Nurses' perceptions of preceptorship of undergraduate students in clinical context.

BACKGROUND: Nurses' perceptions of preceptorships for undergraduate nursing students are crucial for designing effective and tailor-made strategies to improve nurses' involvement, motivation, commitment, and satisfaction in preceptorships. OBJECTIVES: The aim of this study was to determine nurses' perceptions of preceptorships for nursing students in two hospitals located in northern Spain. SETTINGS: This study was conducted in two highly specialized, medium-large, university tertiary care hospitals, including one public and one private hospital, located in northern Spain. PARTICIPANTS: The participants of this study were clinical nurses in private and public health centers who had been preceptors for at least one year. METHODS: A descriptive cross-sectional study was carried out between October 2021 and April 2022, with a total sample of 307. The validated "Involvement, Motivation, Satisfaction, Obstacles and Commitment" (IMSOC) questionnaire was used. Descriptive statistics and bivariate analysis were carried out. The variables included sex, age, educational level, preceptorship training, professional experience, work sector, work setting, and type of contract. RESULTS: The mean global questionnaire score was 115.25 ± 33.86 (95 % CI: 111.62-123), with the highest score obtained for the "Involvement" dimension (29.96; SD: 9.23; 95 % CI: 29.01-34.87). Age showed statistically significant negative correlations with the overall and dimension scores (p < 0.05). Comparisons by work sector and type of contract reflected that nurses working in the private sector and those with permanent contracts had higher motivation and commitment scores. CONCLUSIONS: Preceptors had positive perceptions of their role in undergraduate nursing students' education. Age, work sector, type of contract and time allocation should be considered when designing strategies to enhance the involvement, motivation, commitment, and satisfaction of nurses in their experiences as preceptors for undergraduate nursing students. Improving the preceptorship experience will benefit both nurses and students by improving preparation, satisfaction, and retention.

Postoperative management and nursing care after implantation of a total artificial heart: Scoping review.

INTRODUCTION: End-stage heart failure (HF) is a condition whose only successful long-term treatment, with a survival of more than 10 years, is heart transplantation. However, limited organ availability and the progressive increase in the number of patients with advanced HF have served as an impetus for the development of implantable mechanical assistive devices. AIM: To provide an overview of postoperative management and nursing care after the implementation of a Total Artificial Heart (TAH). METHODS: A scoping review was carried out by consulting the PUBMED, CINAHL, and COCHRANE databases. From all the documents located, information was extracted on the date of publication, country of publication, type of study, and results of interest to answer the research question. In addition, the degree of recommendation was identified. RESULTS: Twenty-three documents were included in the scoping review. Results were classified in relation to: 1) description of the CAT SynCardia®; 2) nursing care in the immediate postoperative period (management of the device and management of hematological, infectious, nephrological, nutritional complications, related to immobilization, sleep-rest disturbances, psychological disorders, and patient and family education); and 3) follow-up at home. CONCLUSIONS: The complexity of implantation of the TAH, the multiple related complications that can arise during this process, both in the immediate post-operative and late, require a standardised and multidisciplinary management. The absence of standardised protocols raises the need for future studies to measure the effectiveness of care in patients with TAH. A multidisciplinary approach is crucial. Nurses must acquire autonomy and involvement in decision-making and develop competencies to address the patient's and family's physiological and psychosocial needs.

Algoritmo de movilización temprana para el paciente crítico. Recomendaciones de expertos / Early mobilisation algorithm for the critical patient. Expert recommendations

