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1.
J Clin Nurs ; 24(5-6): 761-77, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25257917

RESUMEN

AIMS AND OBJECTIVES: The aim of this study was to establish the validity and reliability of an instrument (Inventario del NIvel de Cuidados mediante IndicAdores de clasificación de Resultados de Enfermería) used to assess the dependency level in acutely hospitalised patients. This instrument is novel, and it is based on the Nursing Outcomes Classification. BACKGROUND: Multiple existing instruments for needs assessment have been poorly validated and based predominately on interventions. Standardised Nursing Languages offer an ideal framework to develop nursing sensitive instruments. DESIGN: A cross-sectional validation study in two acute care hospitals in Spain. METHODS: This study was implemented in two phases. First, the research team developed the instrument to be validated. In the second phase, the validation process was performed by experts, and the data analysis was conducted to establish the psychometric properties of the instrument. RESULTS: Seven hundred and sixty-one patient ratings performed by nurses were collected during the course of the research study. Data analysis yielded a Cronbach's alpha of 0·91. An exploratory factorial analysis identified three factors (Physiological, Instrumental and Cognitive-behavioural), which explained 74% of the variance. CONCLUSIONS: Inventario del NIvel de Cuidados mediante IndicAdores de clasificación de Resultados de Enfermería was demonstrated to be a valid and reliable instrument based on its use in acutely hospitalised patients to assess the level of dependency. RELEVANCE TO CLINICAL PRACTICE: Inventario del NIvel de Cuidados mediante IndicAdores de clasificación de Resultados de Enfermería can be used as an assessment tool in hospitalised patients during the nursing process throughout the entire hospitalisation period. It contributes information to support decisions on nursing diagnoses, interventions and outcomes. It also enables data codification in large databases.


Asunto(s)
Enfermedad Aguda/enfermería , Indicadores de Salud , Hospitalización , Evaluación de Necesidades , Diagnóstico de Enfermería , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , España
2.
Artículo en Inglés | MEDLINE | ID: mdl-35886267

RESUMEN

(1) Background: Identifying differences in the competencies of different areas of nursing is a crucial aspect for determining the scope of practice. This would facilitate the creation of a formal structure for clinical practice in advanced and specialised services. The aims of this study are to analyse the distribution of advanced competencies in registered, specialist and advanced practice nurses in Spain, and to determine the level of complexity of the patients attended by these nurses. (2) Methods: A cross-sectional study was developed on registered, specialist and advanced practice nurses, all of whom completed an online survey on their perceived level of advanced competencies and their professional characteristics. (3) Results: In total, 1270 nurses completed the survey. Advanced practice nurses recorded the highest self-perceived level of competency, especially for the dimensions of evidence-based practice, autonomy, leadership and care management. (4) Conclusions: Among registered, specialist and advanced practice nurses, there are significant differences in the level of self-perceived competencies. Patients attended by advanced practice nurses presented the highest levels of complexity. Understanding these differences could facilitate the creation of a regulatory framework for clinical practice in advanced and specialized services.


Asunto(s)
Enfermería de Práctica Avanzada , Enfermeras y Enfermeros , Competencia Clínica , Estudios Transversales , Humanos , Encuestas y Cuestionarios
3.
Enferm Clin (Engl Ed) ; 31(6): 344-354, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34756238

RESUMEN

OBJECTIVE: To analyse the patient-nurse ratio and its association with health outcomes in public hospitals of the Andalusian Health Service (SAS). METHOD: Cross-sectional ecological study carried out in adult units of 26 Andalusian public hospitals. Data on structure (beds, type of unit, nursing control), management (average stay, index of use of stays, complexity index) and nursing staff were collected. They were extracted from official sources: CMBDA, SAS/Health Council (CS) publications and specific respondents to Nursing Directorates. The patient-nurse ratio was calculated and related to 19 indicators of hospital quality, safety, and mortality. Measures of central tendency and Spearman's correlation coefficient were used for statistical analysis. RESULTS: A response was obtained from 100% of the Andalusian hospitals. The average patient-nurse ratio in the three shifts was lower in hospitals with a broader portfolio of services-regional scope (11.6), followed by those with a medium portfolio-specialties (12.7) and hospitals with a basic portfolio-county (13.5). By type of unit, the medical units were 11.8 (SD = 1.8) lower than the surgical ones 13.5 (SD = 2.7). Significant differences were only found in medical units of regional hospitals 10.5 (SD = 1.4) and district hospitals 13.03 (SD = 1.46) (p = .001). In critical care, the ratio was greater than 2 patients per nurse in the three groups. When relating the ratio to health outcomes, 5 significant associations were found: pressure ulcers (p = .005), prevalence of nosocomial infections (p = .036), postoperative sepsis (p = .022), zero bacteraemia verification (p = .045) and mortality from heart failure (p = .004). CONCLUSIONS: The results indicate a high patient-nurse ratio in adult hospitalization units and that there is a positive association between the patient-nurse ratio and worse results related to nursing care.


