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Objetivo: Analizar la tendencia del indicador “Infección del tracto urinario asociado a instalación de catéter urinario a permanencia” en Chile. Material y Método: Estudio ecológico, de series temporales en el sistema sanitario de Chile, correspondiente a un total de 15 regiones, desde el año 2001 al año 2017 (27.087.087 casos). Se incluyeron datos cuyo egreso hospitalario era infección de tracto urinario asociado a catéter urinario a permanencia, según la Clasificación Internacional de Enfermedades (CIE 10). El análisis descriptivo y correlacional (X2 y T de Student, respectivamente) se realizó en función del sexo, tipo de previsión, condición de egreso y operación quirúrgica. El análisis se realizó con el programa SPSS 24 y el nivel de significación estadística fue p< 0,05. La estimación, basada en análisis lineal, estimó cambios porcentuales anuales (APC:Annual Percentage Change) y sus intervalos de confianza al 95%. Se empleó el método de auto-regresión de Prais Winsten. El resguardo ético siguió lo dispuesto en la Ley Nº 20.585. Resultados: Se observó un 2% de crecimiento interanual (APC= 0,00007; IC: 95%= 0,000069-0,000073). En los años 2005, 2008, 2009 y 2011 existió un aumento en el porcentaje de cambio de 2 a 5 puntos. Conclusión: El indicador analizado es un evento que ha presentado una tendencia creciente y significativa en Chile desde el año 2001, lo que resulta paradójico, puesto que el ordenamiento de los procesos hospitalarios, asociado a la Reforma de Salud, debería demostrar una mejora en el comportamiento de este tipo de indicadores. Objective: To analyze the trend indicator “Urinary tract infection associated with indwelling urinary catheter insertion” in Chile. Material and Method: Ecological, time series study, carried out in the Chilean health system, corresponding to a total of 15 administrative regions, from 2001 to 2017 (27.087.087 cases). Data included information on patients whose hospital discharge was urinary tract infection associated with indwelling urinary catheter, according to the International Classification of Diseases (ICD-10). Descriptive and correlational analysis (X2 and Student’s t-test, respectively) was performed according to sex, type of health insurance, hospital discharge condition and surgical operation. The analysis was performed using SPSS 24 software and the level of statistical significance was p

Resumo Objetivo Projetar e validar uma escala para medir a carga de trabalho de enfermagem em Unidades de Internação de Adultos com base na Classificação de Intervenções de Enfermagem (NIC). Métodos Estudo analítico, descritivo, observacional, prospectivo, utilizando principalmente metodologia de pesquisa qualitativa, por meio de grupos focais, comitê de especialistas e entrevistas individuais, para validar uma Escala de Medição da Carga de Trabalho em Unidades de Internação de Adultos, a partir das intervenções selecionadas (NIC), com base nas características inerentes a tais unidades. Foi utilizada seleção aleatória para determinar os participantes (enfermeiros e especialistas) e é representativa das unidades de hospitalização em estudo. O estudo foi realizado de outubro de 2018 a abril de 2019. Resultados Não apenas os grupos focais, mas também as entrevistas individuais e o comitê de especialistas demonstraram concordância sobre a importância de se obter um instrumento para medir a carga de trabalho validado pelos próprios profissionais e representativo de seu trabalho, com linguagem padronizada e adaptada à saúde real. A análise quantitativa conduzida pelo comitê de especialistas mostra uma maior relevância (91,67%) nos itens: “Prevenção” e “Educação para a saúde”, bem como a consistência com a construto e a redação apropriada em 99% dos itens selecionados. Os avaliadores mantiveram a ação em todos os itens com uma taxa de aceitação de 75% a 100%. Conclusão O estudo qualitativo realizado fornece os dados necessários para a concepção e validação de uma escala para medir as cargas de trabalho de enfermagem, identificadas a partir das intervenções de enfermagem (NIC), como indicadores da gestão de recursos humanos. Resumen Objetivo Proyectar y validar una escala para medir la carga de trabajo de enfermería en unidades de internación de adultos con base en la Clasificación de Intervenciones de Enfermería (NIC). Métodos Estudio analítico, descriptivo, observacional, prospectivo, que utilizó principalmente metodología de investigación cualitativa, por medio de grupos focales, comité de especialistas y entrevistas individuales, para validar una Escala de Medición de Carga de Trabajo en Unidades de Internación de Adultos, a partir de las intervenciones seleccionadas (NIC), con base en las características inherentes a tales unidades. Se utilizó selección aleatoria para definir los participantes (enfermeros y especialistas), que es representativa de las unidades de hospitalización en estudio. El estudio fue realizado de octubre de 2018 a abril de 2019. Resultados No solo los grupos focales, como también las entrevistas individuales y el comité de especialistas demostraron concordancia sobre la importancia de obtener un instrumento para medir la carga de trabajo, validado por los propios profesionales y representativo de su trabajo, con un lenguaje estandarizado y adaptado a la salud real. El análisis cuantitativo conducido por el comité de especialistas muestra una mayor relevancia (91,67 %) en los ítems: “Prevención” y “Educación para la salud”, así como una consistencia respecto a la elaboración y redacción apropiada en el 99 % de los ítems seleccionados. Los evaluadores mantuvieron la acción en todos los ítems con un índice de aceptación de 75 % a 100 %. Conclusión El estudio cualitativo realizado proporciona los datos necesarios para la elaboración y validación de una escala para medir la carga de trabajo en enfermería, identificada a partir de las intervenciones de enfermería (NIC), como indicadores de la gestión de recursos humanos. Abstract Objective To design and validate a scale to measure nursing workloads in Adult Hospitalization Units based on Nursing Interventions (NIC). Methods Analytical, descriptive, observational, prospective study, using mainly qualitative research methodology, by means of focus groups, committee of experts and individual interviews, to validate a Workload Measurement Scale in Adult Hospitalization Units, from the selected interventions (NIC) on a basis of the inherent characteristics of such units. A random selection was used to determine the participants (nurses and experts) and it is representative of the hospitalization units under study. It was carried out from October 2018 to April 2019. Results Not only the focus groups but also the individual interviews and the committee of experts conducted agree on the importance of obtaining an instrument to measure workloads validated by the professionals themselves and representative of their work, with standardized language and adapted to actual healthcare. The quantitative analysis conducted by the committee of experts shows a highest relevance (91,67%) in the items: “Prevention” and “Health education”, as well as consistency with the construct and appropriate wording in 99% of the items selected. Evaluators maintained the action on all items with a 75% to 100% acceptance rate. Conclusion The qualitative study carried out provides the necessary data for the design and validation of a scale to measure nursing workloads, identified from the nursing interventions (NIC), as indicators of human resources management.

