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The current retrospective descriptive study evaluated nursing practice variations on pain management in older adults with dementia admitted to an acute geriatrics unit (AGU) before (2018) and during (2021) the coronavirus disease 2019 (COVID-19) pandemic. Data were gathered from electronic health records. Pain intensity was evaluated a median of 1.9 times per day of stay in the pre–COVID-19 sample, whereas in the COVID-19 sample, the median was 0.7 times per day of stay. Median number of analgesic administrations per day of stay and mean percentage of clinical care records that mentioned pain were higher in patients admitted during the pandemic. Variations in nursing care organization in the AGU due to the COVID-19 pandemic had an impact on the patterns of pain management nursing practice in older adults with dementia. [ Research in Gerontological Nursing, x x(x), xx–xx.]

Resumen Objetivo Analizar la calidad de los cuidados brindados durante la pandemia por COVID-19, identificando los cuidados que se han priorizado y los factores que han influido. Ante la situacion de adaptacion de los cuidados exigidos por la pandemia, las enfermeras han podido estar sometidas a factores que las hayan afectado de manera negativa, pero tambien se han podido encontrar estrategias que han permitido mantener la calidad de los cuidados. Metodo Estudio descriptivo con muestra de conveniencia de 225 enfermeras que atendieron a pacientes con COVID-19. Para la recogida de datos se emplea un cuestionario ad hoc de variables personales y laborales, una autovaloracion de los cuidados y la escala Care Left Undone. Resultados La tasa media de cuidados perdidos ha sido de 5,76 (DS 3,1). Se identifican diferencias significativas en funcion de la edad, experiencia profesional y del cambio de estructura y de especialidad. Las estrategias que se asocian de manera significativa con mayor valoracion de la calidad de los cuidados estuvieron relacionadas con la cohesion del equipo, evitar la despersonalizacion, busqueda activa de informacion, estrategias de control de estres y de pensamiento positivo. Se han identificados sentimientos, caracteristicas y estrategias personales y profesionales, que influyen tanto en la percepcion de la calidad como en la perdida de cuidados durante la atencion a la pandemia.

Background: Perceived self-efficacy in advance care planning (ACP) is frequently used to measure the impact of ACP programs for professionals responsible for advanced chronic patients. A validated ...

Background Living-donor transplantation is the best treatment option in patients with chronic kidney failure. Global data show that women are less likely to be kidney recipients than men but are more likely to become living kidney donors. We explored the experience of women who donate a kidney to relatives with biological and socio-cultural ties and to understand the similarities and differences in their experience. Methods A qualitative hermeneutic phenomenological study with an intersectional analysis of gender. Ten women donors accepted in the transplant evaluation period participated, all of whom donated a kidney to a pre-dialysis relative. Two categories were included: women with biological kinship ties (mothers, sisters) and women who have a socio-cultural relationship (wives) with kidney recipient. The data were collected through semi-structured in-depth interviews and analysed using thematic analysis. Results Women donate their kidneys in a convinced manner, without worrying about their health, with an optimistic and positive attitude, and without believing that they are acting heroically. Women with biological kinship ties see it as a ‘naturalization thing’. In contrast, wives donate conditioned by gender roles, but also as a form of empowerment and as a personal benefit: they donate in order to avoid taking on carer role for their husband and as a way of protecting their children. Conclusion The study’s findings expand the conception of kidney donation as solely altruistic and may help professionals to pay attention to the complexity and intersectionality of features present in women who are living kidney donors.

