Situating Preventive Action in a Moral and Clinical Context: A Qualitative Synthesis on Fall Prevention.

The prevention of falls is an integral part of the safety culture of health institutions with mandatory fall prevention programs set within health care facilities. Care providers are key in identifying the risks of falls and in implementing strategic actions to prevent them. With the aim to better understand practices of fall prevention, we conducted a synthesis of qualitative evidence on care providers' practices to prevent older people from falling in health care facilities. This synthesis is part of an integrative review of the role of care providers in fall prevention of adults aged 65 years and above. Primary studies were synthesized with the emerging core category of "a complex decision" and described by four emerging conditions that make that decision complex: (a) permanent threat of a fall, (b) continuous flow of information, (c) lack of control, and (d) ethical dilemmas and moral issues over the course of action. The present synthesis shows that before implementing preventive actions, care providers consider the conditions in which they are immersed, in this way situating their preventive actions in a clinical and a moral context.

Redes de Investigación en Cuidados de Salud: espacio de colaboración científica liderado desde Investén-isciii / Research networks in Nursing Care: a collaborative space led by Investen-isciii

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The SUMAMOS EXCELENCIA Project.

AIM: The gap between research and clinical practice leads to inconsistent decision-making and clinical audits are an effective way of improving the implementation of best practice. Our aim is to assess the effectiveness of a model that implements evidence-based recommendations for patient outcomes and healthcare quality. DESIGN: National quasi-experimental, multicentre, before and after study. METHODS: This study focuses on patients attending primary care and hospital care units and associated socio-healthcare services. It uses the Joanna Brigg's Institute Getting Research into Practice model, which improves processes by referring to prior baseline clinical audits. The variables are process and outcome criteria for pain, urinary incontinence, and fall prevention, with data collection at baseline and key points over 12 months drawn from clinical histories and records. Project funding was received from the Spanish Strategic Health Action in November 2014. DISCUSSION: The project results will provide knowledge on the effectiveness of the Getting Research into Practice model, to apply evidence-based recommendations for the detection and management of pain, urinary incontinence, and fall prevention. It will also establish whether using research results, based on clinical audits and situation analysis, is effective for implementing evidence-based recommendations and improving patients' health. IMPACT: This nationwide Spanish project aims to detect and prevent high-prevalence healthcare problems, namely pain in patients at any age and falls and urinary incontinence in people aged 65 and over. Tailoring clinical practice to evidence-based recommendations will reduce unjustified clinical variations in providing healthcare services. Clinical Trial ID: NCT03725774.

Validation of the Spanish version of Mackey childbirth satisfaction rating scale.

BACKGROUND: The "Mackey Childbirth Satisfaction Rating Scale" (MCSRS) is a complete non-validated scale which includes the most important factors associated with maternal satisfaction. Our primary purpose was to describe the internal structure of the scale and validate the reliability and validity of concept of its Spanish version MCSRS-E. METHODS: The MCSRS was translated into Spanish, back-translated and adapted to the Spanish population. It was then administered following a pilot test with women who met the study participant requirements. The scale structure was obtained by performing an exploratory factorial analysis using a sample of 304 women. The structures obtained were tested by conducting a confirmatory factorial analysis using a sample of 159 women. To test the validity of concept, the structure factors were correlated with expectations prior to childbirth experiences. McDonald's omegas were calculated for each model to establish the reliability of each factor. The study was carried out at four University Hospitals; Alicante, Elche, Torrevieja and Vinalopo Salud of Elche. The inclusion criteria were women aged 18-45 years old who had just delivered a singleton live baby at 38-42 weeks through vaginal delivery. Women who had difficulty speaking and understanding Spanish were excluded. RESULTS: The process generated 5 different possible internal structures in a nested model more consistent with the theory than other internal structures of the MCSRS applied hitherto. All of them had good levels of validation and reliability. CONCLUSIONS: This nested model to explain internal structure of MCSRS-E can accommodate different clinical practice scenarios better than the other structures applied to date, and it is a flexible tool which can be used to identify the aspects that should be changed to improve maternal satisfaction and hence maternal health.

Assessment of bachelor's theses in a nursing degree with a rubrics system: Development and validation study.

BACKGROUND: Writing a bachelor thesis (BT) is the last step to obtain a nursing degree. In order to perform an effective assessment of a nursing BT, certain reliable and valid tools are required. OBJECTIVES: To develop and validate a 3-rubric system (drafting process, dissertation, and viva) to assess final year nursing students' BT. DESIGN: A multi-disciplinary study of content validity and psychometric properties. The study was carried out between December 2014 and July 2015. SETTINGS: Nursing Degree at Universitat Jaume I. Spain. PARTICIPANTS: Eleven experts (9 nursing professors and 2 education professors from 6 different universities) took part in the development and content validity stages. Fifty-two theses presented during the 2014-2015 academic year were included by consecutive sampling of cases in order to study the psychometric properties. METHODS: First, a group of experts was created to validate the content of the assessment system based on three rubrics (drafting process, dissertation, and viva). Subsequently, a reliability and validity study of the rubrics was carried out on the 52 theses presented during the 2014-2015 academic year. RESULTS: The BT drafting process rubric has 8 criteria (S-CVI=0.93; α=0.837; ICC=0.614), the dissertation rubric has 7 criteria (S-CVI=0.9; α=0.893; ICC=0.74), and the viva rubric has 4 criteria (S-CVI=0.86; α=8.16; ICC=0.895). CONCLUSION: A nursing BT assessment system based on three rubrics (drafting process, dissertation, and viva) has been validated. This system may be transferred to other nursing degrees or degrees from other academic areas. It is necessary to continue with the validation process taking into account factors that may affect the results obtained.