Implantación de la valoración y el cuidado de los adultos en riesgo de ideación y comportamiento suicida: una Guía de la Registered Nurses' Association of Ontario (RNAO) / Implementation of the assessment and care of adults at risk for suicidal ideation and behaviour: A guideline of the Registered Nurses' Association of Ontario (RNAO)

OBJETIVO: Conocer la evolución de los cuidados tras la implantación de la Guía de buenas prácticas «Valoración y cuidado de adultos en riesgo de ideación y comportamiento suicida». MÉTODO: Se realizó un estudio descriptivo longitudinal en la Unidad de Hospitalización de Salud Mental del Hospital Universitario Virgen de las Nieves de Granada. Se incluyeron 1.471 pacientes, todos los ingresados entre 2016 y 2018. Se evaluaron el cumplimiento en indicadores del proceso de cuidados y la situación de riesgo suicida, y se obtuvo la tasa de suicidio por 100.000 habitantes. Se calcularon frecuencias absolutas y relativas de los indicadores y su evolución en el tiempo con el test chi-cuadrado de Pearson para p < 0,05. RESULTADOS: Se observó un incremento estadísticamente significativo en todos los procesos. El porcentaje de pacientes con valoración de riesgo suicida aumentó del 16% en 2016 al 45,25% en 2018. La aplicación de medidas de seguridad aumentó hasta el 100% en 2018, y la derivación a otros servicios comunitarios pasó del 70,31% al 90,50%. El porcentaje de pacientes en riesgo de ideación suicida se mantuvo estable. La tasa de suicidios por 100.000 habitantes en la provincia de Granada disminuyó un 24,50%. CONCLUSIONES: La mejora en los procesos de cuidados y la disminución de la tasa de suicidio en Granada desde la implantación son consistentes con los hallazgos de otros estudios y ofrecen una visión esperanzadora. Se deben potenciar las estrategias integrales de prevención y continuar con la evaluación de las iniciativas puestas en marcha

OBJECTIVE: To establish the evolution of the care process after the implementation of the Best Practices Guideline «Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour». METHOD: A descriptive longitudinal study was carried out at the Mental Health Hospitalization Unit in Hospital Universitario Virgen de las Nieves, Granada. All patients admitted to the Unit between 2016 and 2018, 1471 in total, were included. Compliance of care process indicators and suicidal risk were evaluated; in addition, suicide rates per 100,000 inhabitants were obtained. Absolute and relative frequencies of the indicators were calculated, as well as the change during the study period by the chi-square Pearson test, for P<.05. RESULTS: We observed a statistically significant increase in the entire care process. The percentage of patients with suicidal risk assessment improved from 16% in 2016 to 45.25% in 2018. The application of safety measures grew reaching 100% in 2018, and community services referral went from 70.31% to 90.50%. The percentage of patients at risk of suicidal ideation remains stable. Suicide rates per 100,000 inhabitants in Granada decreased by 24.50%. CONCLUSIONS: Improvement in the care process and the decrease in the suicide rate in Granada since the implementation of the guideline are consistent with the results of other research and offer a hopeful vision. Comprehensive strategies for suicide prevention must be promoted, and the evaluation of initiatives undertaken must continue

Implementation of the assessment and care of adults at risk for suicidal ideation and behaviour: A guideline of the Registered Nurses' Association of Ontario (RNAO). / Implantación de la valoración y el cuidado de los adultos en riesgo de ideación y comportamiento suicida: una Guía de la Registered Nurses' Association of Ontario (RNAO).

