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Sleep quality among inpatients of Spanish public hospitals. Sci Rep 2022; 12:21989. [PMID: 36539518 PMCID: PMC9764317 DOI: 10.1038/s41598-022-26412-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
Sleep is a complex process and is needed both in health and illness. Deprivation of sleep is known to have multiple negative physiological effects on people's bodies and minds. Despite the awareness of these harmful effects, previous studies have shown that sleep is poor among hospitalised patients. We utilized an observational design with 343 patients recruited from medical and surgical units in 12 hospitals located in nine Spanish regions. Sociodemographic and clinical characteristics of patients were collected. Sleep quality at admission and during hospitalisation was measured by the Pittsburgh Sleep Quality Index. Sleep quantity was self-reported by patients in hours and minutes. Mean PSQI score before and during hospitalisation were respectively 8.62 ± 4.49 and 11.31 ± 4.04. Also, inpatients slept about an hour less during their hospital stay. Lower educational level, sedative medication intake, and multi-morbidity was shown to be associated with poorer sleep quality during hospitalisation. A higher level of habitual physical activity has shown to correlate positively with sleep quality in hospital. Our study showed poor sleep quality and quantity of inpatients and a drastic deterioration of sleep in hospital versus at home. These results may be helpful in drawing attention to patients' sleep in hospitals and encouraging interventions to improve sleep.
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Debilidades, amenazas, fortalezas y oportunidades de la investigación enfermera en el País Vasco. ENFERMERIA CLINICA 2022. [DOI: 10.1016/j.enfcli.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Strengths, weaknesses, opportunities and threats for nursing research in the Basque Country. ENFERMERIA CLINICA (ENGLISH EDITION) 2022; 33:167-171. [PMID: 36243322 DOI: 10.1016/j.enfcle.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 10/02/2022] [Indexed: 11/07/2022]
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Effects of nursing interventions to improve inpatients' sleep in intensive and non-intensive care units: Findings from an umbrella review. J Clin Nurs 2022; 32:1963-1978. [PMID: 35170142 DOI: 10.1111/jocn.16251] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 12/24/2021] [Accepted: 01/31/2022] [Indexed: 11/29/2022]
Abstract
AIM This review aimed to synthesise the available reviews on the effects of nursing interventions on sleep quality among patients hospitalised in intensive care and non-intensive care units. BACKGROUND Poor sleep quality is a common fact in hospitalised patients. Nurses can contribute to the improvement of patients' sleep quality and duration. DESIGN A review of intervention reviews was carried out and reported following the PRISMA guidelines and checklist. METHODS We systematically searched for reviews published from January 2009 to December 2019 in PubMed, CINAHL Plus, Scopus, Institute for Scientific Information Web of Science, Joanna Briggs Database of Systematic Reviews and Cochrane Central Register of Controlled Trials databases. Searches were repeated at 24 November 2020 to include the most recent evidence. A narrative synthesis of the results was conducted. RESULTS Nine reviews (representing 109 original papers) met the selection criteria and were included for critical appraisal. Overall, nursing interventions and sleep quality were poorly defined. We grouped the interventions into 3 categories (environmental, barrier and internal interventions) to provide a more comprehensive overview and examine effects of nursing interventions on inpatients sleep quality. Inconsistent results were obtained and low quality of the original articles was reported, making it difficult to establish absolute conclusions. CONCLUSION The impact of environmental changes on patients' sleep was positive but inconclusive, while use of earplugs and eye masks, music and acupuncture generally showed positive results with moderate quality of evidence, and no harmful effects were reported.
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Population Health and Health Services: Old Challenges and New Realities in the COVID-19 Era. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041658. [PMID: 33572355 PMCID: PMC7916098 DOI: 10.3390/ijerph18041658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 02/02/2021] [Indexed: 12/14/2022]
Abstract
(1) Background: Health services that were already under pressure before the COVID-19 pandemic to maximize its impact on population health, have not only the imperative to remain resilient and sustainable and be prepared for future waves of the virus, but to take advantage of the learnings from the pandemic to re-configure and support the greatest possible improvements. (2) Methods: A review of articles published by the Special Issue on Population Health and Health Services to identify main drivers for improving the contribution of health services on population health is conducted. (3) Health services have to focus not just on providing the best care to health problems but to improve its focus on health promotion and disease prevention. (4) Conclusions: Implementing innovative but complex solutions to address the problems can hardly be achieved without a multilevel and multisectoral deliberative debate. The CHRODIS PLUS policy dialog method can help standardize policy-making procedures and improve network governance, offering a proven method to strengthen the impact of health services on population health, which in the post-COVID era is more necessary than ever.
