The training needs of critical care nurses: A psychometric analysis

Background/Objective: Nurses develop the care methods they learn through specific training and this enables them to provide care in a safe, effective and efficient manner. Intensive Care Units (ICU), as complex areas in terms of care, require nurses with specific training. Due to this fact, we set ourselves the objective to validate a questionnaire that detects the training needs of intensive care nurses in Spain. Methods: A cross-sectional descriptive study, using an electronic questionnaire, adapted and validated through the Delphi technique, in 85 ICUs in Spain, for which a psychometric analysis is conducted. To explore the dimensions and determine the factorial structure, an Exploratory Factor Analysis (EFA) and a Confirmatory Factor Analysis (CFA) were carried out. Internal consistency was determined through ordinal alpha. The statistical treatment was carried out using the statistical programmes Factor Analysis 10.9.02 and IBM AMOS version 24. Results: A total of 568 Spanish intensive care nurses, randomly divided into two samples, participated in the study. The EFA presented a factorial solution with suitable values for both the Kaiser-Meyer-Olsen Index and Bartlett’s Sphericity. In the CFA, the model fit achieved close to ideal values with a Comparative Fit Index (CFI) and Tucker-Lewis Index (TLI) close to values of 0.9. The values of individual reliability, internal consistency and average variance extracted were appropriate for this type of analysis. Conclusion: The dimensions detected are close to the construct that encompasses the training needs of ICU nurses. The analyses carried out indicate that there are reasonable realities for incorporating these dimensions into the field of nursing training. This study opens the possibility of incorporating new items to adjust the model to improve the explanatory variables. Our findings help us to understand the dimensions that the training programmes should incorporate

Attitudes and Feelings towards the Work of Teachers Who Had a School Nurse in Their Educational Center during the COVID-19 Pandemic

The objective of this study was to analyze the influence of the availability of a health professional on the beliefs, attitudes, and work feelings of teaching staff when facing the COVID-19 pandemic. This is a two-phase study: In the first one, the Delphi technique was used to update an instrument used by the authors in a previous investigation in 2020. The second phase was a cross-sectional, descriptive, and comparative study, carried out through an electronic questionnaire distributed among the teaching staff of the Autonomous Community of the Canary Islands (Spain), during the first two months of the 2021/22 academic year, in the midst of the fifth wave of COVID-19. Data were analyzed using Pearson’s chi-squared test and the linear trend test. The reasons for advantages were analyzed and the dimensions of the questionnaire were compared between the groups studied (with or without a healthcare professional in the center). Out of 640 teachers in the study, 14.7% (n = 94) stated that they had a reference professional with health training in their educational center (a school nurse) for the management of possible cases of COVID-19. Significant differences were found in five of the nine dimensions studied between the groups of teachers analyzed. Teachers who had a health professional, specifically a nurse, during the pandemic indicated that they felt safer in their educational center, as they perceived that they had more personal protective equipment (OR = 2.03, [95% CI: 1.23–3.35]; p = 0.006). They were also more committed (OR = 1.89, [95% CI: 1.04–3.46]; p = 0.038) with their educational work and assumed more obligations (OR = 1.87, [95% CI: 1.01–3.44]; p = 0.045) and risks (OR = 2.82, [95% CI: 1.13–7.07]; p = 0.027). In addition, they presented fewer feelings of burnout (OR = 0.63, [95% CI: 0.41–0.98]; p = 0.041). These results indicate that having nurses in educational centers improves teachers’ ability to cope with a pandemic situation