OBJECTIVE: To establish the evolution of the care process after the implementation of the Best Practices Guideline «Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour¼. METHOD: A descriptive longitudinal study was carried out at the Mental Health Hospitalization Unit in Hospital Universitario Virgen de las Nieves, Granada. All patients admitted to the Unit between 2016 and 2018, 1471 in total, were included. Compliance of care process indicators and suicidal risk were evaluated; in addition, suicide rates per 100,000 inhabitants were obtained. Absolute and relative frequencies of the indicators were calculated, as well as the change during the study period by the chi-square Pearson test, for P<.05. RESULTS: We observed a statistically significant increase in the entire care process. The percentage of patients with suicidal risk assessment improved from 16% in 2016 to 45.25% in 2018. The application of safety measures grew reaching 100% in 2018, and community services referral went from 70.31% to 90.50%. The percentage of patients at risk of suicidal ideation remains stable. Suicide rates per 100,000 inhabitants in Granada decreased by 24.50%. CONCLUSIONS: Improvement in the care process and the decrease in the suicide rate in Granada since the implementation of the guideline are consistent with the results of other research and offer a hopeful vision. Comprehensive strategies for suicide prevention must be promoted, and the evaluation of initiatives undertaken must continue.

Análisis de las prácticas clínicas en el Grado en Enfermería: visión de tutores y estudiantes / Analysis of clinical practices in the Nursing Degree: Vision of tutors and students

Objetivo: Conocer las opiniones de los tutores y de los estudiantes del Grado en Enfermería sobre las prácticas clínicas e identificar estrategias y propuestas de mejora para el desempeño de la labor docente. Método: Estudio cualitativo con perspectiva fenomenológica mediante grupos focales con enfermeros tutores de prácticas clínicas y estudiantes de Enfermería. Los participantes se segmentaron en 3 grupos: estudiantes, tutores del área médica y tutores del área quirúrgica. El número de grupos lo determinó la saturación de la información. Se transcribieron los discursos y se realizó un análisis manual sintáctico y semántico de los discursos para extraer las variables de análisis. Se obtuvieron los permisos del Comité de Ética de la Investigación Provincial y del centro correspondiente. Resultados: Tanto los tutores como los estudiantes destacan la necesidad de capacitar a los tutores en las habilidades formativas y proporcionarles herramientas que faciliten su labor, así como el reconocimiento formal de su función docente. En sus discursos, ambos colectivos proponen un cambio de visión y, sobre todo, de actitudes en el desarrollo de la enseñanza-aprendizaje. Y, por último, se manifiesta la necesidad de un cambio en el modelo de relaciones entre la Universidad y los servicios sanitarios. Conclusiones: Con base en lo anteriormente expuesto, se identifica la necesidad de incentivar y formar a los profesionales clínicos para la función tutorial y de plantear un cambio de modelo que propicie un acercamiento entre la Universidad y el sistema sanitario

Objective: To discover the opinions of the tutors and students of the Degree in Nursing on clinical practices and identify strategies and improvement proposals for teacher performance. Method: A qualitative study with a phenomenological perspective through focus groups with clinical nurse tutors and nursing students. The participants were divided into 3 groups: students, tutors from the medical area and tutors from the surgical area. The number of groups was determined by saturation of the information. The discourse was transcribed and a syntactic and semantic manual analysis of the discourse was made to extract the analysis variables. Permission was obtained from the Provincial Research Ethics Committee and the corresponding centre. Results: Both the tutors and the students emphasized the need to train tutors in teaching skills and provide them with tools that facilitate their work, as well as the need for formal recognition of their teaching function. In their discourse, both groups proposed a change of vision, and above all of attitudes, in the development of teaching-learning. Finally, there is a need for a change in the model of relations between the University and health services. Conclusions: Based on the above, the need to encourage and train clinical professionals as tutors is identified and a change of model proposed to bring the University and the health system closer together

Analysis of clinical practices in the Nursing Degree: Vision of tutors and students. / Análisis de las prácticas clínicas en el Grado en Enfermería: visión de tutores y estudiantes.