Introducción La debilidad adquirida en la unidad de cuidados intensivos (DAU) es desarrollada por el 40-46% de los pacientes ingresados en UCI. Diferentes estudios han mostrado que la movilización temprana (MT) es segura, factible, costo-efectiva y mejora los resultados del paciente a corto y largo plazo. Objetivo Diseñar un algoritmo de MT para el paciente crítico en general y enumerar unas recomendaciones para la MT en subpoblaciones específicas de paciente crítico con más riesgo para la movilización: neurocrítico, traumático, sometido a terapias continuas de depuración renal (TCDR) y con dispositivos de asistencia ventricular (DAV) o membrana de oxigenación extracorpórea (ECMO). Metodología Revisión en las bases de datos Medline, CINAHL, Cochrane y PEDro de estudios publicados en los últimos 10 años, que aporten protocolos/intervenciones de MT. Resultados Se incluyeron 30 artículos. De ellos, 21 eran para guiar la MT en el paciente crítico en general, 7 en pacientes neurocríticos y/o traumáticos, uno en pacientes portadores de TCDR y uno en pacientes portadores de ECMO y/o DVA. Se diseñan 2 figuras: una para la toma de decisiones teniendo en cuenta el bundle ABCDEF y la otra con los criterios de seguridad y objetivo de movilidad para cada uno. Conclusiones Los algoritmos de MT aportados pueden promover la movilización precoz (entre el 1.er y 5.o día de ingreso en UCI), junto a aspectos a tener en cuenta antes de la movilización y criterios de seguridad para suspenderla. (AU)

Introduction Intensive care unit (ICU)-acquired weakness is developed by 40%-46% of patients admitted to ICU. Different studies have shown that Early Mobilisation (EM) is safe, feasible, cost-effective and improves patient outcomes in the short and long term. Objective To design an EM algorithm for the critical patient in general and to list recommendations for EM in specific subpopulations of the critical patient most at risk for mobilisation: neurocritical, traumatic, undergoing continuous renal replacement therapy (CRRT) and with ventricular assist devices (VAD) or extracorporeal membrane oxygenation (ECMO). Methodology Review undertaken in the Medline, CINAHL, Cochrane and PEDro databases of studies published in the last 10 years, providing EM protocols/interventions. Results 30 articles were included. Of these, 21 were on guiding EM in critical patients in general, 7 in neurocritical and/or traumatic patients, 1 on patients undergoing CRRT and 1 on patients with ECMO and/or VAD. Two figures were designed: one for decision-making, taking the ABCDEF bundle into account and the other with the safety criteria and mobility objective for each. Conclusions The EM algorithms provided can promote early mobilisation (between the 1st and 5th day from admission to ICU), along with aspects to consider before mobilisation and safety criteria for discontinuing it. (AU)

Early mobilisation algorithm for the critical patient. Expert recommendations.

INTRODUCTION: Intensive care unit (ICU)-acquired weakness is developed by 40%-46% of patients admitted to ICU. Different studies have shown that Early Mobilisation (EM) is safe, feasible, cost-effective and improves patient outcomes in the short and long term. OBJECTIVE: To design an EM algorithm for the critical patient in general and to list recommendations for EM in specific subpopulations of the critical patient most at risk for mobilisation: neurocritical, traumatic, undergoing continuous renal replacement therapy (CRRT) and with ventricular assist devices (VAD) or extracorporeal membrane oxygenation (ECMO). METHODOLOGY: Review undertaken in the Medline, CINAHL, Cochrane and PEDro databases of studies published in the last 10 years, providing EM protocols/interventions. RESULTS: 30 articles were included. Of these, 21 were on guiding EM in critical patients in general, 7 in neurocritical and/or traumatic patients, 1 on patients undergoing CRRT and 1 on patients with ECMO and/or VAD. Two figures were designed: one for decision-making, taking the ABCDEF bundle into account and the other with the safety criteria and mobility objective for each. CONCLUSIONS: The EM algorithms provided can promote early mobilisation (between the 1st and 5th day from admission to ICU), along with aspects to consider before mobilisation and safety criteria for discontinuing it.

