In order to manage the venous resource of the patient safely and with responsibility, it is necessary to increase the quality of care provided, unifying and standardizing performance criteria, always based on the best scientific evidence. Emergency Unit nurses must apply evidence in their use of the peripherally inserted central venous catheter (PICC), they must know the protocol approved by the Patient Care Management in their hospital and, most of all, must avoid variability of action, which could increase the risks associated with healthcare as well as mistrust by patients. It is extremely important to keep an updated knowledge and to promote the acquisition of clinical practice skills, in order to guarantee quality care in the use of this type of catheters; the level of compliance of the evidence collected in the hospital protocols must be confirmed periodically. Nurses face the challenge of being updated in the management of vascular accesses, and must give response with seriousness and evidence to the care needed by their patients. This manuscript sets out objectively the need for continuous training and qualification for professionals regarding the adequate use of PICC.
Objectives: to present the evidence available regarding shift work and non-communicable diseases associated with nutrition, and to identify the impact on health caused by this type of work, as well as to summarize the most adequate interventions to prevent or treat said conditions.Method: a narrative review. A search was conducted in the Pubmed, Web of Science and Scopus databases, with the MeSH descriptors: "Shift Work Schedule", "Rotating Shift Work", "Night shift work", "Nutritional Status" and "Nutritional Disorders". The filters used were chronological (2018-2023) and language (English and Spanish).Results: twenty-nine (29) articles were selected. All of them coincided in the existence of alterations in the health of workers who conducted shift work, with particular impact on the diet they followed. The main effects were an increase in cardiovascular risk with higher likelihood of suffering metabolic syndrome, an increase in the risk of developing hypertension, and worse glycemic and weight control. In terms of diet interventions, no research articles addressing this matter were found. An intervention was found regarding eight weeks of physical exercise at a gym in the workplace.Conclusions: shift work was associated with higher cardiovascular risk, mostly due to the fact that these workers followed a worse diet (higher amount of energy ingested, without fixed patterns, abuse of fat and sugar, fibre deficiency, etc.) and did not exercise regularly. Interventions are required in the individual, organizational and collective settings, as well as to delve in research through experimental studies on diet.
Objective: to describe the clinical and sociodemographic profile of women with breast cancer (BC) in a tertiary hospital from the Bajío area, Mexico.Methods: a descriptive cross-sectional study with retrospective data collection. There was a review of 262 clinical records of women with BC, selected through probability sample. The study variables were age, place of residence, level of studies, family and personal history of cancer, comorbidities, smoking, use of alcohol, time since diagnosis, clinical and BC treatment variables.Results: the mean age was 58.07 years; 45.8% had no history of cancer, but in those who had it, the most frequent were mother and sister (10.7% and 10.3% respectively). 42.4% of the patients presented obesity, and 23.3% had over two chronic degenerative conditions. 87% of women did not present metastasis; 19.8% were detected in the IIA stage; G0 was the most frequent level of invasion of lymph nodes (35%). The most common treatment approach was the combination of two or more treatments (95.8%). The majority of patients were discharged due to improvement (71%).Conclusions: knowing the sociodemographic and clinical characteristics of BC patients can help to establish specific strategies for prevention and management in this group, thus offering holistic care.
Objective: to assess the effects of a comprehensive yoga and aerobic exercise (AE) intervention versus standard of care (SOC) exercise on the overall impact and severity of fibromyalgia (FM).Methods: three-arm randomised clinical trial in women diagnosed with FM (groups: YOGA, Satyananda Saraswasi asana series (n=31); AE, 7,000 steps per day (n= 31); SOC (n= 61)). Variables and instruments: anthropometric, sociodemographic and clinical data; Fibromyalgia Health Assessment Questionnaire (FIQ); pain (Widespread pain Index (WPI)); symptom severity (Symptom Severity Score (SSS); quality of life (Combined Index of Severity of Fibromyalgia (CISF)); functional capacity (Fibromyalgia Health Assessment Questionnaire (FHAQ)). For comparison between groups, Student's t-test was used.Results: ininety-six women with FM were studied. With respect to the SOC group, statistically significant (p<0.05), and clinically significant improvements were observed with the YOGA and AE interventions in pain index (WPI), overall impact and severity of FM (FIQ), symptom severity (SSS) and quality of life (CISF). However, no improvement in functional capacity (FHAQ) was observed. Comparing both interventions, yoga versus AE, statistically significant differences were seen in specific symptoms (SSS) and quality of life (CISF).Conclusions: healthcare professionals face numerous challenges in the management of these patients. The findings of this trial are promising regarding the beneficial effects of YOGA and AE in decreasing pain, global impact and severity, and symptom severity, as well as improving quality of life in patients with FM.