Objective To determine whether the anteroposterior (AP) diameter of the patellar tendon in volleyball players is associated with a greater sensation of pain and decreased functionality. Material and Methods A descriptive, observational, cross-sectional study conducted on volleyball players. The scores on the Victorian Institute of Sport Assessment–Patella (VISA-P) scale were registered, together with the visual analogue scale (VAS) and the AP diameter of the patellar tendon, at 5 and at 10 mm distal to the inferior pole of the patella. The demographic, anthropometric and playing characteristics were registered and multiple linear regression models were constructed in order to analyze the relationship between the study variables. Results The final sample comprised 112 players. The AP diameter was greater in men and showed a positive significant association with the score on the VAS scale and a negative significant association with the VISA-P for both tendons after adjusting for the remaining variables. Conclusions The measurement of the AP diameter of the patellar tendon may be useful for the prevention of sports injuries in volleyball players as a greater tendon diameter is significantly associated with increased perceived pain and decreased functionality. Future studies should include a biomechanical analysis of jump and reception techniques. Objetivos Determinar si el diámetro antero-posterior del tendón rotuliano en jugadores de voleibol está asociado a una mayor sensación de dolor y menor funcionalidad. Material y Métodos Estudio observacional descriptivo transversal realizado sobre jugadores/as de voleibol. Se registraron las puntuaciones de la escala VISA-P, la escala analógica visual (EVA) y el diámetro antero-posterior del tendón rotuliano a 5 y 10 mm del polo inferior de la rótula distalmente. Se registraron características demográficas, antropométricas y del juego y se construyeron modelos de regresión lineal múltiple para analizar la relación entre las variables de estudio. Resultados La muestra final fue de 112 jugadores. El diámetro antero-posterior fue mayor en hombres y se asoció significativamente con las puntuaciones de la escala EVA positivamente y VISA-P de manera negativa para ambos tendones una vez ajustados por el resto de variables. Conclusiones La determinación del diámetro antero-posterior del tendón rotuliano puede ser útil en la prevención de lesiones deportivas en jugadores de voleibol, al asociarse significativamente un mayor diámetro de éste con una mayor sensación de dolor y menor funcionalidad. Sería conveniente en futuros estudios incluir un análisis biomecánico de la técnica del salto y recepción.

In 2007, the World Health Organization initiated the Surgical Safety Checklist (SSC) as part of an initiative to improve patient outcomes. After publication of the SSC, perioperative nurses identified challenges with implementing it and questioned its effectiveness. We desired to summarize the state of the science on the effectiveness of strategies that perioperative personnel have used to implement and assess the SSC; therefore, we conducted a scoping review. We searched several databases and identified 28 articles that described the three key stages of SSC implementation (ie, before, during, and after). Half of the identified articles addressed intervention strategies and most articles provided strategies for SSC implementation. The literature also indicated that effective implementation occurred when there was adequate planning. Perioperative leaders should work with nurses when implementing the SSC and monitor its use after implementation to verify compliance and help prevent negative patient outcomes.

