Conocimiento y autoeficacia de la enfermera: o profesional para la aplicación del proceso de enfermería en un hospital de tercer nivel de atención / Knowledge and self-efficiency of the professional nursing for the application of the nursing processes in a hospital of a tercer level of attention / Conhecimento e autoeficácia do profissional enfermeiro para a aplicação do processo de enfermagem em um hospital de terceiro nível de assistência

Introducción: El proceso de enfermería (PE) es la herramienta metodológica que permite al profesional de enfermería brindar cuidados centrados en la persona; por lo que su conocimiento y aplicación a nivel hospitalario permite la evaluación del cuidado formal de enfermería. La autoeficacia es a la creencia que posee el profesional de enfermería para desempeñar las acciones necesarias para obtener los resultados deseados. Metodología: Tipo de estudio analítico, trasversal, prospectivo muestra de 213 enfermeros, 181 licenciatura y 32 de especialidad, se aplicó una encuesta y se analizaron los datos mediante SPSS V.25 se utilizó de estadística descriptiva e inferencial, para la correlación de variables se utilizó Pearson y para comparación de los grupos t de student. Resultados: se observó diferencia estadísticamente significativa en el promedio de conocimientos del PE en los grupos de estudios y en la autoeficacia, en la etapa de diagnóstico (t: -2.986, gl 46, p= 0.005), y de evaluación (t: -2.029, gl 50, p= 0.048), y en la autoeficacia en la dimensión de Persuasión verbal (t= -2.364, gl = 211, p= 0.019). Discusión: Los resultados concuerdan con varios autores respecto a que entre mayor es el grado académico mayor es nivel de conocimientos y de la autoeficacia para aplicar el proceso de enfermería. Conclusiones: Se tiene mayor conocimientos y autoeficacia del PE por parte de los enfermeros especialistas. No existe relación entre las variables de autoeficacia y conocimiento

Introduction: The nursing process (EP) is the methodological tool that allows the nursing professional to provide person-centered care; therefore, its knowledge and application at the hospital level allows the evaluation of formal nursing care. Self-efficacy is the belief held by the nursing professional to perform the necessary actions to obtain the desired results. Objective: To compare and analyze the relationship between the level of knowledge and self-efficacy of nursing graduates and specialists in the application of the EP in a third level of care institution. Method: Analytical, prospective, cross-sectional study, sample of 213 nurses, 181 undergraduate and 32 specialty nurses, a survey was applied, and data were analyzed using SPSS V.25, descriptive and inferential statistics were used, Pearson was used for correlation of variables and Student's t-test was used for comparison of groups. Results: A statistically significant difference was observed in the average PE knowledge in the study groups and in self-efficacy, in the diagnosis stage (t: -2.986, gl 46, p=: 0.005), and evaluation (t: -2.029, gl 50, p=: 0.048), and in self-efficacy in the Verbal Persuasion dimension (t= -2.364, gl = 211, p= 0.019). Discussion: The results agree with several authors regarding that the higher the academic degree, the higher the level of knowledge and self-efficacy to apply the nursing process. Conclusions: There is greater knowledge and self-efficacy of EP by specialist nurses. There is no relationship between the variables of self-efficacy and knowledge

Antecedentes: O processo de enfermagem (EP) é a ferramenta metodológica que permite ao profissional de enfermagem prestar cuidados centrados na pessoa; portanto, o seu conhecimento e aplicação a nível hospitalar permite a avaliação dos cuidados de enfermagem formais. Auto-eficácia é a crença do profissional de enfermagem de realizar as acções necessárias para obter os resultados desejados. Objectivo: Comparar e analisar a relação entre o nível de conhecimentos e a auto-eficácia dos licenciados e especialistas de enfermagem na aplicação do PE numa instituição de cuidados de terceiro nível. Método: Estudo observacional, prospectivo, transversal, comparativo, amostra de 213 enfermeiros, 181 licenciados e 32 especialistas, foi aplicado um inquérito e os dados foram analisados usando SPSS V.25. Foram usadas estatísticas descritivas e inferenciais, Pearson foi usado para a correlação de variáveis e o teste t de Student foi usado para a comparação de grupos. Resultados: Foram observadas diferenças estatisticamente significativas no conhecimento médio de EP nos grupos de estudo e na auto-eficácia, na fase de diagnóstico (t: -2,986, gl 46, p=: 0,005), e na avaliação (t: -2,029, gl 50, p=: 0,048), e na auto-eficácia na dimensão de Persuasão Verbal (t= -2,364, gl = 211, p= 0,019). Discussão: Os resultados concordam com vários autores quanto ao grau académico, maior o nível de conhecimento e auto-eficácia para aplicar o processo de enfermagem. Conclusões: Há um maior conhecimento e auto-eficácia do PE por enfermeiros especializados. Não há relação entre as variáveis de auto-eficácia e de conhecimento

