Purpose
To compare skills acquired by undergraduate nursing students enrolled in a medical‐surgical course. To compare skills demonstrated by students with no previous clinical practice ...(undergraduates) and nurses with clinical experience enrolled in continuing professional education (CPE).
Design
In a nonrandomized clinical trial, 101 undergraduates enrolled in the “Adult Patients 1” course were assigned to the traditional lecture and discussion (n = 66) or lecture and discussion plus case‐based learning (n = 35) arm of the study; 59 CPE nurses constituted a comparison group to assess the effects of previous clinical experience on learning outcomes.
Methods
Scores on an objective structured clinical examination (OSCE), using a human patient simulator and cases validated by the National League for Nursing, were compared for the undergraduate control and intervention groups, and for CPE nurses (Student's t test).
Findings
Controls scored lower than the intervention group on patient assessment (6.3 ± 2.3 vs 7.5 ± 1.4, p = .04, mean difference, ‐1.2 95% confidence interval (CI) ‐2.4 to ‐0.03) but the intervention group did not differ from CPE nurses (7.5 ± 1.4 vs 8.8 ± 1.5, p = .06, mean difference, ‐1.3 95% CI ‐2.6 to 0.04). The CPE nurses committed more “rules‐based errors” than did undergraduates, specifically patient identifications (77.2% vs 55%, p = .7) and checking allergies before administering medication (68.2% vs 60%, p = .1).
Conclusions
The intervention group developed better patient assessment skills than the control group. Case‐based learning helps to standardize the process, which can contribute to quality and consistency in practice: It is essential to correctly identify a problem in order to treat it. Clinical experience of CPE nurses was not associated with better adherence to safety protocols.
Clinical Relevance
Case‐based learning improves the patient assessment skills of undergraduate nursing students, thereby preparing them for clinical practice.
Background
Missed nursing care is defined as care that is delayed, partially completed, or not completed at all. The scenario created by the COVID‐19 pandemic may have influenced multifactorial ...determinants related to the care environment, nursing processes, internal processes, and decision‐making processes, increasing missed nursing care.
Aim
This scoping review aimed to establish the quantity and type of research undertaken on missed nursing care during the COVID‐19 pandemic.
Methods
This review was conducted following the Joanna Briggs Institute methodology for scoping reviews. We searched CINAHL, MEDLINE, Scopus, two national and regional databases, two dissertations and theses databases, a gray literature database, two study registers, and a search engine from November 1, 2019, to March 23, 2023. We included quantitative, qualitative, and mixed studies carried out in all healthcare settings that examined missed nursing care during the COVID‐19 pandemic. Language restrictions were not applied. Two independent reviewers conducted study selection and data extraction. Disagreements between the reviewers were resolved through discussion or with an additional reviewer.
Results
We included 25 studies with different designs, the most common being acute care cross‐sectional survey designs. Studies focused on determining the frequency and reasons for missed nursing care and its influence on nurses and organizational outcomes.
Linking Evidence to Action
Missed nursing care studies during the COVID‐19 pandemic were essentially nurses‐based prevalence surveys. There is an urgent need to advance the design and development of longitudinal and intervention studies, as well as to broaden the focus of research beyond acute care. Further research is needed to determine the impact of missed nursing care on nursing‐sensitive outcomes and from the patient's perspective.
This psychometric systematic review aimed to identify the most suitable patient-reported outcome measures (PROMs) of quality of life (QoL) in people affected by diabetic foot.
We performed a ...literature search in MEDLINE (PubMed), CINAHL (EBSCOhost), and PsycINFO (EBSCOhost) databases from inception to February 1, 2022. We also searched gray literature databases. Eligible studies were full-text reports developing a QoL condition-specific PROM or assessing one or more of its measurement properties in people affected by diabetic foot. We assessed the methodological quality of included studies independently using the “Consensus-Based Standards for the Selection of Health Measurement Instruments Risk of Bias” checklist. The measurement properties were evaluated using specific criteria. We graded the quality of the evidence using a “Grading of Recommendations Assessment, Development and Evaluation” approach modified by Consensus-Based Standards for the Selection of Health Measurement Instruments.
