[Burnout and perceived health in Critical Care nursing professionals]. / Burnout y salud percibida en profesionales de enfermería de Cuidados Intensivos.

OBJECTIVE: To assess the level of burnout syndrome in a sample of critical care nursing professionals and analyze its relation with the perception of general health and other sociodemographic and work characteristics. DESCRIPTION: Cross-sectional descriptive study. SITE: Intensive Care Unit of the University Hospital Morales Meseguer, Murcia-Spain. METHOD: Three evaluation tools were used. These included a sociodemographic and work survey, the validated Maslach Burnout Inventory (MBI) questionnaires and the General Health Questionnaire (GHQ-28) in order to assess professional burnout and the general health condition perceived, respectively. RESULTS: Only 42 out of the 56 questionnaires included in the study were valid. This means an answering rate of 75%. The mean score obtained on the emotional tiredness dimension (25.45 6 11.15) stands out. About 42.9% of the sample presented psychological or psychosomatic symptoms that could require specialized care. Correlation between burnout and general health perception was statistically significant (r = 0.536; p < 0.001), this highlighting, above all, the association between the emotional level of tiredness and the B-scale of anxiety symptoms (r = 0.648; p = 0.000). The emotional level of professional burnout found was moderate to high among critical care nursing professionals. A total of 11.9% of the studied sample had a high score in the 3 dimensions of the burnout syndrome: emotional tiredness, depersonalization, and lack of personal job performance. CONCLUSIONS: Burnout and health levels found indicate high vulnerability in the sample studied and the need to establish prevention/intervention programs in this work context.

[An analysis of the papers presented in national congresses of the Spanish Society of Intensive Nursing and Coronary Units in an 8-year period]. / Análisis de las comunicaciones admitidas en los congresos nacionales de la SEEIUC en 8 años (1998-2005).

INTRODUCTION: The research on critical care nursing is generally presented in the annual national congresses of the Spanish Society of Intensive Nursing and Coronary Units (SEEIUC). This study has aimed to analyze the main features of the papers presented in the above-mentioned congresses in order to get a deeper knowledge of the research capacity of our professional group. MATERIALS AND METHODOLOGY: A descriptive, observational and retrospective study. SAMPLE: all the papers. Dimension studied: structure and process. Time: 8 years. DATA SOURCE: a collection of the papers presented in congresses. DEVELOPMENT: collected variables: number of authors, type of paper, city and region, type of study, timing, nursing role, dimension analyzed, topic, hospital, department, type of statistics, relevance, financing, structural quality and others. Statistical processing: descriptive statistics for quantitative variables with means and standard deviation (SD); qualitative variables are written in percentages. We have contrasted hypotheses with chi(2) accepting if p < 0.05 as a statistical significance. RESULTS: Papers 736 (65-119), oral papers 270 (40.4%), mean of authors 4.87 (1-16), SD 1.97; per provinces: Barcelona 146 (19.8%); per autonomous communities: Catalonia 166 (22.6%); hospitals: University Hospital from Bellvitge 27 (4.2%); research studies 426 (65.3%); prospective studies 333 (51%), quantitative 345 (53%); with descriptive statistics 305 (46.9%); with a health perception and health management pattern 76 (10.3%); analyzed quality area: structure 379 (51.5%); with the presence of an autonomous role 380 (51.6%); most mentioned theme: respiratory care 100 (13.6%), with relevance and/or applicability 450 (69%); financed 23 (3.5%). Fulfillment of scientific structure: 97%. CONCLUSIONS: Intensive Nursing Care shows an important amount of oral papers. Research studies stand out among these papers, the former having high structural quality and relevance and/or applicability.

Burnout y salud percibida en profesionales de enfermería de Cuidados Intensivos / Burnout and perceived health in Critical Care nursing professionals

