Transgressions and potential medication errors of nursing students in a simulated environment

Introducción: Los errores de medicación son uno de los eventos de mayor relevancia en la actualidad, derivándose de la interacción entre el medio y los profesionales. La educación debe entrenar a los estudiantes para la seguridad. Objetivo: identificar transgresiones y errores potenciales de medicación en estudiantes de enfermería en los subprocesos de preparación y administración de medicamentos por vía parenteral en ambiente simulado. Método: Estudio cuantitativo, descriptivo realizado en estudiantes de segundo, tercer y cuarto año de la carrera de enfermería de una Universidad chilena. Se evaluaron los subprocesos de preparación y administración a través de la aplicación de una pauta estandarizada de administración segura de medicamentos en ambiente de simulación. Se reconocieron ítems críticos (ítems de transgresiones o errores potenciales) utilizando un punto de corte del 70 %. Resultados: Los estudiantes presentaban edades promedio entre 22 y 24 años, predominando el sexo femenino. Los ítems identificados como críticos en el subproceso de preparación fueron: verificación de la fecha de caducidad del medicamento, transgresión de principios de infecciones asociadas a la atención de salud y preparación de la dosis correcta. En el subproceso de administración se identificó: verificación de alergias, manejo de accesos vasculares, entrega de información e identificación de paciente. Conclusiones: A través de este estudio se identificaron transgresiones y errores potenciales que deben ser trabajados con los estudiantes. La simulación clínica como metodología permite el entrenamiento de competencias orientadas a la provisión de cuidados seguros y de calidad en un ambiente real y protegido

The meaning of postpartum sexual health for women living in Spain : a phenomenological inquiry

Sexual health is a multidimensional phenomenon constructed by personal, social, and cultural factors but continues to be studied with a biomedical approach. During the postpartum period, a woman transitions to mother, as well as partner-to-parent and couple-to-family. There are new realities in life in the postpartum period, including household changes and new responsibilities that can impact the quality of sexual health. This phenomenon is understudied especially in the context of Spain. The purpose of this study was to describe the lived experience of postpartum sexual health among primiparous women giving birth in Catalonia (Spain). This was a phenomenological study with a purposive sample of primiparous women. Data was collected through semi-structured interviews until saturation. Analysis followed Colaizzi's seven-step process with an eighth translation step added to limit cross-cultural threats to validity. Also, the four dimensions of trustworthiness were established through strategies and techniques during data collection and analysis. Ten women were interviewed from which five themes emerged, including: Not feeling ready, inhibiting factors, new reality at home, socio-cultural factors, and the clinician within the health system. Returning to sexual health led women to engage in experiential learning through trial and error. Most participants reported reduced libido, experienced altered body image, and recounted resumption of sexual activity before feeling ready. A common finding was fatigue and feeling overloaded by the demands of the newborn. Partner support was described as essential to returning to a meaningful relationship. Discussions about postpartum sexual health with clinicians were described as taboo, and largely absent from the care model. Evidence-based practices should incorporate the best evidence from research, consider the postpartum sexual health experiences and preferences of the woman, and use clinician expertise in discussions that include the topic of postpartum sexual health to make decisions. As such, human caring practices should be incorporated into clinical guidelines to recognize the preferences of women. Clinicians need to be authentically present, engage in active communication, and individualize their care. More qualitative studies are needed to understand postpartum sexual health in different contexts, cultures, and countries and to identify similarities and differences through meta-synthesis

Motherhood and decision-making among women living with HIV in developed countries: a systematic review with qualitative research synthesis