Application of PDCA Process Management in Day Operation Ward and the Influence of Nursing Quality and Safety.

Objective: To survey the application of PDCA (plan, do, check, and action) process management in day operation ward and the influence of nursing quality and safety. Methods: The routine nursing management was carried out in our hospital from March 2019 to March 2020, which was set as the control group (N = 20), and the PDCA process management was implemented from March 2020 to March 2021 as the research group (N = 20). Twenty nurses and patients were selected as subjects in two periods of time. The nursing quality, the score of individual quality control examination in clinical department, the nursing quality of operating room, the incidence of adverse events and nursing errors, the number of problems existing in the quality management of nursing documents, and the score of nursing satisfaction were accessed. Results: In the comparison of nursing quality, the nursing safety, specialty quality, and nursing norms of the study group were higher compared to the control (P < 0.05). In terms of the scores of individual quality control examination in clinical departments, the scores of ward management, rescue, therapeutic articles, drug management, first-level nursing, nursing documents, and head nurses in the study group were greater compared to the control (P < 0.05). In terms of the operating room nursing quality score, the instrument management, instrument preparation, nurses' cooperation skills, disinfection and isolation quality, and the total score of the study group were above the control (P < 0.05). In terms of the incidence of operative adverse events and nursing errors, the incidence of nosocomial infection, iatrogenic injury, information check error, equipment failure, violation of operation regulations, ECG monitoring error, infusion operation error, and medication error in the study group was lower compared to the control (P < 0.05). According to the comparison of the number of problems existing in the quality management of nursing documents, the number of problems in temperature sheet, medical order, evaluation sheet, nursing record, and other nursing documents in the study group was lower than the control (P < 0.05). The scores of nursing communication, professional technology, nursing service attitude, nursing environment, and knowledge education in the study group were higher in contrast to the control (P < 0.05). Conclusion: The application of PDCA management can effectively enhance the nursing quality and safety of the day operation ward, further facilitate the quality of hospital nursing work, and improve patient satisfaction, which exert great potential, and application value in the management of day ward in the future.

Evaluation of the Effect of Intensive Nursing Intervention Based on Process Analysis.

In order to achieve significant improvements in the evaluation of key indicators such as speed, quality, cost, and service, this paper fundamentally rethinks and completely redesigns the business process, and recreates a new business process. This study combines the particularity of AMI with emergency nursing to construct an in-hospital AMI emergency nursing process to further standardize the AMI rescue work. The implementation of the process helps to clarify the responsibilities and requirements of nurses in the AMI emergency process, reduce the delay time of AMI emergency, and improve the efficiency and effectiveness of emergency. In addition, after refactoring the business process, this paper builds an intelligent digital critical illness monitoring system. This system combines the original work flow of the ICU medical staff, optimizes the work flow of the medical staff through computer technology and information technology, and designs and completes the digital intensive nursing system software to run and use in the hospital and obtain significant results.

Analysis of Risk Factors of Hospital Emergency Nursing Based on Comprehensive Nursing Methods.

In order to improve the comprehensive nursing effect of the hospital emergency treatment, this paper analyzes the process of the hospital emergency treatment. In addition, this paper combines the possible risks to analyze the risk factors of the comprehensive nursing in the hospital emergency treatment and builds an intelligent analysis model based on the actual situation of the hospital emergency treatment. At the same time, this paper conducts a systematic survey of emergency services and gives the composition and structure of the system. In addition, this paper divides the business required by the system into modules, including registration module, doctor workstation, nurse workstation, query statistics module, decision-making module, and maintenance module. Finally, this paper suggests that in the process of the clinical triage, more ideas for improving the existing evaluation model should be proposed, and experience should be transformed into advantages, so as to improve emergency triage skills; establish an objective, quantitative, and scientific concept of emergency classification and triage; and fully realize scientific triage and precise triage.