Introducción. Cada día son más las cirugías realizadas en el mundo, lo que aumenta el riesgo de cometer errores dentro del área quirúrgica. Por ello, es necesario contar con un arraigado clima de seguridad del paciente que permita desarrollar la efectividad de herramientas clave como el listado de verificación quirúrgica. Objetivos. Evaluar de forma realista la implantación del listado de verificación quirúrgica en un hospital de tercer nivel a través de sus profesionales. Metodología. La evaluación realista permite obtener una visión integral de una intervención compleja como es la incorporación del listado de verificación quirúrgica. Se llevarán a cabo tres etapas diferenciadas: análisis del contexto, análisis del mecanismo y análisis del resultado. Estas fases requieren distintas formas de recogida de datos: revisión de la literatura, entrevistas semiestructuradas, encuestas y recogida de indicadores de calidad del programa cirugía segura. Aplicabilidad práctica. Durante el análisis de los datos se obtendrán datos cuantitativos y cualitativos que se integrarán para conseguir una evaluación exhaustiva del proceso de implantación del listado de verificación quirúrgica desde el inicio hasta la actualidad con los correspondientes flujos entre el contexto y sus circunstancias. Con esto conseguiremos destacar la importancia de un plan de implantación con estrategias sólido a través de intervenciones programadas que permiten una mejora y evaluación constante de las herramientas. Abstract Introduction. Every day there are more surgeries performed in the world, which increases the risk of making mistakes within the surgical area. For this reason, it is necessary to have a developed patient safety climate that allows the development of the effectiveness of key tools such as the surgical safety checklist. Objective. Evaluate the implementation of the surgical safety checklist in a tertiary hospital through its professionals. Methodology. The realist evaluation allows obtain a comprehensive vision of a complex intervention such as the incorporation of the surgical safety checklist. Three different stages will be carried out: context analysis, mechanism analysis and result analysis. These phases require different forms of data collection: literature review, semi-structured interviews, surveys, and collection of quality indicators of the safe surgery program. Clinical relevance. Quantitative and qualitative data will be obtained that will be integrated to achieve an exhaustive evaluation of the surgical safety checklist implementation process from the beginning to the present with the corresponding flows between the context and its circumstances. This exhaustive evaluation will be able to highlight the importance of an implementation plan with solid strategies through programmed interventions that allow constant improvement and evaluation of the tools.

Objetivo: Evaluar el nivel de participación de las enfermeras clínicas del entorno sanitario de la Universitat Jaume I de Castellón, donde realizan las prácticas los estudiantes de Grado en Enfermería. Identificar variables que pueden influir en el nivel de participación de las enfermeras clínicas en la tutela clínica de los estudiantes. Método: Estudio observacional, transversal y descriptivo realizado mediante la aplicación del cuestionario validado Implicación, Motivación, Satisfacción, Obstáculos y Compromiso (IMSOC). Se recogieron las variables edad, ámbito de trabajo y formación previa para tutorizar estudiantes. El estudio se llevó a cabo entre enero y diciembre de 2014. Resultados: La muestra fue de 117 enfermeras. La puntuación media global del cuestionario fue de 122,84 (desviación típica: ± 18,69; intervalo de confianza del 95%: 119,4-126,26) puntos. Obtuvieron significación estadística en la puntuación global las variables ámbito de trabajo y recibir formación previa para tutelar estudiantes (p < 0,05). También se observó que las enfermeras de atención primaria obtuvieron mejores puntuaciones en la dimensión «implicación» que los profesionales de otros niveles asistenciales. Conclusiones: El nivel de participación de las enfermeras clínicas de la provincia de Castellón es adecuado. La formación previa que reciben los profesionales para la tutorización de estudiantes, así como pertenecer al ámbito de atención primaria, mejora su nivel de participación. Se recomienda ampliar la investigación a otros entornos, tanto a nivel nacional como internacional. Objective: To evaluate the level of participation of clinical nurses from Castellón where Universitat Jaume I nursing students do their clinical clerkship. To identify the variables that may influence clinical nurses’ participation in students’ clinical mentorship. Method: This observational, cross-sectional and descriptive study was conducted by applying the validated Involvement, Motivation, Satisfaction, Obstacles and Commitment (IMSOC) questionnaire. The variables collected were: age, work environment and previous training. The study was conducted between January and December 2014. Results: The sample included 117 nurses. The overall mean questionnaire score was 122.838 (standard deviation: ± 18.692; interquartile range 95%: 119.415-126.26). The variable “previous training for mentorship students” was statistically significant in the overall score and for all dimensions (P < .05). Primary care nurses obtained better scores in the dimension Implication than professionals working at other care levels. Conclusions: The level of participation of the clinical nurses from Castellón is adequate. The previous training that professionals receive for mentoring students improves both their level of participation and primary care level. Extending this research to other national and international environments is recommended.

