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

Abstract Aim: To determine the impact of the Best Practice Spotlight Organization® initia- tive 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 analy- ses 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

Incidence of Changes in Electoral Competence Rules on the Nationalization of Party Systems: The Strategies of Political Actors in Antioquia, 1997-2011

RESUMEN: En este artículo se sostiene que la nacionalización vertical del sistema de partidos es afectada por la forma como los partidos y candidatos adoptanestrategias para seguir en competencia bajo un marco normativo dado, pues las reglas electorales ofrecen diferentes incentivos para que estos coordinen (o no) sus esfuerzos entre los diferentes niveles electorales. Para ello, a partir de la información de las elecciones de Concejo, Asamblea y Cámara en Antioquia entre 1997 y 2011 se encuentra que los cambios en las reglas electorales de 2003 y su efecto sobre la forma en que los políticos se organizan para la competencia son un factor que afecta la nacionalización vertical del sistema de partidos, haciendo que la competencia a nivel municipal se aparte de la regional y nacional.ABSTRACT: In this article it is argued that vertical nationalization of the party system is affected by the way in which parties and candidates adopt strategies to remain in competition under a given set of rules, since electoral rules offer different incentives for them to coordinate (or not) their efforts among the different electoral levels. For this purpose, based on information from the elections for Council, Assembly and Chamber in Antioquia between 1997 and 2011, it was found that the changes in electoral rules in 2003 and their effect on the way in which politicians organize themselves for elections are a factor that affects vertical nationalization of the party system, distancing the competition on the municipal level from that which takes place on the regional and national levels

Hypothermia Plus Melatonin in Asphyctic Newborns: A Randomized-Controlled Pilot Study

Objectives: To investigate the effect of adding melatonin to hypothermia treatment on neurodevelopmental outcomes in asphyctic newborns. Design: Pilot multicenter, randomized, controlled, double-blind clinical trial. Statistical comparison of results obtained in two intervention arms: hypothermia plus placebo and hypothermia plus melatonin. Setting: Level 3 neonatal ICU. Patients: Twenty-five newborns were recruited. Interventions: The hypothermia plus melatonin patients received a daily dose of IV melatonin, 5 mg per kg body weight, for 3 days. General laboratory variables were measured both at neonatal ICU admission and after intervention. All infants were studied with amplitude-integrated electroencephalography and brain MRI within the first week of life. The neurodevelopmental Bayley III test, the Gross Motor Function Classification System, and the Tardieu scale were applied at the ages of 6 and 18 months. Measurements and main results: Clinical characteristics, laboratory evaluations, MRI findings, and amplitude-integrated electroencephalography background did not differ between the treatment groups. The newborns in the hypothermia plus melatonin group achieved a significantly higher composite score for the cognitive section of the Bayley III test at 18 months old, with respect to the hypothermia plus placebo group (p = 0.05). There were no differences between the groups according to the Gross Motor Function Classification System and Tardieu motor assessment scales. Conclusions: The early addition of IV melatonin to asphyctic neonates is feasible and may improve long-term neurodevelopment. To our knowledge, this is the first clinical trial to analyze the administration of IV melatonin as an adjuvant therapy to therapeutic hypothermia

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

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

Evaluación de la calidad en el servicio del subsector de restaurantes en la ciudad de Santiago de Cali

El presente trabajo de grado tiene como objetivo plantear un modelo de evaluación de la calidad del servicio para medir las percepciones de los usuarios que asisten a los restaurantes vinculados a la Mesa de Turismo del Grupo Multisectorial ubicados en la ciudad de Santiago de Cali, con el fin de implantar alternativas para mejorar la competitividad de los mismos. Este trabajo consta de tres objetivos específicos, los cuales se desarrollaron en cuatro etapas; la primera se basó en el análisis de validez del instrumento a partir de l validez de contenido, criterio y constructo; y de la confiabilidad a través del Alfa de Cronbach a una prueba piloto, se seleccionaron los datos de las encuestas sugeridas y adaptadas por Servperf y las Normas Técnicas de la Calidad para los restaurantes y, finalmente se realizó un estudio sociodemográfico. La segunda etapa se fundamentó en la evaluación de la calidad del servicio, llevando a cabo la toma de encuestas a los clientes para conocer sus percepciones ligeramente después de recibir el servicio. En la tercera etapa, se realizó un análisis estadístico de las percepciones de los usuarios y un análisis de criterios ponderados para la obtención del índice de calidad de servicio general percibido por dichos usuarios. Finalmente, en la cuarta etapa se plantearon estrategias de mejora con el fin de dar respuesta a las dimensiones con menor puntaje de percepción. Se hallaron como resultados que en los restaurantes los usuarios califican mejor la dimensión de seguridad seguido de la empatía, la capacidad de respuesta y la fiabilidad. No obstante, los usuarios se encuentran insatisfechos con la dimensión de tangibilidad. De la misma forma, se descubrió que los usuarios del restaurante La Galería Plaza se encuentran insatisfechos con la dimensión de tangibilidad, mientras que en el restaurante Jardín del Rio los usuarios se encuentran insatisfechos con las dimensiones de tangibilidad y fiabilidad. Por otro lado, el índice de calidad general para La Galería Plaza y Jardín del Rio es de 4,482 y 4,468 respectivamente, mientras que para el subsector en general es de 4,475. Como plan de mejora se planteó una estrategia para cada restaurante referida a los elementos tangibles e instalaciones físicas y dos adicionales para Jardín del Rio referentes a la disposición, proporción y rapidez del servicioThe purpose of this degree project is to propose a model for evaluating the quality of the service to measure the perceptions of the users who attend the restaurants linked to the Tourism Board of the Multisectoral Group located in the city of Santiago de Cali, with the in order to implement alternatives to improve their competitiveness. This work consists of three specific objectives, which were developed in four stages; the first was based on the analysis of the validity of the instrument based on the validity of content, criteria and construct; and from the reliability through Cronbach's Alpha to a pilot test, the data from the surveys suggested and adapted by Servperf and the Technical Quality Standards for restaurants were selected and finally a sociodemographic study was carried out. The second stage was based on the evaluation of the quality of the service, carrying out customer surveys to know their perceptions slightly after receiving the service. In the third stage, a statistical analysis of the perceptions of the users and an analysis of weighted criteria for obtaining the general service quality index perceived by said users was performed. Finally, in the fourth stage, improvement strategies were proposed in order to respond to the dimensions with the lowest perception score. The results were that in restaurants, users better rate the security dimension followed by empathy, responsiveness and reliability. However, users are dissatisfied with the dimension of tangibility. In the same way, it was discovered that users of the La Galería Plaza restaurant are dissatisfied with the tangibility dimension, while in the Jardín del Rio restaurant users are dissatisfied with the dimensions of tangibility and reliability. On the other hand, the general quality index for La Galería Plaza and Jardín del Rio is 4,482 and 4,468 respectively, while for the subsector in general it is 4,475. As an improvement plan, a strategy was proposed for each restaurant referring to the tangible elements and physical facilities and two additional ones for Jardín del Rio regarding the disposition, proportion and speed of the servicePasantía de investigación (Ingeniero Industrial)-- Universidad Autónoma de Occidente, 2020PregradoIngeniero(a) Industria