Impact of the implementation of Identification-Situation-Background-Assessment-Recommendation (ISBAR) tool to improve quality and safety measure in a lithotripsy and endourological unit.

INTRODUCTION: A lack of professional communication and collaboration may be one of the main causes of medication errors. The objective was to evaluate the results of the implementation of ISBAR as a communication and safety tool in a Lithotripsy and Endourologic Unit of a tertiary public hospital. METHODS: A total of 457 patients were included in a retrospective study from 2014 to 2019. Patients were divided into two groups: group A (357 patients) in which an endourological procedure was performed before march of 2018 (without the implementation of ISBAR tool) and Group B (100 patients) with the implementation of ISBAR tool. The inclusion criteria were patients accepted for surgical intervention by anaesthesiology Department and operated in the period of the study. The variables analysed included number of procedures, global, intraoperative and postoperative complications rate, urinary infection or sepsis, NPR (FMEA), percentage of suspended surgical patients and hospital stay. RESULTS: The postoperative complications showed no significant differences between groups, but a trend to diminishing was seen in the complication in the group B. The sepsis reduced its incidence and it was close to significant difference. The operative time was shorter in group B 119,11min (114,63-123,59) vs 115,11min (109,63-121,67) p = 0,3. The reduction in the main postoperative complication (sepsis) explained the lower hospital stay for group B. The severe adverse events detected were reduced completely. CONCLUSIONS: ISBAR tool was an effective patient safety tool improving quality care. To provide safe patient care and improving quality is indispensable an effective communication flow.

Valoración de necesidades formativas de nivel básico en cuidados paliativos en enfermeras de atención primaria en España / Assessment of basic training needs in palliative care in primary healthcare nurses in Spain

Objetivo: Valorar la formación, la percepción de preparación y las necesidades formativas en cuidados paliativos (CP) teóricas y prácticas de las enfermeras de atención primaria en España. Diseño: Estudio descriptivo transversal. Emplazamiento: Centros de atención primaria en España con acceso online. Participantes: Enfermeras de atención primaria en España durante enero y febrero de 2021. De las 344 respuestas, 339 cumplían criterios de inclusión. Mediciones principales: Se analizaron variables sociodemográficas, formación en CP, necesidades de formación mediante cuestionario online de Google Forms e Instrumento INCUE. Se realizaron análisis descriptivos y se compararon los resultados mediante test de simetría exacto y test de Mann-Whitney. Resultados: Mayoritariamente mujeres (82,6%) con una media de edad de 45,5años. El 86,1% de las enfermeras encuestadas tenían formación en CP, siendo básica en el 45,4%. Solo el 40,5% se sienten bastante o muy preparadas para cuidar de pacientes paliativos. Demandaban mayor formación en psicoemocional y duelo y afrontamiento de pérdidas. Superaron el bloque teórico el 83,76%, frente el 43,36% del práctico, detectándose mayores necesidades formativas en este último (p<0,001). Las proporciones de capacitados variaban en función del nivel formativo. Conclusiones: La formación enfermera en CP en atención primaria continúa siendo deficitaria sobre todo en su aplicación práctica, siendo necesaria formación dirigida para que repercuta en el cuidado de las personas con necesidades paliativas y sus familias.(AU)

Aim: Asses training, perception of readiness and training needs in palliative care (PC) theoretical and practical of primary care nurses in Spain, through descriptive cross-sectional study. Design: Descriptive cross-sectional study. Setting: Primary care nurses in Spain with online access. Participants: Primary care nurses in Spain, January and February 2021. 344 responses, 339 met the inclusion criteria. Main neasurements: Sociodemographic variables, PC training, training needs were analyzed. Through Google Forms online questionnaire and INCUE Instrument. Descriptive analyses were performed and the results were compared using the exact symmetry test and the Mann-Whitney test. Results: 82,6% women, with an average age of 45.5years. 86.1% of the nurses had training in PC, been basic in the 45.4%. Only 40.5% feel quite or very prepared to take care for palliative patients. Nurses demanded more training in psycho-emotional and grief and coping with losses. 83.76% passed the theoretical block compared to 43.36% of the practical, detecting higher training needs in the last (P<.001). The passed rates varied depending on the educational level. Conclusions: Nursing training in PC in primary care continues to be deficient, especially in practical application. Targeted training is necessary to have an impact on the care of people with palliative needs and their families.(AU)

[Assessment of basic training needs in palliative care in primary healthcare nurses in Spain]. / Valoración de necesidades formativas de nivel básico en cuidados paliativos en enfermeras de atención primaria en España.