Asunto(s)
Personal de Enfermería en Hospital , Adulto , Estudios Transversales , Servicios de Salud , Hospitales Públicos , Humanos , Evaluación de Resultado en la Atención de Salud
4.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33446438

RESUMEN

AIM: To analyse the patient-nurse ratio and its association with health outcomes in public hospitals of the Andalusian Health Service (SAS). METHOD: Cross-sectional ecological study carried out in adult units of 26 Andalusian public hospitals. Data on structure (beds, type of unit, nursing control), management (average stay, index of use of stays, complexity index) and nursing staff were collected. They were extracted from official sources: CMBDA, SAS/Health Council (CS) publications and specific respondents to Nursing Directorates. The patient-nurse ratio was calculated and related to 19 indicators of hospital quality, safety, and mortality. Measures of central tendency and Spearman's correlation coefficient were used for statistical analysis. RESULTS: A response was obtained from 100% of the Andalusian hospitals. The average patient-nurse ratio in the three shifts was lower in hospitals with a broader portfolio of services-regional scope (11.6), followed by those with a medium portfolio-specialties (12.7) and hospitals with a basic portfolio- county (13.5). By type of unit, the medical units were 11.8 (SD=1.8) lower than the surgical ones 13.5 (SD=2.7). Significant differences were only found in medical units of regional hospitals 10.5 (SD=1.4) and district hospitals 13.03 (SD=1.46) (p=.001). In critical care, the ratio was greater than 2 patients per nurse in the three groups. When relating the ratio to health outcomes, 5 significant associations were found: pressure ulcers (p=.005), prevalence of nosocomial infections (p=.036), postoperative sepsis (p=.022), zero bacteraemia verification (p=.045) and mortality from heart failure (p=.004). CONCLUSIONS: The results indicate a high patient-nurse ratio in adult hospitalization units and that there is a positive association between the patient-nurse ratio and worse results related to nursing care.

5.
Rev Esp Salud Publica ; 952021 Oct 20.
Artículo en Español | MEDLINE | ID: mdl-34668491

RESUMEN

At present, the definition of frailty provided by the World Health Organization (WHO), which incorporates the concepts of intrinsic capacity and functional capacity, as well as the increasing prevalence of these situations in elderly people, reflect the need to develop intervention strategies in the different health systems to prevent and address frailty. This article analyzes the implication of the nursing role, as well as its framework of action and specific competencies for the prevention and addressing of the health needs related to the frail elderly person.This role is developed through the systematic use of comprehensive assessment, existence of nursing diagnoses related to frailty and its risks and the interventions and outcome criteria related to the care of the frail elderly person. Specifically, this article expose the actions and competences of nurses who carry out their activity in primary care and in the community context, in care programs for the elderly and home care, which involve both the frail elderly person and the people who care for them.


En la actualidad, una mayor unanimidad con la definición de la fragilidad, aportada por la Organización Mundial de la Salud (OMS), que incorporan los conceptos de capacidad intrínseca (CI) y capacidad funcional (CF), así como la cada vez mayor prevalencia de estas situaciones en la población mayor, reflejan la necesidad de desarrollar estrategias de intervención en los diferentes sistemas sanitarios para prevenir y abordar la fragilidad. En este artículo se analiza la implicación del rol del enfermero, así como su marco de actuación y competencias específicas para la prevención y abordaje de las necesidades y problemas de salud relacionados con la persona mayor frágil, a través del uso sistemático de la valoración integral, la existencia de diagnósticos enfermeros relativos a la fragilidad y sus riesgos y de las intervenciones y criterios de resultados vinculados a los cuidados de la persona mayor frágil. Especialmente, se exponen las actuaciones y competencias de los enfermeros que desarrollan su actividad en atención primaria y el contexto comunitario, en los programas de atención al mayor y atención domiciliaria, que implican tanto a la persona mayor frágil como a las personas que los cuidan.


