El Baby-Led Weaning como nuevo método de alimentación complementaria del lactante / Baby-Led Weaning as a new method of complementary feeding for infants

Objetivo: describir el método Baby-Led Weaning como nueva forma de alimentación complementaria del lactante.Método: se llevó a cabo una revisión narrativa. La búsqueda bibliográfica se realizó en las bases de datos: IBECS, LILACS, CUIDEN, PubMed, CINAHL y Scielo. Palabras clave usadas: “lactante”, “destete”, “Baby-Led Weaning”. Criterios de inclusión: meta-análisis, revisiones sistemáticas, ensayos clínicos, estudios descriptivos y estudios cualitativos; antigüedad máxima de 10 años; escritos en español e inglés. Se seleccionaron teniendo en cuenta la calidad de la evidencia aportada (CASPe mayor a 7 y STROBE mayor a 11).Resultados: el Baby-Led Weaning (BLW) es un método de alimentación beneficioso para el lactante, ya que reduce el riesgo de sobrepeso (el 86,5% de los alimentados por este sistema adquiere un peso adecuado para su edad), sin incrementar el potencial riesgo de asfixia (solo el 5,6% presentó episodios de atragantamiento). Este método se asocia con un mayor déficit de hierro; sin embargo, en su versión modificada (BLISS) no se observan diferencias respecto al tradicional. La mayoría de las madres tiene una percepción positiva y lo recomendaría. Los profesionales de la salud reconocen los principales beneficios del método BLW.Conclusión: el Baby-Led Weaning es un método de alimentación eficaz. Resulta una alternativa alimentaria valorada positivamente por las madres y por los profesionales de la salud; sin embargo, los sanitarios todavía tienen reticencias a la hora de recomendarlo.(AU)

Objective: to describe the Baby-Led Weaning method as a new approach to complementary feeding for infants.Method: a narrative review was conducted, through a bibliographic review in the IBECS, LILACS, CUIDEN, PubMed, CINAHL and Scielo databases. Key words used: “infant” (“lactante”), “weaning” (“destete”), “Baby-Led Weaning”. Inclusion criteria: meta-analysis, systematic reviews, clinical trials, descriptive studies, and qualitative studies; dated within the previous 10 years; written in Spanish and English. The selection was conducted considering the quality of evidence provided (CASPe >7 and STROBE > 11).Results: Baby-Led Weaning is a feeding method beneficial for infants, because it reduces the risk of excess weight (86.5% of infants fed through this approach achieves an adequate weight for their age), without increasing the potential risk of choking (only 5.6% presented choking episodes). This method is associated with higher iron deficiency; however, no differences were observed in its Modified version (BLISS) vs. the traditional one. Most mothers have a positive perception and would recommend it. Healthcare professionals acknowledge the main benefits of the BLW method.Conclusion: Baby-Led Weaning is an effective feeding method. It represents a feeding approach positively valued by mothers and healthcare professionals; however, the latter are still reluctant to recommend it.(AU)

Impact of Nurses' Intervention in the Prevention of Falls in Hospitalized Patients.

BACKGROUND: Clinical safety is a crucial component of healthcare quality, focused on identifying and avoiding the risks to which patients are exposed. Among the adverse events that occur in a hospital environment, falls have a large impact (1.9-10% of annual income in acute care hospitals); they can cause pain, damage, costs, and mistrust in the health system. Our objective was to assess the effect of an educational intervention aimed at hospital nurses (systematic assessment of the risk of falls) in reducing the incidence of falls. METHODS: this was a quasi-experimental study based on a sample of 581 patients in a third level hospital (Comunitat Valenciana, Spain). An educational program was given to the intervention group (n = 303), and a control group was included for comparison (n = 278). In the intervention group, the nurses participated in a training activity on the systematized assessment of the risk of falls. Analysis was undertaken using the Bayesian logistic regression model. RESULTS: a total of 581 patients were studied (50.6% male, 49.4% female), with an average age of 68.3 (DT = 9) years. The overall incidence of falls was 1.2% (0.3% in the intervention group and 2.2% in the control group). Most of the falls occurred in people ≥65 years old (85.7%). The intervention group had a lower probability of falling than the control group (OR: 0.127; IC95%: 0.013-0.821). Neither the length of hospital stay, nor the age of the participants, had any relevant effect. CONCLUSIONS: the systematic assessment of the risk of a patient falling during hospital processes is an effective intervention to reduce the incidence of falls.

