Analysis of the evolution of competences in the clinical practice of the nursing degree.

OBJECTIVE: to analyze the student's progression in the acquisition of specific and transversal competences in relation to the competence dimensions.Method: the cross-sectional descriptive study was carried out in the clinical practice subjects included in the Nursing Degree. We included 323 students and we contemplated the development of competences through an ad-hoc questionnaire with 4 dimensions: delivery and care management, therapeutic communication, professional development and care management. RESULTS: the academic results between the practice of the second and third year showed an improvement in care provision and therapeutic communication skills (Clinical Placements I: 12%-29%; Clinical Placements II: 32%-47%) and worsened in professional development and care management (Clinical Placements I: 44%-38%; Clinical Placements II: 44%-26%). CONCLUSION: the correlations between these two years were high in all the dimensions analyzed. The evaluation of competence progression in the context of clinical practice in nursing university studies allows us to optimize these practices to the maximum and establish professional profiles with a greater degree of adaptation to the professional future.

Analysis of the evolution of competences in the clinical practice of the nursing degree / Análise da evolução de competências da prática clínica no curso de enfermagem / Análisis de la evolución de las competencias en la práctica clínica del grado en enfermeira

Objective: to analyze the student's progression in the acquisition of specific and transversal competences in relation to the competence dimensions. Method: the cross-sectional descriptive study was carried out in the clinical practice subjects included in the Nursing Degree. We included 323 students and we contemplated the development of competences through an ad-hoc questionnaire with 4 dimensions: delivery and care management, therapeutic communication, professional development and care management. Results: the academic results between the practice of the second and third year showed an improvement in care provision and therapeutic communication skills (Clinical Placements I: 12%-29%; Clinical Placements II: 32%-47%) and worsened in professional development and care management (Clinical Placements I: 44%-38%; Clinical Placements II: 44%-26%). Conclusion: the correlations between these two years were high in all the dimensions analyzed. The evaluation of competence progression in the context of clinical practice in nursing university studies allows us to optimize these practices to the maximum and establish professional profiles with a greater degree of adaptation to the professional future.

Objetivo: analisar a progressão de estudantes na aquisição de competências específicas e transversais em relação às dimensões de competência. Método: este estudo transversal descritivo foi realizado no contexto das disciplinas de prática clínica do curso de enfermagem. O desenvolvimento de competências de 323 alunos foi analisado usando um questionário ad-hoc com quatro dimensões: provisão e gerenciamento do cuidado; comunicação terapêutica; desenvolvimento profissional; e gerenciamento do cuidado. Resultados: os resultados acadêmicos obtidos no segundo e terceiro anos apresentaram melhora nas habilidades referentes à provisão do cuidado e comunicação terapêutica (Práticas Clínicas I: 12%-29%; Práticas Clínicas II: 32%-47%) e uma piora no desenvolvimento profissional e gerenciamento do cuidado (Práticas Clínicas I: 44%-38%; Práticas Clínicas II: 44%-26%). Conclusão: as correlações entre estes dois anos foram altas em todas as dimensões analisadas. A avaliação da progressão de competências no contexto da prática clínica do curso de enfermagem nos permite otimizar estas práticas ao máximo e estabelecer perfis profissionais com maior grau de adaptação para o futuro profissional.

Objetivo: analizar la progresión del alumno en la adquisición de competencias específicas y transversales en relación con las dimensiones de competencia. Método: el estudio descriptivo transversal se realizó en los sujetos de práctica clínica incluidos en la licenciatura de Enfermería. Incluimos 323 estudiantes y contemplamos el desarrollo de competencias a través de un cuestionario ad hoc con 4 dimensiones: suministro y gestión del cuidado; comunicación terapéutica; desarrollo profesional; y, gestión del cuidado. Resultados: los resultados académicos entre la práctica del segundo y tercer año mostraron una mejora en la provisión del cuidado y en las habilidades de comunicación terapéutica: (Colocaciones clínicas I: 12% -29%; Colocaciones clínicas II: 32% -47%) y empeoraron en el desarrollo profesional y en la gestión del cuidado (Colocaciones clínicas I: 44%-38%; Colocaciones clínicas II: 44%-26%). Conclusión: las correlaciones entre estos dos años fueron altas en todas las dimensiones analizadas. La evaluación de la progresión de competencias, en el contexto de la práctica clínica, en los estudios universitarios de enfermería, nos permite optimizar estas prácticas al máximo y establecer perfiles profesionales con un mayor grado de adaptación al futuro profesional.

Enfermeras de cine: cómo son y qué hacen en la gran pantalla / Nurses in films: how they are and what they do in the big screen

El cine nos educa sentimental y emocionalmente sin que nos demos cuenta, porque utiliza los clichés y los estereotipos que forman parte del imaginario colectivo. Los profesionales de la Enfermería son objeto de estereotipos, es decir, de imágenes común y acríticamente aceptadas por la sociedad. En este texto se destacan seis estereotipos de enfermeras: religiosa, heroica, objeto sexual, secretaria obediente, diabólica y, finalmente, profesional; también se comenta cómo el cine muestra al enfermero. Para ello se han seleccionado algunos títulos de películas que ilustran las características de cada estereotipo. Se concluye que es esencial cuestionar y denunciar por parte de las asociaciones e instituciones profesionales el mal uso de la imagen de la enfermera, ya que el signo positivo o negativo de las imágenes tiene consecuencias no solo en la percepción de los pacientes y usuarios, sino también en la asignación de recursos y en las políticas sanitarias (AU)

