Distribución de enfermeras por Unidades de pacientes agudos y Unidades de Cuidados Intensivos en España / Allocation of nurses by acute or Intensive Care Units in Spain

En el contexto sociodemográfico y económico en el que nos encontramos, es necesario que los sistemas sanitarios, potencien la promoción y prevención de la salud e implementen nuevas estrategias para atender a la población. En España se aprecia un importante déficit de enfermeras, con respecto a los países de nuestro entorno. Este déficit implica un aumento de la ratio enfermera-paciente, lo que conlleva un incremento de la morbi-mortalidad de la población y un aumento de costes. Los objetivos de este estudio son conocer la distribución de enfermeras en España en entornos de pacientes agudos y analizar las necesidades por provincias, así como compararlo con las ratios de seguridad recomendadas por organismos oficiales. Para ello se realizó un estudio descriptivo transversal multicéntrico durante 2016. Del análisis de los datos se desprende que la media de pacientes por enfermera y turno es elevada en unidades de agudos polivalentes, situación que se agrava en los turnos de noche, fines de semana y festivos. Y por lo tanto ninguna Comunidad Autónoma cumple en todos los turnos de trabajo las ratios recomendadas. En las Unidades de Cuidados Intensivos, en todas las Comunidades Autónomas, en todos los turnos, están por encima de dos pacientes por enfermera por lo que tampoco se sitúan en estándares recomendados. Es necesario, junto con un cambio de modelo sanitario, incorporar enfermeras al sistema nacional de salud, ya que esto aportara retornos económicos, sociales y de salud

In the socio-demographic and economic context in which we are, it is necessary that the health systems empower health promotion and prevention and implement new strategies to assist the population. In Spain there is a significant deficit in nurses with respect to other countries of our surroundings. This deficit implies an increase in the ratio patient-nurse, which leads to an increase in the morbi-mortality of the population and an increase of the costs. The objectives of this study are to know the distribution of nurses in Spain in acute patient settings and to analyze the needs provinces, as well as to compare it with the safety ratios recommended by official bodies. To this end, a multicentric cross-sectional descriptive study was carried out during 2016. From the analysis of the data it is discovered that both at the level of the province and Autonomous Community, the average number of patients per nurse and shift is high in acute polyvalent care units, a situation that gets worse in night shifts, weekends and holidays. Therefore, no Autonomous Community fulfills the recommended ratios in all shifts. In Intensive Care Units, in all Autonomous Communities, in all shifts, they are above two patients per nurse, so they are not placed within the recommended standards either. It is necessary, together with a change of the health model, to incorporate nurses into the national health system, since this will provide economic, social and health returns

Developing digital educational materials for nursing and sustainability: The results of an observational study.

BACKGROUND: There is limited European literature on nursing and sustainability; nursing students are poorly prepared on the connections between resources, climate change, sustainability, and health, so they must acquire knowledge and develop skills and competencies in this field. The use of digital technologies and teaching via E-learning has grown, and has been widely adopted as a learning method for nursing. OBJECTIVES: The aim of the current study was to test and evaluate digital educational materials on environmental sustainability and health, in the context of university nursing education in different European countries. DESIGN: An observational cross-sectional design. SETTINGS: University of Plymouth, University of Jaén, and University of Esslingen for Nursing Degree Studies. PARTICIPANTS: 299 nursing students: 161 students from University of Jaén; 106 from Plymouth; and 32 from Esslingen. 22 professional evaluators with different profiles were recruited: Teachers, Clinical professionals, Delphi Experts, and Technical Experts. METHODS: We conducted a piloting and validation process. The materials were designed and adapted to the NurSusTOOLKIT Sustainability Literacy and Competency framework. Evaluation was developed by professionals and students. We used the Spanish Standard for the assessment of Digital Educational Material Quality at University level questionnaire. All students provided informed consent prior to taking part in the learning and evaluation. RESULTS: The overall evaluations of materials by students and professionals were 7.98±1.28 and 8.50±1.17, respectively. The Ability to generate learning was scored higher among students (mean difference: 0.84; 0.22-1.47; p=0.008). In the overall assessment by students, statistically significant differences were found between the three universities (Welch: 11.69, p<0.001). CONCLUSIONS: Students, professionals, and technical experts considered the materials to be very good quality, especially regarding the quality of contents, format, and design. For students, these materials can generate reflection and learning regarding environmental and health issues during nursing training.