The aim of this study was to assess health-related quality of life (HRQL) in patients with chronic obstructive pulmonary disease (COPD) and to discuss the different tools available for its assessment. The most widely used assessments are the St. George respiratory questionnaire (SGRQ) and the COPD assessment test (CAT) questionnaire. Both have a different difficulty in exam completion, calculation, and scoring. No studies exist that analyze the validity and internal consistency of using both questionnaires on patients admitted to the hospital for a COPD exacerbation. A multicenter, cross-sectional analytic observational study of patients admitted to the hospital due to a COPD exacerbation (CIE 491.2). During their hospital stay, they were administered the SGRQ and the CAT questionnaire within the framework of a therapeutic education program (APRENDEPOC). Descriptive and comparative analysis, correlations between the scales (Pearson’s correlation index), consistency and reliability calculations (Cronbach’s α), and a forward stepwise multiple linear regression were performed, with significant correlations in both questionnaires considered p < 0.01 with the total scores. A statistical significance of p < 0.05 was assumed. Altogether, 231 patients were admitted for a COPD exacerbation (n = 77) at Hospital Clínic of Barcelona (HCB) and (n = 154) at Hospital Universitario General of Castellón (HUGC). The sample profile was not homogeneous between both centers, with significant differences in HRQL between hospitals. Correlation were noted between both scales (p < 0.01), along with high levels of internal consistency and reliability (CAT 0.836 vs. SGRQ 0.827). The HRQL is related to dyspnea, wheezing, daytime drowsiness, and edema, as well as to the need to sleep in a sitting position, anxiety, depression, and dependence on others in the execution of daily activities. Our regression analysis showed that the SGRQ questionnaire could predict more changes in HRQL with a higher number of variables. The study was partially funded by the Spanish Society of Pneumology and Thoracic Surgery (SEPAR), Nursing area (191/2013).

Objective: Examine the relationships between quality of life, nutrition and frailty in non-institutionalized people older than 75 years of age. Methods: Observational, cross-sectional, analytical study conducted using a questionnaire with a sample of individuals older than 75 years of age residing in the community, who were selected via convenience sampling during 2015. Results: A larger proportion of women had poor quality of life than men: 20.9% as opposed to 9% (p

Objective. The aim herein was to validate a questionnaire to measure the level of participation of clinical nursing professionals in the mentorship of nursing students during clinical practices. Methods. Design and validation of a questionnaire. The psychometric properties of the tool were determined through four phases: 1- literature review; 2- evaluation of content validity; 3- pilot test, cognitive pretest and intra-observer reliability study; 4- construct validity study through an exploratory factor analysis of main components with varimax rotation in a sample of 249 nursing professionals from primary care and hospital care from different Spanish provinces. The internal consistency was studied with Cronbach’s alpha coefficient. Results. The global content validity was above 0.8. The final version of the questionnaire had 33 items, with a global intraclass correlation coefficient of 0.852 and Cronbach’s alpha of 0.837. Factor analysis explained 55.4% of the total variance, with a solution of five factors that made up the dimensions: Implication, Motivation, Satisfaction, Obstacles, and Commitment. Conclusion. The questionnaire evaluated has adequate validity and reliability to permit determining the level of nurse participation in the mentorship of students. Objetivo. Validar un cuestionario para medir el nivel de participación de los profesionales de enfermería clínicos en la tutela de estudiantes de enfermería durante las prácticas clínicas. Métodos. Diseño y validación de un cuestionario. Se determinaron las propiedades psicométricas de la herramienta mediante cuatro fases: 1- revisión de la literatura; 2- evaluación de la validez de contenido; 3- prueba piloto, pretest cognitivo y estudio de la fiabilidad intraobservador; 4-, estudio de validez de constructo mediante un análisis factorial exploratorio de componentes principales con rotación varimax en una muestra de 249 profesionales de enfermería de atención primaria y de atención hospitalaria de diferentes provincias españolas. La consistencia interna se estudió con el coeficiente Alfa de Cronbach. Resultados. La validez de contenido global fue superior a 0.8. La versión final del cuestionario fue de 33 ítems, con un CCI global de 0.852 y un alfa de Cronbach de 0.837. El análisis factorial explicó el 55.4% de varianza total, con una solución de cinco factores que formaron las dimensiones Implicación, Motivación, Satisfacción, Obstáculos y Compromiso. Conclusión. El cuestionario evaluado tiene validez y fiabilidad adecuadas que permite determinar el nivel de participación de las enfermeras en la tutela de estudiantes. This work has been funded by a call for projects of educational innovation, call 2015/2016 by Universitat Jaume I within the project “Acquisition of skills in clinical practices and simulation” (Code: 10G136-733). Approved by Resolution of 02 November 2015.

