Best practices for iatrogenic anaemia prevention in the intensive care unit: Blood-sparing techniques.

Anaemia is a common issue in patients who are admitted to intensive care units and worsens their condition throughout the stay due to the extraction of blood for diagnostic purposes. It is also well-known that an important amount of the carbon dioxide produced by health services is likely attributable to blood donation, testing and manufacture, storage or distribution of blood components. This must be taken into account to perform nursing interventions consistent with the idea of sustainable health care. In this regard, within patient blood management bundles, with the objective of minimizing the use of blood products, it is recommended to use blood-sparing techniques: small volume tubes (SVT) or closed-blood sampling devices (CBSD). Published studies before 2014 (excepting two more recent ones) have shown that by themselves, both techniques reduce drawn volume but do not decrease haemoglobin reduction and/or need of transfusion. Given the lack of cost-effectiveness studies, it may be easier to implement the use of CBSD as it does not require prior consensus on the discard volume or adaptations in the processing of laboratory tests, as is the case with SVT.

Critical thinking level in nursing degree students according to sociodemographic and academic variables: A correlational study.

AIMS: To determine the level of critical thinking of undergraduate nursing students during their clinical practice, as well as to identify the relationship between sociodemographic and academic variables. BACKGROUND: Nursing degree programs should prioritize the development of critical thinking skills in their curriculum and regularly assess students to ensure the acquisition of core competencies. DESIGN: Multicenter, descriptive, cross-sectional, correlational, descriptive study. Participants included were students from the Degree in Nursing enrolled during the academic year 2020-2021. Students were selected by convenience from three universities located in Catalonia, Spain. Data were collected from 429 students, with 98 being excluded due to incomplete data. METHODS: Data were collected by administering the Nursing Critical Thinking in Students Questionnaire and an ad hoc form of sociodemographic and academic characteristics. The STROBE guidelines checklist were followed. The study involves a secondary analysis of data from a previous study that presented psychometric analysis. RESULTS: No significant differences were observed in total Critical Thinking scores across various parameters including academic year, current situation, work experience in healthcare, previous academic training, family situation, or recent stressful events. On average, students demonstrated moderate critical thinking scores. However, statistically significant relationships emerged between critical thinking scores and gender (p=0.046), institution attended for undergraduate studies (p=0.019) and having satisfactory social relationships despite experiencing stressful events (p=0.330). CONCLUSIONS: The study delves into the correlation between critical thinking skills and sociodemographic and academic factors, identifying students who may benefit from specific interventions and advocating for adaptable educational methods. It emphasizes the pivotal role of trust in fostering critical thinking in nursing education and suggests a connection between critical thinking and strong social relationships. In conclusion, evaluating critical thinking is crucial for addressing healthcare challenges, validating teaching strategies and promoting continuous improvement in nursing education.

The nursing critical thinking in clinical practice questionnaire for nursing students: A psychometric evaluation study.

AIM: To adapt and validate the N-CT-4 Practice for use with Spanish nursing students. BACKGROUND: Promoting critical thinking is one of the primary objectives of nursing education programs all over the world. Using reliable and valid instruments to measure critical thinking is essential. The Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 Practice) is used internationally to assess critical thinking in nursing practice. However, little is known about the possible applications of this instrument in the context of nursing education. METHODS: Two-phase study: Phase I, adaptation of the N-CT-4 Practice for use with nursing students and verification of its content validity; phase 2, cross-sectional study to validate its psychometric properties in a sample of 331 nursing students from three university nursing schools. A subsample of 34 students completed the questionnaire on two occasions, with a time interval of two weeks. The construct validity and reliability of the instrument were tested using confirmatory factor analysis, convergent validity, internal consistency reliability and test-retest reliability. The STROBE guidelines and the COSMIN checklist were followed. RESULTS: All items obtained optimal content validity values. The model fit indices obtained from the confirmatory factor analysis supported the hypothesis of the four-dimensional structure on which the original questionnaire was based. Cronbach's alpha of 0.96 indicated high reliability. The correlations between the total score and the scores for the dimensions were statistically significant, positive and high, with values above r = 0.78 (p < 0.05). Lin's concordance correlation coefficient was 0.6 (p < 0.001). CONCLUSIONS: The adapted version of the N-CT-4 Practice is suitable for measuring critical thinking skills in the educational context of the degree course in nursing in Spain. Its psychometric validation yielded satisfactory results.

Academic evaluation, management and satisfaction of clinical practicums among undergraduate students: software CliPrAS@UB.