The experiences described by people who have undergone kidney transplant are complex. Understanding how donors and recipients experience kidney transplantation can help us to design strategies that provide a more person-centred health care.To review articles that report the experiences of donors and recipients in the living-donor kidney transplantation process.A systematic review of qualitative studies was carried out. PubMed, Scopus, Web of Science, CINAHL and PsycINFO databases were used to search for articles published in English, French and Spanish between 2005 and 2018.Twenty-nine articles were included in this review. For recipients, receiving a kidney is a positive experience (positive feelings and significant experience) that also involves certain difficulties and stressors (making a difficult decision, fears and worries). The experience of the donors is positive as they are motivated to improve the life of the recipient. They are committed to donating and use coping strategies as well as experiencing personal growth. On the contrary, being a donor involves certain difficulties and stressors (personal investment, mental, physical and economic impact and overcoming opposition) and a perception of deficiency in the health system (lack of information and attentiveness).Donating and receiving a kidney is a positive experience that involves certain difficulties and a variety of stressors for both the donors and recipients. Moreover, the donors note deficiencies in the health system.Las experiencias que explican las personas sometidas a un trasplante renal son complejas. Entender como experimentan el trasplante renal los donantes y los receptores nos puede ayudar a diseñar estrategias para proporcionar una atención sanitaria más centrada en la persona.Revisar artículos que hablen sobre las experiencias de los donantes y los receptores en el proceso de trasplante renal de donante vivo. MÉTODO: Se realizó una revisión sistemática de estudios cualitativos. Se utilizaron las bases de datos Pubmed, Scopus, Web of Science, Cinahl y Psycinfo para buscar artículos desde el año 2005 hasta 2018 publicados en inglés, francés o español.Se incluyeron 29 artículos en esta revisión. Para los donantes la experiencia de donar es positiva ya que están motivados para mejorar la vida del receptor, donan de forma convencida, utilizan estrategias de afrontamiento y experimentan crecimiento personal. Por otro lado, donar supone dificultades y estresores (inversión personal, impacto económico, físico, mental y superar la oposición) y percepción de carencia en el sistema sanitario (falta de información y desatención). Para los receptores el recibir un riñón es una experiencia positiva (sentimientos positivos y experiencia significativa) ligada también a dificultades y estresores (toma de decisión difícil, temores y preocupaciones).Dar y recibir un riñón es una experiencia positiva que comporta dificultades y factores estresantes diferentes para los donantes y para los receptores. Además, los donantes constatan una carencia en el sistema sanitario. This article is protected by copyright. All rights reserved.

Primary care (PC) professionals have been considered the most appropriate practitioners for leading Advance care planning (ACP) processes with advanced chronic patients. Aim: To explore how PC doctors’ and nurses’ self-efficacy surrounding ACP is linked to their sociodemographic characteristics, background and perceptions of ACP practices. Methods: A cross-sectional study was performed. Sociodemographics, background and perceptions about ACP in practice were collected using an online survey. The Advance Care Planning Self-Efficacy Spanish (ACP-SEs) scale was used for the self-efficacy measurement. Statistical analysis: Bivariate, multivariate and backward stepwise logistic regression analyses were performed to identify variables independently related to a higher score on the ACP-SEs. Results: N = 465 participants, 70.04% doctors, 81.47% female. The participants had a mean age of 46.45 years and 66.16% had spent >15 years in their current practice. The logistic regression model showed that scoring ≤ 75 on the ACP-SEs was related to a higher score on feeling sufficiently trained, having participated in ACP processes, perceiving that ACP facilitates knowledge of preferences and values, and perceiving that ACP improves patients’ quality of life. Conclusion: Professionals with previous background and those who have a positive perception of ACP are more likely to feel able to carry out ACP processes with patients. Keywords: advance care planning; primary care; self-efficacy publishedVersion

Aim To describe nursing-sensitive indicators measured in Catalonia. Background In Catalonia, since 2012, under the umbrella of the Results Centre, outcomes of every health care setting have been published and made open to health care professionals and citizens. Methods Trends study of nursing-sensitive indicators was based on data collected systematically from each setting from 2012 to 2018. Percentages and rates were calculated for each of 14 indicators analysed from all primary care, hospitals and long-term care centres. Results Percentage of population aged 60 years or older correctly vaccinated against flu has been decreasing, while percentage of population aged 14 years or under with correct vaccine status is high (over 91%) and has remained stable over time. Mortality in patients who have developed complications has increased, from 27.1% in 2012 to 34.0% in 2017. Most centres achieved functional improvements during the first 30 days of admission. Conclusions Among all indicators measured in primary care, hospital and long-term care, only 14 analysed are nursing-sensitive; no nursing-sensitive indicators regarding mental health are measured. Implications for nursing management Research focused on development of nursing-sensitive indicators offers an opportunity to measure and benchmark nurses' quality of care and their contribution in achieving populations' health improvement and health care system sustainability.

Objective To analyze the quality of care provided during the COVID-19 pandemic, identifying what care has been prioritized and factors that have influenced such care. Background Given the need to adapt care due to the pandemic, nurses may have been subjected to factors that have negatively affected them, however it has also been possible to find actions that have enabled nurses to maintain the quality of care provided. Method Exploratory study with a sample of 225 nurses. Data collection was performed using a self-assessment of the care provided, the ‘Care Left Undone’ Scale, and ad hoc questionnaire for demographic variables. Results The mean rate of missed care was 5.76. Significant differences were identified according to age, professional experience, field of specialty and personal and professional strategies. Conclusion Both personal and professional feelings, characteristics, and strategies have an effect in the perception of quality of care provided and missed care during the pandemic.