Treball final de Master Universitari en Ciencies de la Infermeria. Codi: SBL017. Curs academic 2016-2017

INTRODUCTION: Recent immunological and transgenic advances are a promising alternative using limited materials of human origin for transplantation. However, it is essential to achieve social acceptance of this therapy. OBJECTIVE: To analyze the attitude of nursing students from Spanish universities toward organ xenotransplantation (XTx) and to determine the factors affecting their attitude. MATERIALS AND METHODS: Type of study: A sociological, multicentre, and observational study. STUDY POPULATION: Nursing students enrolled in Spain (n = 28,000). SAMPLE SIZE: A sample of 10 566 students estimating a proportion of 76% (99% confidence and precision of ±1%), stratified by geographical area and year of study. Instrument of measurement: A validated questionnaire (PCID-XenoTx-RIOS) was handed out to every student in a compulsory session. This survey was self-administered and self-completed voluntarily and anonymously by each student in a period of 5-10 min. STATISTICAL ANALYSIS: descriptive analysis, Student's t test, the chi-square test, and a logistic regression analysis. RESULTS: A completion rate: 84% (n = 8913) was obtained. If the results of XTx were as good as in human donation, 74% (n = 6564) would be in favor and 22% (n = 1946) would have doubts. The following variables affected this attitude: age (P

Objetivo: avaliar a eficácia entre os questionários de qualidade de vida St. George Respiratory Questionnaire e Chronic Obstructive Pulmonary Disease Assessment Test em pacientes com doença pulmonar obstrutiva crônica a partir da análise de correlação e concordância, bem como identificar a ferramenta mais eficaz para avaliar sua qualidade de vida. Método: estudo analítico de coorte transversal com pacientes internados em um hospital espanhol para exacerbação de doença pulmonar obstrutiva crônica. A qualidade de vida relacionada à saúde foi avaliada com os dois questionários. Analisaram-se a correlação e a concordância entre ambos, bem como a consistência interna. As associações foram estabelecidas entre as variáveis clínicas e os resultados do questionário. Resultados: participaram 156 pacientes. Ambas as escalas mostram correlação e concordância entre elas e alta consistência interna. Uma maior sensibilidade do Chronic obstructive pulmonary disease Assessment Test foi observada para detectar a presença de tosse e expectoração. Conclusão: ambos os questionários têm a mesma confiabilidade e validade para medir a qualidade de vida em pacientes com doença pulmonar obstrutiva crônica aguda, sendo que o Chronic Obstructive Pulmonary Disease Assessment é mais sensível para detectar a tosse e a expectoração e com um tempo de preenchimento mais curto. Objective: to evaluate the efficacy of quality of life questionnaires St. George Respiratory Questionnaire and Chronic Obstructive Pulmonary Disease Assessment Test in patients with chronic obstructive pulmonary disease based on correlation and agreement analyses, and identify the most effective tool to assess their quality of life. Method: cross-sectional cohort study with patients hospitalized in a Spanish hospital for exacerbation of chronic obstructive pulmonary disease. Health-related quality of life was assessed with both questionnaires. The correlation and the agreement between the questionnaires were analyzed, as well as the internal consistency. Associations were established between the clinical variables and the results of the questionnaire. Results: one hundred and fifty-six patients participated in the study. The scales had a correlation and agreement between them and high internal consistency. A higher sensitivity of the Chronic Obstructive Pulmonary Disease Assessment Test was observed for the presence of cough and expectoration. Conclusion: the questionnaires have similar reliability and validity to measure the quality of life in patients with acute chronic obstructive pulmonary disease, and the Chronic Obstructive Pulmonary Disease Assessment Test is more sensitive to detect cough and expectoration and requires a shorter time to be completed. Objetivo: evaluar la efectividad entre los cuestionarios de la calidad de vida St. George Respiratory Questionnaire y Chronic obstructive pulmonary disease Assessment Test en pacientes con enfermedad pulmonar obstructiva crónica a partir del análisis de su correlación y concordancia, e identificar la herramienta más efectiva para evaluar su calidad de vida. Método: estudio analítico transversal en pacientes ingresados en un hospital español por exacerbación de la enfermedad pulmonar obstructiva crónica. Se estudió la calidad de vida relacionada con la salud evaluada con los dos cuestionarios. Se analizó la correlación y concordancia entre ambos, así como su consistencia interna. Se establecieron asociaciones entre las variables clínicas y los resultados del cuestionario. Resultados: participaron 156 pacientes. Ambas escalas muestran correlación y concordancia entre ellas y consistencia interna elevada. Se observa una mayor sensibilidad del cuestionario Chronic obstructive pulmonary disease Assessment Test para detectar la presencia de tos y expectoración. Conclusión: ambos cuestionarios presentan la misma fiabilidad y validez para medir la calidad de vida en pacientes con enfermedad pulmonar obstructiva crónica agudizada, siendo el Chronic obstructive pulmonary disease Assessment Test más sensible para detectar tos y expectoración y con un tiempo de cumplimentación más breve.