AIM/OBJECTIVE: To determine the development of competency acquisition, the satisfaction of the agents involved and recording incidents with a digital platform CliPrAS @UB on the Clinical Placements I and II courses in the second and third years of the Bachelor's Degree in Nursing. BACKGROUND: The teaching of clinical practice subjects requires an analysis of the competence evolution, a management structure and an analysis of the satisfaction of the agents involved in the subject. DESIGN: Prospective, analytical, observational cohort study. METHODS: The study was carried out in a public university center in Barcelona with 387 students distributed in nine centers of the network of Health Institutions. RESULTS: An increase of 2.32 points was observed in the competence dimensions of Professional Practice and with a reduction in the average score in the skills of care provision, therapeutic communication and professional development of more than 0.08 points. Regarding the seminars, a reduction of the average global score of 0.58 points was observed. CONCLUSIONS: The use of the CliPrAS @ UB computer platform has improved the implementation of the mandatory documents, the recording of incidents and the overall satisfaction of the students.

Satisfacción de la carpeta de aprendizaje y agentes que intervienen en la práctica clínica en el grado de enfermería / Satisfaction of the learning portfolio and training staff involved in the clinical practice of a bachelor nursing degree

Objetivo. Evaluar las percepciones de los diferentes agentes que intervenían en la utilización de la carpeta de aprendizaje, y determinar el nivel de satisfacción de los estudiantes durante la práctica clínica. Metodología. Se incluyeron 33 profesores y 185 estudiantes matricula-dos durante el curso 2016-2017 en las asignaturas de Estancias Clínicas I y II, correspondientes al segundo y tercer curso de Grado de Enfermería de la Escuela de Enfermería de la Universidad de Barcelona. Se elaboraron dos cuestionarios ad-hoc: uno para evaluar la percepción de los agentes sobre la carpeta de aprendizaje, con 4 dimensiones relacionadas con el uso de la herramienta, la vinculación competencial, los problemas y las limitaciones en el manejo; y un segundo cuestionario sobre el nivel de satisfacción realizado sólo a los estudiantes. Resultados. Según los estudiantes, la utilidad de la carpeta de aprendizaje fue elevada con un 89% (n = 81) y un 71% (n = 67), en segundo y tercer curso respectivamente, pero esta utilidad disminuyó al asociarla con la ayuda que proporcionaba en la adquisición de sus competencias, 37% (n = 37) y 26% (n = 24). La dificultad en su utilización fue del 41% (n = 37) en segundo curso y del 28% (n=26) en tercero. Respecto a la opinión de los tutores de prácticas, tanto la idonei-dad como la utilidad de la carpeta obtuvieron valores elevados con un 91% (n = 30) y un 94% (n = 31), respectivamente. Conclusiones. La utilidad de la car-peta de aprendizaje es alta tanto para estudiantes como para profesores, pero representó un instrumento complejo en su uso, que nos obligará a unificar diseños en el sistema de evaluación para que el estudiante y tutores optimicen esta herramienta

Objective. To evaluate the perceptions of the students in relation to the usefulness of the Learning Portfolio, and to determine the level of students’ satisfaction during clinical practice. Methodology. 33 assistant professors and 185 students of Clinical Practice I and II at Nursing School in University of Barcelona during the 2016-2017 academic year were enrolled. Two ad-hoc questionnaires were elaborated: the first made reference to the usefulness of the Learning Portfolio related to the use of the tool, the competence liaison, the problems and the limitations in the handling of the same; the second questionnaire was about the level of satisfaction made only to students. Results. According to the students, the usefulness of the learning portfolio was high with 89% (n = 81) and 71% (n = 67), at second and third year, respectively. This utility decreased when portfolio was associated with the help provided in the acquisition of students’ competences, 37% (n = 37) and 26% (n = 24). Difficulty in using Portfolio was 41% (n = 37) in second academic year and 28% (n = 26) in the third. Regarding the tutors, both the suitability and the usefulness of the folder obtained high values with 91% (n = 30) and 94% (n = 31), respectively. Conclusions. The usefulness of the learning portfolio is high for both students and teachers. The portfolio re-presents a complex instrument in its use, an aspect that forces us to unify designs in the evaluation system so that the student and tutors optimize this tool

Hematoma renal en paciente monorreno / Haematoma of the kidney in patient with one kidney

No disponible

Características del sueño de los pacientes en una unidad de cuidados intensivos / Sleep characteristic of patients in intensive care unit