Background: Women living with HIV (WLH) lack evidence-based information about reproductive options while man‑ aging pressures from family, clinicians, and communities to give up the idea of having children. As the reproduction intentions of WLH are not well understood, stigmatizing behaviors force them to hide their disease to avoid rejection by their family, partner, and social networks. Compliance with social norms, fear of stigma, and discrimination infu‑ ence their experience. Current research is individual qualitative studies lacking the synthesis perspective necessary to guide intervention development. The purpose of this study was to synthesize the evidence to explain the reproduc‑ tive decision-making process for WLH in developed countries. Methods: A systematic review with qualitative research synthesis was conducted through searches in 10 elec‑ tronic databases (CINAHL, EMBASE, MEDLINE, Scopus, Social Science Citation Index, Web of Science, Google Scholar, Cuidatge, Cuiden Enfspo, and SciELO). Studies published in journals from 1995 to 2019 with qualitative data about reproductive decision-making among WLH in developed countries were eligible for inclusion. Developed country wasoperationalized by membership in the OECD for comparative conditions of social wellbeing and economic stability. The CASP and JBI checklists for qualitative research were used to assess study quality and methodological integrity. Thematic analysis and qualitative meta-summary techniques were used for the synthesis. Results: Twenty studies from 12 developed countries were included in the synthesis. Findings were organized into 3 meta-themes from 15 themes and 45 subthemes, including: (1) Shattered identity, (2) Barriers, inequities, and misinfor‑ mation, (3) Coping, resiliency, and support. Reproductive decision-making was perceived as a complex process infu‑ enced by facilitators and barriers. The facilitators helped WLH cope with their new situation to become more resilient, while the barriers made their situation more difcult to manage. Conclusion: WLH encounter reproductive decision-making with knowledge defcits and limited social support. An integrated approach to holistic care with comprehensive multidisciplinary counseling is needed to support WLH. Clinicians could beneft from professional development to learn how to be authentically present for WLH, including engaging in conversations, demonstrating compassion, and understanding situations. Evidence-based clinical prac‑ tice guidelines need to be tailored for the family planning and sexual health needs of WLH. Keywords: AIDS, HIV, Decision-making, Pregnancy, Reproductive health, Wome

The Helicobacter pylori Genome Project : insights into H. pylori population structure from analysis of a worldwide collection of complete genomes

Helicobacter pylori, a dominant member of the gastric microbiota, shares co-evolutionary history with humans. This has led to the development of genetically distinct H. pylori subpopulations associated with the geographic origin of the host and with differential gastric disease risk. Here, we provide insights into H. pylori population structure as a part of the Helicobacter pylori Genome Project (HpGP), a multi-disciplinary initiative aimed at elucidating H. pylori pathogenesis and identifying new therapeutic targets. We collected 1011 well-characterized clinical strains from 50 countries and generated high-quality genome sequences. We analysed core genome diversity and population structure of the HpGP dataset and 255 worldwide reference genomes to outline the ancestral contribution to Eurasian, African, and American populations. We found evidence of substantial contribution of population hpNorthAsia and subpopulation hspUral in Northern European H. pylori. The genomes of H. pylori isolated from northern and southern Indigenous Americans differed in that bacteria isolated in northern Indigenous communities were more similar to North Asian H. pylori while the southern had higher relatedness to hpEastAsia. Notably, we also found a highly clonal yet geographically dispersed North American subpopulation, which is negative for the cag pathogenicity island, and present in 7% of sequenced US genomes. We expect the HpGP dataset and the corresponding strains to become a major asset for H. pylori genomics

Repeated and longitudinal measures database from 1994 to 2018 to assess Chile’s substance use control policies for the 2000-2010 decade

Database aimed to assess the association of substance-related control policies that were implemented in the 2000-2010 decade on the consumption of alcohol, tobacco, and drugs in Chile

Transgresiones y errores potenciales de medicación en estudiantes de enfermería en ambiente simulado