El proceso de información a los familiares en las unidades de cuidados intensivos: una revisión narrativa / The process of giving information to families in intensive care units: A narrative review

OBJETIVO: La información es una de las necesidades más importantes de los familiares de pacientes críticos. Los profesionales sanitarios identifican también el gran valor de la comunicación con los familiares para reducir su ansiedad y su estrés. A pesar de ello, los familiares pueden sentirse indebidamente informados, lo cual causa un sufrimiento añadido. El objetivo de este estudio es tratar de comprender las perspectivas de los familiares y los profesionales sanitarios sobre la información que se aporta en las unidades de cuidados intensivos (UCI). MÉTODO: Se realizó una revisión narrativa utilizando las bases de datos MEDLINE, CINAHL, PsycINFO y Cochrane Library para identificar los estudios publicados en inglés y en español de 2002 a 2018. RESULTADOS: Se incluyeron 46 estudios, identificándose cinco categorías: 1)«Necesidad de saber»; 2)«Satisfacción del familiar con la información recibida»; 3)«Impacto de la información en las experiencias de los familiares en la UCI»; 4)«Percepciones de las enfermeras y médicos sobre la transmisión de información», y 5)«Proceso de información en la UCI». CONCLUSIONES: La aportación de información honesta y veraz a los familiares de los pacientes críticos es esencial para reducir su ansiedad e incrementar su control, aunque parece que esto no siempre es adecuadamente realizado por el personal. La implicación interdisciplinaria en la aportación de información puede ser beneficiosa para los familiares y los profesionales de las UCI. Esta revisión aporta una nueva comprensión acerca del proceso de información a los familiares de los pacientes de la UCI y puede utilizarse para mejorar la calidad y la humanización de los cuidados en dichas unidades

AIM: Information is one of the most important needs of families of critical patients. Healthcare professionals also identify the great value of communication with families to reduce their anxiety and stress. Despite this, families may feel inadequately informed, causing added suffering. The purpose of this study is to provide an understanding of both families' and healthcare professionals' perspectives on information giving within intensive care units (ICU). METHOD: A narrative review was conducted using MEDLINE, CINAHL, PsycINFO databases and the Cochrane Library to identify studies published in either English or Spanish from 2002 to 2018. RESULTS: 47 studies were included, and five categories were identified: 1)"the need to know"; 2)family satisfaction with the information received; 3)impact of information on families' experiences in the ICU; 4)nurses and physicians' perceptions of information transmission, and 5)information process in the ICU. CONCLUSIONS: Providing honest and truthful information to the families of critical patients is essential to reduce family anxiety and increase family control, although this often appears to be inadequately accomplished by staff. Interdisciplinary involvement in information giving may be beneficial for both families and ICU professionals. This review brings new understanding about the process of information to families of ICU patients and it can be used to improve the quality and humanization of care in the ICUs

Validez de las revisiones sistemáticas: sesgo por inclusión y presentación selectiva de resultados en ensayos aleatorizados de intervenciones en salud / Bias due to selective inclusion and reporting of outcomes and analyses in systematic reviews of randomised trials of healthcare interventions

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The process of giving information to families in intensive care units: A narrative review. / El proceso de información a los familiares en las unidades de cuidados intensivos: una revisión narrativa.

AIM: Information is one of the most important needs of families of critical patients. Healthcare professionals also identify the great value of communication with families to reduce their anxiety and stress. Despite this, families may feel inadequately informed, causing added suffering. The purpose of this study is to provide an understanding of both families' and healthcare professionals' perspectives on information giving within intensive care units (ICU). METHOD: A narrative review was conducted using MEDLINE, CINAHL, PsycINFO databases and the Cochrane Library to identify studies published in either English or Spanish from 2002 to 2018. RESULTS: 47 studies were included, and five categories were identified: 1)"the need to know"; 2)family satisfaction with the information received; 3)impact of information on families' experiences in the ICU; 4)nurses and physicians' perceptions of information transmission, and 5)information process in the ICU. CONCLUSIONS: Providing honest and truthful information to the families of critical patients is essential to reduce family anxiety and increase family control, although this often appears to be inadequately accomplished by staff. Interdisciplinary involvement in information giving may be beneficial for both families and ICU professionals. This review brings new understanding about the process of information to families of ICU patients and it can be used to improve the quality and humanization of care in the ICUs.

