Publications by authors named "Esther Gonzalez-Maria"

25 Publications

  • Page 1 of 1

[Nursing mothers satisfaction with the promotion of breastfeeding and professionals adherence to the recommendations. Multi-center study.]

Rev Esp Salud Publica 2020 Dec 10;94. Epub 2020 Dec 10.

Unidad Maternidad-Pediatría. Hospital Medina del Campo. Valladolid. España.

Objective: The Baby-friendly Hospital Initiative or clinical practice guideline implementation programs have a positive impact on the promotion of breastfeeding (BF). There are knowledge gaps regarding the perceptions of new mothers towards these initiatives, and their degree of satisfaction. Our objective was to describe the satisfaction of BF mothers and adherence to the recommendations of the "Breastfeeding" guide from the Registered Nurses' Association of Ontario (RNAO).

Methods: Between 2018-2019, in 9 Spanish hospitals that implemented the guide, 2,397 nursing mothers were surveyed who met inclusion criteria. A self-administered survey was designed with sociodemographic data, mother-child, BF promotion interventions carried out and degree of satisfaction. Descriptive and bivariate analysis was performed.

Results: The recommendations for skin-to-skin contact, help in breastfeeding, observation of a breastfeeding session and resolution of doubts presented adhesions >84%. Information about support groups, rooming-in and recognize signs of baby satisfaction obtained adhesions <40%. The exclusive BF rate at discharge was 77.5%. The mean satisfaction with skin-to-skin contact and the percentage of satisfaction at discharge were 5.8 and 96.8% respectively. The differences were significant between the degree of satisfaction and the educational level, age, work situation, type of delivery and type of hospital (p<0.05).

Conclusions: According to puerperal women, adherence to the recommendations of the Clinical Practice Guide is good for most interventions and the degree of satisfaction is high.
View Article and Find Full Text PDF

Download full-text PDF

Source
December 2020

Impact of the implementation of best practice guidelines on nurse's evidence-based practice and on nurses' work environment: Research protocol.

J Adv Nurs 2021 Jan 15;77(1):448-460. Epub 2020 Oct 15.

Faculty of Nursing and Physiotherapy, Balearic Islands University, Palma de Mallorca, Spain.

Aim: To determine the impact of the Best Practice Spotlight Organization® initiative on nurses' perception of their work environment and their attitudes to evidence-based practice.

Design: Quasi-experimental, multicentre study. The intervention is the participation in Best Prectice Spotilight Organizations to implement Best Practice Guidelines.

Methods: The study will include seven centres in the interventional group and 10 in the non-equivalent control group, all of them belonging to the Spanish national health system. The Practice Environment Scale of the Nursing Work Index, and the Health Sciences Evidence-Based Practice Questionnaire will be administered to a sample of 1,572 nurses at the beginning of the programme and at 1 year. This 3-year study started in April 2018 and will continue until December 2021. Statistical analyses will be carried out using the SPSS 25.0. This project was approved by the Drug Research Ethics Committee of the Parc de Salut Mar and registered in Clinical Trials.

Discussion: The study findings will show the current state of nurses' perception of their work environment and attitudes to evidence-based practice, and possible changes in these parameters due to the programme.

Impact: The findings could provide a strong argument for health policymakers to scale up the Best Practice Spotlight Organization® initiative in the Spanish national health system.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jan.14598DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7756465PMC
January 2021

Limited Reuse and Extended Use of Filtering Facepiece Respirators.

Enferm Clin 2021 Feb 21;31 Suppl 1:S78-S83. Epub 2020 May 21.

Facultad de Enfermería, Universidad de Murcia; Hospital Reina Sofía, Servicio Murciano de Salud. Instituto Murciano de Investigación Biomédica (IMIB-Arrixaca). (Investén-isciii). CIBERFES, Murcia, España.

Aim: Personal protective equipment (PPE), including respirators, is essential in a pandemic like COVID-19, which has required, on many occasions, the reuse of material due to its shortage. The aim of this review is to summarize available evidence on the reuse and extended use of filtering facepiece respirator.

Method: Scoping review. Search through natural language in PUBMED and Centers, Agencies and Organizations for Disease Control. Limited to articles published between 2010-2020 in English and Spanish.