Objective: based on the literature available, to understand the meaning of sense of humour between nurses and patients in the setting of Mental Health Units, as well as to determine the factors that facilitate its use, o make it difficult.Methods: a narrative review was conducted during the 2022-2023 period. Searches were conducted in Pubmed, PsycINFO, LILACS and CINAHL, using the descriptors: "Nurse-patient relations", "mental health", "wit and humor as topic", "psychiatric nursing". All type of documents addressing this matter according to the objectives were included, published from 2012 until November 2022 in English, Spanish or Portuguese. An article translated from Korean was added due to its relevance.Results: ten (10) manuscripts were included in the review. Findings suggested that sense of humour was perceived as an essential tool in order to strengthen the relations between nurses and patients in psychiatric settings. However, it was highlighted that there are factors which could induce an inadequate use of humour, leading to dehumanization in care and a potential breach in the therapeutic link.Conclusions: it is important to carefully consider the use of humour in the mental health setting, in order to guarantee its effectiveness without compromising the quality of care.
Objective: to describe the evolution of the vascular access care model led by a nurse infusion therapy (ETI) team and its safety results associated with peripherally inserted central vascular access (PICC) in oncohematology patients.Methods: descriptive observational study in a retrospective cohort in 3,423 oncohaematological patients who were indicated for a PICC on an outpatient basis during 2012 to 2021. Variables: Care model, reason for the indication, access placement verification method, vascular access complications. Data collection using primary data from the vascular access registry and clinical registry of the ESPOQ2© computerized history. Descriptive analysis using IBM® SPSS® Statistics V.23.0.Results: infusional teams' reference increased the capacity to place catheters, going from 98 (2013) to 768 (2021). The indication for the PICC went from 45.80% due to initiation of chemotherapy home infusion (2016) to 93.70% due to an indication for an irritant or vesicant drug (2021) (p< 0.001). The introduction of the ultrasound-guided technique and electro-intracavitary method of tip control decreased complications due to mechanical phlebitis and radiation due to catheter verification (p< 0.001).Conclusions: care models with consolidated reference infusion therapy teams increase the safety of cancer patients with PICC vascular access.
Objective: to analyse the prevalence of falls in patients admitted to a University Hospital, as well as to identify the characteristics of those patients who experienced falls, the factors associated with patient care (reasons for falls, the most prevalent specialty, the most frequent shift, whether they were alone or accompanied, etc.) among patients who fell down, and the potential consequences of said falls.Methods: a cross-sectional study, including all adult patients admitted to 20 hospitalization units from the Hospital Universitario de Burgos, who had experienced a fall in 2019 and were included in the register of falls from the GACELA Care® program. The form consisted of 28 data entry fields, and included information about date, time and place of the fall; reasons for falls; consequences of falls, and action by professionals. Descriptive and comparative analysis was conducted, using the relevant statistical tests.Results: in total, 244 (0.9%) falls were registered. The mean age was 73.3 years; 57.8% were male. The highest proportion of falls was recorded at Internal Medicine (29.1%) and Psychiatry (11.1%); 44.2% occurred during the night shift, in patients who were alone (71.7%); without protections (70.5%); and walking around (36.1%). The main reason was motor instability (48,4%); 62.7% of patients remained unharmed. There was a significant association between specialty and work shift and falls.Conclusions: there was a low prevalence of falls in the hospital. The factors associated with a higher proportion of falls were being >75-year-old, male gender, being admitted to medical specialty units, and night shift. Falls commonly occurred when the patient was alone, without protection, when getting up and walking. Most patients did not present any lesions.