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The efficacy of nursing interventions on sleep quality in hospitalized patients: A systematic review of randomized controlled trials. Int J Nurs Stud 2020; 115:103855. [PMID: 33383270 DOI: 10.1016/j.ijnurstu.2020.103855] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/04/2020] [Accepted: 12/04/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the effect of interventions that could be performed by nurses to improve the sleep quality of hospitalized patients in acute and semi-acute units. DESIGN A systematic review of randomized controlled trials and narrative synthesis. DATA SOURCES Seven electronic databases (PubMed, CINAHL Plus, Scopus, ISI WoS, CENTRAL, PsycInfo, and Embase) were accessed on 20 May 2019 with a temporal limit of 10 years prior. REVIEW METHODS Original research studies of interventions that could be delivered by nurses to improve sleep quality during hospitalization in acute and semi-acute units were included. Study selection, data extraction, and risk of bias assessment were performed by two independent reviewers. RESULTS Seventeen studies met the inclusion criteria and were included in this review. The interventions carried out in the trials were classified into four categories of measurement: environmental, physical, behavioural, and combined. Fourteen studies obtained statistically significant improvements; two showed a blend of significant and non-significant improvements; and one reported non-significant results. However, only four trials of the seventeen were judged as having a low risk of bias. CONCLUSIONS Overall evidence about interventions that could be performed by nurses to improve perceived sleep quality in hospitalized patients was found to be positive, and no negative effects were reported. However, higher quality research using both subjective and objective measures is needed, in order to strengthen the evidence.
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Evaluation of implementation strategies of the Best Practices Spotlight Organisations (BPSO) Project in Spain. ENFERMERIA CLINICA 2020; 30:222-230. [PMID: 32389600 DOI: 10.1016/j.enfcli.2019.10.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify favourable elements and barriers to implementation in the Program of Best Practice Spotlight Organization® that establish clinical practice guidelines of the Registered Nurse' Association of Ontario, so that future experiences could benefit from the assessments presented here. METHOD Evaluation research study of the process of implementing guidelines in institutions that make up the first two cohorts of the programme in Spain, through analysis of contents of implantation reports and inductive process, reading, interpretation, coding and categorized according to SWOT structure: Strengths, weaknesses, opportunities and threats. RESULTS Reports from 18 centres in 12 Autonomous Communities have been analyzed, including 22 different guidelines. As weaknesses, problems related to information systems and their exploitation stand out for frequency and intensity. Other elements related to dissemination of results, to professionals, care and factors related to the institution are presented. Standing out as threats are the instability of staff and continued changes in Senior Management or corporate policies. Among the strengths, the exclusive dedication of personnel to the project and its link to institutional objectives are distinguished. As opportunities, the possibility of standardized comparison of own results with others, as well as the dissemination of results are highlighted. CONCLUSION A useful pattern is set up to approach implementation in other scenarios, where changes in professional culture, training, communication and leadership, as well as aligning interests of managers and politicians, facilitate ideal conditions for Evidence-Based Practice.
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Implantación de Guías de buenas prácticas en España a través del Programa de Centros Comprometidos con la Excelencia en Cuidados®. ENFERMERIA CLINICA 2020; 30:136-144. [DOI: 10.1016/j.enfcli.2019.09.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/04/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
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Implementation results of the assessment and management of pain guideline within Best Practice Spotlight Organisations (BPSO®). ENFERMERIA CLINICA 2020; 30:212-221. [PMID: 32354560 DOI: 10.1016/j.enfcli.2020.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 04/06/2020] [Indexed: 10/24/2022]
Abstract
AIM to analyse the progress of implementing the process recommendations of the RNAO Assessment and Management of Pain guideline and health outcomes. METHOD An observational, longitudinal, retrospective study conducted in 3tertiary-level hospitals in Spain. All patients discharged over the last 5 days of each month from the units selected in the implementation process were included. We evaluated structural data, mean hospital stay, implementation strategy and degree of implementation of the process recommendations of the RNAO guideline over the first 3 years of implementation, and outcomes. A descriptive analysis was performed by calculating means and absolute and relative frequencies in periods: baseline (T0), annual, over the 3first years of implementation (T1, T2 and T3 respectively), and inferential. RESULTS 8128 patients were included in the study. Hypotheses were contrasted between the different periods. The initial pain assessment in the first 24h following admission or post-surgery increased after the baseline period in all the hospitals, especially those that did not meet the guidelines from the outset. It continued to rise progressively up to 3 years following implementation (reaching 94.6% in hospital 2). By contrast, implementation of the care plan did not exceed 37.5% and 38.5% in hospitals 1 and 3 respectively. With regard to the outcome indicators, the prevalence of pain at 24hours and intense pain generally decreased in the 3hospitals from T0 or T1 to T3, however no conclusive statistically significant differences were obtained. CONCLUSIONS Implementation of the process recommendations improved from the outset, as did patient outcomes. A decrease in the prevalence and intensity of pain was achieved, although no conclusive data were obtained; all of which leads to better nursing practice with more recording, continuity of care and improved pain management for patients.