Results of Nurse Case Management in Primary Heath Care: Bibliographic Review.

BACKGROUND: The new characteristics of today's population, together with the presence of chronic diseases in the elderly, require a new approach to care, promoting coordination between different levels of care. In this sense, we find the figure of the nurse case manager (NCM) in primary health care mainly responsible for ensuring continuity of care in complex patients with chronic diseases. OBJECTIVE: to describe the role of the NCM in care management, determining its effectiveness in addressing chronic disease (health outcomes and quality of life) and its efficiency in the health system. METHODS: Bibliographic review of scientific evidence on case management applied to nursing. Between March and April 2020 a bibliographic search was carried out in the Dialnet, Scielo, Scopus and Pubmed databases. INCLUSION CRITERIA: articles written in the last 5 years, which analyze how this nursing rol influences the care and health of patients. RESULTS: A total of 16 articles were selected. The NCM reduced the use of the emergency department, hospital admissions, readmissions, and the duration of these in the patients studied. CONCLUSION: The NCM is effective and efficient for both patients and health institutions, and a common practice model is needed that includes standardized protocols and evidence-based practices.

Validation of a questionnaire designed to measure nursing student satisfaction with practical training.

OBJECTIVE: to validate an instrument designed to assess practical training and measure nursing student satisfaction with clinical practice modules. METHOD: cross-sectional study (academic year 2014-2015). Validation of the self-administered, anonymous, 17-item Nursing Student Satisfaction with Practical Training Questionnaire, developed by consensus by eight practical training experts in three nominal group sessions. Exploratory and confirmatory factor analyses were performed to assess internal consistency and validity. Student satisfaction was measured in relation to each module and all modules as a whole. RESULTS: 174 responses. High item-test correlation (≥0.90); Cronbach's alpha = 0.91; Káiser-Meyer-Olkin index =0.86; the results of the Bartlett sphericity test were statistically significant (p<0.001); S-stress=0.17; R2=0.81. Exploratory factor analyses identified 4 factors: simulation, teacher tutoring, care facility selected for the placement, and clinician tutoring. Total explained variance was 66.6%. Confirmatory factor analysis obtained a chi-squared value of 285.275 (p= 0.000). Student satisfaction increases proportionately with each academic year. CONCLUSION: the questionnaire was shown to have good validity and is therefore a reliable instrument for measuring level of nursing student satisfaction with practical training in both clinical and simulated environments.

[Population impact of nurses in care interventions chronicity in Spain. Systematic review]. / Impacto de las intervenciones enfermeras en la atención a la cronicidad en España. Revisión sistemática.

BACKGROUND: Epidemiological projections for the coming decades suggest that most chronic diseases will increase its prevalence. Different models of care have been developed to meet the challenge of chronicity; all implemented initiatives point to primary health care and especially the community nurse as the guarantors of chronic patient care, family and community. However, health policies do not endorse facts. The objective of this review was to evaluate the impact of different nursing interventions in the care strategy to chronicity in Spain. METHODS: Systematic review of the literature on the nurse contribution to address the chronicity in adult patients in Spain. The search was carried out in Medline / Pubmed, Cochrane, EMBASE, LILACS, CINAHL, IME and CUIDEN, databases. Inclusion criteria: written articles in Castilian and English published between 2007 and 2016 involving patients with chronic disease in all their life stages. The quality of the studies was assessed following Prisma criteria and the CEBM levels of evidence and recommendation. RESULTS: The Nursing interventions with the highest impact on the strategy of chronicity care in Spain were cases management and advanced nursing practice (50%), the home-care program offered from Primary Care (41,7%) and Telemonitoring intervention (8,3%). CONCLUSIONS: Nurses interventions have shown favorable results in effectiveness and satisfaction more studies that demonstrate the efficiency of the nurse contribution to the chronicity are needed.