Objetivo. Estimar la prevalencia del síndrome de estarquemado por el trabajo (burnout o desgaste laboral)en una muestra de profesionales de enfermeríaintensiva, y analizar su relación con el nivel de saludpercibida y otras variables sociodemográficas ylaborales.Diseño. Estudio descriptivo transversal.Emplazamiento. Servicio de Cuidados Intensivos delHospital Universitario Morales Meseguer ubicado enMurcia capital.Método. Se emplearon tres instrumentos deevaluación: una encuesta de variablessociodemográficas y laborales, y los cuestionariosvalidados Maslach Burnout Inventory (MBI)y General Health Questionnaire (GHQ-28)de Goldberg, para la evaluación del burnouty el estado general de salud percibido,respectivamente.Resultados. De un total de 56 cuestionariosadministrados, se obtuvieron 42 válidos, lo quesupone una tasa de respuesta del 75%. Destaca lapuntuación media obtenida en la dimensión deagotamiento emocional (25,45 11,15). El 42,9% dela muestra presentó síntomas psíquicos o físicos deorigen psicológico que podrían requerir atenciónespecializada. Resultó significativa la asociaciónburnout-salud general percibida (r = 0,536; p <0,001), destacando sobre todo la asociaciónagotamiento emocional-escala B de síntomas deansiedad (r = 0,648; p = 0,000). Los nivelesencontrados de desgaste profesional resultaron sermoderados-altos. El 11,9% de la muestra estudiadapuntúa alto en las tres dimensiones del síndrome deburnout: agotamiento emocional, despersonalizacióny falta de realización personal en el trabajo.Conclusiones. Los niveles de burnout y saludencontrados nos indican una elevada vulnerabilidaden la muestra estudiada y la necesidad de instaurarprogramas de prevención/intervención dentro deeste contexto laboral

Objective. To assess the level of burnout syndromein a sample of critical care nursing professionalsand analyze its relation with the perception ofgeneral health and other sociodemographic andwork characteristics.Description. Cross-sectional descriptive study.Site. Intensive Care Unit of the University HospitalMorales Meseguer, Murcia-Spain.Method. Three evaluation tools were used. Theseincluded a sociodemographic and work survey, thevalidated Maslach Burnout Inventory (MBI)questionnaires and the General HealthQuestionnaire (GHQ-28) in order to assessprofessional burnout and the general healthcondition perceived, respectively.Results. Only 42 out of the 56 questionnairesincluded in the study were valid. This means ananswering rate of 75%. The mean score obtainedon the emotional tiredness dimension (25.45 11.15) stands out. About 42.9% of the samplepresented psychological or psychosomaticsymptoms that could require specialized care.Correlation between burnout and generalhealth perception was statistically significant(r = 0.536; p < 0.001), this highlighting, above all,the association between the emotional levelof tiredness and the B-scale of anxiety symptoms(r = 0.648; p = 0.000). The emotional levelof professional burnout found was moderateto high among critical care nursing professionals.A total of 11.9% of the studied samplehad a high score in the 3 dimensions of theburnout syndrome: emotional tiredness,depersonalization, and lack of personal jobperformance.Conclusions. Burnout and health levels foundindicate high vulnerability in the sample studiedand the need to establish prevention/interventionprograms in this work context

Análisis de las comunicaciones admitidas en los congresos nacionales de la SEEIUC en 8 años (1998-2005) / An analysis of the papers presented in national congresses of the Spanish Society of Intensive Nursing and Coronary Units in an 8-year period

Introducción. La investigación en enfermería decuidados críticos suele comunicarse en los congresosnacionales de la Sociedad Española de EnfermeríaIntensiva y Unidades Coronarias (SEEIUC) que serealiza anualmente. El objetivo de este estudio esanalizar las características principales de lascomunicaciones presentadas en este evento paraconocer en profundidad la capacidad investigadoradel colectivo.Material y método. Estudio descriptivo,observacional y retrospectivo. Muestreo: todas lascomunicaciones. Dimensión estudiada: estructura yproceso. Tiempo: 8 años. Fuente de datos: libros decomunicaciones. Desarrollo: las variables recogidasfueron el número de autores, tipo de comunicación,ciudad y región, tipo de estudio, temporalidad, rol deenfermería, dimensión estudiada, tema, hospital,servicio, tipo de estadística, relevancia, financiación,calidad estructural y otros. Procesamiento estadístico:estadística descriptiva para variables cuantitativas conmedias y desviación estándar (DE), las cualitativas seexpresan en porcentajes. Contrastes de hipótesis con X2 aceptando significación estadística si p < 0,05.Resultados. Comunicaciones 736 (65-119), enformato oral 270 (40,4%); media de autores 4,87 (1-16), DE 1,97; por provincias: Barcelona 146 (19,8%);por Comunidades: Cataluña 166 (22,6%); hospitales:Hospital Universitario de Bellvitge 27 (4,2%); estudiosde investigación 426 (65,3%); prospectivas 333(51%); cuantitativas 345 (53%); con estadísticadescriptiva 305 (46,9%); patrón percepción-manejode la salud 76 (10,3%); área de calidad estudiada:estructura 379 (51,5%); presencia de rol autónomo380 (51,6%); tema más referenciado: los cuidadosrespiratorios 100 (13,6%); con relevancia y/oaplicabilidad 450 (69%); financiadas 23 (3,5%).Cumplimiento de estructura científica: 97%.Conclusiones. La enfermería de cuidados críticospresenta un número importante de comunicacionesorales, con predominio de estudios de investigacióncon una calidad estructural alta, y con relevancia y/oaplicabilidad