Asunto(s)
Fragilidad , Enfermeras y Enfermeros , Anciano , Anciano Frágil , Evaluación Geriátrica , Humanos , Atención Primaria de Salud , España
6.
Rev Esp Salud Publica ; 952021 Oct 20.
Artículo en Español | MEDLINE | ID: mdl-34668490

RESUMEN

OBJECTIVE: The Health Exam for Adults Over 65 (EdS65+) is a health promotion program delivered in Primary Care (PC) settings in Andalusia. It seeks early detection of frailty and implementation of person-centered biopsychosocial intervention plans. The aim of the study was to describe the characteristics and functional capacity of the participating population, as well as the interventions carried out. METHODS: The sample consists of EdS65+ participants between May 2018 and February 2020 (203,077 individuals). Sociodemographic variables, functional capacity and implemented interventions were collected. Descriptive statistics were obtained and significance tests were performed to measure the sample representativeness and to detect statistically significant differences in the study variables according to sex, age or degree of urbanization. RESULTS: Functional capacity screening results were as follows: autonomous individuals accounted for 61.8%, 22.5% were dependent, 8.2% were pre-fragile, 4.8% were frail and 2.6% were categorized with low dependency. The prevalence of frailty ranged from 1.8% in persons aged 65-69 years to 7.7% in 80-84 years, with overall prevalence of 6.8% in women and 2.1% in men. In the frail population, a basic assessment was performed in 45.4% of cases, health promotion counseling in 55.2%, and prescription of a physical activity program in 43.3% of cases. A total of 19.6% of participants had one or more follow-ups and of these, 13.7% had two or more. CONCLUSIONS: EdS65+ is a unique program in Europe in terms of its long-term implementation and large-scale application in Primary Care services. Hence, the results presented in this study are valuable in growing the knowledge base around frailty and the design and implementation of actions aimed at proactive health promotion and disease prevention.


OBJETIVO: El Examen de Salud para mayores de 65 años (EdS65+) es un programa de promoción de la salud contextualizado en la Atención Primaria (AP) de Andalucía. Busca detectar precozmente la fragilidad y determinar planes de intervención biopsicosociales centrados en la persona. El objetivo del estudio fue describir las características y la capacidad funcional de la población participante, así como las intervenciones realizadas. METODOS: Muestra formada por participantes en EdS65+ entre mayo 2018 y febrero 2020 (203.077 personas). Se recogieron variables sociodemográficas, de capacidad funcional e intervenciones realizadas. Se obtuvieron estadísticos descriptivos y se realizaron pruebas de significación para medir la representatividad de la muestra y detectar diferencias estadísticamente significativas de las variables de estudio según sexo, edad o grado de urbanización. RESULTADOS: Las personas autónomas representaron el 61,8%, seguido del 22,5% de dependientes, 8,2% prefrágiles, 4,8% frágiles y 2,6% con baja dependencia. La prevalencia de fragilidad fue desde el 1,8% en personas de 65-69 años al 7,7% en 80-84 años, del 6,8% en mujeres y del 2,1% en hombres. En población frágil se realizó una valoración básica en el 45,4%, asesoramiento en promoción de la salud en el 55,2% y prescripción de un programa de actividad física en el 43,3%. Un 19,6% tuvo uno o más seguimientos y, de ellos, un 13,7% tuvo dos o más. CONCLUSIONES: El EdS65+ es un programa único en Europa en cuanto a su implementación a largo plazo y su aplicación a gran escala en los servicios de Atención Primaria, lo que hace que los resultados presentados en este estudio aporten gran valor al conocimiento de la fragilidad y al diseño y puesta en marcha de actuaciones dirigidas a la promoción proactiva de la salud y la prevención de la enfermedad.