Results: 83 articles were located, 14 were selected, plus 5 recommendations. The topics included in this study are classified in 7 sections: expiration, extended use and reuse of masks, handling techniques, sealing, physical-psychological effects and compliance, contamination and decontamination of respirators.

Conclusions: The reuse of masks is not recommended by official organizations or manufacturers, and is only accepted in extraordinary cases, such as pandemics. The studies are characterized by having small samples, using different models of respirators adjusting their recommendation to the model.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.enfcli.2020.05.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7241318PMC
February 2021

Evaluation of implementation strategies of the Best Practices Spotlight Organisations (BPSO) Project in Spain.

Enferm Clin 2020 May - Jun;30(3):222-230. Epub 2020 May 7.

Unidad de Investigación en Cuidados y Servicios de Salud (Investén-isciii), CIBERFES, Instituto de Salud Carlos III, Madrid, España.

Objective: To identify favourable elements and barriers to implementation in the Program of Best Practice Spotlight Organization® that establish clinical practice guidelines of the Registered Nurse' Association of Ontario, so that future experiences could benefit from the assessments presented here.

Method: Evaluation research study of the process of implementing guidelines in institutions that make up the first two cohorts of the programme in Spain, through analysis of contents of implantation reports and inductive process, reading, interpretation, coding and categorized according to SWOT structure: Strengths, weaknesses, opportunities and threats.

Results: Reports from 18 centres in 12 Autonomous Communities have been analyzed, including 22 different guidelines. As weaknesses, problems related to information systems and their exploitation stand out for frequency and intensity. Other elements related to dissemination of results, to professionals, care and factors related to the institution are presented. Standing out as threats are the instability of staff and continued changes in Senior Management or corporate policies. Among the strengths, the exclusive dedication of personnel to the project and its link to institutional objectives are distinguished. As opportunities, the possibility of standardized comparison of own results with others, as well as the dissemination of results are highlighted.

Conclusion: A useful pattern is set up to approach implementation in other scenarios, where changes in professional culture, training, communication and leadership, as well as aligning interests of managers and politicians, facilitate ideal conditions for Evidence-Based Practice.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.enfcli.2019.10.027DOI Listing
May 2020

Implementation of best practice guidelines for ostomy care and management: Care outcomes.

Enferm Clin 2020 May - Jun;30(3):176-184. Epub 2020 Apr 28.

Hospital de Medina del Campo, Medina del Campo, Valladolid, España.

Introduction: Care provided to ostomized people is crucial in their progress and rehabilitation. The Registered Nurses' Association of Ontario clinical practice guidelines include greatest evidence nursing interventions for ostomized patient care. The aim of the study is to analyze the impact on patients' care and health outcomes after Care and management of ostomy guideline implementation.

Method: Pre-post quasi-experimental study, carried out in all patients who underwent a digestive or urological ostomy in 8 centres of Best Practices Spotlight Organization® where the ostomy care and management guideline was implanted from 2012 to 2018. Clinical, process and health outcome variables were analyzed and compared in 3 periods of time. Descriptive analysis and comparison of proportions between the periods was performed, using Chi square, applying Yates correction, considering a 95% confidence interval.

Results: Preoperative education went from 36.7 to 47.3% (P<.05); stoma site marking from 25.2 to 33.8% (P<.05); postoperative evaluation from 94.8 to 59% (P<.05); postoperative education from 75.5 to 91.9% (P<.05); peristomal skin complications from 16.6 to 10.9% (P<.05), and ostomy complications from 21.8 to 27.9% (P<.05).

Conclusions: The implementation of the ostomy care and management improved preoperative care, stoma site marking and peristomal skin complications.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.enfcli.2019.10.029DOI Listing
April 2020

Implementation of best practice guidelines for ostomy care and management: Care outcomes.

Enferm Clin 2020 May - Jun;30(3):176-184. Epub 2020 Apr 28.

Hospital de Medina del Campo, Medina del Campo, Valladolid, España.

Introduction: Care provided to ostomized people is crucial in their progress and rehabilitation. The Registered Nurses' Association of Ontario clinical practice guidelines include greatest evidence nursing interventions for ostomized patient care. The aim of the study is to analyze the impact on patients' care and health outcomes after Care and management of ostomy guideline implementation.