Utilization of Nursing Defect Management Evaluation and Deep Learning in Nursing Process Reengineering Optimization.

It was to explore the application of nursing defect management evaluation and deep learning in nursing process reengineering optimization. This study first selects the root cause analysis method to analyse the nursing defect management, then realizes the classification of data features according to the convolution neural network (CNN) in deep learning (DL) and uses the constructed training set and verification set to obtain the required plates and feature extraction. Based on statistical analysis and data mining, this study makes statistical analysis of nursing data from a macroperspective, improves Apriori algorithm through simulation, and analyses nursing data mining from a microperspective. The constructed deep learning model is used, CNN network training is conducted on the selected SVHN dataset, the required data types are classified, the data are analysed by using the improved Apriori algorithm, and nurses' knowledge of nursing process rules is investigated and analysed. The cognition of nursing staff on process optimization and their participation in training were analyzed, the defects in the nursing process were summarized, and the nursing process reengineering was analyzed. The results show that compared with Apriori algorithm, the running time difference of the improved Apriori algorithm is relatively small. With the increase of data recording times, the line trend of the improved algorithm gradually eases, the advantages gradually appear, and the efficiency of data processing is more obvious. The results showed that after the optimization of nursing process, the effect of long-term specialized nursing was significantly higher than that of long-term nursing. Health education was improved by 7.57%, clinical nursing was improved by 6.55%, ward management was improved by 9.85%, and service humanization was improved by 8.97%. In summary, the reoptimization of nursing process is conducive to reduce the defects in nursing. In the data analysis and rule generation based on deep learning network, the reoptimization of nursing process can provide reference for decision-making departments to improve long-term nursing, improve the quality and work efficiency of clinical nurses, and is worthy of clinical promotion.

Content validity of the nursing diagnostic Breathing Pattern, Ineffective, in children with congenital heart defects.

OBJECTIVE: To estimate the content validity of the nursing diagnostic Breathing Pattern, Ineffective, in children with congenital heart defects. METHOD: Methodological study in two stages: 1) integrative literature review; 2) content validation, with 23 nurses. An instrument with 10 related factors and 21 defining characteristics for data collection was used. The analysis by the evaluators was carried out using the relevance criteria. The Content Validity Index was used. Valid results were those above 0.9 with a Wilcoxon test above 0.05. RESULTS: The final proposal incorporates nine from the ten causal factors. From them, five do not belong in the NANDA-I list. Regarding the defining characteristics, they were all considered to be relevant, and five are not among the list of signs and symptoms of the NANDA-I taxonomy. CONCLUSION: The findings of this study include specific elements of the pediatric population with congenital heart defect which are not present in the structure of the diagnostic being studied.

Nursing surveillance and immediate jeopardy in Veteran Health Administration community living centers unannounced survey program 2018 to 2019.

BACKGROUND: The VA Community Living Center (CLC) Unannounced Survey Program aims to assess standards of care set by the government to protect residents. PURPOSE: To describe patterns of practice failures in nursing surveillance causing or having potential to cause immediate jeopardy, as defined by the Centers for Medicare and Medicaid Services. METHODS: Using CLC survey data consisting of 200 statements of deficiency (SODs) for 2018 to 2019, we collected a SOD sample (n = 20) of immediate jeopardy events. They were described using descriptive statistics and discourse content analysis. FINDINGS: We identified clinical events, their duration, work shift, and nursing skill mix for each SOD. Most to least common themes about failures in nursing surveillance were acquisition/transfer of information; decision-making; and early recognition of problems. DISCUSSION: Our analysis of nursing surveillance failures in CLC immediate jeopardy SODs provides insight into opportunities for registered nurses and the nursing skill mix to reduce avoidable harms.

Guardians of humanity? The challenges of nursing practice in the digital age.