OBJETIVO: Las proyecciones epidemiológicas para las próximas décadas sugieren que la mayor parte de las patologías crónicas incrementarán su prevalencia. Se han desarrollado diferentes modelos de atención para afrontar el reto que supone la cronicidad; todas las iniciativas implementadas señalan a la atención primaria de salud y especialmente a la enfermera comunitaria como los garantes de la atención al paciente crónico, su familia y la comunidad, si bien las políticas sanitarias no lo refrendan. El objetivo de esta revisión fue evaluar el impacto de las distintas intervenciones enfermeras incluidas en la estrategia de atención a la cronicidad en España. METODOS: Revisión sistemática de la literatura sobre la aportación enfermera en la atención a la cronicidad en pacientes adultos en España. La búsqueda se realizó en las bases de datos Medline / Pubmed, Cochrane, EMBASE, LILACS, CINAHL, IME y CUIDEN. Criterios de inclusión: artículos escritos en castellano e inglés publicados entre 2007-2016, que incluyesen pacientes con enfermedad crónica en todas las etapas del ciclo vital. Se evaluó la calidad de los estudios siguiendo los criterios Prisma y los niveles de evidencia y recomendación CEBM. RESULTADOS: Las intervenciones enfermeras de mayor impacto en la estrategia de atención a la cronicidad en España fueron la gestión de casos y la práctica avanzada (50%), los programas de atención domiciliaria desde atención primaria (41,7%) y la telemonitorización (8,3%). CONCLUSIONES: Las intervenciones enfermeras demuestran resultados favorables en efectividad y satisfacción. Se necesitan más estudios que evidencien la eficiencia de la aportación enfermera en la cronicidad.

Elementos esenciales de los entornos profesionales enfermeros en Atención Primaria y su influencia en la calidad del cuidado / Essential elements of professional nursing environments in Primary Care and their influence on the quality of care

Objetivos: Conocida su influencia sobre la calidad del cuidado, pretendemos con nuestro estudio valorar las características de los entornos profesionales enfermeros en Atención Primaria de Salud de la Comunidad Canaria, y determinar cuáles son los elementos clave de dichos entornos para mejorar la calidad del cuidado. Método: Estudio observacional, transversal, analítico, en Atención Primaria de Salud de Canarias, con el cuestionario Practice Environment Scale - Nursing Work Index. Se midieron variables sociodemográficas, puntuaciones en el test, y se seleccionaron los ítems fundamentales que las enfermeras consideran que facilitan prestar cuidados de calidad. Se valoró la normalidad de la muestra, y se calcularon estadísticos no paramétricos y paramétricos para analizar la relación entre variables (IC=95% error=5%). Resultados: Participaron 144 enfermeras. Puntuación media total = 81,6. Las 5 dimensiones oscilaron entre puntuaciones medias de 2,25-2,92 (rango 1 a 4). Se seleccionaron 12 elementos clave para mejorar los cuidados: 6 fueron positivos en Canarias, 2 mixtos, y 4 negativos. Siete de los 12 elementos pertenecen a la dimensión 2 (fundamentos enfermeros). Ser coordinadora mostró significación (p<0,000) con mayores puntuaciones. Años de experiencia mostró significación (p<0,021) con la puntuación obtenida en los 12 elementos clave, más alta a menor experiencia. Conclusiones: Los entornos en Atención Primaria de Salud de Canarias son similares a los antecedentes en España. Como áreas de mejora: recursos humanos y participación de las enfermeras en la gestión. Los gestores enfermeros deben conocer sus entornos, implantando cambios prioritariamente sobre los elementos esenciales (AU)

Objectives: Nursing work environments are key determinants of care quality. Our study aimed to evaluate the characteristics of nursing environments in primary care settings in the Canary Islands, and identify crucial components of such environments to improve quality. Method: We conducted a cross-sectional study in primary care organisations using the Practice Environment Scale - Nursing Work Index tool. We collected sociodemographic variables, scores, and selected the essential items conducive to optimal care. Appropriate parametric and non-parametric statistical tests were used to analyse relations between variables (CI = 95%, error = 5%). Results: One hundred and forty-four nurses participated. The mean total score was 81.6. The results for the five dimensions included in the Practice Environment Scale - Nursing Work Index ranged from 2.25 - 2.92 (Mean). Twelve key items for quality of care were selected; six were positive in the Canary Islands, two were mixed, and four negative. 7/12 items were included in Dimension 2 (fundamentals of nursing). Being a manager was statistically associated with higher scores (p<.000). Years of experience was inversely associated with scores in the 12 items (p<.021). Conclusions: Nursing work environments in primary care settings in the Canary Islands are comparable to others previously studied in Spain. Areas to improve were human resources and participation of nurses in management decisions. Nurse managers must be knowledgeable about their working environments so they can focus on improvements in key dimensions (AU)

Essential elements of professional nursing environments in Primary Care and their influence on the quality of care. / Elementos esenciales de los entornos profesionales enfermeros en Atención Primaria y su influencia en la calidad del cuidado.