Method: Pre-post quasi-experimental study, carried out in all patients who underwent a digestive or urological ostomy in 8 centres of Best Practices Spotlight Organization® where the ostomy care and management guideline was implanted from 2012 to 2018. Clinical, process and health outcome variables were analyzed and compared in 3 periods of time. Descriptive analysis and comparison of proportions between the periods was performed, using Chi square, applying Yates correction, considering a 95% confidence interval.

Results: Preoperative education went from 36.7 to 47.3% (P<.05); stoma site marking from 25.2 to 33.8% (P<.05); postoperative evaluation from 94.8 to 59% (P<.05); postoperative education from 75.5 to 91.9% (P<.05); peristomal skin complications from 16.6 to 10.9% (P<.05), and ostomy complications from 21.8 to 27.9% (P<.05).

Conclusions: The implementation of the ostomy care and management improved preoperative care, stoma site marking and peristomal skin complications.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.enfcli.2019.10.029DOI Listing
April 2020

The implementation of Best practice guidelines in Spain through the Programme of the Best Practice Spotlight Organizations®.

Enferm Clin 2020 May - Jun;30(3):136-144. Epub 2019 Nov 26.

Registered Nurses' Association of Ontario (RNAO), Toronto, Ontario, Canadá.

The implementation of Best practice guidelines is effective in improving clinical practice and reducing clinical variability. The Best Practice Guidelines of the Ontario Nurses Association have been implemented in Spain since 2012 following the principles of the Canadian programme of the Best Practice Spotlight Organisations® (BPSO®). The Nursing and Healthcare Research Unit (Investén-isciii) coordinates this programme in Spain, having been nominated BPSO Host by the Ontario Nurses Association. Four strategies were followed: translation of the Best Practice Guidelines, dissemination of same and of the programme, implementation of the Best Practice Guidelines and assessment of the results in competitively selected centres, and, finally, the development of sustainability mechanisms. Implementation is based on the theoretical Knowledge to Action model, which establishes a cycle of 6 phases: identification of the problem and training of selected BPSO®; adaptation to the local context; assessment of facilitators and barriers; adaptation and implementation of interventions; monitoring and evaluation of results, and sustainability. Each of these phases incorporate evidence-based elements that promote the effectiveness of implementation, such as the competitive selection of candidates to participate in the programme, selection by the institution of the guidelines to be implemented, leadership by nurses with a multi-professional approach, planning of the process from work structures that are non-vertical but with the support of the institution, the simultaneous use of multiple strategies, ongoing assessment and feedback of results. All of which is mentored and supported by the BPSO Host. There are currently 27 institutions in Spain of different characteristics that implement a total of 20 clinical guidelines. The scope and structure of the programme has recently been extended with regional BPSO Host coordinating centres, which has brought the number of institutions to 36 and the number of implemented clinical guidelines to 22. The programme has had a positive impact on organisations and the system, on care processes and on patient health. This is evidenced by enriched evidence-based professional practice, the promotion of collaborative networking and by improved patient health outcomes and the quality of care provided.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.enfcli.2019.09.018DOI Listing
November 2019

[Glass ceiling and gender inequalities in the careers of women academics in biomedical sciences].

Gac Sanit 2020 Jul - Aug;34(4):403-410. Epub 2019 Nov 8.

Departamento de Enfermería y Fisioterapia, Facultad de Enfermería y Fisioterapia, Universitat de Lleida, Lleida, España; Grup de Recerca en Cures de la Salut (GRECS), Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, España; Grupo de Estudios Sociedad, Salud, Educación y Cultura (GESEC), Universitat de Lleida, Lleida, España.

Objective: To identify in the international scientific literature the obstacles and potential promoters for the advancement of women academics and researchers in biomedical sciences during their professional careers.

Method: PubMed, Scopus, CinahlPlus, Cochrane Database of Systematic Reviews, PsycInfo and Sociological Abstracts were systematically searched for articles published in English and Spanish between January 2006 and December 2016 on the phenomenon of the glass ceiling in women academics and researchers in biomedical sciences. The screening was carried out by independent reviewers.