Introducción: Los errores de medicación son uno de los eventos de mayor relevancia en la actualidad, derivándose de la interacción entre el medio y los profesionales. La educación debe entrenar a los estudiantes para la seguridad. Objetivo: identificar transgresiones y errores potenciales de medicación en estudiantes de enfermería en los subprocesos de preparación y administración de medicamentos por vía parenteral en ambiente simulado. Método: Estudio cuantitativo, descriptivo realizado en estudiantes de segundo, tercer y cuarto año de la carrera de enfermería de una Universidad chilena. Se evaluaron los subprocesos de preparación y administración a través de la aplicación de una pauta estandarizada de administración segura de medicamentos en ambiente de simulación. Se reconocieron ítems críticos (ítems de transgresiones o errores potenciales) utilizando un punto de corte del 70 %. Resultados: Los estudiantes presentaban edades promedio entre 22 y 24 años, predominando el sexo femenino. Los ítems identificados como críticos en el subproceso de preparación fueron: verificación de la fecha de caducidad del medicamento, transgresión de principios de infecciones asociadas a la atención de salud y preparación de la dosis correcta. En el subproceso de administración se identificó: verificación de alergias, manejo de accesos vasculares, entrega de información e identificación de paciente. Conclusiones: A través de este estudio se identificaron transgresiones y errores potenciales que deben ser trabajados con los estudiantes. La simulación clínica como metodología permite el entrenamiento de competencias orientadas a la provisión de cuidados seguros y de calidad en un ambiente real y protegido. Palabras clave: Educación en Enfermería. seguridad del paciente, errores de medicación, entrenamiento simulado

Faculty attitudes about caring for people living with HIV/AIDS : A comparative study

Background: People living with HIV/AIDS (PLHIV) experience stigma and discrimination. Negative attitudes of nursing faculty about caring for PLHIV can adversely affect student perceptions and their nursing care. The study purpose was to describe nursing faculty attitudes and beliefs about caring for PLHIV. Method: The HPASS (Healthcare Provider HIV/AIDS Stigma Scale), Spanish version, was delivered to nursing faculty in Colombia and Peru. Results: The HPASS was completed by 98 nursing faculty. The overall mean score was 2.41 (SD = 0.69), with subscale scores: stereotypes, 2.55 (SD = 0.84); discrimination, 2.28 (SD = 0.74); and prejudices, 2.41 (SD = 0.63). Peruvian faculty had the highest scores, statistically correlated with the importance of religion, whereas Colombia had the lowest. Conclusion: Nursing faculty attitudes toward PLHIV were slightly positive in Colombia to slightly negative in Peru; however, both countries had negative stereotypes. Knowledge deficiencies about HIV persist and attitudes appear to be influenced by culture and religion

Patient Safety Culture in Latin American Hospitals: A Systematic Review with Meta-Analysis

Introduction: Adverse events in hospitals are prevented through risk reduction and reliable processes. Highly reliable hospitals are grounded by a robust patient safety culture with effective communication, leadership, teamwork, error reporting, continuous improvement, and organizational learning. Although hospitals regularly measure their patient safety culture for strengths and weaknesses, there have been no systematic reviews with meta-analyses reported from Latin America. Purpose: Our systematic review aims to produce evidence about the status of patient safety culture in Latin American hospitals from studies using the Hospital Survey on Patient Safety Culture (HSOPSC). Methods: This systematic review was guided by the JBI guidelines for evidence synthesis. Four databases were systematically searched for studies from 2011 to 2021 originating in Latin America. Studies identified for inclusion were assessed for methodological quality and risk of bias. Descriptive and inferential statistics, including meta-analysis for professional subgroups and meta-regression for subgroup effect, were calculated. Results: In total, 30 studies from five countries—Argentina (1), Brazil (22), Colombia (3), Mexico (3), and Peru (1)—were included in the review, with 10,915 participants, consisting primarily of nursing staff (93%). The HSOPSC dimensions most positive for patient safety culture were “organizational learning: continuous improvement” and “teamwork within units”, while the least positive were “nonpunitive response to error” and “staffing”. Overall, there was a low positive perception (48%) of patient safety culture as a global measure (95% CI, 44.53–51.60), and a significant difference was observed for physicians who had a higher positive perception than nurses (59.84; 95% CI, 56.02–63.66). Conclusions: Patient safety culture is a relatively unknown or unmeasured concept in most Latin American countries. Health professional programs need to build patient safety content into curriculums with an emphasis on developing skills in communication, leadership, and teamwork. Despite international accreditation penetration in the region, there were surprisingly few studies from countries with accredited hospitals. Patient safety culture needs to be a priority for hospitals in Latin America through health policies requiring annual assessments to identify weaknesses for quality improvement initiatives