OBJECTIVE: To discover the opinions of the tutors and students of the Degree in Nursing on clinical practices and identify strategies and improvement proposals for teacher performance. METHOD: A qualitative study with a phenomenological perspective through focus groups with clinical nurse tutors and nursing students. The participants were divided into 3 groups: students, tutors from the medical area and tutors from the surgical area. The number of groups was determined by saturation of the information. The discourse was transcribed and a syntactic and semantic manual analysis of the discourse was made to extract the analysis variables. Permission was obtained from the Provincial Research Ethics Committee and the corresponding centre. RESULTS: Both the tutors and the students emphasized the need to train tutors in teaching skills and provide them with tools that facilitate their work, as well as the need for formal recognition of their teaching function. In their discourse, both groups proposed a change of vision, and above all of attitudes, in the development of teaching-learning. Finally, there is a need for a change in the model of relations between the University and health services. CONCLUSIONS: Based on the above, the need to encourage and train clinical professionals as tutors is identified and a change of model proposed to bring the University and the health system closer together.

Intervenciones enfermeras NIC como herramienta de evaluación de las competencias del Prácticum de estudiantes de Enfermería en las unidades quirúrgicas / NIC as a tool for assessing competences of nursing students in clinical placement at surgical units

INTRODUCCIÓN: Mostramos la utilidad del lenguaje estandarizado NIC para evaluar el alcance de las competencias del Prácticum de los estudiantes de enfermería en las unidades quirúrgicas. OBJETIVO: Conocer las intervenciones de enfermería de la clasificación NIC que los estudiantes pueden aprender a realizar en las unidades quirúrgicas y el grado de dificultad para el aprendizaje de las intervenciones, según las semanas de rotación del alumno en las prácticas clínicas. MÉTODO: Estudio cualitativo mediante técnica de consenso Delphi, con la participación de enfermeros con experiencia docentes que trabajan en unidades quirúrgicas hospitalarias donde los estudiantes realizan el Prácticum. Se triangularon los resultados mediante cuestionario a los tutores sobre el grado de conformidad con los mismos. RESULTADOS: Se consensuan las intervenciones que los alumnos pueden realizar en las unidades quirúrgicas y la frecuencia con que las realizan, también se determina el grado de dificultad de cada intervención y las semanas de prácticas que los alumnos necesitan para alcanzar el grado de aprendizaje esperado para alcanzar las competencias. CONCLUSIÓN: Los resultados nos permitirán diseñar rotaciones más ajustadas a las necesidades del alumnado. Conocer la frecuencia con la que una intervención se realiza en cada unidad determina las posibilidades de su aprendizaje y los indicadores para su evaluación

BACKGROUND: This paper shows the utility of a NIC standardized language to assess the extent of nursing student skills at Practicum in surgical units OBJECTIVE: To identify the nursing interventions classification (NIC) that students can learn to perform in surgical units. To determine the level of difficulty in learning interventions, depending on which week of rotation in clinical placement the student is. Method: Qualitative study using Delphi consensus technique, involving nurses with teaching experience who work in hospital surgical units, where students undertake the Practicum. The results were triangulated through a questionnaire to tutors about the degree of conformity. RESULTS: A consensus was reached about the interventions that students can achieve in surgical units and the frequency in which they can be performed. The level of difficulty of each intervention, and the amount of weeks of practice that students need to reach the expected level of competence was also determined. CONCLUSIONS: The results should enable us to design better rotations matched to student needs. Knowing the frequency of each intervention that is performed in each unit determines the chances of learning it, as well as the indicators for its assessment

[NIC as a tool for assessing competences of nursing students in clinical placement at surgical units]. / Intervenciones enfermeras NIC como herramienta de evaluación de las competencias del Prácticum de estudiantes de Enfermería en las unidades quirúrgicas.

BACKGROUND: This paper shows the utility of a NIC standardized language to assess the extent of nursing student skills at Practicum in surgical units OBJECTIVE: To identify the nursing interventions classification (NIC) that students can learn to perform in surgical units. To determine the level of difficulty in learning interventions, depending on which week of rotation in clinical placement the student is. METHOD: Qualitative study using Delphi consensus technique, involving nurses with teaching experience who work in hospital surgical units, where students undertake the Practicum. The results were triangulated through a questionnaire to tutors about the degree of conformity. RESULTS: A consensus was reached about the interventions that students can achieve in surgical units and the frequency in which they can be performed. The level of difficulty of each intervention, and the amount of weeks of practice that students need to reach the expected level of competence was also determined. CONCLUSION: The results should enable us to design better rotations matched to student needs. Knowing the frequency of each intervention that is performed in each unit determines the chances of learning it, as well as the indicators for its assessment.

