COVID-19 Pandemic on the Clinical Application of Evidence-Based Practice in Health Science Professionals.

(1) Background: Evidence-based practice (EBP) informs daily clinical interventions with the purpose of seeking changes to traditional practice through scientific evidence that justifies the reasons for our actions. The objectives were to describe the barriers, beliefs, and attitudes in the application of EBP among university health professionals (not doctors) and to evaluate the influence of the COVID-19 pandemic among them. (2) Methods: This prospective study is both descriptive and observational. The individuals under study were university health professionals (not doctors) from various autonomous regions within Spain, in both public and private spheres. Sociodemographic and labor-related variables linked to the research and its completion were studied. Likewise, the survey instrument Health Sciences Evidence-Based Practice questionnaire (HS-EBP) was administered to evaluate the barriers to, beliefs in, and attitudes towards evidence-based practice. (3) Results: A total of 716 responses were gathered, of which 387 were collected during the period of confinement, and 343 in the COVID-19 post-confinement period. Possible associations that might help respond to the objectives were explored through a correlational study between the sociodemographic variables and each sub-scale of the HS-EBP 30 questionnaire (n = 716). (4) Conclusions: Barriers to, beliefs in, and attitudes towards evidence-based practice are described. There is a leadership gap where line management provides insufficient motivation to follow work routines. The COVID-19 pandemic has caused immense stress among health professionals. The post-confinement group showed a significant change in the variables "beliefs and attitudes", and likewise in the "evaluation" block, justified by the need to update knowledge and to apply evidence.

Manejo de la anemia ferropénica por la enfermera de preanestesia respecto a las tasas de transfusión perioperatoria / Management of iron deficiency anaemia by the preanaesthesia nurse with respect to perioperative transfusion rates

Objetivo: Describir la prevalencia de transfusión sanguínea (TS) perioperatoria en pacientes con anemia ferropénica preoperatoria y sometidos a cirugía mayor electiva, incluidos en un protocolo de hierro intravenoso (FE IV) liderado por la enfermera de preanestesia. Método: Estudio descriptivo, observacional, longitudinal y retrospectivo en una población de pacientes sometidos a cirugía mayor electiva, vistos en consulta de enfermería de anestesia en un hospital de tercer nivel entre abril de 2014 y enero de 2017. Se incluyeron en el estudio aquellos pacientes con anemia ferropénica incluidos en un protocolo de tratamiento con FE IV prequirúrgico. Resultados: Se estudiaron 50 pacientes. El 12% precisó una TS. Se observó una asociación estadísticamente significativa entre la necesidad de TS intraoperatoria y el número de días entre la primera administración de FE IV y la fecha de la cirugía (p < 0,01), y también con el número de días entre la última administración de FE IV y la intervención quirúrgica (p = 0,04). El aumento de la hemoglobina fue mayor en los pacientes que recibieron más de una dosis frente a los que solo recibieron una dosis de 1.000 mg (p < 0,01). Conclusiones: En nuestro estudio hemos estimado un aumento de la hemoglobina mayor que en otros estudios y una tasa de administración de TS baja (12%). El papel de la enfermera es fundamental para la preselección de estos pacientes

Objective: To describe the prevalence of perioperative blood transfusion (BT) for patients with preoperative iron deficiency anaemia and undergoing major elective surgery, included in an intravenous iron protocol (IV Fe) led by the pre-anaesthesia nurse. Method: Observational, descriptive, longitudinal and retrospective study in a population of patients undergoing major elective surgery, seen in anaesthesia nursing consultation in a tertiary hospital between April 2014 and January 2017. The patients with iron deficiency anaemia, included in the study, were included in a protocol of treatment with preoperative IV Fe. Results: Fifty patients were studied. Twelve percent required a BT. A statistically significant association was observed between the need for intraoperative BT and the number of days between the first administration of IV Fe and date of surgery (P < .01) and also the number of days between the last administration of IV Fe and the surgical intervention (P = .04). The increase in haemoglobin was greater in patients who received more than one dose compared to those who received only one dose of 1,000 mg (P < .01). Conclusions: In our study, we estimated an increase in haemoglobin greater than in other studies and a low administration rate of BT (12%). The role of the nurse is fundamental for the preselection of these patients

Management of iron deficiency anaemia by the preanaesthesia nurse with respect to perioperative transfusion rates. / Manejo de la anemia ferropénica por la enfermera de preanestesia respecto a las tasas de transfusión perioperatoria.

OBJECTIVE: To describe the prevalence of perioperative blood transfusion (BT) for patients with preoperative iron deficiency anaemia and undergoing major elective surgery, included in an intravenous iron protocol (IV Fe) led by the pre-anaesthesia nurse. METHOD: Observational, descriptive, longitudinal and retrospective study in a population of patients undergoing major elective surgery, seen in anaesthesia nursing consultation in a tertiary hospital between April 2014 and January 2017. The patients with iron deficiency anaemia, included in the study, were included in a protocol of treatment with preoperative IV Fe. RESULTS: Fifty patients were studied. Twelve percent required a BT. A statistically significant association was observed between the need for intraoperative BT and the number of days between the first administration of IV Fe and date of surgery (P<.01) and also the number of days between the last administration of IV Fe and the surgical intervention (P=.04). The increase in haemoglobin was greater in patients who received more than one dose compared to those who received only one dose of 1,000mg (P<.01). CONCLUSIONS: In our study, we estimated an increase in haemoglobin greater than in other studies and a low administration rate of BT (12%). The role of the nurse is fundamental for the preselection of these patients.

Interaction of the most membranotropic region of the HCV E2 envelope glycoprotein with membranes. Biophysical characterization.

The previously identified membrane-active regions of the hepatitis C virus (HCV) E1 and E2 envelope glycoproteins led us to identify different segments that might be implicated in viral membrane fusion, membrane interaction, and/or protein-protein binding. HCV E2 glycoprotein contains one of the most membranotropic segments, segment 603-634, which has been implicated in CD81 binding, E1/E2 and E2/E2 dimerization, and membrane interaction. Through a series of complementary experiments, we have carried out a study of the binding and interaction with the lipid bilayer of a peptide corresponding to segment 603-634, peptide E2(FP), as well as the structural changes induced by membrane binding that take place in both the peptide and the phospholipid molecules. Here, we demonstrate that peptide E2(FP) binds to and interacts with phospholipid model membranes, modulates the polymorphic phase behavior of membrane phospholipids, is localized in a shallow position in the membrane, and is probably oligomerized in the presence of membranes. These data support the role of E2(FP) in HCV-mediated membrane fusion, and sustain the notion that this segment of the E2 envelope glycoprotein, together with other segments of E2 and E1 glycoproteins, provides the driving force for the merging of the viral and target cell membranes.