Introduction. The research on critical care nursingis generally presented in the annual nationalcongresses of the Spanish Society of IntensiveNursing and Coronary Units (SEEIUC). This studyhas aimed to analyze the main features of thepapers presented in the above-mentioned congressesin order to get a deeper knowledge of the researchcapacity of our professional group.Materials and methodology. A descriptive,observational and retrospective study. Sample: allthe papers. Dimension studied: structure andprocess. Time: 8 years. Data source: a collection ofthe papers presented in congresses. Development:collected variables: number of authors, type ofpaper, city and region, type of study, timing,nursing role, dimension analyzed, topic, hospital,department, type of statistics, relevance, financing,structural quality and others.Statistical processing: descriptive statistics forquantitative variables with means and standarddeviation (SD); qualitative variables are writtenin percentages. We have contrasted hypotheseswith X2 accepting ‘if p < 0.05’ as a statisticalsignificance.Results. Papers 736 (65-119), oral papers 270(40.4%), mean of authors 4.87 (1-16), SD 1.97; perprovinces: Barcelona 146 (19.8%); per autonomouscommunities: Catalonia 166 (22.6%); hospitals:University Hospital from Bellvitge 27 (4.2%);research studies 426 (65.3%); prospective studies333 (51%), quantitative 345 (53%); withdescriptive statistics 305 (46.9%); with a healthperception and health management pattern 76(10.3%); analyzed quality area: structure 379(51.5%); with the presence of an autonomous role380 (51.6%); most mentioned theme: respiratorycare 100 (13.6%), with relevance and/orapplicability 450 (69%); financed 23 (3.5%).Fulfillment of scientific structure: 97%.Conclusions. Intensive Nursing Care shows animportant amount of oral papers. Research studiesstand out among these papers, the former havinghigh structural quality and relevance and/orapplicability

[Comparative study of burnout in Intensive Care and Emergency Care nursing staff]. / Estudio comparativo del burnout en personal de enfermería de Cuidados Intensivos y Urgencias.

OBJECTIVE: To assess and compare the burnout level between Intensive Care Unit and Emergency Unit, and study its association with the sociodemographic and work characteristics of the professionals surveyed. DESCRIPTION: Cross-sectional, descriptive study. Emplacement. Intensive Care Unit of the university hospital Morales Meseguer, Murcia-Spain. STUDIED SAMPLE: 97 nursing professionals: 55 professionals belong to the Emergency Department, and 42 professionals belong to the Intensive Care Department. METHOD: Two evaluation tools were used: a sociodemographic and work survey, and the Maslach Burnout Inventory, 1986. Quantitative variables expressed as mean +/- SD compared with the Student's T test and qualitative variables compared with the chi2 test. STATISTICAL ANALYSIS: SPSS 12.0(c). RESULTS: The comparative analysis of the burnout dimensions shows that emotional exhaustion level is significantly higher in the intensive care service than in the emergency one (25.45 +/- 11.15 vs 22.09 +/- 10.99) p < 0.05. The rest of burnout dimensions do not show significant differences between both departments. The masculine gender obtains a higher score in the depersonalization dimension of burnout (10.12 +/- 5.38) than female one (6.7 +/- 5.21) p < 0.01. There is greater vulnerability to emotional exhaustion among the professional group with more than 15 years of work experience (F = 3.592; p = 0.031). CONCLUSIONS: The burnout levels are moderate to high among the nursing professionals studied. A total of 5.15% of the sample studied achieves a high score in the three dimensions of the burnout syndrome. The intensive care professionals are the most vulnerable to suffering high levels of emotional exhaustion, and the masculine gender is more susceptible to depersonalization attitudes.

Estudio comparativo del burnout en personal de enfermería de Cuidados Intensivos y Urgencias / Comparative study of burnout in Intensive Care and Emergency Care nursing staff

