Análisis de la donación en asistolia no controlada durante 10 años en la Comunidad de Madrid.

Objetivo. La Comunidad de Madrid es líder en donación en asistolia no controlada (DANC) en España. El objetivo de este trabajo es analizar la rentabilidad de los órganos extraídos válidos de los donantes (categoría IIa) del Registro Nacional Integrado de Información de Donación y Trasplante de la ONT (Registro CORE), correspondientes a esta comunidad. Método. Estudio observacional retrospectivo entre 2007 y 2017 de las DANC, analizando las variables edad, talla, peso, índice de masa corporal (IMC), tiempos asistenciales, tipo de compresión torácica recibida durante la reanima-ción cardiopulmonar (cardiocompresor mecánico vs compresión torácica manual) y órganos extraídos válidos. Resultados. Se registraron 679 donantes, de los que fueron donantes efectivos el 67,6% (n = 458). Se observó una correlación negativa (−0,161) entre la mediana del índice de masa corporal y la mediana del número de órganos extraídos válidos (p < 0,001). También se observó una influencia estadísticamente significativa del tipo de cardiocompresión realizada y la viabilidad del hígado, puesto que solo los extraídos tras reanimación con cardiocompresión mecánica fueron válidos para trasplante. Conclusiones. El IMC y el uso de cardiocompresores mecánicos son variables predictoras a tener en cuenta ante una posible DANC.post-print1546 K

Experiential learning in practice: An ethnographic study among nursing students and preceptors

This study aimed to explore the reflective dialogues and processes that take place between preceptors and their nursing students and to examine how preceptors make use of their expert knowledge in order to enhance students' experiential learning during clinical placements. Two 30-h courses on reflective teaching were conducted. The study sample included 15 preceptors and 27 undergraduate nursing students. Data were collected during the course and during clinical placements at two X hospitals. Data collection included non-participatory observation and informal conversations with preceptors, in-depth interviews and focus groups. Preceptors used a series of strategies to promote experiential learning; these included creating links with practice, the use of examples, allowing students to adopt professional roles and enhancing autonomy. The value of preceptors is their wealth of professional experience, which is key during the learning process of nursing students. Preceptors must learn to master the art of questioning and stimulating reflective dialogues, in order to stimulate students' critical thinking and encourage them to resolve common problems that arise during practice. Students demand a more active role in their own learning processes.Sin financiación1.665 JCR (2018) Q1, 29/118 Nursing0.810 SJR (2018) Q1, 17/152 Nursing (miscellaneous), 218/1400 Education; Q2, 782/2844 Medicine (miscellaneous)No data IDR 2018UE

Analysis of organ procurement from non–heart-beating donors over a 10-year period in Madrid

La Comunidad de Madrid es líder en donación en asistolia no controlada (DANC) en España. El objetivo de este trabajo es analizar la rentabilidad de los órganos extraídos válidos de los donantes (categoría IIa) del Registro Nacional Integrado de Información de Donación y Trasplante de la ONT (Registro CORE), correspondientes a esta comunidad.The Autonomous Community of Madrid procures the largest number of organs from uncontrolled non–heart-beating donors (NHBD) after circulatory death in Spain. The aim of this study was to analyze the yield of these donations in terms of viable organs procured (category IIa) according to information extracted from the CORE registry of the Spanish National Transplant Organization (ONT) for the Madrid area.Sin financiación3.173 JCR (2019) Q1, 4/31 Emergency Medicine0.373 SJR (2019) Q2, 36/87 Emergency MedicineNo data IDR 2019UE

Limitation of therapeutic effort experienced by intensive care nurses

Background: Nurses who practice limitation of therapeutic effort become fully involved in emotionally charged situations, which can affect them significantly on an emotional and professional level. Objectives: To describe the experience of intensive care nurses practicing limitation of therapeutic effort. Method: A qualitative, phenomenological study was performed within the intensive care units of the Madrid Hospitals Health Service. Purposeful and snowball sampling methods were used, and data collection methods included semi-structured and unstructured interviews, researcher field notes, and participants’ personal letters. The Giorgi proposal for data analysis was used on the data. Ethical considerations: This study was approved by the Ethical Research Committee of the relevant hospital and by the Ethics Committee of the Rey Juan Carlos University and was guided by the ethical principles of voluntary enrollment, anonymity, privacy, and confidentiality. Results: In total, 22 nurses participated and 3 themes were identified regarding the nurses’ experiences when faced with limitation of therapeutic effort: (a) experiencing relief, (b) accepting the medical decision, and (c) implementing limitation of therapeutic effort. Conclusion: Nurses felt that, although they were burdened with the responsibility of implementing limitation of therapeutic effort, they were being left out of the final decision-making process regarding the same.Sin financiación1.957 JCR (2018) Q1, 11/54 Ethics, 21/118 Nursing0.956 SJR (2018) Q1, 4/42 Issues, Ethics and Legal AspectsNo data IDR 2018UE

