Autonomous competences and quality of professional life of paediatric nurses in primary care, their relationship and associated factors: A cross-sectional study.

AIMS AND OBJECTIVES: To identify the autonomous competences and quality of professional life of paediatric nurses in primary care, their relationship and possible associated factors. BACKGROUND: The autonomous competences of paediatric nurses vary among healthcare providers in Catalonia, Spain. Autonomy is related to quality of professional life, but little is known about autonomous competences and other factors contributing to paediatric nurses' quality of professional life. DESIGN: A cross-sectional study following the STROBE statement. METHODS: Data from 206 paediatric primary care nurses were analysed. A self-administered survey consisting of an ad hoc questionnaire and a validated instrument to measure quality of professional life (QPL-35 questionnaire) was conducted. Descriptive, bivariate and general multivariate regression analyses were used to identify the relationship between autonomous competences and quality of professional life, and its predicting factors. RESULTS: 47.6% nurses reported a medium level of autonomous competences, 46.6% a high level, and 5.8% a low level. Quality of professional life was medium-high for the domains perception of managerial support and global perception of workload and for the item disconnect from work after work shift, and very high and high values for the domain intrinsic motivation and for the item quality of work life, respectively. Autonomous competences and perceived autonomy were factors associated with quality of professional life. Other associated factors were academic background, specific training and being a paediatric nurse specialist. CONCLUSIONS: Paediatric nurses in primary care have a medium-high level of autonomous competences and they perceive a high level of autonomy. Autonomous competences and level of perceived autonomy are predictors of quality of professional life. RELEVANCE TO CLINICAL PRACTICE: Enhancing paediatric nurses' autonomous competences and academic background, receiving specific training and being paediatric nurse specialists might improve their quality of professional life, healthcare quality and outcomes for the child population.

A qualitative model for evaluating and improving nursing governance in medium- and long-term intermediate care.

AIM: To evaluate nursing governance in intermediate care in Catalonia Spain and propose improvements. BACKGROUND: Drawing on two existing models, the Magnet model and the corporate governance model, we propose that good nursing governance requires nursing leaders to apply the following dimensions: transformational leadership, transformational culture, commitment and sustainability, authority, scientific evidence, transparency and communication, and teamwork. METHOD: A qualitative, exploratory study conducted in two phases. First, we asked nursing leaders in intermediate care to describe their opinions and experiences in each of the dimensions. Next, we observed governance practices at two intermediate care centres and conducted interviews with their nursing leaders. Content analysis was used. RESULTS: Our participants' behaviour corresponded closely to the model in the dimensions of transformational culture and commitment and sustainability but failed to meet the model in the dimensions of scientific evidence and transparency and communication. CONCLUSIONS: Participants had a leadership style focused on transforming their surroundings. According to the model, the leaders in our sample should draw more on scientific evidence and improve their internal communication about outcomes. IMPLICATIONS FOR NURSING MANAGEMENT: Establishing committees of nurses to address areas in which governance does not adhere to the model would create sustainable benefits for patients and nurses in intermediate care.

Formación en enfermería escolar. Efectividad del taller‘Cine y salud escolar’ / School Nurses training. Effectiveness of the workshop ‘Films and School Health’

Objetivo. Este estudio pretende evaluar la efectividad del taller ‘Cine y salud escolar’, que trata la utilización de películas como recurso para reforzar los temas de salud que abordan las enfermeras escolares que han cursado el Máster de Enfermería Escolar. Materiales y métodos. Se empleó un diseño cuasi experimental con pretest y postest y en el cual la intervención fue la realización del taller ‘Cine y salud escolar’. Las variables estudiadas se referían al conocimiento de los recursos necesarios para preparar un tema de salud con el apoyo de secuencias cinematográficas; además, se analizaron los hábitos de las participantes respecto a su consumo de cine comercial. Resultados. Se obtuvieron 112 respuestas. En cuanto a la efectividad del taller se observa que en todas las preguntas el número de respuestas correctas es superior en el postest respecto al pretest. El 56,25% (n = 63) de encuestadas reconoce el uso de películas durante la carrera de enfermería. Se mencionan 37 títulos con contenidos sobre salud, con una mediade 1,53 películas vistas en el último mes. Se vieron 5,11 películas en casa por cada una vista en salas de cine. Conclusiones. En el postest respecto al pretest, se observa un incremento de respuestas correctas en todos los ítems y también una disminución de las respuestas ‘no sabe’, lo que confirmaría la efectividad del taller (AU)