Results: A total of 2254 studies were found, of which 23 were included in the review. The obstacles identified for the promotion of women academics and/or researchers in biomedical sciences are: gender bias in the evaluation of research results, individualism and lack of collaboration, women's lack of influence, the existence of gender inequalities in access to employment. The perception of sexism and discrimination in the work environment, and the difficulties in reconciling work and family life. The promoting elements are: examples of women in leadership positions, mentoring, facilitating conciliation, transparency in recruitment, participation in decision-making, gender assessment of research, awareness of gender inequalities in institutions, promoting collaboration, and pay equity.

Conclusions: By enhancing the elements favouring the promotion of academic women in biomedical sciences would help to reduce the glass ceiling in the career paths of women academics and health science researchers by increasing their participation, leadership and representation. A change of organizational and institutional values is required to achieve this.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.gaceta.2018.10.008DOI Listing
November 2019

Getting guidelines into practice: lessons learned as Best Practice Spotlight Organization host.

Int J Evid Based Healthc 2019 Jun;17 Suppl 1:S15-S17

Registered Nurses' Association of Ontario (RNAO), Toronto, Ontario, Canada.

Background: The Spanish Best Practice Guidelines (BPG) Implementation Project is part of the Best Practice Spotlight Organizations international program, coordinated by the Registered Nurses' Association of Ontario (RNAO).

Aims: To influence the uptake of nursing BPG across healthcare organizations, to enable practice excellence and positive client outcomes.

Methods: After translating the RNAO's BPG into Spanish, the Host Organization published a formal call for proposals to select healthcare settings in Spain to implement the RNAO's BPG and evaluate the results. The approach is nursing-led and multidisciplinary; context specific; and involving a wide range of stakeholders. The implementation of BPG Toolkit guides the process: cascade training, selection of recommendations to be implemented, 3 years of planned implementation activities, monitoring of process and outcome results for patients discharged 60 days every year. The Host Organization supports healthcare settings selected.

Results/discussion: The first call was launched in 2012. Eight healthcare settings (11 sites), serving 1.3 million people, were selected (hospitals and primary healthcare centers). They chose 10 BPG, according to their needs. In 2015 and 2018, 16 more healthcare settings have joined the program with a total of 263 sites. And in 2019, three complete regions will join the program as a regional host. Currently, more than 3200 nurses and 40 other healthcare professionals have been trained, evidence-based protocols have been developed or updated, patient education has been promoted, and international Best Practice Spotlight Organizations indicators have been evaluated in an electronic platform.

Conclusion: The results obtained acknowledge that the RNAO implementation method could be replicated with success internationally. The strategies based on local context have worked and we have consolidated a network that shares knowledge and strategies and promotes evidence-based culture among Spanish healthcare settings and evidence-based care to patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/XEB.0000000000000178DOI Listing
June 2019

The SUMAMOS EXCELENCIA Project.

J Adv Nurs 2019 Jul 2;75(7):1575-1584. Epub 2019 Apr 2.

Unidad de investigación en Cuidados de Salud (Investén-isciii), Instituto de Salud Carlos III, Madrid, Spain.

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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jan.13988DOI Listing
July 2019

Falls assessment and interventions among older patients in two medical and one surgical hospital wards in Spain: a best practice implementation project.

JBI Database System Rev Implement Rep 2018 01;16(1):247-257

The Spanish Centre for Evidence Based Nursing and Healthcare: a Joanna Briggs Institute Centre of Excellence.

Objective: The current project aimed to improve fall prevention and management through clinical audits and the implementation of a quality-improvement cycle at the local level.

Introduction: Falls are one of the most common adverse events reported in hospitals; evidence-based fall prevention interventions aim to reduce the number of people who fall.

Methods: A one-year clinical audit was conducted using a pre-post implementation audit method, namely the Joanna Briggs Institute's (JBI) Practical Application of Clinical Evidence System and the getting research into practice audit and feedback tool. Two medical wards and a surgical ward in a Spanish hospital participated. The subjects were evaluated at baseline and at a follow-up at six months after key strategies had been implemented.

Results: Compliance rates for the evidence-based criteria were low in the baseline audit. Five barriers were identified in relation to fall assessment and management and, based on getting research into practice, strategies were designed, developed and implemented to overcome these barriers. After implementation, most of the fall-risk-assessment criteria showed an overall improvement, but there was no effect on care plan recording. Awareness of the assessment and management of fall risks were increased among professionals and patients on all three study wards.