OBJECTIVES: Nursing work environments are key determinants of care quality. Our study aimed to evaluate the characteristics of nursing environments in primary care settings in the Canary Islands, and identify crucial components of such environments to improve quality. METHOD: We conducted a cross-sectional study in primary care organisations using the Practice Environment Scale - Nursing Work Index tool. We collected sociodemographic variables, scores, and selected the essential items conducive to optimal care. Appropriate parametric and non-parametric statistical tests were used to analyse relations between variables (CI = 95%, error = 5%). RESULTS: One hundred and forty-four nurses participated. The mean total score was 81.6. The results for the five dimensions included in the Practice Environment Scale - Nursing Work Index ranged from 2.25 - 2.92 (Mean). Twelve key items for quality of care were selected; six were positive in the Canary Islands, two were mixed, and four negative. 7/12 items were included in Dimension 2 (fundamentals of nursing). Being a manager was statistically associated with higher scores (p<.000). Years of experience was inversely associated with scores in the 12 items (p<.021). CONCLUSIONS: Nursing work environments in primary care settings in the Canary Islands are comparable to others previously studied in Spain. Areas to improve were human resources and participation of nurses in management decisions. Nurse managers must be knowledgeable about their working environments so they can focus on improvements in key dimensions.

Impacto de las intervenciones enfermeras en la atención a la cronicidad en España. Revisión sistemática / Population impact of nurses in care interventions chronicity in Spain. Systematic review

Fundamentos: Las proyecciones epidemiológicas para las próximas décadas sugieren que la mayor parte de las patologías crónicas incrementarán su prevalencia. Se han desarrollado diferentes modelos de atención para afrontar el reto que supone la cronicidad; todas las iniciativas implementadas señalan a la atención primaria de salud y especialmente a la enfermera comunitaria como los garantes de la atención al paciente crónico, su familia y la comunidad, si bien las políticas sanitarias no lo refrendan. El objetivo de esta revisión fue evaluar el impacto de las distintas intervenciones enfermeras incluidas en la estrategia de atención a la cronicidad en España. Métodos: Revisión sistemática de la literatura sobre la aportación enfermera en la atención a la cronicidad en pacientes adultos en España. La búsqueda se realizó en las bases de datos Medline / Pubmed, Cochrane, EMBASE, LILACS, CINAHL, IME y CUIDEN. Criterios de inclusión: artículos escritos en castellano e inglés publicados entre 2007-2016, que incluyesen pacientes con enfermedad crónica en todas las etapas del ciclo vital. Se evaluó la calidad de los estudios siguiendo los criterios Prisma y los niveles de evidencia y recomendación CEBM. Resultados: Las intervenciones enfermeras de mayor impacto en la estrategia de atención a la cronicidad en España fueron la gestión de casos y la práctica avanzada (50%), los programas de atención domiciliaria desde atención primaria (41,7%) y la telemonitorización (8,3%). Conclusiones: Las intervenciones enfermeras demuestran resultados favorables en efectividad y satisfacción. Se necesitan más estudios que evidencien la eficiencia de la aportación enfermera en la cronicidad

Background: Epidemiological projections for the coming decades suggest that most chronic diseases will increase its prevalence. Different models of care have been developed to meet the challenge of chronicity; all implemented initiatives point to primary health care and especially the community nurse as the guarantors of chronic patient care, family and community. However, health policies do not endorse facts. The objective of this review was to evaluate the impact of different nursing interventions in the care strategy to chronicity in Spain. Methods: Systematic review of the literature on the nurse contribution to address the chronicity in adult patients in Spain. The search was carried out in Medline / Pubmed, Cochrane, EMBASE, LILACS, CINAHL, IME and CUIDEN, databases. Inclusion criteria: written articles in Castilian and English published between 2007 and 2016 involving patients with chronic disease in all their life stages. The quality of the studies was assessed following Prisma criteria and the CEBM levels of evidence and recommendation. Results: The Nursing interventions with the highest impact on the strategy of chronicity care in Spain were cases management and advanced nursing practice (50%), the home-care program offered from Primary Care (41,7%) and Telemonitoring intervention (8,3%). Conclusions: Nurses interventions have shown favorable results in effectiveness and satisfaction more studies that demonstrate the efficiency of the nurse contribution to the chronicity are needed

Evaluación del efecto de una intervención en el estado nutricional de pacientes hospitalizados / Evaluation of the effect of an intervention on the nutritional status of hospitalized patients