Percepción de la calidad de la investigación enfermera en un hospital público

Antecedentes y objetivos Las enfermeras, como profesionales sanitarios, juegan un papel importante en la investigación, ya que sin ellas no se podría avanzar en el cuidado y en los tratamientos. Por ello nos planteamos como objetivos: primero, analizar la percepción de la enfermería sobre el actual sistema de investigación en el conjunto de su hospital y, segundo, estudiar cómo varía dicha percepción en función de su perfil investigador y de su nivel de satisfacción y compromiso con la organización en la que trabaja. Material y método Estudio descriptivo transversal, realizado en un centro hospitalario de tercer nivel. Se trabajó con una muestra de conveniencia formada por enfermeras con una experiencia superior a 6 meses. Se utilizó el cuestionario del Grupo de Expertos del III Foro de Ciencia de la Fundación Lilly, adaptándolo a las características de la población. La encuesta tenía por objeto recoger la percepción y valoración, real e ideal, sobre la investigación que tiene este colectivo. Se realizaron análisis univariados y bivariados mediante el estadístico t de Student. Resultados Para una muestra formada por 295 enfermeras, la percepción y valoración de la situación actual de la investigación en enfermería, el impacto de esta, su reconocimiento y su integración con la labor asistencial estuvieron muy por debajo de las puntuaciones que consideran ideales, obteniéndose diferencias estadísticamente significativas (p < 0,001). Resultaron significativos los valores que reconocen que se precisa mayor investigación por parte de la enfermería, el impacto y reconocimiento por la gerencia y la sinergia con la industria farmacéutica (p < 0,001). El nivel de satisfacción no influyó en la valoración, a diferencia del compromiso. No se observaron diferencias entre el personal de la UCI respecto del resto de servicios en cuanto a la percepción y valoración de la investigación de la enfermería. Conclusiones Las enfermeras asumen la investigación como parte de sus funciones y afirman que el estado de la investigación es muy mejorable. Según estas, es necesaria una infraestructura de apoyo que potencie la investigación en cuidados y el reconocimiento real por parte de las instituciones.Background and objectives Nurses, as health professionals, play an important role in research, as progress in care and treatment could not be made without it. The aim of this study is to analyse the perception by nurses of the current research system in the whole of their hospital and, second, study how this perception varies according to their research profile, as well as their level of satisfaction and commitment to the organisation in which work. Material and method A cross-sectional descriptive study was conducted in a third level hospital with a convenience sample of nurses with more than 6 months experience. The Group of Experts of the III Forum of Science of the Lilly Foundation questionnaire was used, adapting it to the characteristics of the population. The purpose of the questionnaire was to collect the perception and assessment, real and ideal, that nurses have on research. Univariate and bivariate analyses were performed using the Student t-test. Results In the sample of 295 nurses, the perception and assessment of the current situation of nursing research, its impact, its recognition, and its integration with nursing work were well below the ideal scores, obtaining statistically differences (P < .001). There was a significance in the values that recognise that more research is needed by nursing staff, the impact and recognition by management, and synergy with the pharmaceutical industry (P < .001). The level of satisfaction did not affect the assessment, the commitment of the nurses if it influenced their assessment of the research. No differences were found between the ICU staff and the other departments as regards the perception and assessment of nursing research. Conclusions Nurses take the research as part of their functions and mention that the state of the research is very much improved. A support infrastructure is needed to strengthen research in care, as well as real recognition by institutions

Necesidades de formación detectadas por enfermeras de una unidad de cuidados intensivos: un estudio fenomenológico.