Objective: to determine the occupational quality of life in times of COVID-19 of the Nursing Staff of the Hospital Regional de Coronel Oviedo (Paraguay) during 2022.Method: a cross-sectional descriptive study was conducted at the Hospital Regional de Coronel Oviedo, in Paraguay, including male and female nurses with at least one year of experience. The adapted Occupational Quality of Life Questionnaire by Cruz Luque was used, as well as sociodemographic and occupational variables. Pearson's Square Chi Test was used for bivariate analysis between the quality of life questionnaire dimensions and the sociodemographic and occupational variables.Results: the study included 170 professionals, with a 24-to-43-year age range, with prevalence of female gender (84.7%), married civil status (50.5%), with some specialization in the area (48.2%), and mostly working in one single place. The average daily patients were from one to five (54.7%), with 12-hour work shifts (56.4%). The overall perception of their occupational quality of life was between bad (48%) and moderate (37%). Specific dimensions showed that the lowest perception was found in institutional support (48.82%) and integration in the workplace (52.35%). Statistically significant associations were identified between the perception of work quality and demographic and occupational data such as age, gender, educational level, work shift, work experience, hours worked per week and number of jobs.Conclusion: the perception of quality of work was between bad and moderate, and the main critical areas were the dimensions of institutional support and safety at work.
Objective: to describe the characteristics of resilience and its association with the use of alcohol and tobacco among adolescents living in Eastern Tijuana, in the Northern border of Mexico.Method: a descriptive cross-sectional study on a population of 7,611 adolescents from 11 to 16 years old, attending school in the city of Tijuana, Baja California. The sample was estimated in 633 participants, selected through cluster sampling. Sociodemographic variables were collected, their history of use of tobacco and alcohol, as well as resilience (RS-14) (minimum 14 to maximum 98 scores; very low, low, normal, high or very high). Descriptive bivariate statistics were used, as well as logistical regression models adjusted by gender for the "use of alcohol of tobacco" variable.Results: the study included 710 adolescents (50.7% were female); 46% of them had used alcohol or tobacco at some point in their lives, and 27.1% during the past year (31.5% female; 23.3% male; p= 0.005); 29% showed high resilience and 25.5% showed very high resilience. The most frequently obtained high scores were for the statements: I am someone who can be trusted in emergencies (42.5%), I feel proud of my achievements (41.3%), and Life makes sense (33.1%). A negative effect of resilience was found on alcohol and tobacco use at some point in life (ORa= 0.984; CI95% [0.978-0.990]) and during the past year (ORa= 0.987; CI95% [0.981-0.994]).Conclusion: the higher the resilience, the lower the likelihood of using alcohol or tobacco at some point in life and during the last year. Future interventions should consider these results.
Objective: to determine the level of knowledge about prevention of pressure ulcers (PU) by the Nursing Team (nurses and nursing assistants) at a fourth level hospital in Barranquilla, Colombia.Material and method: a descriptive, cross-sectional study conducted at the Internal Medicine and Intensive Care Units (N= 77). Their age, time of training, time of experience, and level of knowledge about PU prevention were measured through the percentage of right answers at the 41-item Pressure Ulcer Knowledge Questionnaire by Pieper and Mott, translated ad hoc, for the sections of evaluation and classification and prevention. Descriptive and bivariate statistics were conducted.Results: the study included 77 persons. The average proportion of right answers at the knowledge test was of 62% (SD= 27) in the section of evaluation and classification of PU prevention (nursing assistants [x–= 61%; SD= 26]; nurses [x–= 64%; SD= 30]; p value= 0.663) and 72% (SD= 17) in the prevention section (nursing assistants [x–= 72; SD= 16]; nurses [x–= 71%; SD= 22]; p value= 0.663). In total, ten of the items exceeded 90% of right answers in the case of nurses, and one in the case of assistants.Conclusions: nurses and Nursing assistants presented an acceptable knowledge regarding PU prevention. It is necessary to implement successful strategies in order to improve prevention and encourage the updating of knowledge
Objective: to analyse the association of sociodemographic characteristics, pre-pregnancy obesity, excessive weight gain during pregnancy and characteristics of delivery with the risk of suffering a post-partum haemorrhage (PPH). Method: a retrospective, cross-sectional, descriptive study conducted with women who gave birth during 2018 in a second level hospital. The study included pregnant women with single birth of a live newborn at term, with vaginal delivery and complete pregnancy monitoring at hospital. The following information was collected from the clinical record: age and origin of the mother, pre-pregnancy body mass index, weight gain during pregnancy, and different variables associated with delivery. The outcome variable was PPH (> 500mL).Results: the study included N= 831 women; their mean age was 31.8 years (SD:5.38), 62.7% were Spanish; 64.6% were multiparous; 41.7% presented pre-pregnancy overweight / obesity; 26.2% had an excessive weight gain during pregnancy; 89,3% had natural deliveries and 70,4% of deliveries were directed. Twenty women presented PPH (2.4%). No association was found with any of the characteristics studied, except for type of delivery (p= 0.039). Patients with non-spontaneous delivery presented higher risk of suffering PPH; 5.39 times more (1.13-25.75; p= 0.022) when delivery was directed and 5.29 (1.3-21.69; p= 0.013) when it was manual. Conclusions: neither sociodemographic factors nor pre and post-pregnancy anthropometric characteristics have influence on the development of PPH. Non-spontaneous delivery increases the risk of PPH up to five times more. These data must be interpreted cautiously.