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Nursing knowledge of and attitude in cardiopulmonary arrest: cross-sectional survey analysis. PeerJ 2019; 7:e6410. [PMID: 30746310 PMCID: PMC6368968 DOI: 10.7717/peerj.6410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 01/07/2019] [Indexed: 11/20/2022] Open
Abstract
Background Nurses are often the first to activate the chain of survival when a cardiorespiratory arrest happens. That is why it is crucial that they keep their knowledge and skills up-to-date and their attitudes to resuscitation are very important. The main aim of this study was to analyse whether the level of theoretical and practical understanding affected the attitudes of nursing staff. Methods A questionnaire was designed using the Delphi technique (three rounds). The questionnaire was adjusted and it was piloted on a test-retest basis with a convenience sample of 30 registered nurses. The psychometric characteristics were evaluated using a sample of 347 nurses using Cronbach’s alpha. Descriptive analysis was performed to describe the sociodemographic variables and Spearman’s correlation coefficient to assess the relationship between two scale variables. Pearson’s chi-squared test has been used to study the relationship between two categorical variables. Wilcoxon Mann Whitney test and the Kruskal–Wallis test were performed to establish relationships between the demographic/work related characteristics and the level of understanding. Results The Knowledge and Attitude of Nurses in the Event of a Cardiorespiratory Arrest (CAEPCR) questionnaire comprised three sections: sociodemographic information, theoretical and practical understanding, and attitudes of ethical issues. Cronbach’s alpha for the internal consistency of the attitudes questionnaire was 0.621. The knowledge that nurses self-reported with regard to cardiopulmonary arrest directly affected their attitudes. Their responses raised a number of bioethical issues. Conclusions CAEPCR questionnaire is the first one which successfully linked knowledge of cardiopulmonary resuscitation to the attitudes towards ethical issues Health policies should ensure that CPR training is mandatory for nurses and all healthcare workers, and this training should include the ethical aspects.
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A Study Protocol for Development and Validation of a Clinical Prediction Model for Frailty (ModulEn): a new European Commitment to Tackling Frailty. Transl Med UniSa 2019; 19:36-41. [PMID: 31360665 PMCID: PMC6581487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
There is a growing need to implement and evaluate the technological solutions that allow the early detection of age-related frailty and enable assessment of the predictive values of frailty components. The broad use of these solutions may ensure an efficient and sustainable response of health and social care systems to the challenges related to demographic aging. In this paper, we present the protocol of the ModulEn study that aims to develop and validate a predictive model for frailty. For this purpose, the sample composed by older adults aged 65-80 years and recruited from the community will be invited to use an electronic device ACM Kronowise® 2.0. This device allows proactive and continuous monitoring of circadian health, physical activity, and sleep and eating habits. It will be used during a period of seven to ten days. The participants will also be given the questionnaires evaluating the variables of interest, including frailty level, as well as their experience and satisfaction with the device use. Data provided from these two sources will be combined and the relevant associations will be identified. In our view, the implications of this study' findings for clinical practice include the possibility to develop and validate tools for timely prevention of frailty progress. In the long term, the ModulEn may contribute to the critical reduction of frailty burden in Europe.