Objective: compare ventilatory time between patients with the application of a disconnection protocol, managed in a coordinated way between doctor and nurse, with patients managed exclusively by the doctor. Method: experimental pilot study before and after. Twenty-five patients requiring invasive mechanical ventilation for 24 hours or more were included, and the protocol-guided group was compared with the protocol-free group managed according to usual practice. Results: by means of the multidisciplinary protocol, the time of invasive mechanical ventilation was reduced (141.94 ± 114.50 vs 113.18 ± 55.14; overall decrease of almost 29 hours), the time spent on weaning (24 hours vs 7.40 hours) and the numbers of reintubation (13% vs 0%) in comparison with the group in which the nurse did not participate. The time to weaning was shorter in the retrospective cohort (2 days vs. 5 days), as was the hospital stay (7 days vs. 9 days). Conclusion: the use of a multidisciplinary protocol reduces the duration of weaning, the total time of invasive mechanical ventilation and reintubations. The more active role of the nurse is a fundamental tool to obtain better results. Objetivo: comparar el tiempo ventilatorio entre pacientes sometidos a desconexión según un protocolo manejado de forma coordinada por el médico y la enfermera con el mismo tiempo en pacientes manejados exclusivamente por el médico. Método: estudio piloto experimental antes y después. Se incluyeron a 25 pacientes que requirieron ventilación mecánica invasiva durante 24 horas o más, y se comparó el grupo orientado por protocolo con el grupo sin protocolo, manejado según la práctica habitual. Resultados: mediante el protocolo multidisciplinar se logró disminuir el tiempo de ventilación mecánica invasiva (141,94 ± 114,50 vs. 113,18 ± 55,14; disminución global de casi 29 horas), el tiempo empleado en el destete (24 horas vs. 7,40 horas) y las cifras de reintubación (13 % vs. 0%) en comparación con el grupo en el que no participó la enfermera. El tiempo hasta iniciar el destete fue menor en la cohorte retrospectiva (2 días vs. 5 días), así como también la estancia hospitalaria (7 días vs. 9 días). Conclusión: la adopción de un protocolo multidisciplinar disminuye la duración del destete, el tiempo total de ventilación mecánica invasiva y las reintubaciones. El papel más activo de la enfermera se considera una herramienta fundamental para obtener mejoras en los resultados. Objetivo: comparar o tempo ventilatório em pacientes submetidos a desconexão segundo um protocolo conduzido de forma coordenada pelo médico e pela enfermeira com o mesmo tempo em pacientes tratados exclusivamente pelo médico. Método: estudo piloto experimental antes e depois. Foram incluídos 25 pacientes que precisaram de ventilação mecânica invasiva durante 24 horas ou mais, e o grupo orientado por protocolo foi comparado com o grupo sem protocolo, tratado conforme a prática habitual. Resultados: mediante o protocolo multidisciplinar, conseguiu-se reduzir o tempo de ventilação mecânica invasiva (141,94 ± 114,50 vs. 113,18 ± 55,14; redução global de quase 29 horas), o tempo empregado no desmame (24 horas vs. 7,40 horas) e as cifras de reintubação (13% vs. 0%) em comparação com o grupo em que não houve participação da enfermeira. O tempo até iniciar o desmame foi menor na coorte retrospectiva (2 dias vs. 5 dias), bem como a internação hospitalar (7 dias vs. 9 dias). Conclusão: a adoção de um protocolo multidisciplinar diminui a duração do desmame, o tempo total de ventilação mecânica invasiva e as reintubações. O papel mais ativo da enfermeira é considerado uma ferramenta fundamental para obter melhorias nos resultados.