[Educational innovation on the practices for the subjects of community nursing, mental health nursing and geriatric nursing]. / Innovación docente en las prácticas de enfermería comunitaria, salud mental y geriatría.

The new European space for higher education requires changes in education manners as well as execution. One of the main challenges is for the students to acquire competence in their professional life. For that purpose they require knowledge, but also skills and a proactive attitude towards learning. In this paper we tell the experience of the Virgen de las Nieves School of Nursing in Granada, with regards to the integration of the practices for the subjects of Community Nursing III, Psychiatric and Mental Health Nursing, and Geriatric Nursing, which are taken in the third year of the Diplomatura en Enfermería degree. Said practices, which were previously being offered separately within different contexts, will be merged in the same program whose scope will be Primary Care. We believe that the experience has been very positive by looking both at the results and the satisfaction of the students and the professional lecturers. It has been achieved an increase in the number of community care practice hours, and students have managed to acquire more autonomy in their learning and to incorporate critical reasoning in their education. In the methodology used, they have been the main evaluators and protagonists in their learning process, seeking the implication of professionals and teaching tutors in this change. The consensus on the objectives and methods, along with the obstacles which had to be overcome, constitutes one of the most interesting aspects of this experience.

Innovación docente en las prácticas de enfermería comunitaria, salud mental y geriatría / Educational innovation on the practices for the subjects of community nursing. Mental health nursing and geriatric nursing

El nuevo espacio europeo de educación superior exige cambios tanto en el fondo como en la forma de enseñar. Uno de los principales retos es que el alumnado adquiera competencias para su vida profesional. Para ello requiere, además de conocimientos, habilidades y actitudes proactivas para el aprendizaje. En este artículo se explica la experiencia de la Escuela Universitaria de Enfermería (EUE) Virgen de las Nieves de Granada, a propósito de la integración de las prácticas de las asignaturas de Enfermería Comunitaria III, Enfermería Psiquiátrica y de Salud Mental y Enfermería Geriátrica, las cuales se cursan en tercer año de la Diplomatura de Enfermería. Dichas prácticas, que anteriormente se realizaban en distintos contextos de forma inconexa, se unen en un mismo programa que tiene como ámbito la atención primaria. Creemos que la experiencia ha sido muy positiva tanto por los resultados como por la satisfacción del alumnado y las profesionales docentes. Se ha conseguido incrementar el número de horas de prácticas extrahospitalarias, que el alumnado adquiriera mayor autonomía en su aprendizaje y que, además, incorporase el razonamiento crítico en su formación. Se ha utilizado una metodología donde han sido los principales evaluadores y dinamizadores de su proceso de aprendizaje, buscando la implicación de profesionales y tutores docentes en dicho cambio. El consenso en los objetivos y en los métodos, así como las barreras que se han tenido que superar constituye una de las partes más interesantes de esta experiencia(AU)

The new European space for higher education requires changes in education manners as well as execution. One of the main challenges is for the students to acquire competence in their professional life. For that purpose they require knowledge, but also skills and a proactive attitude towards learning. In this paper we tell the experience of the Virgen de las Nieves School of Nursing in Granada, with regards to the integration of the practices for the subjects of Community Nursing III, Psychiatric and Mental Health Nursing, and Geriatric Nursing, which are taken in the third year of the Diplomatura en Enfermería degree. Said practices, which were previously being offered separately within different contexts, will be merged in the same program whose scope will be Primary Care. We believe that the experience has been very positive by looking both at the results and the satisfaction of the students and the professional lecturers. It has been achieved an increase in the number of community care practice hours, and students have managed to acquire more autonomy in their learning and to incorporate critical reasoning in their education. In the methodology used, they have been the main evaluators and protagonists in their learning process, seeking the implication of professionals and teaching tutors in this change. The consensus on the objectives and methods, along with the obstacles which had to be overcome, constitutes one of the most interesting aspects of this experience(AU)