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Building Bridges for Innovation in Ageing: Synergies between Action Groups of the EIP on AHA. J Nutr Health Aging 2017; 21:92-104. [PMID: 27999855 DOI: 10.1007/s12603-016-0803-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 04/12/2016] [Indexed: 01/08/2023]
Abstract
The Strategic Implementation Plan of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) proposed six Action Groups. After almost three years of activity, many achievements have been obtained through commitments or collaborative work of the Action Groups. However, they have often worked in silos and, consequently, synergies between Action Groups have been proposed to strengthen the triple win of the EIP on AHA. The paper presents the methodology and current status of the Task Force on EIP on AHA synergies. Synergies are in line with the Action Groups' new Renovated Action Plan (2016-2018) to ensure that their future objectives are coherent and fully connected. The outcomes and impact of synergies are using the Monitoring and Assessment Framework for the EIP on AHA (MAFEIP). Eight proposals for synergies have been approved by the Task Force: Five cross-cutting synergies which can be used for all current and future synergies as they consider overarching domains (appropriate polypharmacy, citizen empowerment, teaching and coaching on AHA, deployment of synergies to EU regions, Responsible Research and Innovation), and three cross-cutting synergies focussing on current Action Group activities (falls, frailty, integrated care and chronic respiratory diseases).
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Erratum to: Building bridges for innovation in ageing: Synergies between action groups of the EIP on AHA. J Nutr Health Aging 2016. [DOI: 10.1007/s12603-016-0850-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care. BMJ Qual Saf 2016. [PMID: 28626086 PMCID: PMC5477662 DOI: 10.1136/bmjqs-2016-005567] [Citation(s) in RCA: 373] [Impact Index Per Article: 46.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To determine the association of hospital nursing skill mix with patient mortality, patient ratings of their care and indicators of quality of care. DESIGN Cross-sectional patient discharge data, hospital characteristics and nurse and patient survey data were merged and analysed using generalised estimating equations (GEE) and logistic regression models. SETTING Adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland. PARTICIPANTS Survey data were collected from 13 077 nurses in 243 hospitals, and 18 828 patients in 182 of the same hospitals in the six countries. Discharge data were obtained for 275 519 surgical patients in 188 of these hospitals. MAIN OUTCOME MEASURES Patient mortality, patient ratings of care, care quality, patient safety, adverse events and nurse burnout and job dissatisfaction. RESULTS Richer nurse skill mix (eg, every 10-point increase in the percentage of professional nurses among all nursing personnel) was associated with lower odds of mortality (OR=0.89), lower odds of low hospital ratings from patients (OR=0.90) and lower odds of reports of poor quality (OR=0.89), poor safety grades (OR=0.85) and other poor outcomes (0.80<OR<0.93), after adjusting for patient and hospital factors. Each 10 percentage point reduction in the proportion of professional nurses is associated with an 11% increase in the odds of death. In our hospital sample, there were an average of six caregivers for every 25 patients, four of whom were professional nurses. Substituting one nurse assistant for a professional nurse for every 25 patients is associated with a 21% increase in the odds of dying. CONCLUSIONS A bedside care workforce with a greater proportion of professional nurses is associated with better outcomes for patients and nurses. Reducing nursing skill mix by adding nursing associates and other categories of assistive nursing personnel without professional nurse qualifications may contribute to preventable deaths, erode quality and safety of hospital care and contribute to hospital nurse shortages.
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Nurses' sleep quality, work environment and quality of care in the Spanish National Health System: observational study among different shifts. BMJ Open 2016; 6:e012073. [PMID: 27496241 PMCID: PMC4985858 DOI: 10.1136/bmjopen-2016-012073] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The main objective of this study was to determine the relationship between the characteristics of nurses' work environments in hospitals in the Spanish National Health System (SNHS) with nurse reported quality of care, and how care was provided by using different shifts schemes. The study also examined the relationship between job satisfaction, burnout, sleep quality and daytime drowsiness of nurses and shift work. METHODS This was a multicentre, observational, descriptive, cross-sectional study, centred on a self-administered questionnaire. The study was conducted in seven SNHS hospitals of different sizes. We recruited 635 registered nurses who worked on day, night and rotational shifts on surgical, medical and critical care units. Their average age was 41.1 years, their average work experience was 16.4 years and 90% worked full time. A descriptive and bivariate analysis was carried out to study the relationship between work environment, quality and safety care, and sleep quality of nurses working different shift patterns. RESULTS 65.4% (410) of nurses worked on a rotating shift. The Practice Environment Scale of the Nursing Work Index classification ranked 20% (95) as favourable, showing differences in nurse manager ability, leadership and support between shifts (p=0.003). 46.6% (286) were sure that patients could manage their self-care after discharge, but there were differences between shifts (p=0.035). 33.1% (201) agreed with information being lost in the shift change, showing differences between shifts (p=0.002). The Pittsburgh Sleep Quality Index reflected an average of 6.8 (SD 3.39), with differences between shifts (p=0.017). CONCLUSIONS Nursing requires shift work, and the results showed that the rotating shift was the most common. Rotating shift nurses reported worse perception in organisational and work environmental factors. Rotating and night shift nurses were less confident about patients' competence of self-care after discharge. The most common nursing care omissions reported were related to nursing care plans. For the Global Sleep Quality score, difference were found between day and night shift workers.