Experiencias del paciente durante la retirada de la ventilación mecánica invasiva: una revisión de la literatura / Patients’ experience during weaning of invasive mechanical ventilation: A review of the literature

Objetivo: La retirada de la ventilación mecánica invasiva (VMI) es un procedimiento en el que influyen factores fisiológicos y psicológicos, siendo estos últimos los menos estudiados. El objetivo fue identificar en la literatura, las experiencias de los pacientes durante la retirada de la VMI y cómo intervienen en dicho proceso. Método: Se realizó una búsqueda bibliográfica en las bases de datos Pubmed, CINAHL y PsycINFO. Los términos de búsqueda fueron: «patient», «experience» y «ventilator weaning». Los límites fueron la edad (> 19 años) y el idioma (inglés, español y finlandés). Resultados: Se analizaron 15 publicaciones. Los principales resultados se agruparon en tres grandes temas según las percepciones, sentimientos y experiencias del paciente, la influencia de la atención de los profesionales y los factores determinantes para la retirada exitosa de la VMI. Los pacientes recuerdan la retirada de la VMI como un proceso estresante y experimentan ansiedad, frustración, desesperación o incertidumbre. Las enfermeras tienen un papel fundamental en la mejora de la comunicación con el paciente y en la anticipación a sus necesidades. El soporte familiar y el cuidado proporcionado por los profesionales se destacan como fundamentales durante el proceso. Para conseguir una retirada exitosa de la VMI se identifica la importancia de la autodeterminación, la automotivación y la confianza de los pacientes. Conclusiones: La atención psicológica, además de la física y la tecnológica, es importante durante la retirada de la VMI para proporcionar un cuidado holístico. Son necesarios estudios de intervención para lograr mejorar la atención a los pacientes durante dicho proceso

Objective: Weaning from invasive mechanical ventilation (IMV) is influenced by physiological and psychological factors, the latter being the least studied. The aim was to identify, through the literature, patients’ experiences during weaning from IMV and report its influencing factors. Method: The literature search was conducted using the Pubmed, CINAHL and PsycINFO databases. The search terms were: ‘patient’, ‘experience’ and ‘ventilator weaning’. The research limits were: age (> 19 years) and language (English, Spanish and Finnish). Results: Fifteen publications were analysed. The main results were grouped into three main categories according to patient's perceptions, feelings and experiences, influence of professionals’ attention and determinants for successful weaning. Patients remember IMV weaning as a stressful process where they experience anxiety, frustration, despair or uncertainty. Nurses have a key role in improving communication with patients and foreseeing their needs. Family support and the care provided by the caregivers were shown as essential during the process. The patient's self-determination, self-motivation and confidence are identified as important factors to achieve successful IMV weaning. Conclusions: Psychological care, in addition to physical and technical care, is important at providing holistic care. Interventional studies are needed to improve the care during the weaning experience

Patients' experience during weaning of invasive mechanical ventilation: A review of the literature. / Experiencias del paciente durante la retirada de la ventilación mecánica invasiva: una revisión de la literatura.

OBJECTIVE: Weaning from invasive mechanical ventilation (IMV) is influenced by physiological and psychological factors, the latter being the least studied. The aim was to identify, through the literature, patients' experiences during weaning from IMV and report its influencing factors. METHOD: The literature search was conducted using the Pubmed, CINAHL and PsycINFO databases. The search terms were: "patient", "experience" and "ventilator weaning". The research limits were: age (>19years) and language (English, Spanish and Finnish). RESULTS: Fifteen publications were analysed. The main results were grouped into three main categories according to patient's perceptions, feelings and experiences, influence of professionals' attention and determinants for successful weaning. Patients remember IMV weaning as a stressful process where they experience anxiety, frustration, despair or uncertainty. Nurses have a key role in improving communication with patients and foreseeing their needs. Family support and the care provided by the caregivers were shown as essential during the process. The patient's self-determination, self-motivation and confidence are identified as important factors to achieve successful IMV weaning. CONCLUSIONS: Psychological care, in addition to physical and technical care, is important at providing holistic care. Interventional studies are needed to improve the care during the weaning experience.