Asunto(s)
Anciano Frágil , Fragilidad , Adulto , Anciano , Femenino , Fragilidad/diagnóstico , Fragilidad/epidemiología , Evaluación Geriátrica , Humanos , Masculino , España , Encuestas y Cuestionarios
7.
Front Psychol ; 12: 729624, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34916989

RESUMEN

Background: The work of health professionals often involves physical as well as psychological strain. They constantly deal with traumatic situations of pain and suffering, which destabilize the sense of well-being. Compassion fatigue is a feeling that appears in these cases and is related to other variables such as burnout or emotional drain. Aims: The principal aim of this project was to deepen the analysis of compassion fatigue and how it could be explained through the relationship with other constructs such as emotional intelligence and perceived health. Methods: This work followed the STROBE checklist for cross-sectional studies. In this study 1,521 nurses (M age = 47.32; SD = 8.44) participated. The responses reported by the nurses were analyzed by classifying them as high or low compassion fatigue and the differences of both groups were analyzed for the variables of emotional intelligence, perceived health and quality of professional life. Results: It was obtained significant differences for all factors except for emotional intelligence factor. A linear regression analysis showed both emotional intelligence and perceived health helped to explain (12%) compassion fatigue. Conclusion: This study provides light on comprehending the conception of compassion fatigue. It highlights the importance of intervention programs that improve the quality of professional life.

8.
Rev Enferm ; 33(3): 18-25, 2010 Mar.
Artículo en Español | MEDLINE | ID: mdl-20429205

RESUMEN

OBJECTIVES: To evaluate the nursing care personalization process in hospitalization units. METHODS: An action research was performed at hospitalization units selected by a convenience sample which guaranteed to carry it out. This process took five phases: approach and awareness, induction, interaction, implementation, and systematization. RESULTS: 18 units started the personalization process but 2 did not finish it. A synthesis of the most relevant results from each phase is presented, including the arguments to make professionals participate in this action research, qualities needed to provide a humanized care, difficulties and facilities, targets, strategies and evaluation of this nursing care personalization process. CONCLUSION: Action research let professionals improved the personalization of the nursing care they provide at their hospitalization units, from strategies adapted to their particular contexts so as to advance to the targets they expected.


Asunto(s)
Atención de Enfermería , Medicina de Precisión , Humanos
9.
Enferm Clin (Engl Ed) ; 29(6): 370-375, 2019.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31668452

RESUMEN

Health systems have a responsibility to respond to the new health needs of the population, which are characterized by factors such as aging, chronicity and/or dependency situations and which requires quality and specialized care adapted to different areas where care is provided, care offered by trained and increasingly qualified professionals to improve the health outcomes of the caregivers. In 2016, in Andalusia the regulatory framework by which is created the statutory professional category of nurse/specialists is published, including the specialty of Mental Health Nursing in the Andalusian Health Service. In the field of Mental Health, the development of this normative framework and the definition and occupation of positions, will allow the health system to combine the role of nurse specialist nurses with that of nurses who provide general care, registered nurses, in order to advance in the best response to the health needs of citizens in this area of care. The development of the specialty will be an added value both to improve the health outcomes of people with mental health problems, and to improve the quality of care, efficiency and sustainability of health systems.


Asunto(s)
Enfermería en Salud Comunitaria/organización & administración , Administración de los Servicios de Salud , Transición de la Salud , Rol de la Enfermera , Enfermería Psiquiátrica/organización & administración , Enfermería en Salud Comunitaria/legislación & jurisprudencia , Humanos , Salud Mental , Competencia Profesional , Enfermería Psiquiátrica/legislación & jurisprudencia , España
10.
Enferm Clin (Engl Ed) ; 29(2): 83-89, 2019.
Artículo en Inglés, Español | MEDLINE | ID: mdl-30799095

RESUMEN

The socio-demographic and epidemiological changes of our environment are characterized by an increase in aging, chronic illness, comorbidities and with it, a progressive escalation of the demand for care. These new demands and expectations of citizenship are accompanied by an evolution of health systems (technological advances, complexity of the healthcare network, limited resources), the need to develop new roles and competence in care, together with the opportunity that full academic development implies: Nursing undergraduate and posgraduate degrees. This is why, at present, it is necessary to reorient care models in order to achieve health care for more agile, efficient and better quality care processes, adapted to the needs and expectations of citizens and to the sustainability of health systems. The Public Health System of Andalusia (SSPA) has developed, in recent decades, different nursing roles that include new competences, with the aim of responding to the needs of citizens. The objective of this article is to present how the competences development framework of nurses has been configured in the SSPA, which also integrates advanced skills in care and advanced practice profiles (Clinical Nurse Specialists and Advanced practice nurses).