Objetivo: Analizar la calidad de los cuidados brindados durante la Pandemia por Covid-19, identificando que cuidados se han priorizado y los factores que han influido. Antecedentes: ante la situación de adaptación de los cuidados exigidos por la Pandemia, las enfermeras han podido estar sometidas a factores que hayan afectado de manera negativa, pero también se han podido encontrar estrategias que hayan permitido mantener la calidad de los cuidados. Método: Estudio descriptivo con muestra de conveniencia de 225 enfermeras que atendieron a pacientes con COVID_19. Para la recogida de datos se emplea un cuestionario ad hoc de variables personales y laborales, una autovaloración de los cuidados y la escala “Care Left Undone”. Resultados: La tasa media de cuidados perdidos ha sido de 5,76 (DS 3,1). Se identifican diferencias significativas en función de la edad, experiencia profesional y del cambio de estructura y de especialidad. Las estrategias que se asocian de manera significativa con mayor valoración de la calidad de los cuidados estuvieron relacionadas con la cohesión del equipo, evitar la despersonalización, búsqueda activa de información, estrategias de control de estrés y de pensamiento positivo. Se han identificados sentimientos, características y estrategias personales y profesionales, que influyen tanto en la percepción de la calidad como en la pérdida de cuidados durante la atención a la pandemia.

Aim To assess pain management nursing practice in older adults with dementia through electronic health records (EHR). Design Retrospective study. Methods Data were collected from EHR related to pain management in older adults with dementia treated at the Acute Geriatrics Unit (AGU) of a university hospital in early 2018. Results EHR related to the pain of 111 patients were reviewed. Pain intensity was assessed at admission in 88% of patients and a median of 1.9 times per day of stay. A disproportionate number of the assessments (39%) occurred during the late shift. A median of 1 drug per day was administered. Pain was recorded in 28% of patients’ care plans, and non‐pharmacological interventions were recorded in 12%. In conclusion, exist variability in pain management nursing practice in older adults with dementia. Admission diagnosis correlated with the analgesic administration schedule, the number of drugs administered and the number of pain nursing annotations.

espanolEn 1859, Florence Nightingale asevero “For the sick it is important to have the best”, la unica forma de identificar lo mejor es investigando sobre los cuidados. La investigacion es la herramienta valida que permite generar o consolidar el conocimiento disciplinar y profesional. En la actualidad los estudios liderados por Linda Aiken han demostrado, en el ambito internacional y durante mas de tres decadas, que los resultados de los pacientes no se explican en funcion de las caracteristicas de los hospitales, sino por la calidad de los cuidados que se les dispensan. Este articulo tiene por objetivo reflexionar sobre la importancia de la investigacion en cuidados, su relacion con la practica basada en la evidencia y los resultados en salud de los pacientes, ademas de revisar los apoyos a la investigacion como son Investen del Instituto de Salud Carlos III, el Plan Estrategico de Investigacion e Innovacion en Salud (PERIS) y la European Academy of Nursing Science (EANS). Sin lugar a dudas la pandemia de la COVID-19 ha situado a las enfermeras en un punto de inflexion que solo, y segun su respuesta para incrementar la visibilidad, sera ascendente o descendente. La investigacion constituye la pieza clave para dar respuesta al reto. EnglishIn 1859, Florence Nightingale stated: “For the sick it is important to have the best”; and the only way to identify the best is through healthcare research, which is the valid tool that allows generating or strengthening disciplinary and professional knowledge. Current studies led by Linda Aiken have demonstrated in the international setting, and for over three decades, that patient outcomes cannot be explained through the hospital characteristics, but by the quality of care provided. This article aims to reflect on the importance of healthcare research, its association with evidence-based practice and health outcomes in patients; also to review support for research such as INVESTEN from the Instituto de Salud Carlos III, the Strategic Plan for Research and Innovation in Health (PERIS), and the European Academy of Nursing Science (EANS). Undoubtedly, the COVID-19 pandemic has placed nurses at a tipping point that will only be ascending or descending based on their response to increase visibility. Research represents the key element to address this challenge.