To assess the effectiveness of the workshop ‘Films and School Health’, dealing with the use of film as a resource to strengthen the health topics that the school nurses address to pupils. Materials and methods. A quasi experimental design with pretest and post-test was carried out, being the intervention was the workshop ‘Films and School Health’. The studied variable was the knowledge of the resources needed to prepare a lesson about health with movies sequences; in addition, the participants’ habits with regard to their consume of commercial films were analyzed. Results. One hundred and twelve replies were obtained. In terms of the effectiveness of the workshop we found that the number of right answers on the post-test is higher than on the pretest for all the items. The 56.25% (n = 63) of surveyed recognizes the use of cinema during their nursing studies. The participants mentioned 37 films related to some healthissue. In average they have seen 1.53 films in the last month. The rate of films seen at home vs those seen in movie theaters was 5.11.Conclusions. The workshop was effective as regards the increase of right answers on the posttest compared to the pretest as well as the decrease of the ‘don’t know’ answers after the intervention (AU)

Formación de los profesionales de la salud en un contexto asistencial con uso de las tecnologías de la información y la comunicación / Training health professionals within a healthcare context using information and communication technologies

La enfermera debería incorporar nuevas habilidades en el manejo de las tecnologías de la información y la comunicación (TIC) que faciliten el desarrollo de su profesión. En este proceso se plantean dudas y resistencias que pueden convertirse en barreras para el desarrollo de su labor profesional. Las estrategias para vencer resistencias ante las nuevas formas de trabajar pasan por facilitar una formación correctamente planificada y adaptada a los profesionales que deben enfrentarse a estas nuevas tecnologías. Algunos de los aspectos clave relacionados con la formación de las enfermeras ante nuevas competencias y que pueden contribuir a su desarrollo exitoso en los centros asistenciales son la definición de tácticas claras de formación con identificación de buenas prácticas asistenciales como mecanismo conductor, el apoyo a las enfermeras asistenciales por parte de las gestoras que lideran los equipos asistenciales y la identificación de la predisposición de los usuarios frente a la formación. Lograr el éxito en el uso de las TIC puede residir en la participación activa de las propias enfermeras en el proceso formativo planificado, teniendo en cuenta nuevos enfoques asistenciales por vía telemática, como alternativa al actual modelo asistencial, tradicionalmente presencial (AU)

The nurse should incorporate new skills in the management of information technology and communication (ICT) to facilitate the development of their profession. This process may raise doubts and resistances that can become barriers when developing their work. Thus strategies to overcome resistance to new ways of working undergo training facilitate well planned and tailored to the professionals who must cope with new technologies. Some of the key issues related to the education of nurses related to new skills, are the definition of clear strategies with training support identifying best practices as mechanism driver training, support to practicing nurses by the leaders who lead care teams as well as the identification of the willingness of users from training. Achieving success in the use of ICT in the active participation of nurses themselves planned in the learning process, taking into account new approaches of tele-care, as an alternative of traditional care (AU)

[New technologies and nursing. Use and perception of primary health care nurses about electronic health record]. / Enfermería y nuevas tecnologías: historia clínica electrónica.

OBJECTIVE: To analyze the nurses make use of electronic health records (EHR) and assess their perception of it. METHOD: A descriptive cross-sectional observational study was conducted in 2010 analyzing the nurses' perceptions of adult and pediatric consultations of primary health care teams in Baix Llobregat (Catalonia) in which the EHR is used. The study variables were: registration of care, continuity of care, training, usability and sociodemographic composition of the sample. The statistical analysis was descriptive. RESULTS: Nurses agree that EHR provides "continuity of care" in relation to nursing care (mean 2.03, Sd.0.83) and overall (mean 2.19, 5d.0.83). Show indifference to the "usability" of the EHR (mean 3.26, Sd.0.5), to facilitate the "record information" (mean 2.69, Sd.0.68) and the need for "training" in the use of EHR (mean 2.6, 5d.0.59). It has been found that with increasing age of the nurse, it shows more agreement that the EHR provides greater continuity of care overall. The average ratings of the continuum of care nurse, recording of information, continuity of care in general are greater the lead time using the EHR. CONCLUSIONS: The nurses' perceptions regarding the EHR are positive in that it provides continuity of care and to exchange information on patient health data.