Conclusions: The current project may improve compliance with regard to promoting evidence-based fall prevention and management interventions. Further audits are necessary to evaluate any improvements achieved, in particular, care plans.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11124/JBISRIR-2017-003349DOI Listing
January 2018

[Relationship between disease burden and research funding through the Health Research Foundation in Spain].

Enferm Clin 2014 Jul-Aug;24(4):219-32. Epub 2014 May 10.

Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España.

Objective: To analyze the relationship between burden of disease during 2007-2009 and public funding of research in health in Spain during 2008-2010.

Method: Descriptive cross-sectional study of burden of disease and funding allocated for research in diseases in the Spanish National Health System.

Results: A review was made of a total of 6,573 project titles funded for the years 2008, 2009 and 2010. During this period, a total of 472.7 million Euros were assigned as grants for research projects. Malignant tumors and neuropsychiatric diseases were the illnesses with greatest funding support. During the study period, it was estimated that there was a total of 15,253,331.3 disability-adjusted life years (DALYs) in Spain, with neuropsychiatric diseases being the category representing most DALYs with 4,396,900 (28.8%). The relationship between funding and DALYs was obtained with a Pearson r equal to 0.759 (p<0.001). The study of congenital diseases had higher funding per DALY than any other disease with an investment of 290.4€/DALY. Among these, the study of cleft palate and esophageal atresia, with ratios of 3,432.7€/DALY and 3,387.6€/DALY respectively, obtained the greatest funding.

Conclusions: The study shows that the relative distribution of economic resources in the study period is consistent with the burden suffered by the Spanish population. This relationship is altered by the funding of the study of congenital anomalies, because of the low number of projects in this area.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.enfcli.2014.04.001DOI Listing
March 2016

Content validity of the Spanish version of the Practice Environment Scale of the Nursing Work Index.

Appl Nurs Res 2013 Nov 14;26(4):e5-9. Epub 2013 Oct 14.

Department of Nursing, University Jaume I, Castellón, Spain. Electronic address:

Objective: The objective of this study is to evaluate the content validity of the Iberian Spanish version of the questionnaire The Practice Environment Scale of the Nursing Work Index (PES-NWI) by using the Content Validity Indexing (CVI).

Methods: A descriptive cross-sectional observational study was conducted. The Spanish version of the questionnaire was translated from the American English instrument through forward and back translation processes. Experts evaluated the translated items through content validity indexing. Once the assessments were completed, CVI indicators were calculated: number of agreements, item Content Validity Index and overall content validity and modified kappa coefficient of the instrument.

Results: The overall content validity of the instrument was 0.82. The average modified kappa coefficient of the items was 0.80, with a rating of 'excellent'. Only 4 of the items were rated as weak or poor.

Conclusions: The study demonstrates that the content validity of the Spanish version of the PES-NWI is acceptable. Some results indicate that some items have cross-cultural applicability challenges that need to be addressed in future research studies. Use of the instrument in other Spanish language speaking countries should be taken with caution since some words may not reflect the language of the healthcare systems there.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.apnr.2013.08.006DOI Listing
November 2013

Sleepiness in Spanish nursing staff--influence of chronotype and care unit in circadian rhythm impairment: research protocol.

J Adv Nurs 2014 Jan 3;70(1):211-9. Epub 2013 Jul 3.

Research Healthcare Unit, Hospital Vall D'Hebron, Barcelona, Spain.

Aims: To determine how prevalent circadian rhythm impairments are in nurses working in medical, surgical and intensive care units in five Spanish hospitals and how the quality of night-time sleeping and sleepiness affect the nurses' morning and evening chronotypes.

Background: Shift work is a recognized work pattern for nurses in all countries. Given the important role that nurses play in hospital care, it is vital to establish what repercussions this has on the nurses' working schedules and how any disturbance in circadian rhythm affects patient safety.

Design: A multicentre, observational, descriptive and cross-sectional study in seven hospitals in the Spanish National Health System.