Digital technologies have become a crucial factor in nursing. Given the fact that many tasks could also be done by robots or AI systems, the place for the nurse in this scenario is unclear. In what way and to what extent will the implementation of ever more sophisticated technology affect nursing practice? It is the aim of this paper to analyse the potential challenges of nursing practice in the digital age. The analysis is conducted through the lens of new materialism, a set of theoretical models that understand the relationship between humans and technology as dynamic and performative. According to this view, there is no prefixed essence of technology. Rather, the meaning of technology is enacted in concrete practice. The analysis shows that in past debates on technology use in nursing, the nurses' role has been defined as guardians of humanity, defending the patient against the dehumanizing effects of technology. This role has been transferred to the digital age, where it is the duty of nurses to cushion the negative effects of digital technology. As an alternative to this outdated role, nurses should be included in processes of technology design and policymaking. Enabling nursing professionals to shape the circumstances of a digitally enhanced holistic practice may empower their status within the healthcare system and also benefit the patient by contributing to a more person-centred care.

Fondamentaux des soins : un cadre et un processus pratique pour répondre aux besoins physiques, psychosociaux et relationnels des personnes soignées.

Since 2008, an international group has been helping to promote a better response to the fundamental needs of individuals receiving care. This group provides a framework on the fundamentals of care that focuses on the relationship between the nurse, the individual being cared for, and his or her relatives, as well as on the response to the patient’s physical, psychosocial, and relational needs. A practice process supports the concrete application of this framework. The purpose of this discursive article is to present the French translation of the Fundamentals of Care Framework and its Practice Process. To begin with, the translation process will be briefly explained. Next, the Fundamentals of Care Framework and the stages in its Practice Process will be presented. To help the reader better understand the proposal, a clinical illustration will be used to present the situation of Mr. Perron, who is living with Alzheimer’s disease, and his spouse, who is his family caregiver. Finally, the article discusses the usefulness of the Fundamentals of Care Framework and its Practice Process in terms of the four main areas of the discipline of nursing : practice, management, training, and research. This article paves the way for the development of knowledge on the fundamentals of care in the French-speaking world.

Desde la enfermería basada en evidencia: patrones de conocimiento: mirando su narrativa: fenómeno del cuidado / From nursing based nursing: patterns of knowledge: looking at his narrative: phenomenon of car / De enfermagem baseada em enfermagem: padrões do conhecimento: olhando

INTRODUCCIÓN: Desde la enfermería basada en evidencia, como procesos cognitivos que ponen en marcha frente a cada situación hacen evidente al proceso de Enfermería como herramienta fundamental para la dirección del cuidado. En el fenómeno de cuidado, surge la situación de enfermería como herramienta científica que permite poner en evidencia los patrones de conocimiento enfermero propuestos por Barbara Carper, los elementos del metaparadigma, así como las fases del proceso de enfermería. Para la operacionalización del mismo, se utilizó la taxonomía de diagnósticos propuestos por la NANDA, así como los resultados esperados (NOC) y las intervenciones sugeridas (NIC). METODOLOGÍA: Para precisar la realidad, se abordó desde el equipaje etnográfico focalizado como metodología analítica explorando desde el aspecto antropológico del cuidado, la enfermería basada en evidencia, patrones de conocimiento desde la narrativa del cuidado como base epistémica para los dominios y taxonomías, teniendo en cuenta la adecuación teórico- epistemológica fundamentado en el paradigma cualitativo- interpretativo a través del interaccionismo simbólico. RESULTADOS Y DISCUSIONES: La enfermería basada en evidencia, surge como el nuevo paradigma emergente, a través de los patrones de conocimiento, hacen parte de la enseñanza y de la práctica de enfermería, de tal forma que aumentan su complejidad y su diversidad epistemológica. Por lo tanto, cada patrón da una orientación de los problemas y las preguntas de la disciplina, reconociendo que los cambios son inherentes al desarrollo del conocimiento en enfermería. Propuestas metodológicas. El fenómeno del cuidado, emerge como necesidad la simbiosis entre el proceso de enfermería y su transcendencia en la investigación científica a través de la enfermería basada en evidencia, vista como un proceso único, individualizado de la práctica de enfermería a través de la narrativa, usando la herramientas de los patrones de conocimiento, teniendo en cuenta que las repuestas de salud-enfermedad de los seres humanos, forman parte del núcleo central del relato y de los significados que las personas les otorgan