Análisis de la intensidad de colaboración profesional entre enfermeras en un área de críticos / Analysis of the intensity of professional collaboration among nurses in a critical care area

Objetivo/s: Analizar la intensidad de colaboración profesional (ICP) entre enfermeras de un área de críticos (AC) polivalente y su relación con el lugar de trabajo «unidad de cuidados intensivos (UCI) y área de hospitalización especializada (AHE)», nivel de educación, edad y años de actividad profesional en AC. Método: Estudio descriptivo transversal. La población atiende a 57 enfermeras de un AC. Registro de variables sociodemográficas: edad, nivel de educación, especialidad, años de ejercicio profesional y tipo de jornada, años de actividad profesional en AC y participación científica. Instrumento: cuestionario «Intensité de la Collaboration Interprofessionalle». Análisis estadísticos: SPSS 20.0. Resultados: Participaron un total de 47 enfermeras (UCI/AHE). Edad media: 35,91 (9,59) años. El 74,46% son diplomadas en enfermería, con formación de posgrado en UCI. Mediana y rango intercuartílico de años de actividad profesional 14 y 14,50. Y de años trabajando en AC 8,50 y 16. El 51,10% trabajan a jornada reducida. Un 61,70% han participado en trabajos científicos. Puntuación media de ICP: 61,68 (6,84). El 57,40% aportan valores de ICP alta. La relación entre el lugar de trabajo (UCI/AHE) y el nivel de educación con la ICP no es estadísticamente significativa (p > 0,05). Sí se encuentran diferencias estadísticamente significativas al comparar la ICP con la edad y los años de actividad profesional en AC (p < 0,05). Conclusiones: El presente estudio muestra que existe una buena ICP en el AC. Las enfermeras de menor edad obtienen una mejor puntuación en la ICP, así como las que llevan trabajando menos tiempo en AC. Las enfermeras con título de grado o máster poseen un nivel de ICP más alto que el resto. También las enfermeras que desarrollan simultáneamente su actividad profesional en UCI y AHE

Objective/s: To analyse the intensity of professional collaboration (IPC) between the nurses in a multidisciplinary critical area (CA) and the relationship with the workplace 'intensive care unit (ICU) and special hospitalisation area (SHA)', educational level, age, and years of professional activity in CA. Method: A cross-sectional descriptive study was conducted with 57 nurses from CA, recording socio-demographic data: age, educational level, speciality titles, years of professional activity and workday type, years of professional activity in the CA, and involvement in scientific works. Tool: Intensity of Inter-professional Collaboration Questionnaire. Statistical analysis: SPSS 20.0. Results: The study included a total of 47 nurses (ICU/SHA), with a mean age of 35.91 (9.59) years. Almost three-quarters (74.46%) were nursing graduates with a posgraduate in ICU. Median and interquartile range of professional experience was 14 and 14.50 years, respectively, and years working in CA was 8.50 and 16 years, respectively. Just over half of them (51.10%) worked part-time, and 61.70% participated in scientific works. The mean IPC score was 61.68 (6.84), with 57.40% providing values of high IPC. The relationship between the workplace (ICU/SHA) and educational level with IPC was not statistically significant (p > .05). There are statistical significant differences between IPC with age and years of professional activity in CA (p < .05). Conclusions: The present study demonstrates the existence of good IPC in the CA. Younger nurses obtain a better IPC score, as well as nurses who have been working for less time in CA. Nurses with a Degree or Masters have a higher level of IPC than the rest, as well as nurses who perform professional activity combining ICU and SHA

[Analysis of the intensity of professional collaboration among nurses in a critical care area]. / Análisis de la intensidad de colaboración profesional entre enfermeras en un área de críticos.

