Nursing Students' Perceptions of a Novel Education Approach to Prevention and Control of Healthcare-Associated Infections: Insights from PrevInf Pilot Study.

BACKGROUND: Healthcare-associated infections (HAIs) pose a significant global threat, particularly in developing regions such as Southeast Asia. International bodies emphasize the role of formal undergraduate training in the prevention and control of HAIs. To address this, we aimed to explore the perceptions of Southeast Asian nursing students regarding a novel educational approach developed by a European-Southeast Asian project consortium. METHODS: A pilot study was conducted in four nursing higher education institutions from Cambodia and Vietnam. First, local nursing educators conducted a 2 h classroom-based training session. Then, students were invited to participate for the first time in one of twelve evidence-based simulation scenarios developed by the research team, covering a range of nursing care situations related to the prevention and control of HAIs. After attending both components, students were asked to complete a paper-based questionnaire and rate their agreement with a set of statements on the appropriateness and meaningfulness of both components. RESULTS: A total of 430 nursing students enrolled in the pilot study; 77.4% were female, with an average age of 19.8 years. The PrevInf educational intervention received positive feedback from participating students across settings, with strong agreement on the importance of proactiveness in competency development (M = 5.9, SD = 1.4). Notable differences between Cambodian and Vietnamese students were observed in terms of their receptiveness to the pre-selected teaching materials (p = 0.001) and strategies (p = 0.01) used by the nursing educators during their experience with the simulation scenarios. CONCLUSIONS: The PrevInf educational intervention shows promise in engaging Southeast Asian nursing students and fostering a deeper understanding of the prevention and control of HAIs. Further studies are warranted to refine the learning content and standardize the pedagogical strategies used by nursing educators across settings. This study was not registered.

Nurses' Adherence to the Portuguese Standard to Prevent Catheter-Associated Urinary Tract Infections (CAUTIs): An Observational Study.

Urinary tract infections are among the most prevalent types of healthcare-associated infections (HAIs) in hospitals and nursing homes, and they are primarily a result of unnecessary catheter usage and inadequate care. In Portugal, epidemiological data indicate that catheter-associated urinary tract infections (CAUTIs) remain widespread in clinical settings, resulting in increased morbidity and mortality rates among vulnerable populations. This study aimed to assess urinary catheter use in an oncology ward in Portugal and to evaluate nurses' adherence to the government-endorsed standards for preventing CAUTIs. An observational study was conducted over a four-month period with daily assessments of nurses' practices during urinary catheter insertion and maintenance using a government-endorsed auditing tool. Data were collected through on-site observations and nurses' feedback. The findings revealed a urinary catheter utilization rate of 17.99%. However, there was a lack of complete adherence to government-endorsed standards among oncology nurses (0%). These results indicate that current practices lack evidence-based standardization. Therefore, there is a need to develop and implement quality improvement initiatives to enhance patient safety and experiences.

Nursing Practices and Sensitive Outcomes Related to Peripheral Intravenous Catheterization in Portugal: A Scoping Review.

Implementation of evidence-based practice (EBP) is essential for ensuring high-quality nursing care. In Portugal, nurses are responsible for care delivery to patients who require peripheral intravenous access. However, recent authors emphasized the predominance of a culture based on outdated professional vascular access practices in Portuguese clinical settings. Thus, the aim of this study was to map the studies conducted in Portugal on peripheral intravenous catheterization. A scoping review was conducted based on the Joanna Briggs Institute recommendations, with a strategy adapted to different scientific databases/registers. Independent reviewers selected, extracted, and synthesized the data. Of the 2128 studies found, 26 were included in this review, published between 2010 and 2022. Previous research shows that Portuguese nurses' implementation of EBP was found to be relatively low overall, while most studies did not attempt to embed EBP change into routine care. Although nurses are responsible for implementing EBP at an individual patient level, the studies conducted in Portugal report nonstandardized practices among professionals, with significant deviations from recent evidence. This reality, combined with Portugal's absence of government-endorsed evidence-based standards for peripheral intravenous catheter (PIVC) insertion and treatment and vascular access teams, may explain the country's unacceptably high incidence of PIVC-related complications reported over the last decade.