Asunto(s)
Competencia Clínica , Atención a la Salud , Educación en Enfermería , Salud Pública , Enfermería de Práctica Avanzada , Humanos , España
11.
Enferm Clin (Engl Ed) ; 29(6): 328-335, 2019.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31640941

RESUMEN

OBJECTIVE: To analyse the distribution of advanced competences in specialist nurses and advanced practice nurses and to evaluate their association with some characteristics of their professional profile. METHOD: Multicentre analytical cross-sectional study. Nurses who worked as advanced practice nurses and specialist nurses were included. Their level of perceived advanced competences was measured, as well as sociodemographic and professional characterization variables. RESULTS: A total of 277 nurses participated (149 practised as advanced practice nurses and 128 as specialists), with an average of 13.88 (11.05) years as a specialist and 10.48 (5.32) years as an advanced practice nurse. In the sample, 28.8% had a master's or doctorate level qualification, 50.2% worked in Primary Care, 24.9% in hospitals and 22.7% in Mental Health. The self-perceived global level was high in the different competences, the lowest dimensions being research, evidence-based practice, quality and safety management and leadership and consulting. The advanced practice nurses obtained a higher level of competence globally and in the dimensions of leadership and consulting, interprofessional relations, care management, and health promotion. There were no differences based on experience or possession of a master's degree or doctorate. In the advanced practice nurses, the practice context did not influence competence levels, although in the specialist nurses it did, in favour of those practicing in Mental Health. CONCLUSIONS: Specialist and advanced practice nurses have different competences that should be adequately managed for the development of advanced and specialist nursing services.


Asunto(s)
Enfermería de Práctica Avanzada/estadística & datos numéricos , Competencia Clínica/estadística & datos numéricos , Especialidades de Enfermería/estadística & datos numéricos , Enfermería de Práctica Avanzada/educación , Estudios Transversales , Escolaridad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Personal de Enfermería en Hospital/estadística & datos numéricos , Enfermería de Atención Primaria/estadística & datos numéricos , Enfermería Psiquiátrica/estadística & datos numéricos , Especialidades de Enfermería/educación , Factores de Tiempo
12.
Enferm Clin ; 26(1): 85-90, 2016.
Artículo en Español | MEDLINE | ID: mdl-26553866

RESUMEN

The purpose of this article is to support the need for a change of care, based on cooperation between those who provide care and those who receive it. This article develops the decisive factors for change: the investee cooperation, the reference in case management, the concept of recovery and terminal care, the reduction of suffering and the value of change reflected in the 'win-win'. In each of them a questioning of the current situation, a methodological analysis and an input of tools and consequences of the change is made. To conclude, the article incorporates the 'itinerary of shared care' as a resource and one of the ways to bring these changes to the reality of day-to-day care.


Asunto(s)
Manejo de Caso , Continuidad de la Atención al Paciente , Cuidado Terminal , Comunicación , Humanos
13.
Pharm. care Esp ; 22(6): 400-420, 2020. tab, graf
Artículo en Español | IBECS (España) | ID: ibc-196718