Forty-three reports (46 studies) providing information on the measurement properties of 10 different PROMs were included. We did not identify any instruments that could be recommended for use. We identified 2 PROMs that were not recommended for use and 8 that were potentially recommended but would require further investigation. Of these 8 PROMs, 4 had better evidence for content validity.
Available PROMs to measure QoL in people affected by diabetic foot have limited evidence for their measurement properties. There is no fully suitable PROM. Pending further evidence, 4 PROMs could potentially be recommended for use.
•Patient-reported outcome measures (PROMs) are standardized measures to quantify the patient’s perspective and help understand how the disease, the health system, and healthcare impact patients.•In this review, we identified 10 quality of life PROMs for people affected by diabetic foot; 4 of these could potentially be recommended for use until further evidence is available.•Findings of this review can be helpful to establish a framework for future assessments of available quality of life PROMs or the design of new ones and for supporting evidence-based decision making by clinicians, researchers, healthcare decision makers, and policy makers.
This column shares the best evidence‐based strategies and innovative ideas on how to facilitate the learning of EBP principles and processes by clinicians as well as nursing and interprofessional ...students. Guidelines for submission are available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741‐6787
Objective structured clinical examination (OSCE) can help mentors, clinical lecturers, and academic lecturers assess students with borderline performance.
Cohort study in 120 fourth-year Nursing ...students (Bachelor’s degree). OSCE stations, designed to evaluate cumulative content and skills, were assessed jointly by academic and clinical lecturers. Scores were compared with other summative assessments.
Mean OSCE score was 5.6 ± 1.2 (10-point scale); 7.5% failed. Final clinical practice score 8.4 ± 0.6, no students failed; content knowledge, 7.7 ± 0.5, 12.3% failed. OSCE and practicum scores were strongly correlated in students who failed OSCE (r = 0.68).
OSCE appropriately identified risk of poor performance in clinical practice.
•Failing objective structured clinical examination (OSCE) scores were well correlated with low clinical assessments by mentors.•Joint academic and clinical OSCE evaluation identified students “failing to fail.”•OSCE helped academic lecturers to coach clinical lecturers and value mentors more.•OSCE requires evidence-based instead of “usual practice” explanations for scores.
Purpose
The aim of this study was to evaluate the validity of lower limb chronic venous disease (CVD) diagnoses entered in a large electronic health record database in primary care in Catalonia, ...Spain; to investigate the reliability of these data for research purposes; and to estimate the prevalence and incidence of CVD, chronic venous insufficiency (CVI), and venous leg ulcer (VLU).
Design
Real‐world data analysis based on a large electronic health record database in primary care in Catalonia, Spain.
Methods
We used a primary care research database (Information System for the Development of Research in Primary Care SIDIAP), which contains anonymous data on some 5.8 million people from 279 primary care centers, accounting for more than 80% of the Catalonian population and 15% of the Spanish population. We evaluated the validity of the ICD‐10 codes for CVD in SIDIAP for 200 adult patients through the responses of 20 primary care physicians to a questionnaire.
Findings
The positive predictive value of CVD in SIDIAP was 89.95% (95% confidence interval CI 84.99–93.40). The prevalence rates for CVD, CVI, and VLU were 9.54% (95% CI 9.51–9.56), 3.87%, and 0.33%, respectively. The incidence rates for CVD, CVI, and VLU were 7.91/1,000 person‐years (95% CI 7.82–8.00), 3.37/1,000 person‐years (95% CI 3.31–3.43), and 0.23/1,000 person‐years (95% CI 0.21–0.24), respectively.
Conclusions
The Catalonian SIDIAP database contains valid CVD diagnoses. The prevalence and incidence rates found using real‐world data are low compared with those in the literature, possibly because CVD is an underdiagnosed entity.