Resumen Objetivos Describir el perfil de pacientes valorados por la Gestora de Continuidad de Cuidados, en un servicio de urgencias e identificar el tipo de recurso asistencial alternativo asignado y los resultados de la practica clinica. Material y metodos Estudio prospectivo de seguimiento al ingreso, en el servicio de urgencias de un hospital de agudos y al alta del recurso asistencial alternativo, de los pacientes valorados por la Gestora de Continuidad de Cuidados, de julio a diciembre de 2015. Se estudiaron las caracteristicas de los pacientes, entorno social y resultados de la practica clinica. Resultados Se incluyeron 190 pacientes, de los cuales reingresaron 13 (6,8%). Desde urgencias, 122 (59,8%) asistencias se derivaron a centros de atencion intermedia, 71(34,8%) a hospitalizacion domiciliaria, 10 (4,9%) al hospital de agudos y un paciente (0,5%) fallecio. Los pacientes derivados a atencion intermedia eran mas complejos, presentaban sindromes geriatricos como motivo de ingreso y diagnostico de demencia. Los derivados a hospitalizacion domiciliaria presentaban mas enfermedades respiratorias y cardiovasculares (p Conclusiones Los pacientes presentan edad avanzada, complejidad, comorbilidad asociada, se derivan a atencion intermedia o a hospitalizacion domiciliaria, no ingresan en el hospital de agudos y reingresan menos que el resto de los pacientes. Al alta al recurso alternativo, los pacientes pierden capacidad funcional y tienen menos polifarmacia.

To describe the profile of patients evaluated by Nurse Care Management in an Emergency Department and identify the type of alternative healthcare resource assigned and report the results of clinical practice.Prospective follow-up, on admission to the Emergency Department in an acute hospital and on discharge from the alternative healthcare resource, of patients assessed by Nurse Care Management, from July to December 2015. The patient characteristics, social environment and results of clinical practice were studied.190 patients were included of whom 13 were readmitted (6.8%). 122 (59.8%) cases from the Emergency Department were referred to to intermediate care facilities, 71 (34.8%) cases for domiciliary care, 10 (4.9%) cases were referred to an acute care hospital and 1 (0.5%) died. Patients referred to intermediate care were more complex, presented geriatric syndromes as their reason for admission and diagnosed with dementia, while those referred to home care presented more respiratory and cardiovascular illnesses (p0.05). The mean Barthel Index and polypharmacy before emergency admission were higher than at the time of discharge from the alternative healthcare resource (p0.05).Patients presenting with advanced age, complexity, comorbidity, are referred to intermediate care facilities or domiciliary care, they are admitted to acute care hospitasl and are readmitted less than other patients. After being discharged from the alternative resource, they lose functional capacity and present less polypharmacy.

Objective To describe the impact of a standard hospital educational intervention including active physical exercises on personal well-being, functional capacity and knowledge of the benefits of prescribed physical activity for patients undergoing haemodialysis. Method An uncontrolled, quasi-experimental, before-and-after study with repeated measures of response variables at 4, 8 and 12 weeks after participating in an educational and physical exercise hospital intervention. It was performed at the Nephrology Unit at the Hospital Complex in Vic within September and December 2014. The patients’ well-being, functional capacity and knowledge were assessed. Assessment tools: NOC nursing indicators, Barthel index scale, FAC Holden, Timed Get Up and Go test and Daniels scale. Results We included 68 (80.0%) patients and 58 (85.3%) completed, with a mean age of 70.16 ± 13.5 years; 62.1% were males. After 12 weeks, the patients had better scores of personal well-being (2.33 ± 1.2, 3.88 ± 0.8), more autonomy to perform activities of daily living (Barthel: 92.8 ± 12.8; 93.5 ± 13.9), more muscle strength (Daniels Scale: 3.81 ± 0.7, 4.19 ± 0.6) and walked more briskly (Get Up and Go test: 14.98 ± 8.5; 15.65 ± 10.5). All of the score differences were statistically significant (P Conclusions The standard educational intervention and active exercise performed at hospital level improved the personal well-being, knowledge and functional capacity of patients on haemodialysis.

Resumen Objetivo Describir el impacto de una intervencion educativa hospitalaria estandarizada incluyendo la realizacion de ejercicios fisicos activos, en el bienestar personal, capacidad funcional y nivel de conocimiento de los pacientes en hemodialisis. Metodo Estudio cuasiexperimental, no controlado, antes y despues, con medidas repetidas de las variables respuesta a las 4, 8 y 12 semanas, despues de participar en una intervencion educativa a nivel hospitalario y de ejercicio fisico intradialisis. Se desarrollo en la Unidad de Nefrologia del Consorcio Hospitalario de Vic, entre setiembre y diciembre de 2014. Se evaluo el bienestar de los pacientes, capacidad funcional y conocimientos. Instrumentos de valoracion: indicadores de resultados de enfermeria NOC, indice de Barthel, escala FAC de Holden, Timed Get Up and Go test y escala de Daniels. Resultados Se incluyeron 68 (80%) pacientes y finalizaron 58 (85,3%) de los cuales el 62,1% eran hombres y una media de edad de 70,16 ± 13,5 anos. Despues de 12 semanas, los pacientes presentaron mejores puntuaciones de bienestar personal (2,33 ± 1,2; 3,88 ± 0,8), mas autonomia para realizar las actividades de la vida diaria (Barthel: 92,8 ± 12,8; 93,5 ± 13,9), mas fuerza muscular (escala de Daniels: 3,81 ± 0,7; 4,19 ± 0,6) y andaban mas ligeros (Get Up and Go test: 14,98 ± 8,5; 15,65 ± 10,5). Todas las diferencias de las puntuaciones fueron estadisticamente significativas (p Conclusiones La intervencion educativa y de ejercicios fisicos activos desarrollada en el ambito hospitalario mejora el bienestar personal, el grado de conocimiento y la capacidad funcional de los pacientes en hemodialisis.