RESUMEN

INTRODUCCIÓN: Las farmacias comunitarias representan un papel clave en la respuesta al COVID-19 y especialmente en el control de enfermedades crónicas más allá de la pandemia. OBJETIVO: Diseño de un nuevo modelo de atención compartida entre farmacia comunitaria y atención primaria para prevenir la fragilidad y promover el autocuidado en personas mayores. MÉTODO: Estudio cualitativo de investigación-acción con mapeo de actores, segmentación de perfiles, grupos de discusión, entrevistas en profundidad y sesiones de diseño creativo. Las técnicas utilizadas aseguraron la participación de personas mayores y profesionales en todas las etapas de diseño. RESULTADOS: Se generaron circuitos comunes de comunicación para los nuevos servicios y protocolos de actuación compartidos. Se propusieron nuevos roles profesionales en respuesta a las necesidades, expectativas y preferencias de las personas mayores. Se diseñaron los servicios de detección de fragilidad, adherencia a nuevos medicamentos, toma de constantes y refuerzo terapéutico. El modelo aporta sistemas de comunicación bidireccional entre atención primaria y farmacia comunitaria y reconoce el papel de la farmacia comunitaria en la promoción del autocuidado y gestión de la patología crónica y la medicación. CONCLUSIONES: Se evidencia la importancia de crear un ecosistema más abierto que dé lugar a innovaciones organizativas que aprovechen la proximidad y capilaridad de las oficinas de farmacia, así como la incorporación de la omnicanalidad en la atención, esencial en situaciones de crisis sanitaria como la actual. Asimismo, queda demostrado que las técnicas de diseño cooperativo favorecen la participación de los agentes involucrados, aumentando su contribución e impacto potencial sobre los resultados


INTRODUCTION: Community pharmacies play a key role in response to COVID-19 and especially in the control of chronic diseases beyond the pandemic. OBJECTIVE: To design a new model of health assistance focused on frailty prevention and the self-care promotion among older adults, using share care services between the community pharmacy and the primary healthcare. METHOD: We conducted a qualitative study of action research using methods as actor mapping, segment profile, discussion groups, in-depth interviews and creative design sessions. Using those techniques during all the design stages allowed us to get an effective participation of older adults and professionals. RESULTS: Common communications circuits for the new services, new professional roles and shared action protocols were created. Furthermore, we designed early frailty detection, medication review associated with fall risk, assessment and intervention for adherence to new medications, vital sign checking and hypertension, diabetes and COPD therapeutic reinforcement services. This model provides two-way communication systems with the primary health care and recognizes the community pharmacy functions in the scope of self-care promotion and chronic pathology and medication self-management. CONCLUSIONS: It is highlighted the importance of creating a more open ecosystem within the community. The feedback obtained will allow to design organizational innovations. This has to be done taking advantage of the community pharmacies proximity and capillarity in the territory, as well as the new incorporation of the omni-channel care. Besides, cooperative design techniques have proved to be an encouragement for the participation of the involved agents, increasing their contribution and potential impact on the results


Asunto(s)
Humanos , Anciano , Farmacias/organización & administración , Atención Primaria de Salud/organización & administración , Infecciones por Coronavirus/prevención & control , Servicios Comunitarios de Farmacia/organización & administración , Modelos de Atención de Salud , Investigación Cualitativa , Anciano Frágil , Calidad de la Atención de Salud , Autocuidado
16.
Enferm. clín. (Ed. impr.) ; 26(1): 85-90, ene.-feb. 2016. tab, graf
Artículo en Español | IBECS (España) | ID: ibc-149199

RESUMEN

El objeto del artículo es fundamentar la necesidad de un cambio de la atención, basado en la cooperación entre los que prestan la atención y los que la reciben. Este artículo desarrolla los factores decisivos para el cambio: la cooperación participada, la referencia en la gestión de casos, el concepto de recuperación y la atención terminal, la reducción del sufrimiento y el valor del cambio reflejado en el «todos ganan». En cada uno de ellos se realiza un cuestionamiento de la situación actual, un análisis metodológico y la aportación de instrumentos y consecuencias del cambio. Finalmente, se incorpora el recurso del «itinerario de atención compartida» como una de las formas de llevar estos cambios a la realidad de la atención en el día a día


The purpose of this article is to support the need for a change of care, based on cooperation between those who provide care and those who receive it. This article develops the decisive factors for change: the investee cooperation, the reference in case management, the concept of recovery and terminal care, the reduction of suffering and the value of change reflected in the ‘win-win’. In each of them a questioning of the current situation, a methodological analysis and an input of tools and consequences of the change is made. To conclude, the article incorporates the ‘itinerary of shared care’ as a resource and one of the ways to bring these changes to the reality of day-to-day care


