Enfermería de Práctica Avanzada en el Sistema de Salud: evolución, aceptación y reconocimiento / Advanced Practice Nursing in the Health System: evolution, acceptance and recognition

Introducción: se estima escasez de 5.9 millones de profesionistas de la salud a nivel mundial. La Enfermería de Práctica Avanzada (EPA), cuenta con conocimientos, competencias y habilidades clínicas específicas para actuar en situaciones de déficit de personal médico, tratando desde enfermedades agudas hasta crónico degenerativas, preservando tanto la salud mental como física. Objetivo: Determinar el desempeño de la Enfermería de Práctica Avanzada en el Sector Salud. Metodología: revisión sistemática sobre la EPA, que incluyó revisiones y artículos originales del periodo 2013-2022 en español e inglés, acerca de su desempeño: evolución, aceptación y reconocimiento. Para la identificación, cribado e inclusión de los artículos se utilizó el modelo PRISMA 2020. Resultados: de un total de 838 artículos identificados, se incluyeron 20 artículos y 7 de otras fuentes como citas y otros sitios web, obteniendo un total de 27 artículos de revisión, que abordan la evolución, la aceptación y reconocimiento. Se realizó análisis cualitativo. Conclusiones: el desempeño de EPA surge por las demandas poblacionales de atención primaria a la salud, diversos países ya cuentan con EPA, asistiendo a sus habitantes desde sus especialidades. La EPA es diversa y extensa, su profesionalización debe ser continua y permanente. En México falta camino para tomar la EPA como parte del equipo multidisciplinario

Abstract Introduction: About 5.9 millions healthcare professionals lack across the world. The Advanced Practice Nursing (APN), has specific knowledge, competences, and clinical abilities to act in medical absence, taking care from acute illness until chronic diseases, preserving both mental and physical health. Objective: To determine the Advanced Practice Nursing (APN) performance in the Health Sector. Methods: A systematic review about APN, including reviews and original articles from the period 2013-2022 in Spanish and English, about performance: evolution, acceptance and recognition. For the identification, screening, and inclusion of the articles the PRISMA 2020 model was used. Results: Of 838 total identified articles, 20 articles were included from the search and 7 from other sources such as citations and other websites, obtaining 27 total articles to be reviewed, which regard the evolution, acceptance and recognition. A qualitative analysis was performed. Conclusions: The APN performance arose because of demands for primary health care; several countries already have APN, providing care to inhabitants through their different specialties. APN is diverse and extensive, its professionalization must be continuous and permanent. In Mexico there is still some way to go to APN to take part in the multidisciplinary team.

The effects of implementation of neurological intensive care sub-specialized module on doctors satisfaction, nurses’ competency and patient’s outcome

@#Objective: This study aimed to evaluate the effects of implementation of a neurological sub-specialized nursing module in critically ill neurological patients. Methods: We selected 22 neurological nurses from our hospital in Nanchang, China as study subjects. The outcome of 100 neurological patients were documented and evaluated. The period from December 2017 to March 2018 was the preimplementation period, in which the conventional nursing was implemented in 50 patients. The time from April 2018 to July 2018 was the post-implementation period, in which the sub-specialized nursing module was implemented with another 50 patients. We conducted assessment and evaluation consisting of doctor satisfaction, nursing complications (aspiration, diarrhea, pressure sores, and ventilatorassociated pneumonia), and the comprehensive ability of nurses in the pre- and post-implementation periods. Results: The total comprehensive ability score of the nurses after implementing the nursing module was higher than that before the implementation (P < 0.05). The satisfaction rate of doctors after implementation (95.45%) was also higher (68.18%) (P < 0.05), and the incidences of nursing complications (aspiration, diarrhea, pressure sores, and ventilator-associated pneumonia) among patients were lower after implementing the nursing module (P < 0.05). Conclusion: The implementation of a sub-specialized nursing module in the care of patients with critically ill neurological diseases can improve the comprehensive ability of nurses and the satisfaction rate of doctors as well as reducing the incidence of nursing-related complications.

Preliminary construction of the evaluation index system for the safety quality of cardiovascular medicine / 现代临床护理

Objective To establish an evaluation index system for the quality and safety of the specialized nursing care in cardiovascular medicine. Methods To screen and evaluate the safety quality evaluation index via a group discussion with Delphi method and analytic hierarchy process referenced to the literatures from the evaluation index of domestic nursing safety quality (NSQ)and on the base ofthe factor quality- quality of links-final quality3-dimensional quality structure theory by Donabedian. Results The first and second round of expert consultation and the recovery rate were 97.05% (33/34) and 94.12% (32/34) respectibely, the effective rate was 100%;The authoritative coefficient of expert of the safety quality evaluation index of the specialized nursing care is 0.867 and 0.879 respectively. In the first round, the average of the importance rating is 3.50-5.00, the standard deviation is 0-0.042 and full mark rate is 34.10%-100%. In the second round, the average of the importance rating is 3.80-4.70, the standard deviation is 0~0.047 and full mark rate is 31.60%-100%. The fluctuation degree of the first round is more than 0.10 with a low coordination degree. However, the fluctuation degree of the second round result is less than 0.10. The coordination coefficients from all qustionnair scores by experts in the two roudns are 0.169 and 0.286. The difference was statistically significant according to the chi-square analysis (X2=6.842, P=0.002). The NSQ evaluatin index included 3 first degree indexes (weight coefficient including 0.2684,link qualing 0.6144,and quality 0.1172),16 second degree indicators (weight coefficient 0.034~0.0859) and 61 third degree indexes ( weight coefficient 0.034~0.0859) and 61 third degree indexes (weight coefficient 0.0052~0.0412). Conclusions This paper preliminary established a specialied NSQ evaluation index with factor quality- quality of links-final quality 3-dimensional quality structure in the field of cardiovascular medicine, which is based on Delphi method and analytic hierarchy process. NSQ provides a measurement tool for nurses in CME.

Application of specialized nursing group in management of patients' venous thromboembolism / 中华护理杂志

In order to better regulate nursing work of venous thromboembolism(VTE) prevention in the hospital,and provide standardized VTE care for hospitalized patients,in 2012,our nursing department established the VTE specialist nursing group.Group members were provided "three steps" training.They performed VTE risk assessment and prevention,and conducted disease management of patients with VTE in hospital.Through development of specialist nursing group,nurses' knowledge of VTE was improved from 53.48±11.56 to 58.36-±14.68,and patients were provided standardized VTE nursing care,which was of great significance to promote the management of VTE in the hospital.

A Study on the Neurosurgical Intensive Care Unit

Authors report on the general features of the Neurosurgical Intensive Care Unit(ICU). The problems encountered in caring for critically ill neurosurgical patients are quite different from the other medical ICU paradigms. The success of the Neurosurgical ICU depends upon 1) the role of specialized nursing staff who should be aware of what the different symptoms and signs of neurological disorders are 2) monitoring data that must be able to connote changes in the neurological status 3) a concept of cooperation among the other medical departments. The materials studied are obtained from 243 patients who had been treated in the Neurosurgical ICU at SNUH during the last 6 years. Various topics are discussed and our therapeutic methods are explained and a new Neurosurgical ICU model is designed.