Background Although qualitative studies have been conducted to identify barriers and facilitators that influence the pain management of older adults with dementia, as far as we know, only a very recent study (Andrews et al., 2019) has used participatory action research (PAR) as a methodology for studying pain management. It allows nurses to examine and improve their practice based on their realities and within their context. Aim To reflect on nursing practice and identify facilitators and barriers in the management of pain in older adults with dementia and to propose actions for improvement. Design We used qualitative participatory action research. Participants/Settings Ten nurses from the geriatric acute care unit of a university hospital in Spain were recruited through convenience sampling. Methods Data were generated through a written questionnaire and three focus groups. Results One of the main facilitators the participants identified was professional experience. The main barriers they identified were lack of knowledge and skills and lack of time. The participants proposed two main improvements: (1) a training program consisting of three courses (pain evaluation and management, dementia and pain, and pharmacology) and (2) the creation of a specific register for nurses to record patients’ pain. Conclusions Involving nurses directly in research on their practices can result in precise proposals for improvements based on their needs and oriented toward improving the quality of care. Moreover, our results confirm previous findings in other countries.

Objectives Many studies regarding nursing student's first experience of facing the death of a patient have focused on classroom methods or exploring attitudes towards death and related fears or anxieties. This review is the first to identify the mechanisms that facilitate practice learning as a result of students' first time experience of handling a patient's death. Design A realist review as a form of a systematic review of the literature. Data sources The literature search focused on the earliest death experience of baccalaureate nursing students and end-of-life care, using databases MEDLINE, CINAHL, SCOPUS, ERIC, PSYCINFO. Review methods Three research questions were addressed following a five-step process of (1) defining the scope of review and developing a theoretical framework, (2) conducting a theory-driven purposive search for evidence, (3) appraising evidence and extracting data, (4) synthesizing data and drawing conclusions, and (5) disseminating findings; with iterative expert consultation and discussion to answer the five questions of any realist review: ‘what works, for whom, in what circumstances, how and why’. Results Thirteen publications were included. Practice learning involves both changes and context improvements to be assessed and discussed by managers, leaders, nurse educators-facilitators and students. The environment and nursing role models are an inherent part of practice learning. Further work is needed to theorize the twelve key outcomes laid out in this review. These proposals require further consensus and the inclusion of inputs from both students and nurses. Conclusion The student nurse receives contradictory messages during the first experience of facing the death of a patient under their care. Considering the importance of this experience, specific indicators should be developed to track and guarantee and the optimal achievement of required competencies.

To analyze the correlation between the state of health, knowledge, and social support of surgical patients' caregivers at home, with the intensity of nursing care and its consequences.A longitudinal observational study with follow-up at admission, discharge and 10 days following discharge at home, held in the surgical hospitalization unit at the Vic University Hospital, (Barcelona). A non-randomized and consecutive sample of 317 informal caregivers of surgical patients with abdominal surgery was included in the study. The characteristics of caregivers were studied using the Nursing Outcomes Classification indicators. The intensity of nursing care, consequences and impact on patient quality of life was evaluated through the validated ICUB97-R questionnaire.Most of the caregivers were women, with an average age of 52,9 ± 13,7years, with no previous experience as caregivers. The greatest intensity of care and impact was observed on caregivers who attended dependent and/or cancer diagnosed patients at home, dedicating the largest time to provide care (p0,005). Predictor variables for the occurrence of consequences during convalescence at home were emotional health satisfaction, routine activity disruption, fear, sleep pattern and being a dependent patient.Emotional health satisfaction, routine activity disruption, fear, sleep pattern and being a dependent patient before surgery are strong predictive variables for the occurrence of consequences on caregivers during convalescence at home. There is a significant negative correlation between punctuations in the ICUB97-R questionnaire and the Nursing Outcomes Classification indicators.