Method: A stratified sample of 1,300 nurses is being collected in three types of units: medical, surgical and intensive care. The 3-year study started in January 2012 and will continue until December 2014, with no exclusion criteria. The Kronowise(®) will be used to monitor the nurses' circadian rhythms, by recording their activity, position and wrist temperature. We will also use three questionnaires to evaluate sleep quality, daytime drowsiness and chronotype: (a) Pittsburg Sleep Quality Index; (b) Epworth Daytime Sleepiness Scale; and (c) Morning and Evening Questionnaire. Data will be collected from each hospital and statistical analysis will be carried out using the SPSS 19.0.

Discussion: The study findings will show the current state of the nurses' circadian rhythms and how shift work can affect them and their job performance. Funding for this 3-year study was granted in December 2011 by the Spanish Health Research Fund (PI 11/00646, Health Ministry). This project is also funded by the Instituto de Salud Carlos III (RETICEF, RD12/0043/0011, RD12/0043/0006).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jan.12200DOI Listing
January 2014

[Work environment and patient safety: data comparison between Seneca and RN4CAST projects].

Enferm Clin 2013 May-Jun;23(3):103-13. Epub 2013 May 4.

Unidad de Investigación en Cuidados de Salud Investén-ISCIII, Instituto de Salud Carlos III, Madrid, España.

Objective: To analyze the relationship between the work environment and burnout of nurses and the quality of care for patient safety at the Spanish National Health System Hospitals included in SENECA and RN4CAST studies.

Method: Descriptive study with a secondary analysis that compares data of 984 patient records, 1469 patient, and 1886 professional surveys from SENECA project, with 2139 nurses' surveys from RN4CAST study, in 24 hospitals. Adverse events data related to care, and patient's and professional's perception of safety were compared with work environment (measured by the Nursing Work Index) and burnout (measured by Maslach Burnout Inventory).

Results: There was a statistically significant relation of pain with «Staffing and resource adequacy» (r=-0,435, p=0,03) and nosocomial infection with «Nursing foundations for quality of care» (r=-0,424; p=0,04) and «Nurse participation in hospital affairs» (r=-0,516, p=0,01) of the Nursing Work Index. The hospital classification obtained from the Nursing Work Index was associated with the patients' perception of safety (r=0,66, p<0,01). Professionals' perception of participation in patient safety issues was associated with the five factors of the Nursing Work Index (r ∈ [|0,41|-|0,78 |], p<0,046) and with Maslach emotional exhaustion (r=-0,518, p=0,01).

Conclusions: The organizations that foster a supportive work environment will have patients that perceive safer care. In addition, proper resource management could decrease the occurrence of adverse events such as pain.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.enfcli.2013.03.005DOI Listing
May 2014

[Perception of work environment of nurses in hospitals of the Spanish national health system. RN4CAST-Spain project].

Enferm Clin 2012 Sep-Oct;22(5):261-8. Epub 2012 Oct 6.

Investigación en cuidados de salud, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España.

Objective: To appraise the perception of Registered Nurses working at Spanish National Health System (SNHS) hospitals about work environment, quality of care and burnout.

Method: Cross-sectional study addressed to 7539 nurses in 59 Spanish public hospitals over 150 beds belonging to the NHS between 2009 and 2010. Data was collected on: socio-demographic and academic background, job satisfaction, perception of work environment (PES-NWI) and burnout (MBI).

Results: Among 7539 questionnaires, 5654 were collected (75%). The nurses' average age was 37,5 (SD=9,5) years old, 88% (4929) were female and they had a median of 12 years of experience. The patient/nurse ratio was 11/1. 26% of nurses (1468) showed their intention to leave the hospital. 55% of nurses (3080) showed moderate job satisfaction. The work environment was unfavorable for 48% (2729) of nurses. 22% (1091) showed high burnout levels.

Conclusions: The results show a high nurses' participation, who relate moderate job satisfaction. However, on PES-NWI, nearly half of nurses show an unfavorable work environment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.enfcli.2012.09.001DOI Listing
December 2013

Validation of the Spanish version of the questionnaire Practice Environment Scale of the Nursing Work Index.

Int J Nurs Stud 2013 Feb 1;50(2):274-80. Epub 2012 Sep 1.

Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain.

Background: The importance of the practice environment in the provision of care and its relation with patient outcomes and nurse-reported outcomes, support the need to have an instrument to measure such practice environment.

Objective: To evaluate the validity and reliability of the Spanish version of the Practice Environment Scale of the Nursing Work Index (PES-NWI), determining the content validity, test-retest reliability, internal consistency and construct validity.