Objective: to determine the level of knowledge regarding palliative care (PC) by Primary Care nurses in Cantabria.Method: a descriptive cross-sectional study on a population formed by Primary Care team and emergency nurses. The sample was estimated in 171 nurses, and there was convenience and snowball sampling. Sociodemographic, occupational and training variables were measured, and there was an evaluation of the overall knowledge about PC through the PCQN validated questionnaire (from 0 and up to 10 points), with its three sub-scales (PC philosophy and principles; psychosocial aspects, management of pain and other symptoms). Descriptive and bivariate statistics was conducted.Results: the study included 180 nurses. The overall mean knowledge was of 5.7 points (SD= 1.3) (principles and philosophy sub-scale [x–= 6.1; SD= 2.5]; management of pain and symptoms [x–= 6.0; SD= 1.5]; psychosocial aspects [x–= 3.7; SD= 2.9]). Statistically significant differences in the level of knowledge were found, based on the years of overall professional experience (5 or lower [x–= 5.2; SD= 1.3]; from 6 to 20 [x–= 5.4; SD= 1.4] or over 20 [x–= 6; SD= 1.2]; p value= 0.012), and on the years of experience at Primary Care (5 or lower [x–= 5.5; SD= 1.3], from 6 to 20 [x–= 5.6; SD= 1.4] or over 20 [x–= 6.3; SD=1]; p value= 0.004).Conclusions: a medium level of knowledge was found in the Primary Care nurses from Cantabria. Knowledge increased at the same time as professional experience. The area with a lower level was the one associated with psychosocial aspects. Training in the palliative care setting is needed for these nurses.
Objective: to identify the conditioning factors for implementation and duration of breastfeeding during COVID-19 from the perspective of midwives from the Castellón province (Spain).Methods: a qualitative study conducted in 2021 through four focus groups (FGs) with midwives from the Castellón province. Data collection was carried out via videoconferences with audio recording, which were transcribed for subsequent discourse analysis with the Atlas Ti program.Results: the enablers for breastfeeding identified by midwives were the promotion of breastfeeding for mothers and the development of access to resources to solve troublesome situations, among others. They reported as barriers the maternal beliefs regarding feeding with artificial formulas based on their biography, a biased social consideration on breastfeeding, lack of protocols for colostrum extraction, and deficient quality of information in social networks, mostly. They acknowledged that the COVID-19 pandemic had positive and negative impacts on breastfeeding. Some measures came up to optimize breastfeeding promotion, such as an increase in the midwife/pregnant mother ratio, home care 24 hours after discharge, unification of protocols among centres, extending to six months the time for incorporation to work, and adaptation of breastfeeding promotion in social networks.Conclusions: conditioning factors for breastfeeding were reported, originating in the Spanish sociosanitary scenario, which are useful as the basis for designing specific promotion actions. The impact of the COVID-19 pandemic on breastfeeding must be considered in situations of prolonged lockout of mothers.
Healthcare professionals play an essential role accompanying the development and growth of children and adolescents, which includes menstrual health education. Considering this, the project for Link with the Environment called “Juntos Crecemos Contigo” (“Together we grow with you”) was created by the University of San Sebastián, which provides for the training of Nursing students as Menstrual Health Promoters by the Malva Miranda Foundation. One year after conducting this activity, the students answered a survey about their experience, and 80% stated that it was an incentive for acquiring knowledge on menstrual health; while 85.7% pointed out that this type of participative methodology allowed them to acquire and transfer new knowledge as part of their professional training. Results show that this is an innovative methodology, highly effective, and which strengthens the promotion of integrated health in boys and girls.