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Review: Impact case studies submitted to REF 2014: The hidden impact of nursing research. J Res Nurs 2016. [DOI: 10.1177/1744987116646248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Perspectives: Implementation strategies to adopt and integrate evidence-based nursing. What are we doing? J Res Nurs 2015. [DOI: 10.1177/1744987115619800] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Implantación de guías de buenas prácticas en España. Programa de centros comprometidos con la excelencia de cuidados. MEDUNAB 2015. [DOI: 10.29375/01237047.2383] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Introducción: El programa de implantación de Guías de Buenas Prácticas, denominado en España Centros Comprometidos con la Excelencia en Cuidados®, se inició en 2010 tras un acuerdo de colaboración entre la Unidad de Investigación en Cuidados de Salud (Investén-isciii) de España, el Centro Colaborador Español del Instituto Joanna Briggs para los Cuidados de Salud basados en la Evidencia y la Registered Nurses' Association of Ontario (RNAO), siguiendo los mismos principios que el programa Best Practice Spotlight Organizations (BPSO®) iniciado por RNAO, en Canadá, en 1999. Objetivo: Describir la implantación de Guías de Buenas Prácticas de RNAO en el marco del programa de Centros Comprometidos con la Excelencia en Cuidados® (Best Practice Spotlight Organizations®) en España. El programa tiene como objetivo fomentar, facilitar y apoyar la implantación, evaluación y mantenimiento de buenas prácticas en cuidados, para el periodo 2012-2014. Metodología y Resultados: se han seleccionado 8 instituciones de salud y una universidad que implantan las guías de buenas prácticas de RNAO en función de sus necesidades. Tras los 24 primeros meses de implantación se ha formado a los profesionales de salud, constituido grupos estables de trabajo, desarrollado o actualizado protocolos de cuidados y registros correspondientes, también se han evaluado de forma sistemática los resultados de proceso y de salud de los pacientes. También se han difundido activamente los principales logros del programa. Conclusiones: Los candidatos a Centros Comprometidos con la Excelencia en Cuidados® están realizando un gran esfuerzo y los resultados empiezan a mostrar que son positivos, con una creciente cultura de cuidados basados en la evidencia, y el impulso de la investigación y el inicio de un trabajo colaborativo en red.[Albornos-Muñoz L, González-María E, Moreno-Casbas T. Implantación de guías de buenas prácticas en España. Programa de centros comprometidos con la excelencia en cuidados. MedUNAB 2015; 17 (3): 163-169].
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Prevalence, patterns and predictors of nursing care left undone in European hospitals: results from the multicountry cross-sectional RN4CAST study. BMJ Qual Saf 2013; 23:126-35. [PMID: 24214796 DOI: 10.1136/bmjqs-2013-002318] [Citation(s) in RCA: 357] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Little is known of the extent to which nursing-care tasks are left undone as an international phenomenon. AIM The aim of this study is to describe the prevalence and patterns of nursing care left undone across European hospitals and explore its associations with nurse-related organisational factors. METHODS Data were collected from 33 659 nurses in 488 hospitals across 12 European countries for a large multicountry cross-sectional study. RESULTS Across European hospitals, the most frequent nursing care activities left undone included 'Comfort/talk with patients' (53%), 'Developing or updating nursing care plans/care pathways' (42%) and 'Educating patients and families' (41%). In hospitals with more favourable work environments (B=-2.19; p<0.0001), lower patient to nurse ratios (B=0.09; p<0.0001), and lower proportions of nurses carrying out non-nursing tasks frequently (B=2.18; p<0.0001), fewer nurses reported leaving nursing care undone. CONCLUSIONS Nursing care left undone was prevalent across all European countries and was associated with nurse-related organisational factors. We discovered similar patterns of nursing care left undone across a cross-section of European hospitals, suggesting that nurses develop informal task hierarchies to facilitate important patient-care decisions. Further research on the impact of nursing care left undone for patient outcomes and nurse well-being is required.