Resumen Objetivo Describir los casos atendidos por la gestora de continuidad de cuidados en un hospital de agudos durante los primeros 6 meses de su actividad, asi como el perfil de los pacientes atendidos y la asignacion de recursos. Metodo Estudio descriptivo transversal prospectivo de pacientes con necesidades de atencion compleja que requirieron de enlace de continuidad asistencial y fueron atendidos por la gestora de continuidad de cuidados, en un centro de agudos, durante los meses de octubre de 2013 a marzo de 2014. Se estudiaron las caracteristicas de los pacientes, su entorno social y la asignacion de los recursos asistenciales. Resultados Se analizaron 1.034 casos de demanda que correspondieron a 907 pacientes (mujeres 55,0%; edad: 80,57 ± 10,1, cronicos 47,8%) de los cuales reingresaron el 12,2%. En el modelo multivariante se observo que las variables asociadas al reingreso eran la polifarmacia (OR: 1,86; IC: 1,2-2,9) y el historial de caidas previo al ingreso (OR: 0,586; IC: 0,36-2,88). Conclusiones Los pacientes atendidos por la GCC son mayores de 80 anos, con comorbilidades, sindromes geriatricos, necesidades de atencion complejas y de final de vida, a los que se les asigna un recurso alternativo a la hospitalizacion que evita reingresos.

Resumen Objetivo Identificar el tipo de cuidados que prestaban los cuidadores de pacientes intervenidos de cirugia abdominal en el Consorcio Hospitalario de Vic, Vic (Barcelona), comparar la intensidad que suponian estos cuidados durante el proceso quirurgico, conocer las repercusiones del cuidar sobre su salud, e identificar los factores que contribuian a la necesidad de prestacion de cuidados y aparicion de repercusiones en los cuidadores, en sus domicilios. Metodologia Estudio observacional longitudinal con seguimiento al ingreso, al alta y a los 10 dias en cuidadores informales no remunerados, de pacientes con patologia quirurgica abdominal. Se estudiaron las caracteristicas de los cuidadores y de los pacientes quirurgicos que cuidaban. Para identificar los cuidados que prestaba el cuidador y las repercusiones desencadenadas por cuidar en su salud, se utilizo el cuestionario ICUB97-R, basado en el modelo de Virginia Henderson. Resultados La mayoria de los cuidadores eran mujeres, de 52,9 ± 13,7 anos y sin experiencia previa como cuidadoras. La mayor intensidad de cuidados y repercusiones se objetivo en el momento de llegar a casa, tras el alta hospitalaria (p Conclusiones Los cuidadores durante el proceso quirurgico prestan numerosos cuidados en el domicilio, dependiendo de las caracteristicas de los pacientes que cuidan y ello repercute sobre su calidad de vida.

Objective To determine which interventions within the Nursing Interventions Classification are most often applied in intensive care units and to validate the time required for each. Methodology A three-stage e-Delphi was conducted; 21 panelists were recruited, seven manager nurses and 14 clinical nurses with higher degrees and more than five years experience in intensive care nursing. The first round explored the most common interventions applied. Additionally, panelists were asked to propose others. In the second round, participants reflected on the interventions where no consensus was reached as well as to estimate the time required for each intervention. In the third, panelists were queried about the time required for the interventions for which consensus regarding the time was not reached. Results A total of 183 interventions were included; 50% of the “Physiological: Complex” domain. The list included 52 (90%) of the 58 “core interventions for critical care nursing” identified in the Nursing Interventions Classification. The time required for 89.1% of the interventions was the same as in the Nursing Interventions Classification seminal work recommendations. Conclusion Results provide a clear picture of nursing activity in general intensive care units, allows to tailor the Nursing Intervetions Classification in Catalonia context and to confirm findings of previous studies.

