Objetivo Conocer el nivel de competencia en Práctica Basada en la Evidencia (PBE) de las enfermeras de Atención Primaria (AP) en España y analizar los factores asociados. Diseño Estudio transversal de carácter nacional, realizado en enero-marzo de 2020. Emplazamiento AP en España. Participantes Setecientas ochenta enfermeras de AP en activo en el Sistema Nacional de Salud con experiencia profesional mínima de un año. Mediciones principales 1) Variables sociodemográficas, profesionales y de acceso a información científica, y 2) variable de resultado: competencia en PBE (actitud, conocimientos, habilidades y utilización), evaluada mediante el cuestionario EBP-COQ Prof©. Se realizaron análisis bivariados y multivariados mediante regresión lineal. Resultados La puntuación media en el nivel de competencia en PBE de las enfermeras de AP fue de 131,5 (desviación típica [DT] 17,0). Por dimensiones: actitud 36,8 (DT 3,6); conocimientos 38,2 (DT 8,9); habilidades 23,0 (DT 3,5) y utilización 33,3 (DT 6,1). Leer más de 3 artículos en el último mes es la variable que tiene más influencia sobre todas las dimensiones del EBP-COQ Prof©, seguida de la formación en PBE (más de 150 h) y la tutorización de alumnos de Enfermería. El nivel educativo (máster, especialista y doctorado) se asocia con las dimensiones conocimientos y habilidades, mientras que trabajar en un centro BPSO® se asocia con la utilización de la PBE. Conclusiones Estos hallazgos pueden orientar a los gestores en los servicios de AP a planificar estrategias que mejoren el nivel de competencia en PBE de las enfermeras, dirigidas principalmente a lograr una aplicación real en la práctica clínica. No obstante, se hace necesario considerar el posible impacto del sesgo de selección en los resultados.
Background:The restrictions imposed during the management of the pandemic led to lack of care of other health problems.Purpose: To assess changes in the health status of complex multimorbidity elderly, functional and cognitive capacities, perception of the social surroundings, care provided by the nurses, including nursing diagnosis and interventions, use of health services, adverse events, and use of devices and technical help during the first 6 months of the Covid-19 pandemic.Design: A 1-year longitudinal cohort study was conducted. Methods: Ninety-seven complex multimorbid elderly attended in primary care were evaluated every 3 months in a health area of the Spanish National Health System (SNHS). The research was called "SAMAC3 study".Results: Significant negative changes were observed in the functional and cognitive capacity of the elderly, and in several nursing diagnoses. A decrease was observed in the frequency of visit to the nurses, hospital admittance, length of hospital stays, and falls. Conclusions:The functional and cognitive capacities of the cohort became worse.However, a significant decrease in the frequency of use of health services was observed. The nurses detected significant changes in activity-exercise, cognitiveperception, and roles-relationships, but their interventions were mostly centered on resolving clinical matters that required immediate attention.
Aim To evaluate the changes produced after the application of the Best Practice Spotlight Organization® (BPSO®) Program on the attitude towards the evidence‐based practice, the nurses’ perception of the organisational climate and nurse outcomes in a health area of the Spanish National Health System. Background There is limited research that associates strategies of evidence‐based practice implementation with changes on the work environment and nurse outcomes. Methods Cross‐sectional study that compared data on the nurses’ perception of the work environment. Five guidelines were implemented between 2012 and 2015 in a health area. Data were collected in 2012 and 2016/2017, using a questionnaire consisting of five previously validated tools. X2, t test, ANOVA and multivariate analysis were carried out. Results A total of 451 nurses participated. Compared with the baseline evaluation in 2012, several outcomes changed significantly (p < .001), nurses were younger and were more satisfied with “salary”, “annual leaves” and “sick leave”. The rest of the nurse outcomes were not modified. Conclusions Nurses' perception of the work environment is favourable, although the application of the BPSO® Program has not produced any major changes. Implications for Nursing Management Measures are suggested that are oriented towards the planning of staffing and the increase in the participation of the nursing staff in programmes of implementation of guidelines.
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