Designing an ongoing nursing quality management control framework

OBJETIVOS: Uno de los sistemas básicos de trabajo en evaluación y mejora de la calidad asistencial lo constituyen los sistemas de monitorización de la misma, mediante el uso de indicadores de calidad. Sin embargo, los sistemas de mejora o cuadros de mando no informatizados no permiten monitorizar de forma continua las actuaciones de enfermería, sólo de forma puntual o sincrónica. Por ello, el proyecto que se plantea pretende crear un sistema de monitorización CONTINUO de la calidad en la atención de Enfermería, diseñando, definiendo e implementando indicadores adaptados a través de la fórmula matemática al programa informático Green Cube, programa de historia clínica única informatizada del usuario de Clínica Vistahermosa. El proyecto en sí se ha incluido como objetivo de calidad del centro para el año 2014. A través de ellos se identificarán situaciones de mejora potencial o bien desviaciones de la práctica estandarizada con la finalidad de mejorar la calidad en la atención de Enfermería

Transforming the Future Healthcare Workforce across Europe through Improvement Science Training: A Qualitative Approach

Healthcare improvement science (HIS) is the generation of knowledge to cultivate change towards improving health systems performance. Our purpose was to evaluate the experience of European nursing students after an intensive one-week summer program conducted in 2019 at the University of Alicante in Spain. The educational intervention combined theoretical and practical HIS contents, with students from different countries, educational programs, and health systems. The intervention was evaluated under a qualitative approach through the open discussion group technique based on the method of participatory action research (PAR), with a total of 25 students who reflected about their experiences and perceptions during the intervention. The responses were used to improve the program’s contents, its didactics, and organization. Nursing empowerment, professional recognition, and healthcare research were some of the seven main categories identified through the systematic content analysis method triangulated by three experienced researchers. According to the students’ replies, values like compassion, respect, or empathy were identified as key elements of care. Promoting international students’ networking emerged as the key to creating a positive provision for change and the generation of improvement initiatives. Building a HIS culture may potentially provide future healthcare professionals with critical thinking skills and the resources needed to improve their future work settings.The research was financed by the European Union-funded ERASMUS Lifelong Learning Project, ISTEW: Improvement Science Training for European Healthcare Workers (Project No. 539194-LLP-1-2013-1-UK-ERASMUS-EQR)

Phenomenological Approach to the Meaning and Impact of Organ Donation in the Family

La donación de órganos es un acontecimiento crítico tras la pérdida de un ser querido. España, a pesar de ser el país del mundo con mayor tasa de donantes, todavía mantiene una negativa familiar del 15,56%. Objetivos: conocer y analizar el impacto de la donación de órganos a través de los significados que tiene para la familia en el contexto español. Materiales y método: estudio cualitativo fenomenológico según el marco conceptual y método de Giorgi. Luego de respetar, al menos, tres años de duelo desde la pérdida de un ser querido, se entrevistaron en profundidad a once familias que donaron órganos en el Hospital La Fe en Valencia. Resultados: tras el análisis de los resultados, se describieron veintisiete unidades de significado que fueron clasificadas en relativos a la pérdida y relativos a la donación de órganos y, posteriormente, correlacionadas. Conclusiones: la donación aparece como mecanismo de alivio o compensación del fallecimiento del familiar.Organ donation is a critical event after the loss of a loved one. Spain, despite being the country with the highest donor rate in the world, still maintains a family negative rate of 15.56%. Objective: Know and analyze the impact of organ donation based on its meaning for the family in the Spanish context. Materials and method: This is a phenomenological qualitative study based on Giorgi's conceptual framework and method. Eleven families who had donated organs at the Hospital La Fe in Valencia were interviewed in depth, following at least three years of mourning since the loss of a loved one. Results: After the results were analyzed, twenty-seven units of meaning were described and classified as relative to the loss and relative to the organ donation. They were then correlated. Conclusion: Organ donation appears to be a relief mechanism or a kind of compensation for the death of a family member