INTRODUCTION: From nursing based on evidence, as cognitive processes that put in place in front of each situation make evident to the process of Nursing as a fundamental tool for the direction of care. In the care phenomenon, the nursing situation arises as a scientific tool that allows to put into evidence the patterns of nursing knowledge proposed by Barbara Carper, the elements of the metaparadigm, as well as the phases of the nursing process. For the operationalization of the same, the taxonomy of diagnoses proposed by the NANDA was used, as well as the expected results (NOC) and the suggested interventions (NIC). METHODOLOGY: To clarify reality, it was approached from the ethnographic baggage focused as analytical methodology, exploring from the anthropological aspect of care, evidence-based nursing, patterns of knowledge from the care narrative as an epistemic basis for domains and taxonomies, taking into account the theoretical-epistemological adaptation based on the qualitative-interpretive paradigm through symbolic interactionism. RESULTS AND DISCUSSIONS: Nursing based on evidence, emerges as the new emerging paradigm, through the knowledge patterns, are part of the teaching and practice of nursing, in such a way that they increase its complexity and its epistemological diversity. Therefore, each employer gives an orientation of the problems and the questions of the discipline, recognizing that the changes are inherent in the development of knowledge in nursing. Methodological proposals. The phenomenon of care, emerges as a need the symbiosis between the nursing process and its transcendence in scientific research through evidence-based nursing, seen as a unique, individualized process of nursing practice through the narrative, using the tools of knowledge patterns, taking into account that the health-illness responses of human beings are part of the central core of the story and the meanings that people give them

INTRODUÇÃO: A partir da enfermagem baseada em evidências, como processos cognitivos que se colocam à frente de cada situação, evidencia-se o processo de Enfermagem como uma ferramenta fundamental para a direção do cuidado. No fenômeno do cuidado, a situação de enfermagem surge como uma ferramenta científica que permite evidenciar os padrões de conhecimento de enfermagem propostos por Barbara Carper, os elementos do metaparadigma, bem como as fases do processo de enfermagem. Para a operacionalização dos mesmos, utilizou-se a taxonomia de diagnósticos proposta pela NANDA, bem como os resultados esperados (NOC) e as intervenções sugeridas (NIC). METODOLOGIA: Para esclarecer a realidade, foi abordada a partir da bagagem etnográfica focada como metodologia analítica, explorando desde o aspecto antropológico do cuidado, enfermagem baseada em evidências, padrões de conhecimento da narrativa do cuidado como base epistêmica para domínios e taxonomias, levando em consideração a adaptação teórico-epistemológica baseada no paradigma qualitativo-interpretativo através do interacionismo simbólico. RESULTADOS E DISCUSSÕES: A enfermagem baseada em evidências, emerge como o novo paradigma emergente, através dos padrões de conhecimento, fazem parte do ensino e prática de enfermagem, de forma a aumentar sua complexidade e sua diversidade epistemológica. Portanto, cada empregador dá uma orientação sobre os problemas e as questões da disciplina, reconhecendo que as mudanças são inerentes ao desenvolvimento do conhecimento em enfermagem. Propostas metodológicas. o fenômeno do cuidado, emerge como uma necessidade a simbiose entre o processo de enfermagem e sua transcendência na pesquisa científica por meio da enfermagem baseada em evidências, vista como um processo único e individualizado de prática de enfermagem através do narrativa, utilizando as ferramentas dos padrões de conhecimento, levando em conta que as respostas saúde-doença dos seres humanos fazem parte do núcleo central da história e dos significados que as pessoas lhes dão

PICOT-clinic, acrónimo para la inferencia del razonamiento clínico en enfermería / PICOT-clinic, acronym for inference of clinical reasoning in nursing / PICOT-clinic, acrónimo para a inferência do raciocínio clínico em enfermagem

OBJETIVO: Presentar la codificación del acrónimo PICOT-clinic, como abordaje de mejora de los procesos de inferencia, deducción, inducción del razonamiento clínico en Enfermería: Método. Codificación de las etapas del PICOT-clinic se integran en transición consecutiva y consecuente en el razonamiento clínico, sostenidas por referencial teórico de Enfermería, los patrones de calidad de los cuidados de enfermería de la Orden de los enfermeros, la vulnerabilidad, así como el potencial de recuperación del cliente y las dimensiones de respuesta humana, propiciando la formulación de los Diagnósticos de Enfermería, respetando los principios de priorización de diagnósticos de Enfermería, planificando la prescripción de Intervenciones de Enfermería Focalizadas asociado con los objetivos SMARTp. RESULTADOS: El acrónimo PICOT-clinic como proceso para la sistematización del razonamiento de la clínica de los cuidados de Enfermería, presenta cinco etapas, P: persona a cuidar; I: Inferencia, deducción e inducción del razonamiento clínico; C: comparación de datos clínicos; O: Outcomes esperados para el cliente; T: Tipo y diseño de las intervenciones de Enfermería. CONCLUSIÓN: El PICOT-clinic es un organizador de debate estructurado que influye las diferentes formas de razonamiento de los enfermeros, la integración teórico-práctica, habilidades de pensamiento crítico, socialización intrínseca y ejercicio de la enfermería, enfocado en la situación real