Introducción: Las competencias que abordan en su entorno laboral las enfermeras de cuidados intensivos (UCI), han aumentado con la adquisición de nuevas responsabilidades asociadas a cuidados y dispositivos a realizar al paciente crítico. Múltiples estudios avalan la necesidad de la especialización de las enfermeras que trabajan en este tipo de unidades. Apoyado en estas evidencias, la European Federation of Critical Care Nurse, recomienda unificar la formación de las enfermeras de cuidados intensivos. Por tanto, nos planteamos el siguiente objetivo: valorar las necesidades formativas que detectan las enfermeras de UCI a través de sus vivencias y experiencias profesionales. Método: Estudio cualitativo descriptivo, con enfoque fenomenológico, a través de una entrevista semiestructurada donde se estudiaron los 4 ámbitos que la European Federation of Critical Care Nurse recoge (clínico, profesional, gestión y educativo). Se entrevistaron a 15 enfermeras de una UCI polivalente. Resultados: Los entrevistados reconocen que la formación previa era deficiente para los cuidados y medidas de soporte que tuvieron que afrontar. Consideran que la formación posterior y la experiencia fueron determinantes para poder desarrollar efectivamente su labor profesional. Además afirman que las medidas de soporte y los cuidados son temas a desarrollar continuamente mediante una formación dirigida.Introduction: The competences of intensive care (ICU) nurses in their healthcare environment, have increased with the acquisition of new responsibilities associated with new care and devices for critical patients. Many studies suggest the need for specific training of nurses that work in these units. Based on this evidence, the European Federation of Critical Care Nurses Associations, recommends unifying the training of intensive care nurses. Therefore we set ourselves the following objective: to assess the training needs detected by ICU nurses through their experience and practical knowledge. Method: Descriptive qualitative study, with a phenomenological approach, through semistructured interview where the four areas (clinical practice, professional, management and educational) covered by the European Federation of Critical Care Nurses Associations were studied. Fifteen nurses from an adult polyvalent ICU were interviewed. Results: The interviewees acknowledged that the previous training was deficient for the care and support measures that they had to face. They considered that subsequent training and experience were decisive in order to carry out their work effectively. They also stated that support measures and care are topics to be developed continuously through targeted training. Conclusion: The nurses in this research study acknowledged that training is needed to achieve the competences required in ICU, and these are affected by the type of unit and patients

Competencias enfermeras en el ámbito clínico en una Unidad de Cuidados Intensivos Polivalente mediante un estudio fenomenológico

Ponencia presentada en CUALISALUD 2017, XII Reunión Internacional de Investigación Cualitativa en Salud "Narrativas, fuente de evidencias cualitativas", reunión digital celebrada del 16 al 17 de noviembre de 2017, organizada por Fundación Index.Algunos estudios apoyan que la especialización en cuidados mejora los resultados en la atención, es por tanto, que se debe asegurar una formación acorde a determinados puestos laborales(1). En muchos países, se está optando por la creación de programas formativos al respecto. Sobre todo, ante las evidencias demostradas por Aiken et al, donde los niveles educativos del personal de enfermería afectan a la mortalidad(2). A pesar de que estamos en el Espacio Europeo de Educación Superior (EEES), las diferentes soluciones propuestas por Lakanmaa et al desde Finlandia, no son simétricas a las que se pueden desarrollar en el Sistema Nacional de Salud Español(3,4). En el ámbito del cuidado al paciente crítico se han diseñado diferentes instrumentos de medida como el Intensive and Critical Care Nursing Competence Scale (ICCN-CS)(3,4) y el Basic Knowledge Assesment Tool, versión 7 (BKAT-7) (5), todos ellos surgidos a partir de las necesidades detectadas al respecto por la European Federation of Critical Care Nurses Association (EfCCNa), para homogeneizar los cuidados intensivos en Europa(6). La necesidad de formación detectada no procede únicamente de las asociaciones y sociedades científicas, sino también de las propias enfermeras, quienes observan carencias en formación en competencias específicas. Existe la necesidad de preguntarse, que competencias son necesarias en cada unidad (4) e incluso valorar, que demandan las propias enfermeras en su propio contexto laboral(7– 9) sin dejar atrás, que la formación continua es un puente hacia la excelencia de los cuidados, que se practican en estas áreas supertecnificadas(10), y esto puede evitar el riesgo que puede suponer la falta de formación en estas unidades(11). Es por ello, que se plantea como objetivo conocer las competencias en el ámbito clínico que detectan enfermeras de UCI son necesarias en su realidad laboral a través de sus vivencias y experiencias laborales

Valoración de la tolerancia digestiva en la nutrición enteral del paciente crítico