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[Work setting, satisfaction and burnout of the nurses in critical care units and hospitalization units. RN4CAST-Spain project]. ENFERMERIA INTENSIVA 2013; 24:104-12. [PMID: 23932519 DOI: 10.1016/j.enfi.2013.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 06/03/2013] [Accepted: 06/21/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To know if there are differences between the critical care units and the medical-surgical care units regarding the perception of the nurses working in National Health System hospitals about their work environment, burnout level and job satisfaction. METHOD A cross-sectional study was conducted with 6,417 nurses from the medical-surgical care units and with 1,122 nurses from critical care units of 59 Spanish hospitals with more than 150 beds. Socio-demographic, job satisfaction, perception of work environment (Practice Environment Scale of the Nursing Work Index [PES-NWI questionnaire]) and burnout measured with the Maslach Burnout Inventory (MBI) data were collected. RESULTS The PES-NWI showed differences in 4 out of its 5 factors. It showed better values in medical-surgical units in all the factors, except for Staffing and resource adequacy (P<.001), where critical care units showed a mean level of agreement of 2.41 versus 2.19 for the medical-surgical units. Regarding burnout, this was higher in the medical-surgical care units (P=.039) where 23% (952) of the nurses had high levels. Job satisfaction was lower in the critical care units (P=.044) with 70% (578) of nurses being very or strongly satisfied. CONCLUSIONS The opinion of the nurses, working in critical care units about their hospital is unfavorable. They showed lower levels of burnout than those working in medical-surgical units.
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Development and validation of the competence in evidence based practice questionnaire (EBP-COQ) among nursing students. BMC MEDICAL EDUCATION 2013; 13:19. [PMID: 23391040 PMCID: PMC3598337 DOI: 10.1186/1472-6920-13-19] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 01/31/2013] [Indexed: 05/14/2023]
Abstract
BACKGROUND Nursing educators need rigorously developed instruments to assess competency in evidence based practice (EBP) at undergraduate level. This concept is defined as the capability to choose and use an integrated combination of knowledge, skills and attitudes with the intention to develop a task in a certain context. Also, we understand that EBP is gaining knowledge and skills, as well as increasing positive attitudes toward EBP that will promote a change in behaviour to implement EBP in practice. This study aims to develop a psychometric test of the Evidence Based Practice Evaluation Competence Questionnaire (EBP-COQ) among undergraduate nursing students. METHODS The questionnaire was developed by item generation through a review of scientific literature and focus groups. The instrument was validated in terms of content validity through an expert review. The EBP-COQ was administered to a cohort of nursing students (n =100) to evaluate test reliability and select the best items. Psychometric properties of the final instrument were assessed in a sample of 261 nursing students. RESULTS The EBP-COQ consisted of 25 items. A factorial analysis grouped the items into the three categories that define competence relating to EBP: attitude, knowledge and skills. Cronbach's alpha was 0.888 for the entire questionnaire. The factor solution explained 55.55% of the variance. CONCLUSIONS EBP-COQ appears to measure with adequate reliability the attributes of undergraduate nursing students' competence in EBP. The instrument is quick to disseminate and easy to score, making it a suitable instrument for nursing educators to evaluate students' self-perceived competence in EBP.