Mapping the Status of Healthcare Improvement Science through a Narrative Review in Six European Countries

With the aim to explore how improvement science is understood, taught, practiced, and its impact on quality healthcare across Europe, the Improvement Science Training for European Healthcare Workers (ISTEW) project “Improvement Science Training for European Healthcare Workers” was funded by the European Commission and integrated by 7 teams from different European countries. As part of the project, a narrative literature review was conducted between 2008 and 2019, including documents in all partners’ languages from 26 databases. Data collection and analysis involved a common database. Validation took place through partners’ discussions. Referring to healthcare improvement science (HIS), a variety of terms, tools, and techniques were reported with no baseline definition or specific framework. All partner teams were informed about the non-existence of a specific term equivalent to HIS in their mother languages, except for the English-speaking countries. A lack of consensus, regarding the understanding and implementation of HIS into the healthcare and educational contexts was found. Our findings have brought to light the gap existing in HIS within Europe, far from other nations, such as the US, where there is a clearer HIS picture. As a consequence, the authors suggest further developing the standardization of HIS understanding and education in Europe.The research conducted until 2015 was funded by the European Union funded ERASMUS Lifelong Learning Project, ISTEW: Improvement Science Training for European Healthcare Workers (Project No. 539194-LLP-1-2013-1-UK-ERASMUS-EQR)

Developing a framework for evaluating the impact of Healthcare Improvement Science Education across Europe: a qualitative study

Purpose: Frontline healthcare professionals are well positioned to improve the systems in which they work. Educational curricula, however, have not always equipped healthcare professionals with the skills or knowledge to implement and evaluate improvements. It is important to have a robust and standardized framework in order to evaluate the impact of such education in terms of improvement, both within and across European countries. The results of such evaluations will enhance the further development and delivery of healthcare improvement science (HIS) education. We aimed to describe the development and piloting of a framework for prospectively evaluating the impact of HIS education and learning. Methods: The evaluation framework was designed collaboratively and piloted in 7 European countries following a qualitative methodology. The present study used mixed methods to gather data from students and educators. The framework took the Kirkpatrick model of evaluation as a theoretical reference. Results: The framework was found to be feasible and acceptable for use across differing European higher education contexts according to the pilot study and the participants’ consensus. It can be used effectively to evaluate and develop HIS education across European higher education institutions. Conclusion: We offer a new evaluation framework to capture the impact of HIS education. The implementation of this tool has the potential to facilitate the continuous development of HIS education.This work was supported by the European Union ERASMUS Lifelong Learning Project, ISTEW (Improvement Science Training for European Healthcare Workers) (Project No. 539194-LLP-1-2013-1-UK-ERASMUS-EQR)

Lights4Violence: a quasi-experimental educational intervention in six European countries to promote positive relationships among adolescents.

Background Preventing intimate partner violence or dating violence (DV) among adolescents is a public health priority due to its magnitude and damaging short and long-term consequences for adolescent and adult health. In our study protocol, we complement prior experiences in DV prevention by promoting protective factors (or assets) against gender violence such as communication skills, empathy and problem-solving capability through “Cinema Voice”, a participatory educational intervention based on adolescents’ strengths to tackle DV. Methods/design A longitudinal quasi-experimental educational intervention addressed to boys and girls ages 13–17 years, enrolled in secondary education schools in Alicante (Spain), Rome (Italy), Cardiff (UK), Iasi (Romania), Poznan (Poland) and Matosinhos (Portugal). Both process and results evaluations will be carried out with 100–120 intervention and 120–150 control group students per city at three time periods: before, after and 6 months after the implementation of the following interventions: 1) Training seminar with teachers to promote knowledge and skills on the core issues of intervention; 2) Workshops with intervention groups, where participants produce their own digital content presenting their perspective on DV; and 3) Short film exhibitions with participants, their families, authorities and other stakeholders with the objective of share the results and engage the community. Outcome measures are self-perceived social support, machismo, sexism, tolerance towards gender violence, social problem-solving and assertiveness as well as involvement in bullying/cyberbullying. Other socio-demographic, attitudes and violence-related co-variables were also included. Discussion This study may provide relevant information about the effectiveness of educational interventions that combine a positive youth development framework with educational awareness about the importance of achieving gender equality and preventing and combating gender violence. To our knowledge, this is the first study that involves six European countries in an educational intervention to promote violence protective assets among enrolled adolescents in secondary schools. This study may provide the needed tools to replicate the experience in other contexts and other countrie