Aims and objectives. This study aimed to translate the community nursing version of the Developing Evidence-Based Practice questionnaire, adapt the Spanish translation to the primary care context in Spain, and evaluate its reliability and validity. Background. Instruments available in Spanish to date are not designed to rigorously evaluate barriers and incentives associated with evidence-based practice implementation in community health nursing. Design. Classical Test Theory approach. Methods. The 49-item Developing Evidence-Based Practice questionnaire was translated, back-translated and pilot-tested. Two items were added to assess respondents' ability to read and understand the English language. During the first six months of 2010, 513 nurses from 255 primary health care centres in Catalunya (Spain) voluntarily participated in the study. Internal consistency and test-retest reliability were evaluated. Internal structure was analysed by principal component analysis. A randomized, controlled, parallel-design study was carried out to test scores' sensitivity to change with two groups, intervention and control. The intervention consisted of eight hours of in-person training, provided by experts in evidence-based practice. Results. Of 513 nurses, 445 (86.7%) nurses responded to all 51 items. Factor analysis showed six components that explained 51% of the total variance. Internal consistency and test-retest reliability were satisfactory (Cronbach a and intraclass correlation coefficients > 0.70). A total of 93 nurses participated in the sensitivity-tochange tests (42 in the intervention group, 51 controls). After the training session, overall score and the 'skills for evidence-based practice' component score showed a medium (Cohen d = 0.69) and large effect (Cohen d = 0.86), respectively. Conclusions. The Developing Evidence-Based Practice questionnaire adapted to community health nursing in the primary care setting in Spain has satisfactory psychometric properties. Relevance to clinical practice. The Developing Evidence-Based Practice questionnaire is a useful tool for planning and evaluating the implementation of evidencebased practice in community health nursing.

To describe the profile of patients treated by a Continuity of Care Manager in an acute-care center during the first six months of its activity, as well as the profile of patients treated and the resource allocation.A prospective cross-sectional study was conducted on patients with complex care needs requiring continuity of care liaison, and who were attended by the Continuity of Care Nurse during the period from October 2013 to March 2014. Patient characteristics, their social environment and healthcare resource allocation were registered and analyzed.A total of 1,034 cases of demand that corresponded to 907 patients (women 55.0%; age 80.57±10.1; chronic 47.8%) were analyzed, of whom 12.2% were readmitted. In the multivariate model, it was observed that the variables associated with readmission were polypharmacy (OR: 1.86; CI: 1.2-2.9) and fall history prior to admission (OR: 0.586; CI: 0.36-2-88).Patients treated by a Continuity of Care Nurse are over 80 years, with comorbidities, geriatric syndromes, complex care, and of life needs, to whom an alternative solution to hospitalization is provided, thus preventing readmissions.

To evaluate the results after two years of the implementation of surgical patients' hospital home care program in Consort. Hospitalari de Vic.Longitudinal study conducted between January 2011 and December 2012 on patients enrolled in hospital home care program patients. Sociodemographic, clinical, financial, management and patients experience variables were analysed. Data were obtained from hospital home care program records and Hospital Information Systems in addition to telephone surveys. We performed a univariate descriptive analysis using the statistical package SPSS Statistics 19. RESULTS. 691 patients were assessed, and 80.75% were included in hospital home care program. The average hospital length of stay was 5.01 days, with a 3.05% of readmission rate. A higher number of male patients were treated; patients under general surgery, orthopaedics and urology specialties were the more prevalence in the program. 82% of patients were assigned to the care plan "surgical patient", and the most recorded potential complications were pain (539) and infection (436). The mean overall satisfaction score with care was 8.67 +/- 1.37 out of 10.The results objectively reflect the impact of hospital home care program in our context. Moreover, it highlights the importance of the advanced nursing role.

To identify the care given by informal caregivers to patients who underwent abdominal surgery in the Consorci Hospitalari of Vic (Barcelona). To compare the responsibility burden for those caregivers in all the different stages of the surgical process. To determine the consequences of the care itself on the caregiver's health and to identify the factors that contribute to the need of providing care and the appearance of consequences for the caregivers in the home.A longitudinal observational study with follow-up at admission, at discharge and 10 days, of 317 non-paid caregivers of patients who suffer underwent surgery. The characteristics of caregivers and surgical patients were studied. The validated questionnaire, ICUB97-R based on the model by Virginia Henderson, was used to measure the care provided by informal caregivers and its impact on patient quality of life.Most of the caregivers were women, with an average age of 52.9±13.7 years without any previous experience as caregivers. The greater intensity of care and impact was observed in the time when they arrived home after hospital discharge (p0.05). The predictive variables of repercussions were being a dependent patient before the surgical intervention (β=2.93, p=0.007), having a cancer diagnosis (β=2.87, p.001) and time dedicated to the care process (β=0.07, p=0.018).Caregivers involved in the surgical process provide a great amount of care at home depending on the characteristics of patients they care for, and it affects their quality of life.

The goal of the present study is to describe the methodology followed in the implementation of the mentoring research projects developed by the three residents of mental health during the 2009-10 academic years and present the results obtained and recognition. We designed eight targeted monthly tutorials and educational material complementing the methodological support. The development of the project followed an established pattern that allowed progressively advancing in the various phases. When completed the projects, the most relevant were selected for presentation at the XI National Meeting of Residents of Mental Health Nursing, and planned a public presentation of all projects. The main findings from the evaluation work were made for every resident of the experience and the quality of the tutorials. In his narrative are the positive enrichment achieved during the year of residency from the perspective of learning as well as relationship with mentors. In the individual assessment reflect relevant aspects of the authorization process as closeness, trust, resolving doubts, guidelines for intervention. The project presented at the national meeting took second award.