Short Peripheral Venous Catheters Contamination and the Dangers of Bloodstream Infection in Portugal: An Analytic Study.

Peripheral venous catheters (PVCs) are the most used vascular access devices in the world. However, failure rates remain considerably high, with complications such as PVC-related infections posing significant threats to patients' well-being. In Portugal, studies evaluating the contamination of these vascular medical devices and characterizing the associated microorganisms are scarce and lack insight into potential virulence factors. To address this gap, we analyzed 110 PVC tips collected in a large tertiary hospital in Portugal. Experiments followed Maki et al.'s semi-quantitative method for microbiological diagnosis. Staphylococcus spp. were subsequently studied for the antimicrobial susceptibility profile by disc diffusion method and based on the cefoxitin phenotype, were further classified into strains resistant to methicillin. Screening for the mecA gene was also done by a polymerase chain reaction and minimum inhibitory concentration (MIC)-vancomycin as determined by E-test, proteolytic and hemolytic activity on skimmed milk 1% plate and blood agar, respectively. The biofilm formation was evaluated on microplate reading through iodonitrotetrazolium chloride 95% (INT). Overall, 30% of PVCs were contaminated, and the most prevalent genus was Staphylococcus spp., 48.8%. This genus presented resistance to penicillin (91%), erythromycin (82%), ciprofloxacin (64%), and cefoxitin (59%). Thus, 59% of strains were considered resistant to methicillin; however, we detected the mecA gene in 82% of the isolates tested. Regarding the virulence factors, 36.4% presented α-hemolysis and 22.7% ß-hemolysis, 63.6% presented a positive result for the production of proteases, and 63.6% presented a biofilm formation capacity. Nearly 36.4% were simultaneously resistant to methicillin and showed expression of proteases and/or hemolysins, biofilm formation, and the MIC to vancomycin were greater than 2 µg/mL. Conclusion: PVCs were mainly contaminated with Staphylococcus spp., with high pathogenicity and resistance to antibiotics. The production of virulence factors strengthens the attachment and the permanence to the catheter's lumen. Quality improvement initiatives are needed to mitigate such results and enhance the quality and safety of the care provided in this field.

Nurses' Involvement in the Development and Usability Assessment of an Innovative Peripheral Intravenous Catheterisation Pack: A Mix-Method Study.

Guaranteeing peripheral venous access is one of the cornerstones of modern healthcare. Recent evidence shows that the lack of adequate clinical devices can result in the provision of substandard care to patients who require peripheral intravenous catheterization (PIVC). To address this challenge, we aimed to develop a PIVC pack for adult patients and assess the usability of this new device. METHODS: Following a mix-method design, the PIVC pack development and usability assessment were performed in two phases with the involvement of its potential end-users (nurses). In phase one (concept and semi-functional prototype assessment), focus group rounds were conducted, and a usability assessment questionnaire was applied at each stage. In phase two (pre-clinical usability assessment), a two-arm crossover randomised controlled trial (PIVC pack versus traditional material) was conducted with nurses in a simulated setting. Final interviews were conducted to further explore the PIVC pack applicability in a real-life clinical setting. RESULTS: High average usability scores were identified in each study phase. During the pre-clinical usability assessment, the PIVC pack significantly reduced procedural time (Z = -2.482, p = 0.013) and avoided omissions while preparing the required material (Z = -1.977, p = 0.048). The participating nurses emphasised the pack's potential to standardise practices among professionals, improve adherence to infection control recommendations, and enhance stock management. CONCLUSIONS: The developed pack appears to be a promising device that can assist healthcare professionals in providing efficient and safe care to patients requiring a PIVC. Future studies in real clinical settings are warranted to test its cost-effectiveness.

