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Protocolo de investigación enfermera en una unidad terapéutica educativa

Introducción. Las relaciones durante la infancia/adolescencia son fundamentales para la construcción psíquica. La familia y el colegio son inicialmente los medios de socialización donde la calidad de la experiencia relacional predetermina un modelo futuro. Las dificultades en el ámbito relacional tienen una repercusión en la salud mental de los menores. Existe un incremento de las conductas conflictivas e inhibidas en el alumnado, al igual que un aumento en prevalencia de trastornos psiquiátricos, siendo necesaria una evaluación de los recursos. Metodología. Este estudio cuasi-experimental unicéntrico, pre-post sin grupo control, tipo longitudinal de carácter prospectivo tiene como objeto evaluar los cambios en el desempeño del rol de padres y las habilidades de interacción social y resiliencia personal de la población atendida en la Unidad Terapéutica Educativa de Ortuella, desde una perspectiva enfermera, durante un curso escolar. La prueba Kolmogorov-Smirnov o Shapiro-Wilk determinará si la distribución de la variable es normal. Se utilizará la t de Student para muestras pareadas o Wilcoxon cuando la distribución de la variable no fuese normal y McNemar para comparación de proporciones, con un intervalo de confianza del 95%, considerándose significativo una p<0.05. Utilidad práctica. Los resultados permitirán comprobar si la permanencia de un curso escolar en la Unidad Terapéutica Educativa se relaciona con una mejora de las variables a estudio.

ABSTRACT

Introduction. Relationships during childhood/adolescence are fundamental for the psyche construction. The family and the school are the initial means of socialization and it is there where the quality of the relational experience predetermines a future model. Difficulties in the relational sphere have an impact on the mental health of minors. There is an increase in conflictive and inhibited behaviors in students, as well as an increase in the prevalence of psychiatric disorders, making an evaluation of resources necessary. Methodology. This unicentric quasi-experimental study, pre-post without control group, longitudinal type of prospective nature, aims to evaluate the changes in the performance of the parental role and the social interaction skills and personal resilience of the population served in the Educational Therapeutic Unit of Ortuella, from a nursing perspective, during a school year. The Kolmogorov-Smirnov or Shapiro-Wilk test will determine whether the distribution of the variable is normal. Student's t test will be used for paired samples or Wilcoxon when the distribution of the variable is not normal and McNemar for comparison of proportions, with a confidence interval of 95%, with p<0.05 being considered significant. Utility in practice. The results will allow us to verify whether the permanence of a school year in the Educational Therapeutic Unit is related to an improvement in the variables under study.

Nurses' perceived barriers and facilitators to the implementation of nurse prescribing: Delphi study and focus group

Abstract

Aim

To obtain consensus on barriers and facilitators to nurse prescribing following its recent introduction in Spain.

Design

A three round online Delphi survey and focus group.

Methods

An exploratory method was used with three consecutive rounds of questionnaires based on anonymity and feedback, and a focus group. The study was carried out with primary care, specialized care, socio-health care and manager nurses.

Results

On the basis of the Delphi study that was conducted, a list of 15 barriers and 18 facilitators of nurse prescribing was obtained. However, no general consensus was found with respect to the prioritization of these barriers/facilitators. The analysis of the results of the focus group confirmed the information obtained from the Delphi study. The main barriers highlighted were dependence on the figure of the physician, insufficient training in pharmacology, a lack of institutional support and the limited list of products that could be prescribed. The key facilitators were academic knowledge and ongoing training and education, independence in the functions and responsibilities of the nursing profession, adaptation to new roles and autonomy in the case of chronic care processes.

Conclusion

Nurses were generally positive about the introduction of nurse prescribing. The commitment of nurses to training and their accreditation as prescribers (internal forces) and health policy and nursing management (external forces) play a fundamental role in supporting the basis of nurse prescribing and ensuring that it is developed with the identified support resources, such as staff training and the provision of the materials necessary for its proper implementation, all with the aim of guaranteeing quality healthcare.

Implications for the Profession and/or Patient Care

Strong models of nurse prescribing are being considered globally to address population needs. The results can help the future implementation of non-medical independent prescribing and provide guidance to the government and society on the interventions that can be used to consolidate it.

Impact

What problem did the study address? By 2027, the world's population will receive more than 4.5 trillion doses of medicine each year. However, the WHO estimates a projected shortfall of 10 million health workers by 2030. Inadequacies with traditional physician-led care systems mean that new approaches are imperative to maintain patient access to prescription medicines, with NP being a key element in this regard. In Catalonia (Spain), the accreditation process for nurses as prescribers was implemented in 2021. It is therefore of vital importance to question and consult the nurses themselves, the main promoters of the process, to find out their perceptions and thus be able to take them into consideration in the implementation process. What were the main findings? A total of 15 barriers and 17 facilitators were identified. The main perceived barriers are dependence on the figure of the physician, insufficient training in pharmacology during undergraduate studies and a lack of institutional support. The main perceived facilitators are academic knowledge and ongoing education and training, independence in nursing functions and responsibilities, and adaptation to new roles and tasks. Where and on whom will the research have an impact? These results can contribute to improving NP implementation in Spain and serve as a reference for other countries, especially where NP education and training have only recently been instigated or are in the planning process.

Reporting Method

Standards for reporting qualitative research: a synthesis of recommendations. SRQR.

Patient or Public Contribution

No patient or public contribution.

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