Clinical Relevance
Real‐world data can inform clinicians on lower limb venous health in a population, show changes as individuals age, and reveal aspects where healthcare can be improved.
Many interprofessional education programs are being designed to help students improve their collaborative practice. Traditionally, the evaluation of these programs is focused on attitudes, knowledge ...and skills, but according to some authors, the evaluation of these activities should be expanded to include the evaluation of the development of an interprofessional identity. The Interprofessional Socialization and Valuing Scale (ISVS) is a self-report tool used to measure interprofessional socialization, but it has not been validated with Spanish students. In this study, the tool was translated into Spanish and administered to a sample of 645 undergraduate students. The data were analyzed to estimate structural validity, internal consistency and convergent validity. Regarding the structural validity, our data supported the unidimensional model found in the English version of the ISVS-21 (normed chi-square = 2.3, RMSEA = 0.045, SRMR = 0.087, CFI = 0.963 and TLI = 0.969). The internal consistency reliability of the scale was adequate, Cronbach α = 0.913 95% CI 0.903, 0.923. The Spanish version of the ISVS-21 shows adequate psychometric properties in terms of the construct validity (structural validity and convergent validity) and internal consistency of its scores. This study provides the Spanish-speaking population with an adaptation of the only instrument that has been specifically developed to assess interprofessional socialization.
Nurse prescribing in Spain: The law and the curriculum Romero‐Collado, Angel; Raurell‐Torreda, Marta; Zabaleta‐Del‐Olmo, Edurne ...
Nursing & health sciences,
September 2017, 2017-Sep, 2017-09-00, 20170901, Letnik:
19, Številka:
3
Journal Article
Recenzirano
In this cross‐sectional study, we explored course content related to pharmacology and/or healthcare products and supplies in all nursing degree programs in Spain. Changes in nurse‐prescribing ...legislation in Spain require that nurses take a certification course before prescribing over‐the‐counter products and medications. Using a cross‐sectional descriptive study, between July and September 2014, the degree programs of all centers that offer a degree in nursing in Spain were examined, selecting those with course information available online. All centers offered at least one pharmacology course. One‐third of the required courses had content related to pharmacology and healthcare products/supplies. The analysis showed that the course content and training received during the current nursing degree program provides the knowledge and skills needed to prescribe healthcare products/supplies and medications that do not now require a doctor's prescription, without the need for additional training and certification. It is essential that government regulation of nursing education be aligned with nursing competencies, curriculum standards, clinical practice, and evidence‐based research to provide the maximum level of confidence for nursing professionals and their patients.
Aim
To identify the extent of nurse prescription and determine specific medications and/or health‐care supplies routinely prescribed by primary care nurses in Spain in a changing legal context. To ...explore nurse perceptions of legalized nurse prescription's relationship to professional identity.
Background
Although the Spanish public has similar confidence in nurses and physicians, professional identity remains a concern for nurses. Nurse prescription has a confusing history in Spain but is increasingly common elsewhere, and may enhance nursing's professional profile.
Method
A cross‐sectional survey reporting the occurrence of nurse prescription in one province in Spain and primary care nurses' perceptions of nurse prescription and professional identity in this province.
Result
The response rate was 69.6% (87 nurses). Frequent nurse‐prescribed medications were vaccinations (63.1%), topical antiseptics (60.7%) and antipyretics (44.8%); health‐care supplies included supplies for diabetes (51.8%), wound care dressings (44.2%) and incontinence (26.7%). Respondents indicated that nurse prescription positively contributes to the profession and to its development.
Conclusion
Nurse prescribing exists in primary care in Spain, and formal legalization is in progress but awaits a consensus formulary. Nurses indicated that full legalization would increase professional autonomy and contribute positively to the profession, as an example of how policy can have an impact on practice.
Implications for nursing management
Spain's experience with inconclusive shifts in the legal status of nurse prescribing may contribute to the discussion in countries where this professional practice is not yet established.
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