Evidence-Informed Development of a Bundle for Peripheral Intravenous Catheterization in Portugal: A Delphi Consensus Study.

Contrary to many international settings, there are no clinical guidelines for peripheral intravenous catheter (PIVC) insertion and maintenance in Portugal. We sought to derive an international consensus on a PIVC bundle that could guide Portuguese nurses' clinical decision-making in this scope. METHODS: Two international vascular access specialist groups participated in an online Delphi panel. During the first round, specialists (n = 7) were sent a summary report from a previous observational study conducted in a surgical ward in Portugal. Based on the report findings, specialists were asked to provide five to eight PIVC insertion and maintenance interventions. Then, another set of specialists (n = 7) scored and revised the recommendations until a consensus was reached (≥70% agreement). The PIVC bundle was made available and discussed with the surgical ward's nurses. RESULTS: After three rounds, a consensus was achieved for five evidence-informed interventions: (i) involve the person and assess the peripheral venous network; (ii) maintain an aseptic no-touch technique; (iii) ensure proper catheter dressing and fixation; (iv) perform catheter flush & lock; (v) test the peripheral venous catheter's functionality and performance at each shift. CONCLUSION: The final version of the PIVC bundle achieved consensus among international experts. Despite the positive feedback provided by the ward nurses, future studies are warranted to assess its effectiveness in standardizing PIVC care delivery and its potential implications for care outcomes in Portuguese clinical settings.

Organizational Commitment and Intention to Leave of Nurses in Portuguese Hospitals.

Intention to leave is influenced by the commitment and individual and structural factors. It is a critical dimension in health systems due to the shortage of professionals and the potential impact on the quality of care. The present paper: (i) characterizes organizational commitment and intention to leave; (ii) analyzes the relationship between structural factors (such as, work environment and nurse staffing), individual factors (age), and nurses' organizational commitments and intention to leave; and (iii) analyzes the differences in the intention to leave and in the organizational commitment according to service specialty, nurses' specialization, and contractual relationship in Portuguese public hospitals. A cross-sectional study was conducted with a sample of 850 nurses from 12 public hospitals units. The results show a high affective and continuance commitment of nurses with the hospital, and a reduced tendency of the intention to leave. A significant positive association was also found between the intent to leave and individual/structural factors. Organizational commitment and intention to leave levels are satisfactory, despite the influence of several factors, such as nurse staffing, work environment, or other opportunities for professional development. The results identify particularly sensitive areas that, through adequate health and management policies, can reduce nurses' intentions to leave and promote the sustainability of the health system.

Nurses' Practices in the Peripheral Intravenous Catheterization of Adult Oncology Patients: A Mix-Method Study.

A significant number of adult oncology patients require at least one peripheral intravenous catheter to fulfill their therapeutic plan. Recent evidence indicates that catheter failure rates are high in this cohort, impacting care outcomes and patient experience during cancer treatment. This reality represents a challenge to nurses worldwide since in most international settings they are responsible for delivering quality care during the insertion and maintenance of such devices. This study aims to explore current nursing practices regarding the insertion, maintenance, and surveillance of peripheral intravenous catheters in oncology patients. A two-phase mix-method study was conducted with the nursing team from the surgical ward of a large oncology hospital in Portugal. In phase one (observational prospective study), nurses' practices during catheter insertion and maintenance were observed by the research team and recorded using standardized instruments and validated scales. In phase two, three online focus groups were conducted with the nursing team to present the results observed in phase one and explore their perceptions of current practices. All ethical principles were assured throughout the study. Significant divergent practices were observed and identified by the nurses, especially concerning patient involvement, nurses' adherence to the aseptic, non-touch technique, catheter stabilization and dressing, and catheter flushing and locking. Such practices may partially explain the high complication rate found (26%) and substantiate the need for future intervention in this field.

Nursing Students' Perceptions on Healthcare-Associated Infection Control and Prevention Teaching and Learning Experience in Portugal.