Objetivo. Estimar y comparar el nivel de burnout existente en los Servicios de Cuidados Intensivos y Urgencias, y estudiar su asociación con las características sociodemográficas y laborales de los profesionales encuestados. Diseño. Estudio descriptivo transversal. Emplazamiento. Servicios de Urgencias y Cuidados Intensivos del Hospital Morales Meseguer (Murcia). Muestra. Noventa y siete profesionales de enfermería, 55 pertenecientes al Servicio de Urgencias y 42 al Servicio de Cuidados Intensivos. Método. Se emplearon dos instrumentos de evaluación: una encuesta de variables sociodemográficas y laborales, y el cuestionario Maslach Burnout Inventory, de 1986. Las variables cuantitativas se expresan como media ± desviación estándar comparadas con t de Student y las cualitativas se comparan con Chi2. El análisis de datos se realizó mediante el programa informático SPSS 12.0(C). Resultados. El análisis comparativo de las dimensiones que componen el burnout demuestra que los niveles de agotamiento emocional son significativamente mayores en el Servicio de Cuidados Intensivos que en el de Urgencias (25,45 ± 11,15 frente a 22,09 ± 10,99) p < 0,05. El resto de dimensiones que componen el síndrome no ha demostrado diferencias significativas entre ambos servicios. El género masculino obtiene una mayor puntuación en la dimensión de despersonalización (10,12 ± 5,38) que el género femenino (6,7 ± 5,21) p < 0,01. Existe una mayor vulnerabilidad al agotamiento emocional en el grupo de profesionales que llevan más de 15 años trabajando (F = 3,592; p = 0,031). Conclusiones. Los niveles encontrados de burnout resultaron ser moderados-altos. El 5,15% de la muestra total estudiada puntúa alto en las tres dimensiones del síndrome, los profesionales de Cuidados Intensivos son los más vulnerables a padecer elevados niveles de agotamiento emocional y el género masculino es el más propenso a las actitudes de despersonalización

Objective. To assess and compare the burnout level between Intensive Care Unit and Emergency Unit, and study its association with the sociodemographic and work characteristics of the professionals surveyed. Description. Cross-sectional, descriptive study. Emplacement. Intensive Care Unit of the university hospital Morales Meseguer, Murcia-Spain. Studied sample. 97 nursing professionals: 55 professionals belong to the Emergency Department, and 42 professionals belong to the Intensive Care Department. Method. Two evaluation tools were used: a sociodemographic and work survey, and the Maslach Burnout Inventory, 1986. Quantitative variables expressed as mean ± SD compared with the Student's T test and qualitative variables compared with the chi2 test. Statistical analysis: SPSS 12.0(C). Results. The comparative analysis of the burnout dimensions shows that emotional exhaustion level is significantly higher in the intensive care service than in the emergency one (25.45 ± 11.15 vs 22.09 ± 10.99) p < 0.05. The rest of burnout dimensions do not show significant differences between both departments. The masculine gender obtains a higher score in the depersonalization dimension of burnout (10.12 ± 5.38) than female one (6.7 ± 5.21) p < 0.01. There is greater vulnerability to emotional exhaustion among the professional group with more than 15 years of work experience (F = 3.592; p = 0.031). Conclusions. The burnout levels are moderate to high among the nursing professionals studied. A total of 5.15% of the sample studied achieves a high score in the three dimensions of the burnout syndrome. The intensive care professionals are the most vulnerable to suffering high levels of emotional exhaustion, and the masculine gender is more susceptible to depersonalization attitudes

La disminución de las radiografías de tórax innecesarias en la Unidad de Cuidados Intensivos: aplicación de un ciclo conjunto de mejora de la calidad / Decrease of unnecessary chest x-rays in Intensive Care Unit: application of a combined cycle of quality improvement

Objetivo. Demostrar que el consenso interdisciplinar mejora la calidad del trabajo en la Unidad de Cuidados Intensivos (UCI), evitando exploraciones radiológicas rutinarias innecesarias, planteándose una monitorización de los resultados para mantener este bajo porcentaje de peticiones. Diseño. Ciclo de mejora de calidad asistencial. Ámbito. UCI de 18 camas de carácter polivalente. Pacientes. Pacientes ingresados en la UCI en el periodo de un mes, durante el cual se hizo un muestreo aleatorio sistemático. Intervenciones. Establecimiento de un protocolo consensuado de petición de radiografías de tórax portátiles (RTP) rutinarias. Tras comprobar el exceso de RTP siguiendo estos criterios, se acordó con todos los intensivistas su aplicación. Cinco años después se volvió a valorar el grado de incumplimiento y se incluyó un calendario de monitorizaciones para evitar la vuelta al exceso de solicitudes no justificadas. Además se introdujo un sistema de petición consensuado entre dos intensivistas, de manera que todas las RTP programadas para cada día se solicitaban por parte de dos intensivistas, atendiendo a los mencionados criterios. Variable. Peticiones que incumplen el protocolo de RTP programada. Resultados. En 1997, el grado global de incumplimiento era del 16,9%. Tras reducirlo al 6,1%, la falta de control posterior llevó a que en 2003 fuese del 27,6%. Los pacientes estables con cardiopatía isquémica (44,4% y 53,8% de todos los incumplimientos en esos dos años) constituyen el grueso de las indicaciones inadecuadas. El uso de un modelo de solicitud que requiere del consenso de dos intensivistas consiguió una reducción del incumplimiento al 2,5% en 2003. El calendario de monitorización ha permitido seguir en el tiempo el grado de cumplimiento y detectar la relajación en la prescripción. Conclusiones. Las RTP innecesarias pueden reducirse fácilmente incidiendo sobre los pacientes clínicamente estables. La obligación de justificar una petición rutinaria (consenso entre intensivistas) permite disminuir el número de peticiones de RTP. La monitorización periódica es la herramienta final para el éxito del ciclo de mejora