Review the evidence about the relationship between nursing staff characteristics and patient care results.Systematic Review Research at CENTRAL, the Cochrane Plus library MEDLINE CINAHL, EMBASE and PsycINFO until June 2009. Original studies on adult patients checked into hospitals in acute care sections of whatever design have been included, these studies were published either in Spanish or English. Two independent reviewers evaluated the quality of these studies under the GRDAE system and extracted data.55 studies were included. Patient-nurse ratio has repercussions on costs, mortality and the appearance of complications. Controversy on the repercussion regarding care quality. The relationship of nursing hours per patient has repercussions on satisfaction, infection, cardiac alterations, bleeding, average hospital stay net costs, sepsis, and ulcers. Controversy on repercussions regarding falls, medication errors and life quality decreases the complications, and promotes self-care. Nurses-emotional states bears an influence on falls and medication errors.There is a relationship between the nursing staff and patient care results. This review's results have to be considered with caution and evaluated as a tendency since quality conditions their interpretation. Nursing staffs acquire a special relevance in the Spanish health system context due to changes produced in the population and type of patient, the deficit of professionals, and the modification of nursing study plans.

Background This is an updated version of the original review published in Issue 4, 2004 of The Cochrane Library. Lung cancer is one of the leading causes of death globally. Despite advances in treatment, the outlook for the majority of patients remains grim and most face a pessimistic future accompanied by sometimes devastating effects on emotional and psychological health. Although chemotherapy is accepted as an effective treatment for advanced lung cancer, the high prevalence of treatment-related side effects as well the symptoms of disease progression highlight the need for high-quality palliative and supportive care to minimise symptom distress and to promote quality of life. Objectives To assess the effectiveness of non-invasive interventions delivered by healthcare professionals in improving symptoms, psychological functioning and quality of life in patients with lung cancer. Search methods We ran a search in February 2011 to update the original completed review. We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2011, Issue 2), MEDLINE (accessed through PubMed), EMBASE, PsycINFO, AMED, British Nursing Index and Archive (accessed through Ovid) and reference lists of relevant articles; we also contacted authors. Selection criteria Randomised or quasi-randomised clinical trials assessing the effects of non-invasive interventions in improving well-being and quality of life in patients diagnosed with lung cancer. Data collection and analysis Two authors independently assessed relevant studies for inclusion. Data extraction and risk of bias assessment of relevant studies was performed by one author and checked by a second author. Main results Fifteen trials were included, six of which were added in this update. Three trials of a nursing intervention to manage breathlessness showed benefit in terms of symptom experience, performance status and emotional functioning. Four trials assessed structured nursing programmes and found positive effects on delay in clinical deterioration, dependency and symptom distress, and improvements in emotional functioning and satisfaction with care. Three trials assessed the effect of different psychotherapeutic, psychosocial and educational interventions in patients with lung cancer. One trial assessing counselling showed benefit for some emotional components of the illness but findings were not conclusive. One trial examined the effects of coaching sensory self monitoring and reporting on pain-related variables and found that although coaching increases the amount of pain data communicated to providers by patients with lung cancer, the magnitude of the effect is small and does not lead to improved efficacy of analgesics prescribed for each patient’s pain level. One trial compared telephone-based sessions of either caregiver-assisted coping skills training (CST) or education/support involving the caregiver and found that patients in both treatment conditions showed improvements in pain, depression, quality of life and self efficacy. Two trials assessed exercise programmes; one found a beneficial effect on self empowerment and the other study showed an increase in quadriceps strength but no significant changes for any measure of quality of life. One trial of nutritional interventions found positive effects for increasing energy intake, but no improvement in quality of life. Two small trials of reflexology showed some positive but short-lasting effects on anxiety and pain intensity. The main limitations of the studies included were the variability of the interventions assessed and the approaches to measuring the considered outcomes, and the lack of data reported in the trials regarding allocation of patients to treatment groups and blinding. Authors' conclusions Nurse follow-up programmes and interventions to manage breathlessness may produce beneficial effects. Counselling may help patients cope more effectively with emotional symptoms, but the evidence is not conclusive. Other psychotherapeutic, psychosocial and educational interventions can play some role in improving patients' quality of life. Exercise programmes and nutritional interventions have not shown relevant and lasting improvements of quality of life. Reflexology may have some beneficial effects in the short term.