Asunto(s)
Humanos , 50230 , /métodos , Relaciones Médico-Paciente , Participación del Paciente/métodos , Cuidadores/educación , Toma de Decisiones
18.
Enferm. clín. (Ed. impr.) ; 31(6): 344-354, Nov-Dic. 2021. tab
Artículo en Español | IBECS (España) | ID: ibc-220660

RESUMEN

Objetivo: Analizar la ratio paciente-enfermera y su asociación con los resultados en salud en hospitales públicos del Servicio Andaluz de Salud (SAS). Método: Estudio ecológico transversal realizado en unidades de adultos de 26 hospitales públicos andaluces. Se recogieron datos de estructura (camas, tipo de unidad, control de enfermería), de gestión (estancia media, índice de utilización de estancias, índice de complejidad) y de dotación enfermera. Fueron extraídos de fuentes oficiales: CMBDA, publicaciones de SAS/Consejería de Salud (CS) y específicos demandados a Direcciones de Enfermería. Se calculó la ratio paciente-enfermera y se relacionó con 19 indicadores de calidad hospitalaria, seguridad y mortalidad. Para el análisis estadístico se utilizaron medidas de tendencia central y el coeficiente de correlación de Spearman. Resultados: Se obtuvo respuesta del 100% de los hospitales andaluces. El promedio de ratio pacientes-enfermera en los 3 turnos fue menor en hospitales con cartera de servicios más amplia-ámbito regional (11,6), seguido de los de cartera media-especialidades (12,7) y los hospitales con cartera básica-comarcales (13,5). Por tipo de unidad, en las médicas fue menor 11,8 (DE=1,8) respecto a las quirúrgicas 13,5 (DE=2,7). Solo se hallaron diferencias significativas en unidades médicas de los hospitales regionales 10,5 (DE=1,4) y comarcales 13,03 (DE=1,46) (p=0,001). En cuidados críticos la ratio fue mayor de 2 pacientes por enfermera en los 3 grupos. Al relacionar la ratio con resultados en salud se hallaron 5 asociaciones significativas: úlceras por presión (p=0,005), prevalencia de infecciones nosocomiales (p=0,036), sepsis postoperatoria (p=0,022), verificación bacteriemia zero (p=0,045) y mortalidad por insuficiencia cardíaca (p=0,004).(AU)


Aim: To analyse the patient-nurse ratio and its association with health outcomes in public hospitals of the Andalusian Health Service (SAS). Method: Cross-sectional ecological study carried out in adult units of 26 Andalusian public hospitals. Data on structure (beds, type of unit, nursing control), management (average stay, index of use of stays, complexity index) and nursing staff were collected. They were extracted from official sources: CMBDA, SAS/Health Council (CS) publications and specific respondents to Nursing Directorates. The patient-nurse ratio was calculated and related to 19 indicators of hospital quality, safety, and mortality. Measures of central tendency and Spearman's correlation coefficient were used for statistical analysis. Results: A response was obtained from 100% of the Andalusian hospitals. The average patient-nurse ratio in the three shifts was lower in hospitals with a broader portfolio of services-regional scope (11.6), followed by those with a medium portfolio-specialties (12.7) and hospitals with a basic portfolio- county (13.5). By type of unit, the medical units were 11.8 (SD=1.8) lower than the surgical ones 13.5 (SD=2.7). Significant differences were only found in medical units of regional hospitals 10.5 (SD=1.4) and district hospitals 13.03 (SD=1.46) (p=.001). In critical care, the ratio was greater than 2 patients per nurse in the three groups. When relating the ratio to health outcomes, 5 significant associations were found: pressure ulcers (p=.005), prevalence of nosocomial infections (p=.036), postoperative sepsis (p=.022), zero bacteraemia verification (p=.045) and mortality from heart failure (p=.004). Conclusions: The results indicate a high patient-nurse ratio in adult hospitalization units and that there is a positive association between the patient-nurse ratio and worse results related to nursing care.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Enfermeras y Enfermeros , Rol de la Enfermera , Relaciones Enfermero-Paciente , Hospitales Públicos , Gestión de la Salud Poblacional , Carga de Trabajo , Seguridad del Paciente , Evaluación de Resultado en la Atención de Salud , Enfermería , Estudios Ecológicos , Estudios Transversales
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