Diversidad y alimentación hospitalaria. Diseño de un cuestionario de valoración de la adaptación cultural / Diversity and Diet in Hospital. Design of a Questionnaire on Assessment of Cultural Adaptation

Una realidad actual es el aumento de la población inmigrante en los hospitales y por tanto las enfermeras debemos adaptar los cuidados a las necesidades de la población que atendemos. Objetivos: Conocer las posibilidades de introducir metodología participativa para abordar problemas de carácter socio-sanitario, dentro de la institución hospitalaria. Determinar la capacidad de las Unidades de Enfermería hospitalaria para introducir cuidados culturalmente adaptados. Diseñar e introducir en los registros de enfermería la valoración del nivel de adaptación cultural del paciente en materia de alimentación. Se ha utilizado metodología de acción-participación, donde los actores se convierten en participantes activos de la investigación. Han colaborado en el proyecto: por una parte personas inmigrantes que nos han contado sus experiencias con la alimentación en el hospital, la metodología ha sido por medio de grupos de discusión y además han participado en los talleres en la cocina del hospital como expertos en la realización de los platos representativos de su cultura. También enfermeras a las que se les ha solicitado que participen en la realización del cuestionario sobre adaptación cultural en materia de alimentación, y la que han validado posteriormente. E igualmente personal de cocina que ha colaborado en los talleres. Los grupos de inmigrantes nos han permitido acercarnos a sus vivencias en materia de alimentación, así como aprender en los talleres como se realizan platos tradicionales de sus países. Las enfermeras, como expertas, han colaborado mediante grupos focales para encontrar las variables que culturales de la población que atienden (..) (AU)

A reality nowadays is the increase of immigrant population in hospitals so, we must adapt, our attentions, as nurses, to the necessities of the patients we care for. Objectives: to assess the possibilities of introducing participative methodology in order to face social-health problems within the frame of a health institution; to assess the capacity of hospital nursing Units in order to introduce culturally adapted attentions; to design and introduce assessments of the patients cultural adaptation levels regarding diet in the nursing registers. A methodology based on action-participation was used, where actors became active participants in the research. On the one hand, the collaborators of the current study were immigrants, who had told us about their experiences with hospital diet. Methodology was based on discussion groups and they participated in workshops celebrated in the hospital kitchen as experts in the elaboration of the most representative dishes of their culture. On the other part, some nurses were asked to participate in carrying out the questionnaire on cultural adaptation regarding diet, a participation that was validated afterwards. Finally, kitchen staff also collaborated in these activities. Groups of immigrants allowed us to get closer to their experiences regarding diet, and also to learn in the workshops how to prepare traditional dishes of their countries of origin. Nurses and specialists collaborated through focal groups to find variables that could determine the degree of cultural adaptation of the person we were caring for. It is not yet easy to introduce changes in hospitals to achieve that attentions will be adapted to other cultures. The incorporation of assessment scales on cultural adaptation can be a first resource for nurses to get aware of the cultural differences of the population they are caring for (..) (AU)

Enfermería y género, tiempo de reflexión para el cambio / Nursing and gender, time for thinking in order to change

Que la enfermería realice una reflexión sobre la actividad profesional, la obliga a posicionarse, y para ello es necesario conocer su historia, dónde se encuentra y hacia dónde va. Definir la profesión de enfermería es difícil, incluso para los propios profesionales, tanto por la variedad de adjetivos que se emplean, como por su significación. La indefinición y la falta de un consenso en este sentido, ha hecho y sigue influyendo en la percepción del colectivo. Se ha realizado una revisión de la bibliografía, para conocer que es lo que enfermería publica sobre la percepción de su actividad, ayudándonos a reflexionar lo que para la profesión es importante. Utilizaremos una perspectiva de género, ya que nos parece una de las más adecuadas para dar luz y definirla, tanto por su composición, mayoritariamente femenina, como por su principal actividad: el cuidado (AU)