Healthcare-associated infections (HAI) are one of the major concerns worldwide, posing significant challenges to healthcare professionals' education and training. This study intended to measure nursing students' perceptions regarding their learning experiences on HAI prevention and control. In the first phase of the study, a cross-sectional and descriptive study with a convenience sample composed of undergraduate nursing students from Portugal, Spain, Poland, and Finland was conducted to develop the InovSafeCare questionnaire. In the second phase, we applied the InovSafeCare scale in a sample of nursing students from two Portuguese higher education institutions to explore which factors impact nursing students' adherence to HAI prevention and control measures in clinical settings. In phase one, the InovSafeCare questionnaire was applied to 1326 students internationally, with the instrument presenting adequate psychometric qualities with reliability results in 14 dimensions. During phase two, the findings supported that Portuguese nursing students' adherence to HAI prevention and control measures is influenced not only by the curricular offerings and resources available in academic settings, but also by the standards conveyed by nursing tutors during clinical placements. Our findings support the need for a dedicated curricular focus on HAI prevention and control learning, not only through specific classroom modules, innovative resources, and pedagogical approaches, but also through a complementary and coordinated liaison between teachers and tutors in academic and clinical settings.

Estudios realizados en Portugal en el ámbito del cateterismo urinario: protocolo de scoping review / Estudios realizados en portugal en el ámbito del cateterismo urinario: protocolo de scoping review / Urinary catheterization studies carried out in portugal: scoping review protocol

Contexto: A literatura internacional sugere há um distanciamento entra as evidências científicas e a prática clínica relativamente ao uso de cateteres urinários. Em Portugal, a informação referente às práticas relacionadas com o cateterismo urinário encontra-se dispersa na literatura, o que dificulta a com-preensão da temática e suas implicações.Objetivos: Mapear os estudos realizados em Portugal no âmbito do cateteris-mo urinário para dar resposta a: i) quais os principais focos de investigação de estudos? ii) Quais os settings dos estudos de investigação? iii) Quais as práti-cas relacionadas com inserção, manutenção e remoção do cateter urinário? iv) Quais são os indicadores reportados no âmbito de cateterismo urinário?Método de revisão: Metodologia de scoping review proposta pelo Joanna Briggs Institute. Definiu-se um protocolo adequado a cada base de dados científica, para identificar os estudos que respondam aos critérios delinea-dos. Serão incluídos todos os estudos cujos participantes sejam pessoas com cateter urinário ou profissionais de saúde com competências para inserção, manutenção e remoção de cateteres urinários, excluindo estudos relaciona-dos com cirurgia do trato urinário ou estruturas adjacentes, autocateterismo e cateterismo intermitente. O processo de análise da relevância, extração e síntese dos dados será desenvolvido por revisores independentes.Apresentação e interpretação dos resultados: O mapeamento dos estudos contribuirá para a identificação dos principais focos de estudo, práticas rela-cionadas com o cateterismo urinário e principais indicadores associados.Conclusão: Espera-se que esta revisão sustente o desenvolvimento de futuros estudos que potenciem a eficácia/segurança dos cuidados prestados ao doen-te com cateter urinário. (AU)

Contexto: La literatura internacional sugiere que existe una brecha entre la evidencia científica y la práctica clíni-ca en relación al uso de catéteres urinarios. En Portugal, la información sobre las prácticas relacionadas con el cateterismo urinario está dispersa en la literatura, lo que dificulta la comprensión del tema y sus implicaciones.Objetivos: Mapear los estudios realizados en Portugal en el ámbito del cateterismo urinario para responder: i) ¿Cuáles son los principales focos de investigación? ii) ¿Cuáles son los escenarios de los estudios de investi-gación? iii) ¿Cuáles son las prácticas relacionadas con la inserción, mantenimiento y extracción del catéter urinario? iv) ¿Cuáles son los indicadores reportados en el ámbito del cateterismo urinario?Método de revisión: metodología de revisión de alcance propuesta por el Joanna Briggs Institute. Se definió un protocolo apropiado para cada base de datos científi-ca, para identificar los estudios que cumplen con los criterios descritos. Se incluirán todos los estudios cuyos participantes sean personas con catéter urinario o pro-fesionales de la salud con habilidades para la inserción, mantenimiento y extracción de catéteres urinarios, ex-cluyendo los estudios relacionados con cirugía del tracto urinario o estructuras adyacentes, autocateterismo y cateterismo intermitente. El proceso de análisis de rele-vancia, extracción y síntesis de los datos será desarrollado por revisores independientes.Presentación e interpretación de resultados: El mapeo de los estudios contribuirá a la identificación del foco principal de estudio, las prácticas relacionadas con el ca-teterismo urinario y los principales indicadores asociados.Conclusión: Se espera que esta revisión apoye el de-sarrollo de estudios futuros que mejoren la eficacia / seguridad de la atención brindada a los pacientes con catéteres urinarios. (AU)