OBJECTIVE: To present the coding of PICOT-clinic acronym, as an approach to improve the inference, deduction, induction processes of clinical reasoning in Nursing. Method. Coding of PICOT-clinic stages are integrated in consecutive and consequent transition on clinical reasoning in Nursing, based on a theoretical framework of Nursing, on fundamental patterns of Nursing knowledge, on Nursing care quality patterns of the Order of Nurses, on the vulnerability, as well as on the client's recovery potential, and on the dimensions of human responses, propitiating the formulation of the Nursing Diagnoses, respecting the principles of prioritization of Nursing diagnoses, planning the prescription of Tailored Nursing Interventions associated with SMARTp objectives. RESULTS: The PICOT-clinic acronym as a process for the systematization of Nursing care clinic rationale, presents the five stages, P: person to take care of; I: Inference, deduction and induction of clinical reasoning; C: comparison of clinical data; O: Outcomes expected for the client; T: Type and design of Nursing interventions. CONCLUSION: PICOT-clinic is a structured organizer of debate that influences the different forms of nurses' reasoning in the deepening of knowledge, in the theoretical-practical integration, in the critical thinking skills, in the intrinsic socialization to Nursing practice, focused on the circumstance/real situation

OBJETIVO: Apresentar a codificação do acrónimo PICOT-clinic, como abordagem de melhoria dos processos de inferência, dedução, indução do raciocínio clínico em Enfermagem: Método. Codificação das etapas do PICOT-clinic, integradas em transição consecutiva e consequente no raciocínio clínico em Enfermagem, sustentadas num referencial teórico de Enfermagem, nos padrões fundamentais do conhecimento em Enfermagem, nos padrões de qualidade dos cuidados de Enfermagem da Ordem dos Enfermeiros, na vulnerabilidade, bem como no potencial de recovery do cliente e nas dimensões de resposta humana, propiciando a formulação dos Diagnósticos de Enfermagem, respeitando os princípios de priorização de diagnósticos de Enfermagem, planeando a prescrição de Intervenções de Enfermagem Focadas associadas a objetivos SMARTp. RESULTADOS: O acrónimo PICOT-clinic como processo para a sistematização do raciocínio da clínica dos cuidados de Enfermagem, apresenta cinco etapas, P: pessoa a cuidar; I: Inferência, dedução e indução do raciocínio clínico; C: comparação dos dados clínicos; O: Outcomes esperados para o cliente; T: Tipo e desenho das intervenções de Enfermagem. CONCLUSÃO: O PICOT-clinic é um organizador de debate estruturado que influencia as diferentes formas de raciocínio dos Enfermeiros no aprofundamento do conhecimento, na integração teórico-prática, nas habilidades de pensamento crítico, na socialização intrínseca ao exercício da Enfermagem, focado na circunstância/situação real

[SARS-CoV-2: recommendations on nursing care for dialyzed and transplanted patient].

Coronavirus disease 2019 is an infectious respiratory syndrome caused by the virus called SARS-CoV-2, belonging to the family of coronaviruses. The first ever cases were detected during the 2019-2020 pandemic. Coronaviruses can cause a common cold or more serious diseases such as Middle Eastern Respiratory Syndromes (MERS) and Severe Acute Respiratory Syndrome (SARS). They can cause respiratory, lung and gastrointestinal infections with a mild to severe course, sometimes causing the death of the infected person. This new strain has no previous identifiers and its epidemic potential is strongly associated with the absence of immune response/reactivity and immunological memory in the world population, which has never been in contact with this strain before. Most at risk are the elderly, people with pre-existing diseases and/or immunodepressed, dialyzed and transplanted patients, pregnant women, people with debilitating chronic diseases. They are advised to avoid contacts with other people, unless strictly necessary, and to stay away from crowded places, also observing scrupulously the recommendations of the Istituto Superiore di Sanità. In this article we detail the recommendations that must be followed by the nursing care staff when dealing with chronic kidney disease patients in dialysis or with kidney transplant patients. We delve into the procedures that are absolutely essential in this context: social distancing of at least one meter, use of PPI, proper dressing and undressing procedures, frequent hand washing and use of gloves, and finally the increase of dedicated and appropriately trained health personnel on ward.