Purpose. To demonstrate that interdisciplinary consensus improves the quality of work in the daily Intensive Care Unit (ICU), thus avoiding unnecessary routine x-ray examinations. We propose to monitor the results to maintain this low percentage of requests for x-rays. Design. Cycle of improvement in care quality. Setting. An 18-bed polyvalent ICU. Patients. A random sample of patients admitted in ICU during one month. Interventions. Establishment of basic agreed on protocol for routine chest portable x-ray (CPR) indications. After assessing the excessive amount of CPR according to those criteria, all intensivists accepted their application. Five years later, a second assessment of the degree of non-compliance was carried out and a monitoring schedule was established in order to avoid making unnecessary CPR again. Furthermore, a consensus between two intensivists was considered obligatory before a CPR request. Accordingly, all non-urgent CPR forms were signed by two intensivists, following the mentioned clinical criteria. Variable. Unsuitable portable chest x-ray indications. Results. In 1997, the overall non-compliance rate (ONCR) was 16.9%. After reducing it to 6.1%, lack of follow-up led to a non-compliance rate of 27.6% in 2003. Stable patients with uncomplicated ischemic heart disease (44.4% in 1997 and 53.8% in 2003) accounted for most of the inadequate ONCR indications. By using the consensus system for requesting routine portable x-rays that required the agreement of two intensivists achieved a reduction of non-compliance to 2.5% in 2003. The monitoring schedule designed has made it possible to follow the time of compliance degree and detect relaxation in the prescriptions. Conclusions. Unnecessary CPR can be easily reduced stressing our control in clinically stable patients. The requirement to justify a routine request (agreement between intensivists) makes it possible to decrease the number of CPRs. Periodic monitoring is the definitive tool for a successful improvement cycle

[Decrease of unnecessary chest x-rays in Intensive Care Unit: application of a combined cycle of quality improvement]. / La disminución de las radiografías de tórax innecesarias en la Unidad de Cuidados Intensivos: aplicación de un ciclo conjunto de mejora de la calidad.

PURPOSE: To demonstrate that interdisciplinary consensus improves the quality of work in the daily Intensive Care Unit (ICU), thus avoiding unnecessary routine x-ray examinations. We propose to monitor the results to maintain this low percentage of requests for x-rays. DESIGN: Cycle of improvement in care quality. SETTING: An 18-bed polyvalent ICU. PATIENTS: A random sample of patients admitted in ICU during one month. INTERVENTIONS: Establishment of basic agreed on protocol for routine chest portable x-ray (CPR) indications. After assessing the excessive amount of CPR according to those criteria, all intensivists accepted their application. Five years later, a second assessment of the degree of non-compliance was carried out and a monitoring schedule was established in order to avoid making unnecessary CPR again. Furthermore, a consensus between two intensivists was considered obligatory before a CPR request. Accordingly, all non-urgent CPR forms were signed by two intensivists, following the mentioned clinical criteria. VARIABLE: Unsuitable portable chest x-ray indications. RESULTS: In 1997, the overall non-compliance rate (ONCR) was 16.9%. After reducing it to 6.1%, lack of follow-up led to a non-compliance rate of 27.6% in 2003. Stable patients with uncomplicated ischemic heart disease (44.4% in 1997 and 53.8% in 2003) accounted for most of the inadequate ONCR indications. By using the consensus system for requesting routine portable x-rays that required the agreement of two intensivists achieved a reduction of non-compliance to 2.5% in 2003. The monitoring schedule designed has made it possible to follow the time of compliance degree and detect relaxation in the prescriptions. CONCLUSIONS: Unnecessary CPR can be easily reduced stressing our control in clinically stable patients. The requirement to justify a routine request (agreement between intensivists) makes it possible to decrease the number of CPRs. Periodic monitoring is the definitive tool for a successful improvement cycle.