Design: A cross-sectional survey of bedside care nurses undertaken in 2009 in medical, surgical and critical care wards of 33 Spanish National Health Service hospitals with more than 150 beds.

Methods: The validation process followed the internationally recognized guidelines about psychometric properties of instruments: translation and back-translation, content validity, test-retest reliability, internal consistency and construct validity. Other study variables included, like nurses' intention to leave and job satisfaction.

Results: The Intraclass Correlation Coefficient (ICC) for an overall score on the 31 item questionnaire was 0.87 (CI 95%: 0.85-0.89). Cronbach's alpha was 0.90 (CI 95%: 0.87-0.93). The weighted Kappa Index obtained for each of the items ranges from 0.24 (CI 95%: 0.22-0.26) to 0.51 (CI 95%: 0.49-0.53). The Content Validity Index score ranges from 0.5 for the item "Opportunities for advancement" to 1. Five of the terms attain this maximum level of agreement: "Active staff development or continuing education programs for nurses", "Enough registered nurses on staff to provide quality patient care", "Enough staff to get the work done", "Management that listens and responds to employee concerns" and "Collaboration between nurses and physicians".

Conclusions: The validation process indicates that the Spanish version of the PES-NWI is valid and reliable in its current version and it can be used to measure the practice environment of Spanish nurses working in clinical practice in hospitals of the Spanish NHS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijnurstu.2012.08.001DOI Listing
February 2013

[The Spanish best practice guidelines implementation project 2011-2016].

Enferm Clin 2011 Sep-Oct;21(5):275-83. Epub 2011 Sep 15.

Facultad de Enfermería, Universidad de Murcia, España.

The Spanish Best Practice Guidelines Implementation Project 2011-2016 is intended to establish a reference framework for encouraging nursing decision-making based on the best available evidence at different levels of the National Health Service. In line with the Quality Plan for the National Health System 2010 of the Government of Spain, it pretends to improve the effectiveness, safety and efficiency of health care nurse, which will benefit our patients. This Project has been developed and will be set up thanks to the collaboration between the national Nursing Research Development and Coordination Unit (Investén-isciii), the Spanish Joanna Briggs Institute Collaboration Centre (consisted of the Institute of Health Carlos III, 14 Spanish Autonomous Communities and the Ministry of Health, Social Policy and Equality), and the Registered Nurses' Association of Ontario (RNAO), Canada. The Project is structured in four basic strategies in order to answer the objectives. The first strategy is the translation of the 41 Best Practice Guidelines, which were developed by RNAO to the date. The second strategy, the dissemination of the BPG, aims to promote awareness of the existing guidelines across the whole nursing community, and to provide free on-line access. The third and fourth strategies aim to promote and facilitate the BPGs use and maintenance. To achieve these 2 last strategies, a Network of Centres Committed to Excellence in Care will be created to implement, evaluate and sustain these BPGs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.enfcli.2011.07.013DOI Listing
February 2012

Spanish nurses' attitudes towards research and perceived barriers and facilitators of research utilisation: a comparative survey of nurses with and without experience as principal investigators.

J Clin Nurs 2011 Jul 3;20(13-14):1936-47. Epub 2011 May 3.

National Nursing Research Unit, Unidad de coordinación y desarrollo de Investigación en Enfermería (Investen-isciii), Instituto de Salud Carlos III, Madrid, Spain.

Aims And Objective: To examine attitudes towards research and perceived barriers and facilitators of research utilisation in clinical practice in a broad cross-section of Spanish nurses.

Background: Nurses' attitudes towards research are critical in determining whether study findings are used to improve practice.

Design: Cross-sectional comparative survey in Hospitals, Primary Care Centres and University-affiliated schools of nursing.

Methods: Surveys were completed by 917 nurses: 69 who received funding from the Spanish national agency (1998-2004) and a nationally representative sample of 848 nurses who did not have the same research experience (the Comparison group). Two instruments (BARRIERS and Attitudes towards nursing research) were translated and culturally adapted for use in Spain. A descriptive analysis of demographic and practice characteristics was performed. Total scale scores, as well as subscale scores, were computed and compared across the two groups using one-way analysis of variance (anova) and multivariate analysis of variance (manova) with post hoc tests. Pearson product-moment correlation coefficients were computed between the total tool scores and subscales measuring barriers and attitudes in both groups.