Currículum enfermero y estrategias pedagógicas en materia de sostenibilidad medioambiental en los procesos de salud y cuidado / Curriculum nurse and strategies training on environmental sustainability and climate change

Fundamentos: Las enfermeras deben ser conocedoras de cómo afecta el cambio climático a la salud. Para la obtención de estos conocimientos es necesario definir las competencias a adquirir y las estrategias pedagógicas que afronten la sostenibilidad medioambiental en la formación de Enfermería. Objetivo: Describir las dimensiones que debe incluir la formación enfermera en materia de sostenibilidad medioambiental, cambio climático y cuidados de salud y determinar las estrategias pedagógicas más adecuadas. Métodos: Se realizó una revisión narrativa de publicaciones sobre sostenibilidad medioambiental en relación a enfermería y cuidados de salud de los últimos 10 años. Se diseñaron estrategias de búsqueda para quince bases de datos de enfermería y ciencias de la salud. Los resultados se sistematizaron en matrices de datos. Resultados: La formación enfermera en sostenibilidad medioambiental debe incluir contenidos sobre globalización, impacto ambiental, promoción de salud, uso de recursos y gestión adecuada de residuos, alimentos e influencias de los procesos de producción, los efectos del tabaquismo y los efectos ambientales en la salud de la infancia. Los enfoques educativos más adecuados para incluir la sostenibilidad medioambiental en la formación enfermera son la Investigación-Acción Participativa y el aprendizaje basado en problemas. Conclusiones: La formación enfermera en materia de sostenibilidad medioambiental debe incluir competencias en diferentes niveles: en lo individual, comprendiendo los fundamentos y el alcance del problema y actuando consecuentemente en el ámbito profesional y en el personal, y en el plano social, Enfermería tiene un papel clave en la promoción de la salud medioambiental (AU)

Background: Nurses should be knowledgeable about how it affects climate change to health. To acquire this knowledge it is necessary to define competencies and educational strategies that tackle environmental sustainability in nursing training. Objective: To describe the dimensions that should be included in nurse education in the field of environmental sustainability, climate change and health care and determine the most appropriate pedagogical strategies. Methods: A narrative review of publications on environmental sustainability in relation to nursing and health care in the last 10 years has been carried out. Search strategies have been designed for fifteen databases of Nursing and Health Sciences. The results were systematized in a data arrays. Results: Training nurse in environmental sustainability should include contents about globalization, environmental impact, promotion of health, use of resources and proper management of waste, food and influences of production processes, the effects of smoking and environmental effects on the health of children. Educational approaches more appropriate to include environmental sustainability in the nurse training are the Participatory Action Research and problem-based learning. Conclusion: The training nurse on environmental sustainability should include competencies at different levels: individual, understanding the rationale and scope of the problem and acting accordingly in the professional field and in the personnel; and at the social level, nursing has a key role in the promotion of environmental health (AU)

Análisis del embarazo adolescente: miradas cualitativas a los casos de Bucaramanga y Jaén / Analysis of adolescent pregnancy: a qualitative approach at the cases of Bucaramanga and Jaén

Anualmente millones de jóvenes menores de edad quedan embarazadas, exponiéndose a una serie de riesgos biológicos relacionados con la gestación y a diversas consecuencias sociales. Objetivos: Conocer las percepciones y los imaginarios de las adolescentes frente al embarazo a temprana edad, en una región de Andalucía (España) y otra de Colombia. Material y métodos: Se realizó un estudio cualitativo con enfoque fenomenológico. Se entrevistó a 31 mujeres adolescentes en diferentes periodos del embarazo y el posparto. El contacto con las participantes se efectuó a través de servicios públicos sociales o sanitarios de cada uno de los contextos de estudio. Se llevó a cabo un análisis de contenido de las categorías emergentes, mediante un proceso cíclico, reflexivo, flexible y metódico, adaptado del procedimiento propuesto por Miles y Huberman. Resultados: Se han identificado elementos en común en la maternidad adolescente, independientemente del contexto en el que se desarrolla. Las percepciones y creencias sobre un embarazo adolescente están poco definidas y desarrolladas. Algunas jóvenes interpretaron su embarazo y maternidad en términos positivos y de cumplimiento de un proyecto de vida, aunque las implicaciones negativas fueron más argumentadas. Conclusiones: Los resultados de este estudio ponen de relieve la complejidad de las creencias y percepciones hacia el embarazo adolescente. Las intervenciones en salud sexual y reproductiva dirigidas a la población adolescente deberían tener en cuenta esta diversidad de sentimientos y conductas (AU)

Every year millions of underage girls become pregnant and are exposed to a series of biological risks associated with pregnancy and a variety of social consequences. Objective: The objective of this study is to know the perceptions and imaginary of the adolescents on the pregnancies at early age, in a region of Andalusia (Spain) and another region of Colombia. Materials and methods: A qualitative study with phenomenological approach was conducted. We interviewed 31 adolescent women in different periods of pregnancy and postpartum. Contact with the participants is carried out through public social services or health of each of the contexts of study. We realized a content analysis of the emergent categories, across a cyclical, reflective, flexible and methodical, adapted process of the procedure proposed by Miles and Huberman. Results: We have identified some elements in common in the adolescent maternity, independently of the context in which it develops. Perceptions and beliefs about a teenage pregnancy are poorly defined and developed. Some young women interpret its pregnancy in positive terms and they think that they fulfill a life project although the negative implications are more argued. Conclusions: Our results highlight the complexity of beliefs and perceptions toward pregnancy in adolescence. Sexual and reproductive health interventions targeting adolescent population should take into account the variety of feelings and behaviors (AU)