Films will educate us sentimental and emotionally without our realizing it, because they use the clichés and stereotypes that are part of collective thinking. Nursing professionals are the object of stereotypes, that is to say, of images commonly and uncritically accepted by society. This text highlights six nurse stereotypes: religious, heroic, sexual object, obedient secretary, diabolic and, finally, professional. There is also a discussion about the way in which male nurses are shown in films. To this aim, there has been a selection of some films titles that illustrate the characteristics of each stereotype. The conclusion is that it is essential for professional associations and institutions to question and denounce the bad use of the nurse image, because the positive or negative use of the images will have consequences not only in the perception by patients and users but also in the assignment of resources and in healthcare policies (AU)

Surveillance nursing diagnoses, ongoing assessment and outcomes on in-patients who suffered a cardiorespiratory arrest.

Objective The purposes of this study were to examine the frequency of surveillance-oriented nursing diagnoses and interventions documented in the electronic care plans of patients who experienced a cardiac arrest during hospitalization, and to observe whether differences exist in terms of patients' profiles, surveillance measurements and outcomes. Method A descriptive, observational, retrospective, cross-sectional design, randomly including data from electronic documentation of patients who experienced a cardiac arrest during hospitalization in any of the 107 adult wards of eight acute care facilities. Descriptive statistics were used for data analysis. Two-tailed p-values are reported. Results Almost 60% of the analyzed patients' e-charts had surveillance nursing diagnoses charted in the electronic care plans. Significant differences were found for patients who had these diagnoses documented and those who had not in terms of frequency of vital signs measurements and final outcomes. Conclusion Surveillance nursing diagnoses may play a significant role in preventing acute deterioration of adult in-patients in the acute care setting.

Surveillance nursing diagnoses, ongoing assessment and outcomes on in-patients who suffered a cardiorespiratory arrest / Diagnósticos de enfermagem de vigilância, avaliação contínua e resultados em pacientes que sofreram uma parada cardiorrespiratória / Diagnósticos enfermeros de vigilancia, evaluación en curso y resultados en pacientes hospitalizados que sufrieron paro cardiorrespiratorio

ABSTRACT Objective The purposes of this study were to examine the frequency of surveillance-oriented nursing diagnoses and interventions documented in the electronic care plans of patients who experienced a cardiac arrest during hospitalization, and to observe whether differences exist in terms of patients' profiles, surveillance measurements and outcomes. Method A descriptive, observational, retrospective, cross-sectional design, randomly including data from electronic documentation of patients who experienced a cardiac arrest during hospitalization in any of the 107 adult wards of eight acute care facilities. Descriptive statistics were used for data analysis. Two-tailed p-values are reported. Results Almost 60% of the analyzed patients' e-charts had surveillance nursing diagnoses charted in the electronic care plans. Significant differences were found for patients who had these diagnoses documented and those who had not in terms of frequency of vital signs measurements and final outcomes. Conclusion Surveillance nursing diagnoses may play a significant role in preventing acute deterioration of adult in-patients in the acute care setting.

RESUMO Objetivo Determinar a frequência de registro eletrônico de diagnósticos e intervenções de vigilância no plano de cuidados para pacientes que sofreram uma parada cardíaca durante a admissão e avaliar se existem diferenças com base no perfil do paciente, medidas de monitoramento e resultados. Método Estudo descritivo, observacional, retrospectivo, transversal, que incluiu dados dos registros eletrônicos de pacientes internados em uma das 107 unidades de oito hospitais de cuidados agudos. Para análise dos dados foram utilizados estatísticos descritivos. Os valores de p foram relatados em dois ramos. Resultados Foram obtidos dados de 492 documentos de enfermagem de pacientes que sofreram uma parada cardíaca. Quase 60% dos prontuários eletrônicos incluídos na análise continham um ou mais diagnósticos de vigilância. Diferenças significativas foram encontradas entre os pacientes com e sem registro desses diagnósticos, no que se refere à frequência das medições dos sinais vitais e aos resultados finais. Conclusão Os diagnósticos de vigilância podem desempenhar um papel importante na prevenção de deterioração aguda em pacientes adultos hospitalizados.

RESUMEN Objetivo Los objetivos de este estudio fueron examinar la frecuencia de los diagnósticos enfermeros basados en la vigilancia y las intervenciones documentadas en los planes de asistencia mediante sistema informático de pacientes que pasaron por paro cardiaco durante estancia hospitalaria y observar si existen diferencias en términos de perfil de los pacientes, medidas de vigilancia y resultados. Método Descriptivo, observacional, retrospectivo, transversal, randomizado, incluyendo datos de documentación informática de pacientes que pasaron por paro cardiaco durante estancia hospitalaria en cualquiera de las 107 alas adultas de las ocho instalaciones de cuidados intensivos. Las estadísticas descriptivas fueron utilizadas para los análisis de datos. Valores P bilaterales fueron relatados. Resultados Casi el 60% del los pacientes analizados por la gráfica electrónica tuvieron diagnóticos enfermeros de vigilancia representados en los planes de cuidados informatizados. Fueron encontradas diferencias significativas en pacientes que tuvieron dichos diagnósticos documentados y los que no los tuvieron en términos de frecuencia de mediciones de señales vitales y resultados finales. Conclusión Los diagnósticos enfermeros de vigilancia pueden jugar un rol significativo en la prevención del deterioro agudo de pacientes adultos hospitalizados en las unidades de cuidados intensivos.