Enfermería y nuevas tecnologías. Historia clínica electrónica / New technologies and nursing. Use and perception of primary health care nurses about electronic health record

Objetivo: analizar la utilización que efectúan las enfermeras de la Historia Clínica Electrónica (HCE), así como valorar la percepción que tienen de la misma. Método: se realizó un estudio descriptivo observacional transversal durante el año 2010, analizando la percepción de las enfermeras de las consultas de adultos y pediatría de los equipos Atención Primaria de Salud del Baix Llobregat (Cataluña) en las que se utiliza la HCE. Las variables de estudio fueron: sociodemográficas, registro de los cuidados, continuidad asistencial, formación, usabilidad. El análisis estadístico realizado fue descriptivo. Resultados: las enfermeras están bastante de acuerdo en que HCE proporciona «continuidad asistencial» en relación a la atención enfermera (media 2,03, Sd.0,83) y en general (media 2,19, Sd.0,83). Muestran indiferencia respecto a la «usabilidad» de la misma (media 3,26, Sd.0,5), a que facilite el «registro de la información» (media 2,69, Sd.0,68) y a la necesidad de «formación» en el uso de la HCE (media 2,6, Sd.0,59). Se ha detectado que a medida que aumenta la edad de la enfermera manifiesta más acuerdo acerca de que la HCE proporciona mayor continuidad asistencial general. Las valoraciones medias de la continuidad asistencial enfermera, registro de la información y continuidad asistencial en general son mayores cuanto más tiempo llevan utilizando la HCE. Conclusiones: la percepción de la enfermera respecto a la HCE es positiva en cuanto a que proporciona continuidad asistencial y permite intercambiar información de los datos de salud del paciente(AU)

Objective: To analyze the nurses make use of electronic health records (EHR) and assess their perception of it. Method: A descriptive cross-sectional observational study was conducted in 2010 analyzing the nurses' perceptions of adult and pediatric consultations of primary health care teams in Baix Llobregat (Catalonia) in which the EHR is used. The study variables were: registration of care, continuity of care, training, usability and sociodemographic composition of the sample. The statistical analysis was descriptive. Results: Nurses agree that EHR provides «continuity of care» in relation to nursing care (mean 2.03, Sd.0.83) and overall (mean 2.19, Sd.0.83). Show indifference to the «usability» of the EHR (mean 3.26, Sd.0.5), to facilitate the «record information» (mean 2.69, Sd.0.68) and the need for «training» in the use of EHR (mean 2.6, Sd.0.59). It has been found that with increasing age of the nurse, it shows more agreement that the EHR provides greater continuity of care overall. The average ratings of the continuum of care nurse, recording of information, continuity of care in general are greater the lead time using the EHR. Conclusions: The nurses' perceptions regarding the EHR are positive in that it provides continuity of care and to exchange information on patient health data(AU)

New technologies and nursing: use and perception of primary healthcare nurses about electronic health record in Catalonia, Spain.

This study was aimed to analyze and assess the use and perception of electronic health records (EHRs) by nurses. The study sample included 113 nurses from different shifts of primary health facilities in Catalonia, Spain, devoted to adult as well as pediatric outpatients using EHRs throughout the year 2010. A majority of the sample (87.5%) were women and 12.5% were men. The average age was 44.27 years and the average time working in primary healthcare was 47.15 months. A majority (80.4%) received specific training on the use of the EHR and 19.6% did not. The use of the application required side technical support (mean: 3.42) and it is considered necessary to learn more about the performance of the application (mean: 3.50). The relationship between the average ratings that nurses have about the EHR and age shows that there is no statistically significant linear relationship (r=-0.002, p-value=0.984). As to how long they have used the EHRs, there are significant differences (r=-0.304, p-value=0.00), so the more time the nurse takes using the EHR, the greater degree of satisfaction is shown. In addition, there are significant differences between nurses' perceptions regarding the EHR and gender (t=-0.421, p-value=0.675). Nurses assessed as positive the contribution of the EHRs in their nursing care day work (average score: 2.55/5). Considering that the usability of the EHR device is assessed as satisfactory, the results of the perception of nurses show that we must also take into account the training and emphasize the need for a side technical support in the implementation process of the EHR. Doing so, the positive perception that nurses have in regard to information and communication technology in general and with respect to the EHR in particular may be increased.