Fundamento y objetivos. Comparar el estado nutricional de una población de pacientes hospitalizados distribuidos en 2 grupos diferentes, tanto al ingreso como al alta hospitalaria y evaluar la influencia de la alteración nutricional en la estancia hospitalaria. Material y métodos. Estudio cuasiexperimental formado por 2 grupos de pacientes (N=581): un grupo de intervención (n=303), en el que las enfermeras responsables recibieron formación específica en metodología de cuidados y otro de control (n=278), en el que las enfermeras siguieron su dinámica habitual. Cada grupo estaba compuesto por 2 unidades de cuidados con pacientes tanto de especialidades médicas como quirúrgicas. Criterios de inclusión: pacientes ingresados en las unidades elegidas con una estancia mínima de 5 días. La selección de la muestra se realizó de manera prospectiva y consecutivamente tras realizar la acción formativa. Resultados. De los 581 pacientes estudiados, el 49,4% eran mujeres y el 50,6% hombres, con una edad media de 68,29 (DT 16,23) años. En el grupo intervención, la odds ratio (OR) asociada a un buen estado nutricional se multiplicaba por 1,7 veces (OR=1,67) respecto al grupo control en la primera evaluación y por 1,4 veces (OR=1,43) al alta. La estancia media en días resultó mayor en el grupo control (13,71, DT 10,19) que en el grupo intervención (10,89, DT 7,49) (p<0,001). Conclusión. La intervención basada en metodología sistematizada en las unidades intervenidas resultó positiva. Los pacientes ingresados en ellas presentaron una menor alteración nutricional y una menor estancia hospitalaria que los ingresados en las unidades control (AU)

Background and objectives. To compare the nutritional status of a population of hospitalized patients, divided into 2 different groups, both at admission and hospital discharge, and to assess the influence of nutritional alteration during the hospital stay. Material and methods. Quasi-experimental study comprising 2 groups of patients (N=581); an intervention group (n=303), in which nurses received specific training on managing care methodology, and a control group (n=278), in which nurses continued their usual dynamics. Each group was made up of 2 care units with patients from both surgical and medical specialties. Inclusion criteria: patients admitted to the selected units with a minimum stay of 5 days. The sample selection was performed prospectively and consecutively after implementing the training. Results. Of the 581 patients studied, 49.4% were women and 50.6% were men. Mean patient age was 68.29 (SD 16.23) years. In the intervention group, the odds ratio (OR) associated with good nutritional status was multiplied by 1.7 (OR=1.67) compared to the control group in the first evaluation and by 1.4 times (OR=1.43) at hospital discharge. The average stay in days was higher in the control group (13.71, SD 10.19) than in the intervention group (10.89, SD 7.49) (P<.001). Conclusion. The systematic methodology-based intervention in the chosen units was positive. Patients admitted to the intervention units had a lower nutritional alteration and a shorter hospital stay than those admitted to the control units (AU)

Evaluation of the effect of an intervention on the nutritional status of hospitalized patients. / Evaluación del efecto de una intervención en el estado nutricional de pacientes hospitalizados.

BACKGROUND AND OBJECTIVES: To compare the nutritional status of a population of hospitalized patients, divided into 2 different groups, both at admission and hospital discharge, and to assess the influence of nutritional alteration during the hospital stay. MATERIAL AND METHODS: Quasi-experimental study comprising 2 groups of patients (N=581); an intervention group (n=303), in which nurses received specific training on managing care methodology, and a control group (n=278), in which nurses continued their usual dynamics. Each group was made up of 2 care units with patients from both surgical and medical specialties. INCLUSION CRITERIA: patients admitted to the selected units with a minimum stay of 5 days. The sample selection was performed prospectively and consecutively after implementing the training. RESULTS: Of the 581 patients studied, 49.4% were women and 50.6% were men. Mean patient age was 68.29 (SD 16.23) years. In the intervention group, the odds ratio (OR) associated with good nutritional status was multiplied by 1.7 (OR=1.67) compared to the control group in the first evaluation and by 1.4 times (OR=1.43) at hospital discharge. The average stay in days was higher in the control group (13.71, SD 10.19) than in the intervention group (10.89, SD 7.49) (P<.001). CONCLUSION: The systematic methodology-based intervention in the chosen units was positive. Patients admitted to the intervention units had a lower nutritional alteration and a shorter hospital stay than those admitted to the control units.