Leadership in Nursing Excellence: The Magnet Recognition® Journey Experiences in Europe.

Improving work conditions and the provision of high-quality care and patient safety is an issue in European hospitals. Inspired by a US program for nursing excellence, Magnet Recognition, a Belgian hospital shared their experiences by organizing a summer school in 2019 with nurses of 21 hospitals from 9 countries. This article explains the hospital's research program, the link between the journey and the content of the summer school, lessons learned, and the extent to which participants of European hospitals were interested in nursing excellence and Magnet designation.

Nurse workarounds in the electronic health record: An integrative review.

OBJECTIVE: The study sought to synthesize published literature on direct care nurses' use of workarounds related to the electronic health record. MATERIALS AND METHODS: We conducted an integrative review of qualitative and quantitative peer-reviewed research through a structured search of Academic Search Complete, EBSCO Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, Engineering Village, Ovid Medline, Scopus, and Web of Science. We systematically applied exclusion rules at the title, abstract, and full article stages and extracted and synthesized their research methods, workaround classifications, and probable causes from articles meeting inclusion criteria. RESULTS: Our search yielded 5221 results. After removing duplicates and applying rules, 33 results met inclusion criteria. A total of 22 articles used qualitative approaches, 10 used mixed methods, and 1 used quantitative methods. While researchers may classify workarounds differently, they generally fit 1 of 3 broad categories: omission of process steps, steps performed out of sequence, and unauthorized process steps. Each study identified probable causes, which included technology, task, organizational, patient, environmental, and usability factors. CONCLUSIONS: Extensive study of nurse workarounds in acute settings highlights the gap in ambulatory care research. Despite decades of electronic health record development, poor usability remains a key concern for nurses and other members of care team. The widespread use of workarounds by the largest group of healthcare providers subverts quality health care at every level of the healthcare system. Research is needed to explore the gaps in our understanding of and identify strategies to reduce workaround behaviors.

Assessment of the Nursing Quality Indicators for Reporting and Evaluation (NQuIRE) database using a data quality index.

A comprehensive data quality assessment is necessary to expand a nursing database that is designed for evaluating the impact of implementing Best Practice Guidelines (BPG) developed by the Registered Nurses' Association of Ontario (RNAO). This case report presents a method to standardize data quality assessments of the Nursing Quality Indicators for Reporting and Evaluation (NQuIRE) database by developing a data quality framework (DQF) and assessing key dimensions of the framework using a data quality index (DQI). The data quality index is a single key performance metric for assessing the quality of the database. The aims of sharing this case report are 2-fold: (1) to promote best practices for assessing data quality by developing and implementing a data quality framework and (2) to demonstrate an unprecedented method of assessing the data quality of a nursing database.

Advancing nursing practice for improved health outcomes using the principles of perceptual control theory.

This article describes how an empirically supported theory of human behaviour, perceptual control theory, can be used to advance nursing practice and improve health outcomes for people who are accessing nursing care. Nursing often takes a pragmatic approach to the delivery of care, with an emphasis on doing what appears to work. This focus on pragmatism can sometimes take precedence over any consideration of the underlying theoretical assumptions that inform decisions to take one particular approach over another or the mechanisms through which nursing interventions have their effects. For nursing to develop as a profession, there needs to be an increased focus on the core principles that underpin the delivery of care. In addition to understanding what works, nurses must develop their understanding of how and why particular approaches work or do not work. Understanding the fundamental principles that underpin nurses' actions will lead to more efficient and effective approaches to the delivery of nursing care. It will also enable nurses to maximize those elements of their practice that are most beneficial for people and minimize other activities that either have little effect or actually lead to worse outcomes. In this article, we will propose that the phenomenon of control is fundamental to human health. Perceptual control theory provides a coherent theoretical framework that enables us to understand the phenomenon of control through a functional model of human behaviour. People are healthy when their neurochemical, physiological, biological, psychological and social states are all controlled satisfactorily. We will explain the implications of understanding health as control throughout the paper. From this perspective, we will argue that the aim of nurses and nursing should be to support people to maintain or recover control over those aspects of their lives that are important and meaningful to them.