Context: International literature suggests that there is a gap between scientific evidence and clinical practice concerning the use of urinary catheters. In Portugal, evidence regarding practices related to urinary catheterization is dispersed in the literature, which makes it difficult to understand the theme and its implications.Objectives: To map the studies carried out in Portu-gal in the scope of urinary catheterization to answer: i) what are the main research investigation focuses? ii) What are the research studies settings? iii) What are the practices related to insertion, maintenance and removal of the urinary catheter? iv) What are the indicators reported in the scope of urinary catheter-ization?Review method: Scoping review methodology pro-posed by the Joanna Briggs Institute. An appropriate protocol was defined for each scientific database, to identify studies that meet the criteria outlined. All studies will be included whose participants are people with a urinary catheter or health professionals with skills for insertion, maintenance and removal of uri-nary catheters, excluding studies related to surgery of the urinary tract or adjacent structures, self-catheter-ization and intermittent catheterization. The process of analyzing the relevance, extraction and synthesis of the data will be developed by independent reviewers.Presentation and interpretation of results: The map-ping of the studies will contribute to the identification of the main study focuses, practices related to urinary catheterization and the main associated indicators.Conclusion: It is hoped that this review will support the development of future studies that enhance the efficacy/safety of care provided to patients with uri-nary catheters. (AU)

Nursing Students' Perceptions on Healthcare-Associated Infection Control and Prevention Teaching and Learning Experience: Development and Validation of a Scale in Four European Countries.

Healthcare-associated infections are one of the major concerns worldwide. This study presents the development and the validation process of the InovSafeCare scale and aimed at identifying and measuring the ecosystem variables related to healthcare-associated infection (HCAI) prevention and control practices in European nurse students. Qualitative and quantitative approaches were used to (1) elaborate an item pool related to the educational environment, the healthcare setting environment, and the attitudes, beliefs, and performance of the nursing students regarding HCAI prevention and control and (2) analyze psychometric properties of the scale using factor analysis. The validated InovSafeCare scale was applied to undergraduate nursing students of five European Higher Education Institutions. The partial least square structural equation modeling (PLS-SEM) method with SMART-PLS3 software was used. The study sample consists of 657 nursing students, who responded a self-report inventory. From the analyzed data were identified 14 factors. The InovSafeCare scale reveals good validity and reliability of the dimensions in different European countries.

Tradução, adaptação cultural e validação da Venous International Assessment Scale para português europeu / Translation, cultural adaptation, and validation of the Venous International Assessment Scale to European Portuguese / Traducción, adaptación cultural y validación de la escala Venous International Assessment al portugués europeo