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Percepción del entorno laboral de las enfermeras españolas en los hospitales del Sistema Nacional de Salud. Proyecto RN4CAST-España. ENFERMERIA CLINICA 2012; 22:261-8. [DOI: 10.1016/j.enfcli.2012.09.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Revised: 09/10/2012] [Accepted: 09/17/2012] [Indexed: 10/27/2022]
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Fin de una etapa. ENFERMERIA CLINICA 2011; 21:307. [DOI: 10.1016/j.enfcli.2011.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Accepted: 11/03/2011] [Indexed: 10/14/2022]
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Spanish nurses' attitudes towards research and perceived barriers and facilitators of research utilisation: a comparative survey of nurses with and without experience as principal investigators. J Clin Nurs 2011; 20:1936-47. [PMID: 21539627 DOI: 10.1111/j.1365-2702.2010.03656.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVE To examine attitudes towards research and perceived barriers and facilitators of research utilisation in clinical practice in a broad cross-section of Spanish nurses. BACKGROUND Nurses' attitudes towards research are critical in determining whether study findings are used to improve practice. DESIGN Cross-sectional comparative survey in Hospitals, Primary Care Centres and University-affiliated schools of nursing. METHODS Surveys were completed by 917 nurses: 69 who received funding from the Spanish national agency (1998-2004) and a nationally representative sample of 848 nurses who did not have the same research experience (the Comparison group). Two instruments (BARRIERS and Attitudes towards nursing research) were translated and culturally adapted for use in Spain. A descriptive analysis of demographic and practice characteristics was performed. Total scale scores, as well as subscale scores, were computed and compared across the two groups using one-way analysis of variance (anova) and multivariate analysis of variance (manova) with post hoc tests. Pearson product-moment correlation coefficients were computed between the total tool scores and subscales measuring barriers and attitudes in both groups. RESULTS The investigators differed from other nurses on several demographic and work characteristics (more males, older age and more likely to work a fixed day shift schedule). On the whole, investigators showed more favourable attitudes but perceived several elements as posing greater barriers to research utilisation than the Comparison groups. Across all respondents, issues related to the quality of research were rated as the greatest barriers to research utilisation, followed by organisational barriers, barriers involving the communication of findings and finally, those related to nurses' values, awareness and skills. CONCLUSIONS Very similar profiles of perceptions and attitudes regarding research were found in these samples of Spanish nurses relative to those from other countries in earlier reports. Nurses who had experience conducting research demonstrated more favourable research-related attitudes and perceived barriers differently than those without such experience. RELEVANCE TO CLINICAL PRACTICE Understanding different organisational and experience perspectives is important to identify challenges and opportunities to ensure research utilisation in clinical practice.
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Analysis of nursing research studies submitted to Spain’s health research fund and the resulting scientific output. J Res Nurs 2009. [DOI: 10.1177/1744987108102006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract A descriptive observational study was conducted to ascertain and analyse the scientific status of nursing in Spain, based on nursing research studies submitted to the Health Research Fund ( Fondo de Investigación Sanitaria-FIS) for public funding and their ensuing scientific output. The study selection criteria required the following: the principal researcher to be a nurse; and the terms, ‘nursing’, ‘self-care’, ‘care’, ‘ulcer’ and/or ‘home care’ included in title or key words. For analysis of bibliographic output, a bibliographic search was made of national and international databases. During the study period (1996–2004), 673 nursing studies were submitted for public funding, with 28% being funded as a result. Of these, 37% addressed research topics focused on clinical practice. Most relied on quantitative methodology, with a descriptive design (48%). Of the studies funded from 1996 to 2002 (86), only 58% resulted in publications; of the total of 73 publications so yielded, only five were published in international journals. The main grounds for rejection of studies were also reviewed. Although nursing research is progressively increasing, it is essential to continue striving to enhance the quality and dissemination of such research.
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Proceso de la revisión externa de manuscritos enviados para su publicación a Enfermería Clínica. ENFERMERIA CLINICA 2008; 18:229-31. [DOI: 10.1016/s1130-8621(08)72380-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Applying to the European Research Area Network Scheme (ERA-NET): collaborative working for nursing and midwifery research. Int Nurs Rev 2006; 53:297-300. [PMID: 17083419 DOI: 10.1111/j.1466-7657.2006.00509.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM This paper reports on work undertaken to achieve an application for monies from the European Commission's 6th Framework Programme by some key stakeholders, working with a nursing and midwifery research agenda at national policy levels. BACKGROUND A short outline of the European Commission's European Research Area Network scheme is given in order to set the paper in context, and the vision underpinning the application is discussed. CONCLUSION The paper describes the processes that were undertaken to bring to fruition such collaborative work, and some key lessons are outlined. Seeking opportunities to enhance nursing and midwifery research within a European context gives value to the application, which was ultimately successful.
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Abstract
AIM The aim of this work was to identify priorities for nursing research in Spain. The Co-ordination and Development of Nursing Research Centre (Investén-isciii group) carried out the study using the Delphi technique during the period April 1998 to January 1999. METHODS Study subjects were professionals involved in different nursing activities. From 1250 eligible professionals initially contacted, 452 (38%) responded in round 1 and 258 (57%) in round 2. But only 189 filled out correctly the questionnaires from both rounds of data collection (overall response rate was 21.6%). RESULTS The participants identified priorities related to continuity and co-ordination of nursing care, quality of nursing care, impact of invasive techniques and treatments on the quality of life of patients, needs of the primary care givers, quality of life among elders, satisfaction of customers and needs of terminal patients and their families.
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