Results: The investigators differed from other nurses on several demographic and work characteristics (more males, older age and more likely to work a fixed day shift schedule). On the whole, investigators showed more favourable attitudes but perceived several elements as posing greater barriers to research utilisation than the Comparison groups. Across all respondents, issues related to the quality of research were rated as the greatest barriers to research utilisation, followed by organisational barriers, barriers involving the communication of findings and finally, those related to nurses' values, awareness and skills.

Conclusions: Very similar profiles of perceptions and attitudes regarding research were found in these samples of Spanish nurses relative to those from other countries in earlier reports. Nurses who had experience conducting research demonstrated more favourable research-related attitudes and perceived barriers differently than those without such experience.

Relevance To Clinical Practice: Understanding different organisational and experience perspectives is important to identify challenges and opportunities to ensure research utilisation in clinical practice.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/j.1365-2702.2010.03656.xDOI Listing
July 2011

[Interventions directed by nurses for reducing cardiac risk factors].

Enferm Clin 2010 Sep-Oct;20(5):317-9

Centro Colaborador Español del JBI. Investén-ISCIII. Instituto de Salud Carlos III. Madrid. España.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.enfcli.2010.07.004DOI Listing
February 2011

[Barriers to the utilization of research. A descriptive study of clinical nurses and nurses with experience as researchers].

Enferm Clin 2010 May-Jun;20(3):153-64. Epub 2010 May 12.

Unidad de Coordinación, Desarrollo de la Investigación en Enfermería Investén-ISCIII, Instituto de Salud Carlos III, Madrid, España.

Objective: To identify barriers to the utilization of research as perceived by Spanish nurses in clinical practice and by nurses who have been principal investigators of a research project funded by the national health research funding agency.

Method: Cross-sectional, descriptive and observational study conducted in 2006 in hospitals, primary care health centres and nursing schools from the 17 Spanish Regions. Principal investigators of at least one project funded by the national health research funding agency between 1998 and 2004 were also included. A Spanish version of The BARRIERS to Research Utilization Scale was used. Socio-demographic and occupational variables were gathered with a questionnaire developed by the research team, which was self-administered.

Results: A final sample of 854 out of 1,026 registered nurses (83.43%), and 69 principal investigator nurses out of 86 (80.23%) completed the survey. Highest rated barriers in the group of clinical practicing nurses were: "There is insufficient time on the job to implement new ideas" (mean=3.13; SD=1.08), "The nurse is unaware of the research" (mean=2.84; SD=1.14). Amongst principal investigators, the items rated highest were "The nurse is unaware of the research" (mean=3.12; SD=1.15) "The nurse does not feel capable of evaluating the quality of the research" (mean=2.97; SD=0.88).

Conclusions: Clinical nurses tend to believe that time pressures stand in the way of implementing research findings in practice. Results are consistent with studies in other countries and maintained over time.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.enfcli.2010.01.005DOI Listing
January 2011

[Internet resources on ageing and health].

Enferm Clin 2009 Jul-Aug;19(4):215-20. Epub 2009 Jul 18.

Biblioteca, Agencia Laín Entralgo, Madrid, España.

The general ageing of the world population at the beginning of the XXI century is an established fact, and in the next few years it will be a topic for debate and of interest to the public and, in particular, among health professionals. The Internet, as an inexhaustible information source of a different kind, could be a useful resource for consulting and updating for these professionals. The main health sciences sources that are available on the Internet are presented and commented upon. These may be useful for those professionals who wish to identify the most relevant information on ageing.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.enfcli.2009.04.003DOI Listing
January 2010

[The quality of care in primary care does not differ between specialized nurses and family physicians].

Enferm Clin 2009 Jul-Aug;19(4):233-4. Epub 2009 May 17.

Unidad de coordinación y desarrollo de Investigación en Enfermería, Investén-isciii, Instituto de Salud Carlos III, Madrid, España.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.enfcli.2009.03.003DOI Listing
January 2010

[Free resources for evidence-based care].

Enferm Clin 2007 Nov-Dec;17(6):285-6

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/s1130-8621(07)71819-3DOI Listing
June 2008