Developing a competence framework for nurses in pharmaceutical care: A Delphi study

Background: Nurses play an important role in pharmaceutical care. They are involved in: detecting clinical change; communicating/discussing pharmacotherapy with patients, their advocates, and other healthcare professionals; proposing and implementing medication-related interventions; and ensuring follow-up of patients and medication regimens. To date, a framework of nurses' competences on knowledge, skills, and attitudes as to interprofessional pharmaceutical care tasks is missing. Objectives: To reach agreement with experts about nurses' competences for tasks in interprofessional pharmaceutical care. Methods: A two-phase study starting with a scoping review followed by five Delphi rounds was performed. Competences extracted from the literature were assessed by an expert panel on relevance by using the RAND/UCLA method. The experts (n = 22) involved were healthcare professionals, nurse researchers, and educators from 14 European countries with a specific interest in nurses' roles in interprofessional pharmaceutical care. Descriptive statistics supported the data analysis. Results: The expert panel reached consensus on the relevance of 60 competences for 22 nursing tasks. 41 competences were related to 15 generic nursing tasks and 33 competences were related to seven specific nursing tasks. Conclusions: This study resulted in a competence framework for competency-based nurse education. Future research should focus on imbedding these competences in nurse education. A structured instrument should be developed to assess students' readiness to achieve competence in interprofessional pharmaceutical care in clinical practice.The research was supported by the Erasmus+ Programme of the European Union (grant number 2018–1-BE02-KA203–046861) and MDMJ accountants, an accountancy service in Belgium that financially supported the Belgian authors, without any conflicts of interest

EUPRON: nurses’ practice in interprofessional pharmaceutical care in Europe. A cross-sectional survey in 17 countries

Abstract Objectives Safe pharmaceutical care (PC) requires an interprofessional team approach, involving physicians, nurses and pharmacists. Nurses’ roles however, are not always explicit and clear, complicating interprofessional collaboration. The aim of this study is to describe nurses’ practice and interprofessional collaboration in PC, from the viewpoint of nurses, physicians and pharmacists. Design A cross-sectional survey. Setting The study was conducted in 17 European countries, each with their own health systems. Participants Pharmacists, physicians and nurses with an active role in PC were surveyed. Main outcome measures Nurses’ involvement in PC, experiences of interprofessional collaboration and communication and views on nurses’ competences. Results A total of 4888 nurses, 974 physicians and 857 pharmacists from 17 European countries responded. Providing patient education and information (PEI), monitoring medicines adherence (MMA), monitoring adverse/therapeutic effects (ME) and prescribing medicines were considered integral to nursing practice by 78%, 73%, 69% and 15% of nurses, respectively. Most respondents were convinced that quality of PC would be improved by increasing nurses’ involvement in ME (95%), MMA (95%), PEI (91%) and prescribing (53%). Mean scores for the reported quality of collaboration between nurses and physicians, collaboration between nurses and pharmacists and interprofessional communication were respectively <7/10, ≤4/10, <6/10 for all four aspects of PC. Conclusions ME, MMA, PEI and prescribing are part of nurses’ activities, and most healthcare professionals felt their involvement should be extended. Collaboration between nurses and physicians on PC is limited and between nurses and pharmacists even more

Nurse students’ competences in interprofessional pharmaceutical care in Europe: cross-sectional evaluation