Treball final de Màster Universitari en Ciències de la Infermeria. Codi: SAV017. Curs acadèmic 2013-2014Introducción: La Nutrición Enteral (NE) es la técnica de alimentación más extendida en las Unidades de Cuidados Intensivos (UCI). Está técnica precisa de sondas gástricas y/o post-pilóricas, para la administración de productos alimenticios complejos por la vía digestiva. Las enfermeras realizan en todo momento: la valoración, control, administración y vigilancia de la administración. Estudios recientes, han objetivado la necesidad de mejorar la alimentación del paciente crítico consiguiendo el objetivo calórico antes de los 7 días. Objetivos: Valorar la consecución del objetivo calórico prescrito en la muestra seleccionada y relacionarlo con su estancia en UCI. Método: Estudio descriptivo prospectivo en pacientes ingresados correlativamente en la unidad del estudio, UCI del Hospital Universitario Insular de Gran Canaria durante 3 meses. Los criterios de ingreso fueron: adultos, presencia de ventilación mecánica al ingreso y nutrición enteral a lo largo del ingreso. Los criterios de exclusión, fueron cirugía que afecte a la integridad de los intestinos y traslado a otra unidad antes del alta. Resultados: Los pacientes de la muestra que recibieron NE desde el inicio de su ingreso estuvieron menos tiempo de estancia en UCI, 16 días. Como aspecto negativo, se ha encontrado que el grupo de pacientes que se alimentaron a lo largo del ingreso con Nutrición parenteral (NPT), tuvieron un promedio de días 36.4 días, mayor que sus homónimos en el grupo que recibió sólo NE. Conclusiones: Se ha relacionado conseguir el objetivo calórico mediante la NE con una menor estancia en UCI, por lo que medidas destinadas a mejorar la tolerancia generarían mejores resultados.Aims: Enteral Nutrition (NE) is the most widespread feeding technique in the intensive care units (ICU). This technique requires of gastric tubes and /or post-pyloric, for the administration of complex food by the digestive route. Nurses perform at all times: the assessment, control, administration and supervision of the administration. In recent studies, it has been found the need to improve the nutrition of critically ill patients getting the calorie goal within 7 days. Objectives: Evaluate the achievement caloric target required by the selected sample and relate their length of ICU stay. Methodology: A prospective descriptive study in patients admitted correlatively in the study unit, ICU of Hospital Universitario Insular de Gran Canaria for 3 months. Admission criteria were adults mechanically ventilated on admission and enteral nutrition along the admission. Exclusion criteria were surgery that affects the wholeness of the gut and transfer to another unit before discharge. Findings: Patients in the sample who received NE from the start of their admission spent less time of stay in ICU, 16 days. On the negative side, it has been found that the group of patients who were fed along their income with parenteral nutrition (TPN), had an average of 36.4 days more than their counterparts in the group that received only NE. Conclussions: It has been linked to achieve the calorie goal by NE with a shorter stay in the ICU, so measures designed to improve tolerance would generate better results

Necesidades formativas de las enfermeras de cuidados intensivos en España

La presente tesis explora mediante un estudio de metodología mixta las necesidades formativas de las enfermeras de cuidados intensivos. Se desarrolló una búsqueda bibliográfica basada en estudios previos para la creación de una entrevista semiestructurada. Esta entrevista nos permitió acercarnos a las vivencias sobre este concepto de las enfermeras de una unidad polivalente (n=15). Estas entrevistas fueron utilizadas por el equipo investigador, para la creación de un cuestionario de 66 items y que posteriormente se distribuyó a nivel nacional. Participaron en el estudio 85 UCIs, reclutando un total de 568 enfermeras. Los análisis estadísticos aplicados nos determinaron una alta conciencia sobre la necesidad de formación previa centradas a través de 13 factores y que generaban diferencias entre los grupos comparados. La conclusión es que se precisa una formación específica que englobe todos los ámbitos del cuidado. Siendo las enfermeras con mayor formación y experiencia las que más lo demandan.This thesis explores the training needs of intensive care nurses through a mixed methodology study. A literature search was developed based on previous studies to make a semi-structured interview. This interview allowed us to get closer to the experiences of this concept of nurses in a multipurpose unit (n=15). These interviews were used by the research team to create a 66-item questionnaire that it was later distributed nationwide. 85 ICUs participated in this study for which we recruited a total of 568 nurses. Statistical analyses determined a high awareness of the need for prior training focused on 13 factors that generated differences between the compared groups. The conclusion is that specific training is required that all areas of care were included. Furthermore, it is the nurses with the most training and experience who most demand this qualification.Programa de Doctorat en Ciències de la Infermeri