Resumo Enquadramento: Um número significativo de pessoas adultas tem um acesso venoso periférico difícil, o que leva a múltiplas tentativas de punção e ao esgotamento da rede venosa. A escala Venous International Assessment (VIA) é considerada a nível internacional como um instrumento fiável que classifica as vias de acesso venoso periférico das pessoas e determina o risco de complicações associadas. Objetivos: Traduzir, adaptar culturalmente e validar a Escala VIA para português europeu. Metodologia: Estudo da tradução, adaptação cultural, e avaliação das propriedades psicométricas da escala VIA em amostra não probabilística de 100 pessoas doentes a precisar de cateterização venosa periférica. Resultados: A versão em português europeu da escala VIA (EARV) revelou valores moderados de fiabilidade inter-observadores (k = 0,490; p < 0,0005). As validades do critério e do constructo da EARV foram avaliadas através de análise preditiva, convergente e correlacional, com magnitudes moderadas a grandes e significância estatística. Conclusão: A EARV é um instrumento fiável e válido que pode ajudar os profissionais de saúde portugueses na determinação e categorização de acessos venosos periféricos difíceis. Contudo, recomenda-se a realização de mais estudos para testar a aplicabilidade transversal desta escala.

Abstract Background: A significant number of adult patients experience difficult peripheral intravenous access, leading to multiple puncture attempts and venous network depletion. The Venous International Assessment (VIA) Scale is referenced internationally as a reliable instrument that classifies patients' peripheral intravenous accesses and determines the risk of related complications. Objectives: To translate, culturally adapt and validate the VIA Scale to European Portuguese. Methodology: Study of the translation, cultural adaptation, and evaluation of the psychometric properties of the VIA Scale in a nonprobability sample with 100 patients in need of peripheral intravenous catheterization. Results: The Portuguese version of the VIA Scale (EARV) revealed moderate inter-rater reliability scores (k = 0.490; p < 0.0005). The criterion and construct validity of the EARV were assessed through predictive, convergent, and correlational analysis, with moderate to large magnitudes, and statistical significance. Conclusion: The EARV is a reliable and valid instrument that can assist Portuguese health professionals in determining and categorizing difficult peripheral intravenous access. Further studies are recommended to test the transversal applicability of the scale.

Resumen Marco contextual: Un número significativo de adultos experimenta dificultades al ser sometido a un acceso venoso periférico, lo que provoca múltiples intentos de punción y el deterioro de la red venosa. La escala Venous International Assessment (VIA) está considerada internacionalmente como un instrumento fiable que clasifica los accesos venosos periféricos en las personas y determina el riesgo de complicaciones relacionadas. Objetivos: Traducir, adaptar culturalmente y validar la escala VIA al portugués europeo. Metodología: Estudio de traducción, adaptación cultural y evaluación de las propiedades psicométricas de la escala VIA en una muestra no probabilística con 100 personas que necesitan ser sometidos a un cateterismo venoso periférico. Resultados: La versión portuguesa desarrollada de la escala VIA (EARV) mostró puntuaciones de concordancia entre evaluadores moderadas (k = 0,490; p < 0,0005). La validez de criterio y de constructo de la EARV se evaluó mediante un análisis predictivo, convergente y correlacional, con magnitudes de moderadas a amplias y significación estadística. Conclusión: La EARV es un instrumento fiable y válido que puede ayudar a los profesionales sanitarios portugueses a determinar y categorizar la dificultad de un acceso venoso periférico. Se necesita realizar futuros estudios para comprobar la aplicabilidad transversal de la escala.

Peripherally Inserted Central Catheter Placement in a Cardiology Ward: A Focus Group Study of Nurses' Perspectives.

Intravenous therapy administration through peripheral venous catheters is one of the most common nursing procedures performed in clinical contexts. However, peripherally inserted central catheters (PICC) remain insufficiently used by nurses and can be considered a potential alternative for patients who need aggressive intravenous therapy and/or therapy for extended periods. The purpose of this study was to understand nurses' perspectives about PICC implementation in their clinical practice. As part of an action-research project, three focus groups were developed in June 2019 with nineteen nurses of a cardiology ward from a Portuguese tertiary hospital. From the content analysis, two main categories emerged: 'nursing practices' and 'patients'. Nurses considered PICC beneficial for their clinical practice because it facilitates maintenance care and catheter replacement rates. Moreover, nurses suggested that, since there is a need for specific skills, the constitution of vascular access teams, as recommended by international guidelines, could be an advantage. Regarding patient benefits, nurses highlighted a decrease in the number of venipunctures and also of patient discomfort, which was associated with the number of peripheral venous catheters. Infection prevention was also indicated. As an emerging medical device used among clinicians, peripherally inserted central catheters seem to be essential to clinical practice.