Background: Safe pharmaceutical care requires competent nurses with specific knowledge, skills and attitudes. It is unclear whether nursing students are adequately prepared to perform pharmaceutical care in practice. Mapping their pharmaceutical care competences can lead to a better understanding of the extent to which curricula fit expectations of the labour market. Objectives: To assess pharmaceutical care competences of final-year nursing students of different educational levels. Design: A cross-sectional survey design. Settings: In 14 European countries, nursing schools who offer curricula for level 4 to 7 students, were approached. Participants: Through convenience sampling 1741 final-year student nurses of level 4 to 7 were included. Sampling strategies were country-specific. Methods: A web-platform was developed with an assessment of the level in which students mastered pharmaceutical care competences. Knowledge questions, case studies (basic/advanced level), self-reported practical skills and attitudes were evaluated. Results: Mean scores for knowledge questions differed significantly (p<0.001) between level 5 (56/100), level 6 (68/100) and level 7 students (72/100). For basic cases level 5 students reached lower scores (64/100) compared with level 6 (71/100) and level 7 (72/100) students (p=0.002 and p=0.005). For more advanced cases no difference between levels was observed (overall mean 61/100). Most students (63-90%) considered themselves skilled to perform pharmaceutical care and had positive attitudes towards their participation in pharmaceutical care (65-97%). Conclusions: Relatively low knowledge scores were calculated for final-year student nurses. In some domains, lower levels of students might be insufficiently prepared to take up responsibilities in pharmaceutical care. Our assessment can be used as a tool for educators to evaluate how prepared nursing students are for pharmaceutical care. Its further implementation for students of different educational levels will allow benchmarking between the levels, both within and between countries.This work was supported by the Erasmus+ Programme of the European Union [grant number 2018-1-BE02-KA203-046861] and Consensus accountants, an accountancy service in Belgium that financially supported the Belgian authors, without any conflicts of interest

Origin and development of alimentary habits and customs as a sociocultural resource for mankind: an approach to history and anthropology of care with regard to alimentation

Entre todas las criaturas de la Tierra, el hombre es la única que posee el sentido del destino y el que puede simbolizar incluso sobre aquello que a simple vista pudiese parecer un fenómeno u objeto estrictamente físico y material. Así, cualquier tipo de alimento -frutas, hortalizas, legumbres, pescado...- goza de distintos valores simbólicos atribuidos por el hombre de distintas culturas en diferentes épocas, ya que los caracteres que unen al hombre con los animales, así como las habilidades y las organizaciones sociales que desarrolló mucho antes de que empezaran las épocas históricas, constituyen un preciado legado que aunque en lenta, silenciosa, pero sin embargo constante evolución, se ha perpetuado hasta los tiempos actuales. El papel que los alimentos han jugado dentro de la dieta humana, así como en el proceso involuntario de nutrición y en la acción consciente de alimentarse, se traduce en este trabajo desde su vertiente antropológica, siguiendo una clara visión histórica. El objetivo principal de este trabajo es mostrar de qué forma ha perdurado ese valor simbólico y social de los alimentos a lo largo de la Historia en diferentes culturas, dónde se encuentra su punto de partida y cuáles son los pilares sobre los que descansa su esencia en relación a los cuidados.Amongst all creatures on earth, man is the only one that has a "sense of destiny" and is able to symbolise even what appears to be strictly physical and material objects or phenomena. Therefore, any food -fruits, vegetables, pulses, fish- can possess various symbolic values according to different cultures and eras. The characteristics that link mankind with animals, and the social organisations and abilities developed long ago constitute a precious legacy which -in slow, quiet but constant evolution- have survived until present. The role that food has played within human diet, the involuntary nutrition process and the conscious feeding action is approached here from an anthropological point of view, following a clear historic view. The main objective of this work is to show the way in which the social and symbolic value of food through history in different cultures has survived, where its starting point is located, and the foundations on which its essence with regard to care leans