Comparison of attitudes to breastbeeding among Spanish-born and Chinese-born postpartum women in Madrid

The aim of the study was to determine whether the attitude towards breastfeeding among Chinese postpartum women who have immigrated to Spain differs from that of Spanish-born postpartum women. Cross-sectional study, with between-group comparison, of 73 postpartum women admitted to the maternity units of the 12 de Octubre Hospital. Attitudes toward breastfeeding were analyzed using the Spanish of Chinese version of the Iowa Infant Feeding Attitude Scale (IIFAS). Chinese immigrant women obtained scores of approximately 9 points less when compared to Spanish-born women, after adjusting for different socioeconomic, educational and work-related factors.Sin financiación2.475 JCR (2018) Q1, 30/125 Pediatrics; Q2, 27/83 Obstetrics & Ginecology1.285 SJR (2018) Q1, 22/188 Obstetrics and Gynecology, 32/318 Pediatrics, Perinatology and Child HealthNo data IDR 2018UE

Los cuidados de los hijos de la primera generación de inmigrados en el contexto de las instituciones sanitarias de Madrid (España)

Objetivo principal: Explorar los cuidados en los hijos de inmigrados y la relación enfermera-padres inmigrados. Metodología: Estudio de casos cualitativo con enfoque etnográfico. Observación en dos hospitales y un centro de atención primaria. Veinticuatro entrevistas semiestructuradas grabadas. Análisis cualitativo mediante comparaciones constantes. Resultados principales: Los resultados se articulan en tres grandes bloques: (1) Ser padre o madre inmigrado, (2) El sistema sanitario y los inmigrados, y (3) Los cuidados culturales. Conclusión principal: Se constataron diferencias en la percepción en relación a cuidados específicos como la higiene, el colecho, el método canguro, el cordón umbilical, la ropa, la lactancia materna y la alimentación. Factores como la barrera idiomática, los roles de género, los patrones familiares, entre otros, influyen en las diferencias encontradas. La relación inmigrante (padres) / profesionales viene determinada por la sociedad en la que ambos están inmersos (culturas de origen y culturas autóctonas) y el contexto institucional (culturas profesionales).Sin financiaciónNo data JCR 20180.106 SJR (2018) Q4, 126/163 History and Philosophy of Science, 512/562 Public Health, Environmental and Occupational Health, 273/308 Health (social science)No data IDR 2018UE

Mortality risk and complications relating to interhospital transfers of patients with acute coronary syndrome receiving primary coronary angioplasty performed by the Medical Emergency Service of Madrid 112: a group comparison study

The performance of a primary percutaneous coronary intervention is the practice recommendation with the highest level of evidence for the treatment of acute coronary syndrome (ACS). If this intervention cannot be performed at the hospital where the patient is admitted, the patient must be transferred to a hospital with a haemodynamic laboratory. This can lead to a decreased availability of a mobile intensive care unit (MICU), contributing towards a lower survival rate of critical patients due to a delay in treatment administration. The aim of this study was to describe the risk of mortality, the complications, and the impact of interhospital transfer (IHT) in patients diagnosed with an ACS. Methods: A prospective observational study was performed comparing two patient groups: patients diagnosed with ST-segment elevation (STEMI) and patients diagnosed with non-ST-segment elevation. The variables collected included sex, age, cardiovascular risk factors, and any complications arising during IHT. Prior to being transported, the Risk Score for Transport Patients (RSTP) was used, together with the Rapid Emergency Medicine Score (REMS). The latter scale was repeated upon arrival at the accepting medical facility. Results: The study included 104 patients, of whom 67 were men (64.42%). Of these, 52.88% were diagnosed with STEMI. Patients with ACS presented an intermediate risk of mortality and the need for transfer to a MICU was indicated. The incidence of complications registered during transfers was 16.35%. Conclusions: The use of scales such as the REMS and the RSTP are helpful for obtaining a more objective risk profile, suited to the real needs of patients diagnosed with an ACS.Sin financiación0.202 JCR (2017) Q4, 25/26 Emergency medicineUE