Nurse staffing in Portuguese public hospitals.

AIM: This study aims to contribute to the knowledge of nurse staffing in hospital settings in central and northern Portugal. BACKGROUND: Nurse staffing is a critical factor for the quality and safety of health care and is still an understudied topic in Portugal. METHOD: A cross-sectional study was conducted with a sample of 850 nurses from 12 public hospitals in the central and northern regions of Portugal. RESULTS: Nurse staffing in these hospital units is insufficient, especially in internal medicine units and central hospitals. Nurses' perceptions are in line with the objective data. CONCLUSIONS: The shortage of nurses is a horizontal issue that is especially serious in internal medicine units and central hospitals and a potential threat to the quality of care. IMPLICATIONS FOR NURSING MANAGEMENT: The results stress the need for an urgent leadership intervention in nurse staffing levels in the hospitals analysed in this study. Contextual knowledge about nurse staffing is essential for decision-making and supporting health and human resource management policies.

Associativism in nursing, public communication, and interaction with the media.

OBJECTIVE: To describe the processes of producing messages and interacting with the media by professional nursing associations. METHODS: Qualitative, descriptive study based on semi-structured interviews with managers of five professional nursing associations in Portugal. The data were subjected to thematic content analysis. RESULTS: Regulatory and union associations use public relations services and refer more strategies for interacting with journalists. Professional specialization associations interact less frequently and prefer social media for publishing their messages. Voluntary work and the reduced professionalization of the communication of specialized associations favors a nursing retraction stance towards the media. FINAL CONSIDERATIONS: Organizational and cultural factors may help to explain nursing's limited access to the media. The use of renewal, cooperation, and education strategies will help overcome some of the limitations experienced by these associations.

Personal and technological skills to coach people with noncommunicable diseases: development and validation of a scale for nursing students.

BACKGROUND: Current international policies converge to the need of empowering patients and families in becoming more autonomous in the self-caring and management of their noncommunicable diseases (NCDs). Given their professional scope, nurses are the most well-positioned health professionals to answer this societal challenge. In the literature, health coaching and the use of information and communication technologies (ICTs) emerge as two still under-used contributions to nursing practice in this regard. Given the lack of instruments and research developed so far in the use of health coaching and ICTs during nurses training, we aim to develop a scale that explores nursing students' perceptions regarding their coaching skills of people with NCDs and the potential role of ICTs in this domain. METHODS: After a comprehensive literature review, an initial items list (n = 39) was delineated and discussed by a panel of international experts. After conceptual and structural consensus, the pre-validated version of the Personal and Technological Skills to coach people with noncommunicable diseases scale (PTSC-NCD scale) was created. Then, the pre-validated PTSC-NCD scale was translated to Portuguese, Finnish, Flemish and Slovenian following Beaton and colleagues' recommendations, and applied to undergraduate nursing students in five European universities. Principal component analysis and reliability analysis were performed in each country through the statistical program Statistical Package for the Social Sciences (version 22.0). All ethical assumptions were complied with throughout this study. RESULTS: 874 nursing students enrolled in the study, predominantly female (71.1%) and with a mean age of 22.4 years (SD = 5.49). After data analysis across international settings, three dimensions emerged: Coaching Centred Personal Skills (F1); Digital Technology Improving Patient-Centred Care (F2); and Digital Technology Improving Relational Skills (F3). All the dimensions showed good reliability (Cronbach's alpha >.80). CONCLUSION: The PTSC-NCD scale evidence good validity and reliability indicators across different international settings.

Impact of safe nurse staffing on the quality of care in Portuguese public hospitals: A cross-sectional study.

