La colaboración interinstitucional en la producción científica española en Enfermería: análisis de redes sociales

ObjectiveThe objectives of this paper are to analyze the Spanish scientific production in nursing, define its temporal evolution, its geographical and institutional distribution, and observe the interinstitutional collaboration.MethodWe analyze a comprehensive sample of Spanish scientific production in the nursing area extracted from the multidisciplinary database SciVerse Scopus.ResultsThe nursing scientific production grows along time. The collaboration rate is 3.7 authors per paper and 61% of the authors only publish one paper. Barcelona and Madrid are the provinces with highest number of authors. Most belong to the hospitalary environment, followed closely by authors belonging to the university. The most institutions that collaborate, sharing authorship of articles are: University of Barcelona, Autonomous University of Barcelona and Clinic Hospital of Barcelona.DiscussionThe nursing scientific production has been increasing since her incorporation at the university. The collaboration rate found is higher than found for other papers. It shows a low decrease of occasional authors. It discusses the outlook of scientific collaboration in nursing in Spain, at the level of institutions by co-authorship of papers, through a network graph. It observes their distribution, importance and interactions or lack thereof.ConclusionsThere is a strong need to use international databases for research, care and teaching, in addition to the national specialized information resources. Professionals are encouraged to normalization of the paper's signature, both, surnames and institutions to which they belong. It confirms the limited cooperation with foreign institutions, although there is an increasing trend of collaboration between Spanish authors in this discipline. It is observed, clearly defined three interinstitutional collaboration patterns.     

Precisión de las características definitorias del diagnóstico de enfermería termorregulación ineficaz en recién nacidos

ObjectiveTo identify the measures of accuracy for defining characteristics of the nursing diagnosis: Ineffective thermoregulation in newborns.MethodDiagnostic accuracy study with cross-sectional design performed in medium and high-risk maternity units, located in Fortaleza city/Brazil. A total of 216 newborns were evaluated to identify the defining characteristics of the diagnosis under study. The measures of accuracy for defining characteristics were obtained from a latent class model with random effects for the calculation of sensitivity and specificity values.ResultsThe characteristics of increased respiratory rate and warm skin to the touch had higher sensitivity values (99.9%) and lower specificity (79 and 75%) and the characteristics of body temperature fluctuations above and below the normal parameters and hypertension had the highest specificity (80.4 and 100%, respectively).ConclusionThe characteristic fluctuation of the body temperature above and below the normal parameters may be better to confirm the diagnosis, having presented a higher specificity value.     

Características de la provisión del servicio de gestión de casos en el entorno comunitario en Andalucía a partir del registro RANGECOM

ObjectiveTo describe the characteristics of case management in terms of population served, interventions, use of services and outcomes such as mortality, readmissions, pressure ulcers, falls, drug problems and institutionalization.MethodFollow-up study of a cohort, from the RANGECOM Multicentric Registry of Andalusia. The study population were patients included in the case management services of Health Centres and their family caregivers.ResultsData from 835 patients with a mean age of 76.8 years (SD: 12.1), 50.24% women, are presented. They had an important comorbidity (Charlson 3.1, SD: 2.5) and high dependence (Barthel 37.5, SD: 31.4). Sixty-two point two percent of the interventions deployed by the case managers were grouped into three domains: behavioural (26.0%), health system (20.2%) and safety (14.1%). Mortality was 34.4% and hospital admissions 38.1%. Patients with more hospital readmissions had more visits to the Emergency Department (OR: 1.41; 95% CI: 1.22-1.63), more telephone interventions by case managers (OR: 1.12; 95% CI: 1.02-1.24) and imaging tests (OR: 1.37; 95% CI: 1.17-1.60), together with greater caregiver burden (OR: 1.31; 95% CI: 1.08-1.59), the presence of medical devices at home (OR: 1.69; 95% CI: 1.00-2.87) and received less “Case Management” intervention.ConclusionsThe patients who absorb the demand of case management nurses present high complexity, for which they deploy behavioural interventions, navigation through the health system and clinical safety.     

Atención de la patología aguda de enfermería en atención primaria: caso clínico en la odinofagia

Since 2008, the Institut Catala de la Salut (ICS) introduced the nurses management plan for acute pathology, in primary care centres.In the implementation of this system of organization, the ICS introduced various diseases protocols with performance algorithms.To raise awareness of the the practice of acute pathology, we present a clinical case. An urgent consultation of a 30 year-old male, with fever, sore throat and cough, which was managed and resolved by a nurse.The aim of this new management plan is that nursing is the first health professional to take care of patient coming to primary care centre without a scheduled visit, to avoid saturating the general clinic or hospital emergencies. This new organisational system involves an increase in the responsibilities of nursing in the diagnosis and treatment of patients.     

Implicación de la enfermería en ensayos clínicos con terapia celular

Research with stem cells has made a qualitative leap since the research group from Minnesota University Stem Cell Institute in the USA published a study in July 2002, which showed that the bone marrow stem cells of adults multiplied indefinitely without losing their ability to differentiate.In this hospital the first implant of stem cells derived from adipose tissue was performed in this hospital in 2003 in an attempt to close a complex perianal fistula in a patient with Crohn's disease. As a result of this first success, a multidisciplinary research team was formed to study the application of stem cells in the treatment of complex anal fistula. Since its creation, it has included a nurse whose role is fundamental in the coordination of the different phases of the trials and the involvement of patients in these. The development of these new treatments, along with their complexity and direct effects on the patient, involves the training and presence of the professional nurse in these teams. The improvement shown in tissue healing would make it very worthwhile to demonstrate their efficacy in wound care, pressure sores, diabetic foot, etc.     

Satisfacción del paciente con la atención de enfermería

Patient satisfaction is one of the outcomes of health care. We determined the level of satisfaction with nursing care among hospital patients, measured as a differential score between expectations and perceptions, and analyzed the relevant socio-demographic and care-related characteristics.A cross-sectional study was performed by sending a postal survey with the SERVQUAL scale to all patients discharged from the hospital in 5 distinct periods over 2 years.The psychometric characteristics were validated for their reliability and validity. The determinant variables on the SERVQUAL score were analyzed by ANCOVA. The overall differential score was −0.74. Determinants of satisfaction were sex (p < 0.001), level of education (p < 0.019), the overall evaluation of the hospital (p < 0.001) and knowing the name of the nurse (p < 0.001).     

Características de los reanimadores asociadas a la correcta compresión torácica durante la reanimación cardiopulmonar

AimTo analyse the caregivers’ physical, anthropometrical and educational characteristics associated with adequate chest compression and full chest recoil during cardiopulmonary resuscitation (CPR).MethodsAn observational prospective research study was conducted. Emergency and critical care health professionals and students performed two minutes of chest compressions on a dummy. Depth and residual leaning after the compressions were assessed and their association with several variables (physical, anthropometrical, and educational) was analysed using logistic regression models.ResultsTwo hundred thirty-eight volunteers participated. Previous experience of the rescuer in less than six CPRs (OR: 3.03; CI 95%: 1.2-7.63) was related to a higher probability of not achieving an adequate depth of compressions. Greater height (OR: .93; 95% CI: .87-.99) and grip strength (OR: .94; 95% CI: .89-.99) were associated with correct performance of chest compression. We did not find any characteristic related to chest recoil.ConclusionsThe caregiver's previous experience with CPR was the strongest factor associated with adequate performance of chest compressions. To a lesser extent, the professional's height and upper body muscle strength also have an influence. No factors associated with the adequacy of full chest recoil were identified.