Reacciones adversas a los medios de contraste yodados en radiología / Adverse reactions to iodinated contrast media

Objetivo. Los objetivos del estudio fueron determinar la incidencia de las reacciones adversas al contraste yodado, así como conocer las características de las mismas en un grupo de pacientes de procedencia ambulatoria, hospitalizados y urgencias de un centro hospitalario privado de Barcelona. Método. Se realizó un estudio de cohortes retrospectivo durante un periodo de 60 meses desde febrero de 2002 hasta febrero de 2007, analizando los pacientes sometidos a exploraciones de radiología con contraste yodado. Se evaluaron las reacciones adversas en el registro manual desarrollado en cumplimiento del Programa de Garantía de Calidad en Radiodiagnóstico. Las variables del estudio fueron vía de administración del contraste, dosis de contraste administrado, tipo de reacción adversa, signos y síntomas. El análisis estadístico realizado ha sido de tipo descriptivo. Resultados. Las reacciones adversas fueron 68 (0,3%), 64 leves (94,1%), 4 moderadas (5,9%) y 0 graves. En función de la vía de administración (endovenosa o oral) las reacciones fueron 67 (94%) y 1 (6%) respectivamente. En las inyecciones de contraste endovenoso con dosis entre 40 y 80ml, las reacciones leves fueron 87,5%, las moderadas el 12,5% y las graves el 0%. En la administración con dosis de contraste endovenoso entre 90 y 150ml, las reacciones leves fueron del 94,9% y las moderadas el 5,1%. Conclusiones. El número de reacciones adversas a los contrastes yodados utilizados en radiología es bajo y son leves, sin embargo, la enfermera debe estar preparada para reconocerlas y actuar ante ellas (AU)

Objective. The aim of the study is to determine the incidence of adverse reactions to iodinated contrast media and to characterise them in a group of outpatients, inpatients and emergency patients in a private hospital in Barcelona. Method. A retrospective cohort study was carried out over a 60 months period, from February 2002 to February 2007, analysing the patients who underwent to iodinated contrast radiological examinations. Adverse reactions were evaluated from the manual record format developed following the requirements of the Quality Assurance Program in Radiology. Study variables were, administration route, contrast media dose, adverse reaction type, and signs and symptoms. Statistical analysis was descriptive. Results. A total of 68 (0.3 %) of adverse reaction were registered of which 64 were mild (94.1%), 4 moderate (5.9%) and none severe. On the basis of the administration route (intravenous or oral) adverse reaction were 67 (94%) and 1 (6%) respectively. With a 40–80ml contrast media dose by injection, mild adverse reactions were 87.5%, moderate 12.5% and severe 0%. With a 90–150ml contrast media dose by injection, mild adverse reaction were 94.9% and moderate 5.1%. Conclusions. The number of adverse reaction using iodinated contrast media is low and are they are generally mild; however the nurse must be ready to recognise and treat them (AU)

[Adverse reactions to iodinated contrast media]. / Reacciones adversas a los medios de contraste yodados en radiología.

OBJECTIVE: The aim of the study is to determine the incidence of adverse reactions to iodinated contrast media and to characterise them in a group of outpatients, inpatients and emergency patients in a private hospital in Barcelona. METHOD: A retrospective cohort study was carried out over a 60 months period, from February 2002 to February 2007, analysing the patients who underwent to iodinated contrast radiological examinations. Adverse reactions were evaluated from the manual record format developed following the requirements of the Quality Assurance Program in Radiology. Study variables were, administration route, contrast media dose, adverse reaction type, and signs and symptoms. Statistical analysis was descriptive. RESULTS: A total of 68 (0.3 %) of adverse reaction were registered of which 64 were mild (94.1%), 4 moderate (5.9%) and none severe. On the basis of the administration route (intravenous or oral) adverse reaction were 67 (94%) and 1 (6%) respectively. With a 40-80ml contrast media dose by injection, mild adverse reactions were 87.5%, moderate 12.5% and severe 0%. With a 90-150ml contrast media dose by injection, mild adverse reaction were 94.9% and moderate 5.1%. CONCLUSIONS: The number of adverse reaction using iodinated contrast media is low and are they are generally mild; however the nurse must be ready to recognise and treat them.