OBJECTIVE/S: To analyse the intensity of professional collaboration (IPC) between the nurses in a multidisciplinary critical area (CA) and the relationship with the workplace "intensive care unit (ICU) and special hospitalisation area (SHA)", educational level, age, and years of professional activity in CA. METHOD: A cross-sectional descriptive study was conducted with 57 nurses from CA, recording socio-demographic data: age, educational level, speciality titles, years of professional activity and workday type, years of professional activity in the CA, and involvement in scientific works. Tool: Intensity of Inter-professional Collaboration Questionnaire. STATISTICAL ANALYSIS: SPSS 20.0. RESULTS: The study included a total of 47 nurses (ICU/SHA), with a mean age of 35.91 (9.59) years. Almost three-quarters (74.46%) were nursing graduates with a posgraduate in ICU. Median and interquartile range of professional experience was 14 and 14.50 years, respectively, and years working in CA was 8.50 and 16 years, respectively. Just over half of them (51.10%) worked part-time, and 61.70% participated in scientific works. The mean IPC score was 61.68 (6.84), with 57.40% providing values of high IPC. The relationship between the workplace (ICU/SHA) and educational level with IPC was not statistically significant (p>.05). There are statistical significant differences between IPC with age and years of professional activity in CA (p<.05). CONCLUSIONS: The present study demonstrates the existence of good IPC in the CA. Younger nurses obtain a better IPC score, as well as nurses who have been working for less time in CA. Nurses with a Degree or Masters have a higher level of IPC than the rest, as well as nurses who perform professional activity combining ICU and SHA.

Restricciones físicas en UCI: su utilización y percepción de pacientes y familiares / Physical restraint use in critical care units. Perceptions of patients and their families

IntroducciónLa utilización de restricciones físicas en las Unidades de Cuidados Intensivos (UCI) es habitual, aunque se conoce poco sobre la percepción que tienen los pacientes y familiares.Objetivos1) Analizar la prevalencia y el uso de las restricciones físicas en una UCI polivalente. 2) Conocer la percepción de los pacientes que han estado con un sistema de restricción física y 3) Conocer la percepción de los familiares de los pacientes que han estado con restricción física.MétodoInvestigación descriptiva, que ha utilizado métodos cuantitativo y cualitativo, realizada en una UCI polivalente. Para responder al primer objetivo se analizaron todos los pacientes, 101, que durante el periodo de estudio estuvieron con restricción física. Para el segundo y tercer objetivos, se entrevistaron 30 pacientes y 30 familiares utilizando la guía de Strumpf&Evans, modificada por Hardin (1993). Las entrevistas fueron grabadas y transcritas íntegramente, realizándose un análisis de contenido del lenguaje utilizando el método de Hsieh&Shannon.ResultadosLa única restricción utilizada fue la muñequera, prevalencia 43,47%. El 72% de los pacientes la llevó ≤12h y el 28%>12h. Del análisis de las entrevistas de los pacientes emergen cuatro temas: aceptación de la restricción física condicionada por las creencias y la información recibida; sentimientos y sensaciones generadas por la restricción física; alternativas propuestas; repercusión en el futuro. Y de las de los familiares, tres: impresiones producidas por las restricciones; motivos de aceptación o rechazo; alternativas a las restricciones.ConclusionesLa mayoría de los pacientes estuvieron con restricción física durante un breve periodo de tiempo, utilizándose un único sistema. Los pacientes con restricción física y sus familiares manifestaron diversidad de sentimientos y sensaciones, sin repercusión negativa en el futuro. En general expresaron su acuerdo, si bien una información más precisa mejoraría su aceptación (AU)