AIM: Asses training, perception of readiness and training needs in palliative care (PC) theoretical and practical of primary care nurses in Spain, through descriptive cross-sectional study. DESIGN: Descriptive cross-sectional study. SETTING: Primary care nurses in Spain with online access. PARTICIPANTS: Primary care nurses in Spain, January and February 2021. 344 responses, 339 met the inclusion criteria. MAIN NEASUREMENTS: Sociodemographic variables, PC training, training needs were analyzed. Through Google Forms online questionnaire and INCUE Instrument. Descriptive analyses were performed and the results were compared using the exact symmetry test and the Mann-Whitney test. RESULTS: 82,6% women, with an average age of 45.5years. 86.1% of the nurses had training in PC, been basic in the 45.4%. Only 40.5% feel quite or very prepared to take care for palliative patients. Nurses demanded more training in psycho-emotional and grief and coping with losses. 83.76% passed the theoretical block compared to 43.36% of the practical, detecting higher training needs in the last (P<.001). The passed rates varied depending on the educational level. CONCLUSIONS: Nursing training in PC in primary care continues to be deficient, especially in practical application. Targeted training is necessary to have an impact on the care of people with palliative needs and their families.

Design and Validation of the INCUE Questionnaire: Assessment of Primary Healthcare Nurses' Basic Training Needs in Palliative Care.

Many instruments have been created to measure knowledge and attitudes in palliative care. However, not only is it important to acquire knowledge, but also that this knowledge should reach patients and their relatives through application in clinical practice. This study aimed to develop and psychometrically test the INCUE questionnaire (Investigación Cuidados Enfermeros/Investigation into Nurses' Care Understanding of End-of-Life) to assess the basic training needs of primary or home healthcare nurses in palliative care. A questionnaire was developed based on the classical theory of tests and factor analysis models. Initially, 18 experts developed 67 items in two blocks and determined content validity by two rounds of expert panels. Exploratory factor analysis and reliability testing were conducted with a non-probabilistic sample of 370 nurses. Some items were observed to have very low homogeneity indices or presented convergence problems and were eliminated. Questionnaire reliability was 0.700 in the theoretical block (KR20 Index) and 0.941 in the practical block (Cronbach's alpha). The model converges and shows an adequate fit, specifically CFI = 0.977, TLI = 0.977 and RMSEA = 0.05. The correlation between the two factors in the model is ρ = 0.63. The questionnaire objectively evaluates primary or home healthcare nurses' knowledge of palliative care and its practical application, thereby facilitating more efficient training plans.

Abordaje interdisciplinar del cuidado a una mujer con ostomía de alto débito / No disponible

Las complicaciones derivadas de una ostomía de alto débito provocan graves alteraciones nutricionales, cutáneas e infecciosas. El manejo de estas ostomías por parte de la persona portadora es muy complejo y genera problemas de autoestima y afrontamiento. Presentamos el caso de una mujer con ostomía de alto débito secundaria a síndrome de intestino corto, con malnutrición severa, dermatitis periestomal y grandes dificultades para el manejo de su situación. Tras valoración según necesidades de Virginia Henderson realizamos un abordaje interdisciplinar, con la elaboración de un plan de cuidados que contemplaba todos los aspectos del ser humano, biológicos, psicológicos y sociales. Se utilizaron los dispositivos adecuados para el control del efluente y el tratamiento y posterior prevención de la dermatitis. Las dificultades para el afrontamiento se abordaron desde un punto de vista holístico, facilitando el aprendizaje, proporcionando asesoramiento y apoyo emocional. Se adiestró a la persona en el manejo de la ostomía, la dieta y la higiene en la manipulación de los dispositivos para la TIV. Todo ello contribuyó a una mejor adaptación a su nuevo estado de salud

No disponible