Psychometric Properties of the Connor-Davidson Resilience Scale for South America (CD-RISC-25SA) in Peruvian Adolescents

Resilience describes the ability of someone to adapt to adverse life experiences by adjusting to demands with behavioral flexibility. When encountering crisis situations, resilient people typically spring back emotionally with increased strength and internal composure. Measuring resilience is important for assessing the ability of adolescents to respond to adverse situations. The objective of this study was to evaluate the psychometric performance of the Spanish version of the Connor-Davidson Resilience Scale (CD-RISC) © for South America (CD-RISC-25SA) in a population of vulnerable Peruvian adolescents. This study used a cross-sectional design to measure sociodemographic variables and resilience. Participants were 451 adolescents living in a shelter in Lima, Perú. Face and content validity were established by expert panel, construct validity was evaluated with exploratory and confirmatory factor analysis, and internal consistency was assessed with Cronbach’s alpha. The analysis resulted in a four-dimensional model with 22 items explaining almost 27% of the variance with a Cronbach’s alpha of 0.90. The dimensions included self-confidence and self-trust from previous experiences, internal resources to cope with difficult situations, personal competence and tenacity, and self-regulation with external resources. Two of the 3 items eliminated from the instrument were related to the original dimension “spirituality influences” which may have been incorrectly translated and adapted without equivalence of meaning for cross-cultural research. The CD-RISC-25SA is not a stable multidimensional instrument for measuring resilience across the cultures and contexts of countries. However, the instrument appears to be stable for measuring resilience as a single dimension. For measuring resilience in the context of Peru, a four-dimensional model with 22 items was validated. Variations in the psychometric properties of translated instruments may result from not establishing the equivalence of meaning for each item before performing cross-cultural research. Researchers need to search for a more precise understanding of resilience as a universal concept transferable across borders and through translations

Reproductive decision-making of Black women living with HIV: A systematic review

Background: Black women living with HIV account for a higher proportion of new HIV diagnoses than other groups. These women experience restricted access to reproductive services and inadequate support from healthcare providers because their position in society is based on their sexual health and social identity in the context of this stigmatizing chronic disease. By recognizing the analytical relevance of intersectionality, the reproductive decision-making of Black women can be explored as a social phenomenon of society with varied positionality. Objective: The purpose of this review was to synthesize the evidence about the reproductive decision-making of Black women living with HIV in high-income countries from the beginning of the HIV epidemic to the present. Methods: This systematic review was guided by the JBI evidence synthesis recommendations. Searches were completed in seven databases from 1985 to 2021, and the review protocol was registered with PROSPERO (CRD420180919). Results: Of 3503 records, 22 studies were chosen for synthesis, including 19 observational and three qualitative designs. Nearly, all studies originated from the United States; the earliest was reported in 1995. Few studies provided detailed sociodemographic data or subgroup analysis focused on race or ethnicity. Influencing factors for reproductive decisionmaking were organized into the following seven categories: ethnicity, race, and pregnancy; religion and spirituality; attitudes and beliefs about antiretroviral therapy; supportive people; motherhood and fulfillment; reproductive planning; and health and wellness. Conclusion: No major differences were identified in the reproductive decision-making of Black women living with HIV. Even though Black women were the largest group of women living with HIV, no studies reported a subgroup analysis, and few studies detailed sociodemographic information specific to Black women. In the future, institutional review boards should require a subgroup analysis for Black women when they are included as participants in larger studies of women living with HIV