Objective: to determine the clinical and metabolic characteristics in adults with Type 2 diabetes according to the presence of diagnostic criteria for metabolic syndrome (MS).Method: a descriptive cross-sectional study with simple randomized probability sampling, including patients with Type 2 diabetes. There was measurement of body composition, blood pressure, and biochemical parameters. In order to determine the metabolic syndrome diagnosis, criteria by the International Diabetes Federation were applied. There was bivariate analysis among those who presented diagnostic criteria for SM and those who did not, using the Mann Whitney’s U test for hypothesis contrast.Results: the mean age of the sample studied was 59.7% (SD: 11.5 years). Most participants were female (65.3%) and with a middle socioeconomic level (75.5%). The prevalence of metabolic syndrome was 40%, and hyperglycaemia was the most frequent alteration (93.3%). The majority of patients with MS showed statistically significant overweight and obesity (p< 0.05), as well as higher figures of body mass index, waist circumference, total cholesterol, triglycerides, glucose, atherogenic indexes and blood pressure.Conclusions: patients with T2D showed a high prevalence of MS. In patients with MS, hyperglycaemia was the most frequent alteration, followed by central obesity measured by waist circumference; and according to their BMI, the majority presented overweight and obesity. The mean triglycerides, blood pressure and atherogenic indexes of these patients were higher vs. those who did not meet diagnostic criteria for MS.
Objective: to describe the humanized Nursing care from the parental perspective at the Paediatric Intensive Care Unit (PICU).Method: husserlian-oriented descriptive phenomenological methodology. The participants were parents of the paediatric population (3-to-6 years old) admitted at the PICU in the Community of Madrid. Convenience and snowball sampling were conducted with nine participants. There was data collection through semistructured interviews based on open questions about topics of interest, with a duration between 40 and 50 minutes. Content analysis was conducted following the method in three stages by Strauss and Corbin.Results: three categories were identified: Disruption of admission at the PICU, Time and space at the Pediatric ICU, and Nursing care at the PICU. Parents showed a major lack of knowledge about the care and tasks conducted at the Intensive Care Units before their children were admitted. In all cases, they felt fear and uncertainty. Parents valued consistency, thorough follow-up and emotional support as an essential part of Nursing care in these units.Conclusions: the effective inclusion of parents still represents a challenge, and there is an insufficient perception of the support by the Nursing team towards them. It must be considered to include families in the care of their children at the PICU, in order to reduce stress and improve the perception of Nursing care.
Objective: to analyse patient satisfaction regarding care received from the Nursing staff during their admission at a hospitalization unit for acute mental health patients.Methods: an analytical cross-sectional study conducted in 2021 at the hospitalization unit for acute Psychiatry patients at a Vallés Occidental hospital in Catalonia (Spain). The study population were those persons hospitalized for over a week who completed the Caring Assessment Tool CAT-V (range 27-135), in its version translated into Spanish. Besides, the clinical variables of participants were collected: a) type of admission: voluntary / involuntary, b) diagnosis at admission, c) use of mechanical restraint, d) use of toxic substances. There was univariate and comparative analysis of the variables collected.Results: the study included 100 patients, with 42.5 years as mean age (19-72); of these, 55% (p= 55) was female. Satisfaction obtained a median score (P25-P75) of 114 (103-125), and was placed in the fourth quartile. Satisfaction values stayed in the fourth quartile, without showing any statistically significant differences in any of the factors considered, except for those values associated with the use of mechanical restraint, which showed statistical differences (p= 0,023), with a worse perception of satisfaction with care in those for whom it was used, median (P25-P75) 96.5 (87-114), vs. those for whom it was not, 116 (108-125). Even though no significant differences were observed for the rest of variables studied, an increase in satisfaction stood out among voluntary admissions and older persons.Conclusions: patients presented high satisfaction with care received from Nursing staff during their admission at a hospitalization unit for acute mental health patients. The prevalence of the use of mechanical restraints had a negative impact on satisfaction with care received.