The complex chronic disease requires a model of care based found on multidisciplinary teams. The aim of this study was to analyse the development of nursing leadership in managing the complex chronic patient (CCP) and to identify how the resources for the attention and follow up of these patients are managed.A qualitative descriptive approach was followed through participant observation, in-depth interview to 7 health professionals (5 nurses, a doctor, and a social worker) and a discussion group with 9 Primary Health Care nurses from a intentional sample. Discourse analysis was undertaken following Conde approach: fixing discurse positions, creating and analyzing symbolic configuratons, analyzing and interpreting semantic configurations and drawing up the discourse.From discourse analysis two main dimensions emerged on the nursing leadership and management: a) nursing as the leader of care: the need of nursing leadership and of improvement in the coordination structures were recognized, and b) nursing as resources manager in the CCP care related to social and health risks and resources coordination.Our findings enhance the case management and the home delivery care as foundations to be effective handle of CCP, where nursing has a privileged role.

Objective: To know the variability in clinical practice related to the treatment of neonatal hyperbilirubinemia in the Neonatology Unit of the General University Hospital of Elche (Spain), where a specific clinical practice guide is not used. Method: Retrospective audit of medical records of 130 patients ≥35 weeks of gestational age who presented neonatal indirect (unconjugated) hyperbilirubinemia of non-immune cause during their first weeks of life, and required treatment with phototherapy in the Neonatal Unit of the General University Hospital of Elche, during the period 2010–2014. Result: Total serum bilirubin (TSB) levels at admission, the phototherapy time and the clinical stay vary with the type of applied phototherapy (p

Objetivo: determinar los factores relacionados con el riesgo de desnutrición en la población de mayores de 75años no institucionalizada. Método: estudio transversal realizado mediante cuestionario en una muestra de 326 individuos mayores de 75 en Castellón (España), durante 2015. Seleccionados mediante muestreo intencionado. Resultados: Prevalencia de desnutrición 2,8%. El 26,9% de los individuos están en riesgo de desnutrición, las mujeres lo presentan en mayor proporción (31,5%). Las mujeres presentan una salud general buena en menor proporción que los hombres, el 55% frente a 69%. Tienen menor riesgo de desnutrición los individuos que tienen una percepción positiva y los que tienen una buena salud general. Los mayores frágiles presentan un mayor riesgo de desnutrición (57,5%) frente a los no frágiles (20,2%) p< 0.001. Conclusión: Se relacionan con mayor riesgo de desnutrición, mujeres fragilidad, percepción de la salud, salud global y utilización de Servicios sanitarios (consulta de la enfermería). Objective: to determine the factors related to the risk of malnutrition in a non-institutionalized population over 75 years of age. Method: a cross-sectional study was conducted using a questionnaire in a sample of 326 individuals over 75 years of age in Castellón (Spain), during 2015, and selected through intentional sampling. Results: Malnutrition prevalence was 2.8%. 26.9% of the individuals were at risk of malnutrition, whereas women presented a higher rate (31.5%). Women with a good overall health status showed a lower rate than men, 55% and 69%, respectively. Individuals that showed a lower risk of malnutrition are those with a positive perception than those who have a good overall health. Frail elderly people showed a higher risk of malnutrition (57.5%) compared to non-frail subjects (20.2%) p< 0.001. Conclusion: Frail women, self-assessed health, overall health, and use of health care services (nursing consultation) were related to a higher risk of malnutrition. Objetivo: determinar os fatores relacionados com o risco de desnutrição na população acima de 75 anos não institucionalizada. Método: estudo transversal realizado mediante questionário em uma amostra de 326 indivíduos acima de 75 anos em Castellón (Espanha), durante 2015, e que foram selecionados por meio de amostragem intencional. Resultados: prevalência de desnutrição de 2,8%. 26,9% dos indivíduos correm risco de desnutrição, sendo que as mulheres se apresentam em maior proporção (31,5%). As mulheres apresentam uma boa saúde geral em menor proporção que os homens, 55% e 69%, respectivamente. Os indivíduos que apresentam um menor risco de desnutrição são os que têm uma percepção positiva e os que têm uma boa saúde geral. Os idosos frágeis apresentam um risco maior de desnutrição (57,5%) comparado aos não frágeis (20,2%) p< 0.001. Conclusão: relacionam-se com maior risco de desnutrição as mulheres frágeis, a percepção da saúde, a saúde global e a utilização dos serviços de saúde (consulta de enfermagem).