IntroductionThe use of physical restraints in Intensive Care Units (ICU) is common although little is known about patients’ and relatives’ perceptions of this use.Objectives1) To analyze the prevalence and use of physical restraints in a general adult ICU; 2) to know the perceptions of patients who experienced use of physical restraints and; 3) to know the perceptions of relatives of patients who used physical restraints.MethodsThis descriptive study, which used both quantitative and qualitative methods, was carried out in an adult ICU. For the first objective, all the patients (101) who had used any kind of physical restraint were analysed. For the second and third objectives, 30 patients and 30 relatives were interviewed using the guidelines of Strumpf & Evans as modified by Hardin (1993). All interviews were recorded, fully transcribed and then submitted to a language content analysis using the method of Hsieh & Shannon.ResultsThe only physical restraint used was the wrist restraint with a prevalence of 43.47%. Seventy-two percent of patients wore the restraint ≤12h and 28%>12h. Analysis of the patient interviews revealed 4 main themes: acceptance of the restraint conditioned by beliefs and information provided; feelings and sensations caused by the use of the restraint; alternatives proposed and future repercussions. Three themes emerged from the interviews with relatives: impressions caused by the use of the restrictions; reasons for accepting or rejecting them; alternatives to the use of restraints.ConclusionsMost patients used physical restraints for a short period of time and only the wrist restraint was used. Patients using physical restraints and their relatives expressed a wide range of feelings and sensations, with no negative future repercussions. In general, they agreed with the use of restraints although more precise information would lead to greater acceptance (AU)

[Physical restraint use in critical care units. Perceptions of patients and their families]. / Restricciones físicas en UCI: su utilización y percepción de pacientes y familiares.

INTRODUCTION: The use of physical restraints in Intensive Care Units (ICU) is common although little is known about patients' and relatives' perceptions of this use. OBJECTIVES: 1) To analyze the prevalence and use of physical restraints in a general adult ICU; 2) to know the perceptions of patients who experienced use of physical restraints and; 3) to know the perceptions of relatives of patients who used physical restraints. METHODS: This descriptive study, which used both quantitative and qualitative methods, was carried out in an adult ICU. For the first objective, all the patients (101) who had used any kind of physical restraint were analysed. For the second and third objectives, 30 patients and 30 relatives were interviewed using the guidelines of Strumpf & Evans as modified by Hardin (1993). All interviews were recorded, fully transcribed and then submitted to a language content analysis using the method of Hsieh & Shannon. RESULTS: The only physical restraint used was the wrist restraint with a prevalence of 43.47%. Seventy-two percent of patients wore the restraint ≤12h and 28%>12h. Analysis of the patient interviews revealed 4 main themes: acceptance of the restraint conditioned by beliefs and information provided; feelings and sensations caused by the use of the restraint; alternatives proposed and future repercussions. Three themes emerged from the interviews with relatives: impressions caused by the use of the restrictions; reasons for accepting or rejecting them; alternatives to the use of restraints. CONCLUSIONS: Most patients used physical restraints for a short period of time and only the wrist restraint was used. Patients using physical restraints and their relatives expressed a wide range of feelings and sensations, with no negative future repercussions. In general, they agreed with the use of restraints although more precise information would lead to greater acceptance.

La calidad asistencial en cuidados intensivos evaluada por los pacientes mediante la escala SERVQUAL / Care quality in intensive care evaluated by the patients using a service quality scale (SERVQUAL)

Introducción La evaluación realizada por los pacientes de la calidad del servicio que han recibido es importante para introducir estrategias de mejora en la calidad asistencial.Objetivos1. Evaluar la calidad asistencial mediante el análisis de las diferencias obtenidas entre las expectativas y las percepciones que los pacientes tienen del servicio recibido en la UCI.2. Analizar si existe relación entre la calidad asistencial evaluada por los pacientes y las variables sociodemográficas.MétodoSe estudió prospectivamente a 86 pacientes que durante su estancia en la UCI estuvieron conscientes y orientados. A las 24h del alta de la UCI se les pasó la escala SERVQUAL (Service Quality), adaptada para el ámbito hospitalario por Babakus y Mangold (1992); esta escala mide la calidad asistencial basada en la diferencia de puntuaciones obtenidas entre las expectativas y las percepciones de los pacientes; las puntuaciones positivas indican que las percepciones de los pacientes superan sus expectativas. La escala tiene 5 dimensiones: tangibilidad, fiabilidad, capacidad de respuesta, seguridad y empatía. Incluye 15 ítems para las percepciones y los mismos para las expectativas, con 5 grados de respuesta (1: totalmente en desacuerdo-5: totalmente de acuerdo).ResultadosLa puntuación media de las percepciones (66,92) superó la de las expectativas (62,30). La puntuación media de la diferencia entre percepciones y expectativas para el total de la escala SERVQUAL fue de (..) (AU)