Encuesta sobre Equipamiento y Uso de Tecnologías de Información y Comunicación (TIC) en los Hogares Año 2022El 94,5% de la población de 16 a 74 años ha usado Internet en los tres últimos meses El 55,3% ha comprado en la red en los tres últimos meses El 14,0% de los ocupados de 16 a 74 años ha teletrabajado durante la semana anterior a la entrevista El 82,9% de los hogares con al menos un miembro de 16 a 74 años dispone de algún tipo de ordenador (de sobremesa, portátil, Tablet…).Por tipo de dispositivo, el 77,9% cuenta con ordenadores de sobremesa o portátiles y el 55,4% con alguna Tablet.El porcentaje general de hogares con ordenador disminuye 0,8 puntos respecto a 2021.Este descenso se debe, principalmente, a la bajada de 2,1 puntos en la tenencia de Tablet, ya que la proporción de hogares con ordenadores de sobremesa o portátiles se mantiene respecto al año anterior. Evolución del equipamiento TIC en los hogaresPorcentaje de hogares con algún miembro de 16 a 74 años TIC_H-2022 (2/15) Instituto N acional de EstadísticaEl teléfono móvil está presente en casi la totalidad de los hogares (99,5%, al igual que en 2021).Por su parte, el teléfono fijo continúa su descenso y se encuentra disponible en el 62,5% de los hogares, 4,7 puntos menos que en 2021.El 99,9% de los hogares cuenta con algún tipo de teléfono (fijo y/o móvil) y el 62,1% con ambos tipos.Un 0,4% dispone únicamente de fijo y un 37,3% utiliza exclusivamente el móvil para comunicarse desde el hogar (frente al 32,6% de 2021).Cuanto mayor es la población del municipio de residencia y mayores son los ingresos netos, más equipamiento TIC tienen los hogares (ordenadores y teléfono fijo). Hogares con acceso a InternetUn total de 16,3 millones de hogares con al menos un miembro de 16 a 74 años (el 96,1% del total) disponen de acceso a Internet por banda ancha fija y/o móvil.En 2021 el porcentaje fue del 95,9%.El principal tipo de conexión de banda ancha es a través de modalidades fijas (fibra óptica o red de cable, ADSL…), que está presente en el 83,0% de los hogares (independientemente de que dispongan también de conexión por móvil).Por su parte, el 13,1% sólo accede a Internet mediante conexión móvil (3G ,4G, 5G…).En ambos tipos de conexión, se observa una subida de 0,1 puntos respecto a 2021.Los hogares utilizan más la banda ancha fija y menos la conexión sólo a través de banda ancha móvil cuanto mayor es la población de su municipio y de más ingresos netos disponen.El 96,2% de los hogares con ingresos mensuales netos de 3.000 euros o más dispone de acceso fijo y el 3,4% lo hace sólo a través de móvil.Por el contrario, entre los hogares que ingresan menos de 900 euros los porcentajes son del 67,3% en acceso fijo y del 21,8% sólo mediante el móvil.
Objective: to describe the Nursing care needs derived of the main consequences in newborns (NBs) diagnosed with hypoxic-ischemic encephalopathy (HIE) and treated with therapeutic hypothermia at the Hospital Universitario Miguel Servet in Zaragoza (Spain).Method: a descriptive cross-sectional study with retrospective data about 32 patients, through clinical record review. The study variables were sociodemographic, clinical (the scale by García-Alix was used to determine the severity of GIE), and Nursing care needs.Results: thirty-two (32) patients were studied; 68.8% were diagnosed with moderate HIE and 31.2% with severe HIE, with 21.9% of death outcomes after treatment. Out of these patients, 31.3% suffered meconium fluid aspiration at the time of delivery; 32% had visual alterations, 20% had alterations in their skin integrity, 16% had elimination problems and epileptic seizures, and 12% presented microcephalia. 100% of them were enrolled in school, 12% had support at school, and only 4% needed to attend a special education centre. Regarding their families, 68% received support after discharge from hospital, and 56% were included in an early care program.Conclusion: the paediatric population with HIE treated with hypothermia presented sequels at medium-long term; the most relevant were visual and skin integrity alterations, elimination problems, epileptic seizures and microcephalia. Programs for follow-up and support after discharge from hospital must be promoted, for an early detection of warning signs, as well as for accompanying their families.