The objective of this study was to assess the effectiveness of an education program and telephone call follow-up at improving the health related quality of life (HRQL) of patients with chronic obstructive pulmonary disease (COPD). Method: Experimental, controlled, randomized, single blind study, masked data analysis. Duration of 2 years and 3 months. Patients hospitalised for exacerbation. The effectiveness was evaluated by calculating the absolute and relative change (%) of the St. George questionnaire scores (total and by dimensions) before and after the intervention program. Calculation of the effect of the group variable on the absolute and relative changes of the variables, Multiple Analysis of Variance (MANOVA). Results: Completed study of 116 patients. Greater effects on their HRQL reported at admission (48.3 ± SD 20.0 years). Patients in the intervention group improved significantly in their total SGRQ scores (−6.83) in absolute and relative terms and more significantly in their activity dimension (−16.05). Conclusions: The education program was effective at improving global HRQL, especially the activity dimension, in exacerbated COPD patients. Practice implications: This research contributes to clarifying the benefits and contents of education programs for patients with COPD; hospital admission is the suitable moment to contact these patients. This work was partially funded by the Spanish Society of Respiratory Diseases (SEPAR, to use the Spanish acronym) in its Nursing section 191/2013 aimed at result dissemination.

Objective: to identify aspects of improvement of the quality of the teaching-learning process through the analysis of tools that evaluated the acquisition of skills by undergraduate students of Nursing.Method: prospective longitudinal study conducted in a population of 60 secondyear Nursing students based on registration data, from which quality indicators that evaluate the acquisition of skills were obtained, with descriptive and inferential analysis.Results: nine items were identified and nine learning activities included in the assessment tools that did not reach the established quality indicators (p

Objetivos: evaluar la efectividad de una intervención educativa de práctica basada en la evidencia sobre los conocimientos, habilidades y actitudes del estudiantado de segundo año del grado en enfermería. Método: estudio cuasi-experimental (antes-después). La población de estudio consistió en 120 estudiantes inscritos en el curso de Cuidados de Enfermería en los Procesos de Atención Sanitaria. La intervención educativa se basó en clases teóricas y prácticas sobre el proceso de práctica basada en la evidencia y el uso de la técnica de incidentes críticos durante las rotaciones clínicas. La efectividad se midió con el Cuestionario de Competencia en Práctica Basada en la Evidencia por medio de tres medidas pareadas y utilizando el análisis de varianza de medidas repetidas. Resultados: las puntuaciones medias del Cuestionario de Competencia en Práctica Basada en la Evidencia fueron 79,83 (IC 95% 78,63-81,03) para la medición basal, 84,53 (IC 95% 83,23-85,83) para la medición intermedia, y 84,91 (IC 95% 83,26-86,55) para la medición final, con una diferencia estadísticamente significativa entre las tres medidas pareadas (p

Objective: To determine the association and predictive nature of certain socio-demographic, education, work and research variables on nurses' participation level in the clinical care of students. Design: A cross-sectional analytical study using a validated questionnaire between February and June 2014. Setting and Participants: A consecutive sample of 117 nurses who worked in public health centres in the province of Castellón (Spain) in 2014. The nurses who had never mentored students and the questionnaires that were

OBJECTIVE: to identify the training nursing professionals receive and its relevance to the workplace, as well as professional demand for continuous education. METHODOLOGY: this was a descriptive observational study using a questionnaire entitled "Training and Adaptation of the Nursing Professional to the Workplace" available at: http://enfermeriadocente.es for nursing professionals. RESULTS: 53.8% of nurses do not consider the training received to be relevant to the needs of the workplace and 94.2% reported that linking academic education to the workplace impacts on the quality of care provided. CONCLUSIONS: Nursing professionals think that continuous education needs to be adjusted to their jobs and careers. Education should be viewed as a continuum, which begins with training.

­­­­­­­­­­­­­­­­­­­­ Resum o Objetivo : Determinar a associacao entre variaveis sociodemograficas e de trabalho da equipe de enfermagem, e o nivel de satisfacao no uso das escalas NEMS e NAS em uma UTI, observando qual a mais adequada. Metodo : Estudo descritivo, incidental, quantitativo e concorrente. Avaliacao das escalas NAS e NEMS por enfermeiros/as de UTI atraves de um questionario elaborado e validado para uma amostra. Analise descritiva e associacao das variaveis sociodemograficas e de trabalho com cada pergunta do questionario. Analise estatistica usando SPSS versao V.18.0. Resultados : A escala NAS obteve melhor avaliacao global (7,20 pontos), e em todos os itens (de 5,66 a 7,36 pontos), que a escala NEMS (3,93 pontos). Conclusao : Profissionais mais antigos no hospital avaliam melhor a escala NEMS, e os mais antigo na UTI consideram a NAS mais apropriada para medir cargas de trabalho para a unidade, pacientes e profissionais, em comparacao com NEMS.

En tiempo de aniversario con 40 años de estudios de Enfermería en la Universidad en España, es importante avanzar en la mejora del cuidado de las personas. In this 40th anniversary of studies of Nursing in the University in Spain, it is important to advance in the improvement of the care of people.

Editorial relativa a la adaptación española del EFQ