Conceptual and operational definition of nursing outcomes regarding the breastfeeding establishment.

OBJECTIVE: to construct conceptual and operational definitions of Nursing Outcomes "Breastfeeding establishment: infant (1000)" and "Breastfeeding establishment: maternal (1001)". METHOD: integrative literature review in the following databases: PUBMED (United States National Library of Medicine); LILACS (Latin American and Caribbean Health Sciences Literature); CINAHL (Cumulative Index to Nursing and Allied Health Literature); SciVerse SCOPUS; Web of Science; BDENF (Brazilian Nursing Database) and EMBASE (Excerpta Medica Database). The gray literature was explored to elucidate topics not covered by the articles. Of 3242 articles, 96 were selected to be read in full, and 43 were used for constructing the definitions. Five theses, three dissertations, three books and two manuals were selected. RESULTS: all the results were reviewed. The definitions facilitated the improvement of the content proposed by the Nursing Outcomes Classification, favoring its application in clinical practice and supporting the development of research and teaching. CONCLUSION: it was proposed to change the definition of the two outcomes, as well as to change the title of one of them to "Breastfeeding establishment: newborn & infant" (1000), modifying seven of its indicators and excluding one. For the outcome related to the mother, it was proposed to modify two indicators and exclude one.

Complexity Leadership in the Nursing Context.

Consolidation through mergers and acquisitions is occurring across health care as a strategic move to address the disruptive forces of complexity. While consolidation is improving the overall fitness and viability of health care organizations, it is having the opposite effect on the professionals working within them who are reporting increasing rates of burnout from ongoing complexity in the health care environment. This happens in all organizations that try to respond to complexity with traditional bureaucratic leadership approaches. What is needed is to replace bureaucratic leadership with the networked approach of complexity leadership. The idea is not to "do more with less" but to "do things better." In this article, we show how to do this by applying complexity leadership to the nursing context. Complexity leadership is a framework for enabling people and organizations for adaptability. It views leaders not as managerial implementers of top-down directives but as collaborators who work together to enhance the overall adaptability and fitness of the system. From a complexity leadership perspective, the role of nurse leaders should be not only to help the system run but also to help it run better by increasing organizational adaptability.

Mapping nursing practices in rehabilitation units in Spain and the United Kingdom: A multiple case study.

Because of the crisis in the health sector with few employment opportunities, many Spanish nurses are looking for professional development abroad. No studies have mapped nursing practices across Europe. The aim of this research was to provide a comprehensive approach to understand nursing practices and features of the context in Spain and the United Kingdom within the rehabilitation unit and to discuss those practices from a patient safety point of view. Multiple case study design with thematic analysis was applied in this study. The methods for data collection were in-depth interviews, nonparticipant observations, and document analysis. Results were classified into six categories: resources, techniques and nursing procedures, patients' personal care, health education, documentation task, and attitudes and communication skills. This study concludes that differences exist between nursing practices despite both countries having similar nursing competences. In addition, the UK unit has a positive safety culture, recognizes that mistakes happen, and applies more barriers to avoid them. The study provides valuable information to help the decision-making process for Spanish nurses considering working in the UK.

Effectiveness of Nursing Interventions using Standardized Nursing Terminologies: An Integrative Review.

The purpose of this integrative review is to synthesize recent literature that used NANDA International diagnoses, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC) to determine the effectiveness of nursing interventions and cost-analysis and to identify the direction for future effectiveness research using standardized nursing terminologies (SNTs). A search was performed using the Cumulative Index to Nursing and Allied Health Literature, Scopus, and KoreaMed, covering the period from 2003 to 2018. A total 267 articles were identified, and 24 articles were analyzed for this review. Eighteen studies evaluated the effectiveness of nursing interventions based on outcomes, and of those 18 studies, four examined the effectiveness based on the development of NNN linkages. Six studies analyzed the cost of nursing interventions. Integrating SNTs into electronic health records (EHRs), developing NNN linkages, and further effectiveness studies using SNTs are required to determine the value of nursing care to improve patient outcomes.