Impact of the first interprofessional education undergraduate program in Spain

In 2015, the Universidad Europea de Madrid started the first interprofessional education program in Spain. Nursing students undergo different interprofessional education activities in all 4 academic years, covering various aspects of the following 3 competencies: interprofessional communication, role clarification (definition, interaction and defense), and authority models and decision making. In second year, they integrate these activities with students from psychology, pharmacy and medicine. We assessed the self-perception of second year nursing students with an adapted and validated IPEC questionnaire, in four different transversal moments of the academic year 2015-16. Differences in mean values were analyzed with the Kruskal-Wallis test and post-hoc Mann-Whitney tests with Bonferroni corrections in case of statistical significance. Results showed that this IPE program improves the self-perception second year students have about their competence in interprofessional communication, especially in the dimensions of oral expression, active listening, communication tools and interprofessional conflict resolution.Sin financiación1.772 JCR (2018) Q3, 46/82 Health Policy & Services, 61/98 Health Care Sciences & Services0.864 SJR (2018) Q2, 712/2844 Medicine (miscellaneous)No data IDR 2018UE

Adherence to initial exclusive breastfeeding among Chinese born and native Spanish mothers

Background Benefits of breastfeeding on the health of children, mothers and society are well known. However, breastfeeding rates vary according to the population examined. Chinese-born women migrated to high-income countries have shown low breastfeeding rates. Nevertheless, studies comparing breastfeeding rates of Chinese-born immigrants and natives are scarce. The aims of this study were therefore: 1) to compare the rate of exclusive breastfeeding at hospital discharge after giving birth between Chinese-born women resident in Spain and native Spanish women, 2) to assess the influence of the biological, socioeconomic, work-related and cultural factors on exclusive breastfeeding in women of Chinese origin. Methods A cross-sectional descriptive study with between group comparisons. This study included 73 postpartum women (33 Chinese-born and 40 native Spanish women). The association between exclusive breastfeeding and the country of origin was assessed by binary logistic regression. Results Native Spanish women showed a greater prevalence of exclusive breastfeeding (80%) compared to Chinese born immigrant women (36.4%) (adjusted for socioeconomic status, parental level of education, age, cesareans and birth weight) (OR = 0.21; 95% CI 0.05–0.91; p = 0.037). However, in other models that considered both work and cultural influences, no differences were observed. Discussion The classic biological and socioeconomic variables (educational and socioeconomic levels) do not seem to explain the lower rates of exclusive breastfeeding among Chinese immigrant women. This paradigm of inequity appears to be based on both the work conditions as well as cultural characteristics of Chinese born women in Spain, such as their overall attitude towards breastfeeding.Los beneficios de la lactancia materna en la salud de los niños, las madres y la sociedad son ampliamente conocidos. Sin embargo, las tasas de lactancia materna varían según la población estudiada. Las mujeres de origen chino que han inmigrado a países desarrollados muestran tasas muy bajas de lactancia materna. Los objetivos de la investigación son comparar las tasas de lactancia materna exclusiva tras el parto, al alta del hospital, entre mujeres de origen chino y de origen español, y evaluar la influencia de variables biológicas, socioeconómicas, relacionadas con el trabajo y culturales sobre las tasas de lactancia materna. Estudio descriptivo transversal con comparación entre grupos. Se incluyó a 73 puérperas (33 de origen chino y 40 españolas). La asociación entre lactancia materna y país de origen se evaluó utilizando regresión logística. Resultados: Las mujeres españolas mostraron una mayor prevalencia de lactancia materna exclusiva (80%) en comparación con las mujeres de origen chino (36,4%), ajustando por nivel socioeconómico, nivel educativo de los padres, edad de la madre, parto por cesárea y peso al nacer). Sin embargo, al construir otros modelos de regresión logística en los que se incluyó variables relacionadas con el trabajo de la madre, o la actitud respecto a la lactancia materna, las diferencias pasaban a ser no significativas. Discusión: Las variables clásicas biológicas y socioeconómicas no explican la diferencia en las tasas de lactancia materna entre mujeres de origen chino y españolas. Sin embargo, parece que esas diferencias están relacionadas con las condiciones laborales de las mujeres chinas (trabajan más mujeres, por cuenta propia, incorporándose antes al mundo laboral tras el parto...) y con aspectos culturales (actitud menos positiva hacia la lactancia materna).Sin financiación2.239 JCR (2019) Q2, 33/82 Obstetrics & Gynecology1.275 SJR (2019) Q1, 19/185 Obstetrics and GynecologyNo data IDR 2019UE

Simulación de alta complejidad con pacientes reales en escenario sobre oncología pediátrica

Las habilidades para comunicar es una de las competencias que pretendemos desarrollar con nuestros alumnos de Enfermería. Cuando esa comunicación debe realizarse ante situaciones complicadas, como puede ser un paciente de oncología pediátrica o su familia, consideramos imprescindible una formación específica al respecto. Por ello, éste ha sido el segundo curso en el que Patricia, madre de Belén de 10 años de edad, diagnosticada de Leucemia Linfoblástica Aguda con 6 meses de vida, colabora con nosotros en la asignatura de “Cuidados en la Infancia y en la Adolescencia”.SIN FINANCIACIÓNNo data 2017UE