Nurses’ perception on competency requirement and training demand for intensive care nurses

Various authors have explored the combination of competencies necessary for ensuring safe and quality care carried out by nurses in Intensive Care Units (ICUs). Nurses’ perception of training is an element that must be studied in order to adopt appropriate educational measures. This study aimed to evaluate nurses’ perception of the importance of intensive care training in Spain. Methods: A descriptive, cross-sectional, multicentre study was conducted on a national level in Spain. Totally 85 ICUs took part in the study. The questionnaire used was developed using the Delphi method and had 66 items to investigate nurses’ perception on competency requirements and training needs. The evaluation was conducted by a 10-point Likert scale. Results: The sample was 568 Spanish nurses. Significant differences were found on an academic level, in terms of gender and hospital type, and in the professional experience of the nurse when it comes to evaluating the different training items; the differences in overall questionnaire scores among these groups were statistically significant (P < 0.05). The nurses analyzed believe that previous training and professional experience in other care services are necessary before starting work in an ICU. Conclusion: Implementation of training programs tailored to the needs of critical nurses had benefits for nurses and the health system. Nurses benefited from training focused on the skills and knowledge of each moment of their working life. Nurses have a different evaluation of their training needs throughout their professional cycle. Therefore, their training must be adapted to the professional stage of each nurse

Feelings of the health personnel in Spain, towards their work, after five waves of the COVID-19 pandemic

Health personnel have faced highly adverse circumstances in the workplace since the beginning of the COVID-19 pandemic. Prolonged exposure to stressful situations at work is considered to affect the physical, psychological, and emotional health of these workers, as well as job performance. The objective of this study was to analyze the beliefs, attitudes, and feelings of health personnel from one Spanish region towards their work after five waves of the COVID-19 pandemic. A Cross-sectional descriptive study was carried out using an electronic questionnaire, adapted, and validated through the Delphi technique. A convenience sampling of 783 was recruited among health personnel from the Canary Islands during the fifth wave of the pandemic in September 2021. Bivariate analyzes have been performed by the Chi-square test accepting statistical significance (p 0.050). The 94.3% (n=738) of the respondents considered the pandemic to have highlighted the shortcomings of the Spanish health system. A clear level of exhaustion and/or a reduction in the level of commitment can be observed in these workers as the pandemic continues, as participants reported feeling both mentally and physically exhausted when finishing their shifts, and even “burned out by their work”. This study highlights the resilience and vocation of healthcare professionals, who even considering the effects of the pandemic would choose the same profession. On the other hand, these professionals felt undervalued by their institutions, and almost one of every five, precised psychological support in some point during the health crisis

The Need for Psychological Support of Health Workers during the COVID-19 Pandemic and the Influence on Their Work

The aim of this research was to analyze how the need for psychological support of health workers (HCWs) influenced the beliefs, perceptions and attitudes towards their work during the COVID-19 pandemic and to predict the need of psychological assistance. A descriptive transversal study was conducted based on a self-administered questionnaire distributed to health professionals working in the Canary Islands, Spain. The data were analyzed using Pearson’s chi-squared test and the linear trend test. The correlation test between ordinal and frequency variables was applied using Kendall’s Tau B. Multiple logistic regression was used to predict dichotomous variables. The sample included 783 health professionals: 17.8% (n = 139) of them needed psychological or psychiatric support. Being redeployed to other services influenced the predisposition to request psychological help, and HCWs who required psychological support had more negative attitudes and perceptions towards their work. After five waves of COVID-19, these HCWs reported to be physically, psychologically and emotionally exhausted or even “burned out”; they did not feel supported by their institutions. The commitment of health personnel to fight against the COVID-19 pandemic decreased after the five waves, especially among professionals who required psychological support