AIM: To assess the impact of safe nurse staffing on the quality of care, based on the structure-process-outcome approach, in Portuguese hospitals. BACKGROUND: Safe nurse staffing is essential for the quality of care in hospital settings, together with work environment, organisational commitment and nursing practices. However, there is little evidence of its analysis in the Portuguese context. METHOD: A cross-sectional survey study was conducted using a sample of 850 nurses from 12 public hospital units in the central and northern regions of Portugal. RESULTS: The proposed structural equation model for quality assessment has a good fit (χ2 /df = 2.37; CFI = 0.88, PCFI = 0.83; PGFI = 0.77, RMSEA = 0.04), showing the impact of safe nurse staffing, work environment, and affective and normative organisational commitment on the quality of care (mortality rate and adverse events). The mediating effect of nursing practices was also found. CONCLUSION: Safe nurse staffing, which is compromised in 90% of the units, is a predictor of the quality of care through the mediating effect of nursing practices. IMPLICATIONS FOR NURSING MANAGEMENT: The results not only highlight the need for urgent intervention but also support political decision-making with a view to improving the access to quality care.

Associativism in nursing, public communication, and interaction with the media / Asociación en enfermería, comunicación pública e interacción mediática / Associativismo em enfermagem, comunicação pública e interação com a mídia

ABSTRACT Objective: To describe the processes of producing messages and interacting with the media by professional nursing associations. Methods: Qualitative, descriptive study based on semi-structured interviews with managers of five professional nursing associations in Portugal. The data were subjected to thematic content analysis. Results: Regulatory and union associations use public relations services and refer more strategies for interacting with journalists. Professional specialization associations interact less frequently and prefer social media for publishing their messages. Voluntary work and the reduced professionalization of the communication of specialized associations favors a nursing retraction stance towards the media. Final considerations: Organizational and cultural factors may help to explain nursing's limited access to the media. The use of renewal, cooperation, and education strategies will help overcome some of the limitations experienced by these associations.

RESUMEN Objetivo: Describir los procesos de producción de mensajes y de interacción mediática por parte de asociaciones profesionales de enfermería. Métodos: Estudio cualitativo de tipo descriptivo con base en entrevistas semiestructuradas con dirigentes de cinco asociaciones profesionales de enfermería de Portugal. Los datos sometidos al análisis de contenido temático. Resultados: Las asociaciones de regulación y sindicalismo recorren a servicios de relaciones públicas y refieren más estrategias de interacción con periodistas. Las asociaciones de especialización profesional interaccionan con menor frecuencia y prefieren las redes sociales para publicaren sus mensajes. El trabajo voluntario y la reducida profesionalización de la comunicación de asociaciones especializadas tienden a una postura de retracción de la enfermería hacia mediática. Consideraciones finales: Factores organizacionales y culturales podrán ayudar a explicar el acceso limitado de la enfermería a la midiática. El recurso a estrategias de renovación, cooperación y educación permitirá superar algunas de las limitaciones vividas por esas asociaciones.

RESUMO Objetivo: Descrever os processos de produção de mensagens e de interação com a mídia por parte de associações profissionais de enfermagem. Métodos: Estudo qualitativo de tipo descritivo com base em entrevistas semiestruturadas com dirigentes de cinco associações profissionais de enfermagem de Portugal. Os dados foram sujeitos à análise de conteúdo temático. Resultados: As associações de regulação e sindicalismo recorrem a serviços de relações públicas e referem mais estratégias de interação com jornalistas. As associações de especialização profissional interagem com menor frequência e preferem as redes sociais para publicarem as suas mensagens. O trabalho voluntário e a reduzida profissionalização da comunicação de associações especializadas tendem a uma postura de retração da enfermagem para com a mídia. Considerações finais: Fatores organizacionais e culturais poderão ajudar a explicar o acesso limitado da enfermagem à mídia. O recurso a estratégias de renovação, cooperação e educação permitirá superar algumas das limitações vividas por essas associações.