Introduction The evaluation made by the patients on the quality of service received is important to introduce improvement strategies in the care quality.Objectives1. To evaluate the care quality through the analysis of the differences obtained between expectations and perceptions, that the patients have of the service received in the ICU2. To analyze if there is any relationship between care quality evaluated by the patients and the sociodemographic variables.MethodA total of 86 patients who were conscious and oriented during their stay in the ICU were studied prospectively. At 24h of the discharge from the ICU, the SERVQUAL (Service Quality) scale, adapted for the hospital setting by Babakus and Mangold (1992), was applied. This scale measures the care quality based on the difference in scores obtained between expectations and perceptions of the patients. The positive scores indicate that the perceptions of the patients exceed their expectations. The scale has 5 dimensions: Tangibility, Reliability, Responsiveness, Assurances and Empathy. It includes 15 items for perceptions and the same for expectations, with 5 grades of response (1 totally disagree – 5 totally agree).ResultsThe mean score of perceptions 66.92) exceeded that of the expectations (62.30). The mean score of the difference between perceptions and expectations for the total of the SERVQUAL scale was 4.62. It was also positive for each one of the dimensions: Tangibility=1.44, Reliability=0.53, Responsiveness=0.95, Assurances=0.99, Empathy=0.71. No statistically significant associations were found between care quality evaluated by the patients and the sociodemographic variables.ConclusionThe care quality perceived by the patients in the ICU exceeds their expectations, and had no relationship with the sociodemographic characteristics(AU)

[Care quality in intensive care evaluated by the patients using a service quality scale (SERVQUAL)]. / La calidad asistencial en cuidados intensivos evaluada por los pacientes mediante la escala SERVQUAL.

INTRODUCTION: The evaluation made by the patients on the quality of service received is important to introduce improvement strategies in the care quality. OBJECTIVES: 1. To evaluate the care quality through the analysis of the differences obtained between expectations and perceptions, that the patients have of the service received in the ICU. 2. To analyze if there is any relationship between care quality evaluated by the patients and the sociodemographic variables. METHOD: A total of 86 patients who were conscious and oriented during their stay in the ICU were studied prospectively. At 24h of the discharge from the ICU, the SERVQUAL (Service Quality) scale, adapted for the hospital setting by Babakus and Mangold (1992), was applied. This scale measures the care quality based on the difference in scores obtained between expectations and perceptions of the patients. The positive scores indicate that the perceptions of the patients exceed their expectations. The scale has 5 dimensions: Tangibility, Reliability, Responsiveness, Assurances and Empathy. It includes 15 items for perceptions and the same for expectations, with 5 grades of response (1 totally disagree - 5 totally agree). RESULTS: The mean score of perceptions 66.92) exceeded that of the expectations (62.30). The mean score of the difference between perceptions and expectations for the total of the SERVQUAL scale was 4.62. It was also positive for each one of the dimensions: Tangibility=1.44, Reliability=0.53, Responsiveness=0.95, Assurances=0.99, Empathy=0.71. No statistically significant associations were found between care quality evaluated by the patients and the sociodemographic variables. CONCLUSION: The care quality perceived by the patients in the ICU exceeds their expectations, and had no relationship with the sociodemographic characteristics.