El sueño, en cuanto acto de dormir, es un estado de reposo uniforme de un organismo, en contraposición con el estado de vigilia, que es cuando el ser humano está despierto. El sueño se caracteriza por los bajos niveles de actividad fisiológica (presión sanguínea, respiración, frecuencia cardiaca) y por una respuesta menor ante estímulos externos.El descanso nocturno de los pacientes ingresados en Cuidados Intensivos es un aspecto de gran importancia dentro del proceso de salud/enfermedad, ya que tiene una repercusión directa en su adecuada recuperación.Las Unidades de Cuidados Intensivos han sido consideradas generadoras de estrés debido a su propia arquitectura y su avanzada tecnología, relacionándose de este modo con la aparición de síntomas cognitivos por parte de los pacientes que conjuntamente con otros factores han desembocado en el llamado "síndrome UCI". El objetivo de la presente revisión es describir los factores que influyen sobre el sueño de los pacientes de cuidados intensivos(AU)

The dream, as a measure of sleep, is a uniform resting state of an organism, as opposed to the waking state, when man is awake. Sleep is characterized by low levels of physiological activity (blood pressure, respiration, heart rate) and a lower response to external stimuli. Night rest of patients admitted to intensive care is an issue of great importance in the process of health/disease, as it has a direct impact of their adequate recovery Intensive Care Units have been considered generating stress due to this architecture and advanced technology, thus interacting with the appearance of cognitive symptoms by patients in conjunction with other factors have resulted in the ¨ICU Syndrome¨. The aim of this review is to describe the factors that the influence the dreams of intensive care patients(AU)

Neuroplasticidad y psicoestimulación en enfermos de Alzheimer / Neuroplasticity and psychostimulation in Alzheimer´s disease

Las enfermedades son procesos multifactoriales como resultado de una interacción entre el genotipo del individuo y los diversos factores ambientales. La enfermedad en los países desarrollados radica en la incompatibilidad de nuestro genoma, el cual resultó seleccionado para adaptarse al medio ambiente ancestral en el que se desarrolló la especie humana, con el medio ambiente y el estilo de vida actuales. Genes que fueron adaptativos en el medio ambiente ancestral pueden resultar perjudiciales en el actual. Algunas enfermedades multifactoriales parecen ser exclusivas del ser humano. Como muestra más indicativa, hoy en día en la población actual está la enfermedad de Alzheimer. El término plasticidad fue introducido en 1890 por el psicólogo William James para describir la naturaleza modificable del comportamiento humano. En los últimos años del si glo XIX, Santiago Ramón y Cajal propuso que estas modificaciones comportamentales tendrían seguramente un sustrato anatómico. Sin embargo, tras la muerte de Cajal se adoptó una forma rígida de ver el sistema nervioso central adulto. Una vez terminado su desarrollo, la anatomía del sistema nervioso central se mantenía inalterable, salvo los procesos degenerativos. La memoria se convirtió en una de las áreas más activas durante los años sesenta y se dio a conocer como psicología co gnitiva. La psicoestimulación de las capacidades plásticas (neuroplasticidad) mejora las condiciones cognitivas de los enfermos de Alzheimer, consiguiendo un mayor mantenimiento de estos enfermos (cognitivo, conductual y funcional). Desarrollar programas interactivos para psicoestimular y rehabilitar el deterioro cognitivo en pacientes con déficits neurocognitivos ayuda a esta población a mejorar su funcionamiento social(AU)

Diseases are multifactorial process and the result of an interaction between the genotype of individual and environmental factors. The disease in developed countries lies in the inconsistency of our genome, which was selected to match the ancestral environment in which the human species evolved, the environment and current lifestyle. Genes that were adaptive in the ancestral environment may be detrimental in the current. Multifactorial diseases appear to be unique to humans. As shown indicative today in the current population is Alzheimer’s disease. The term plasticity was introduced in 1890 by psychologist William James to describe the changeable nature of human behavior. In the last years of the nineteenth century, Santiago Ramón y Cajal proposed that these behavioral changes would likely anatomical substrate. However, after the death of Cajal adopted a hard-to see the adult central nervous system. Assumed that, once their development, the anatomy of the central nervous system remained unchanged, except for the degenerative processes. The report became one of the most active areas during the ‘60s becoming known as cognitive psychology. The plastic capacity psychostimulation (neuroplasticity) improves the cognitive conditions of getting Alzheimer's disease increased maintenance of these patients (cognitive, behavioral and functional). Develope interactive programs to psicostimulate and rehabilitate the cognitive deterioration in pactiens with neurocognitives deficits, helps this population to improve their social working(AU)