Enfermeria Clinica最新文献

{"title":"La ciencia de la implementación: potencial transformador para el avance de las enfermeras en el cuidado del acceso vascular","authors":"Enrique Castro-Sánchez ,&nbsp;Ismael Fernández-Fernández ,&nbsp;Ian Blanco-Mavillard","doi":"10.1016/j.enfcli.2025.502306","DOIUrl":"10.1016/j.enfcli.2025.502306","url":null,"abstract":"<div><div>This special article addresses the complexity of vascular access care and explores how implementation science can act as a catalyst to optimize vascular nursing practice. Although vascular access care is crucial, its quality is often unsatisfactory due to the diversity of procedures, technologies, and the need to adapt to each patient. Despite numerous improvement interventions, high complication rates and suboptimal use of these vascular devices persist.</div><div>Implementation science can be a crucial strategy to overcome these identified challenges, recognizing the behaviors of healthcare professionals, especially nurses, and their relevance to ensure quality care within the local and organizational context. In this sense, it is challenging to integrate implementation science into the nursing practice of vascular care, such as resistance to change and resource constraints, but it also offers opportunities for innovation and interdisciplinary collaboration. We suggest reevaluating specialized nursing roles to focus on implementation of interventions and optimizing care decisions related to vascular access. This integration requires the development of new competencies and an understanding of the organizational context, key elements to ensure the sustainability and effectiveness of interventions.</div></div>","PeriodicalId":46453,"journal":{"name":"Enfermeria Clinica","volume":"35 4","pages":"Article 502306"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GloVANet y WoCoVA: plataformas que integran evidencia y práctica en el acceso vascular","authors":"Gloria Ortiz Miluy ,&nbsp;Timothy Spencer","doi":"10.1016/j.enfcli.2024.502166","DOIUrl":"10.1016/j.enfcli.2024.502166","url":null,"abstract":"<div><div>Vascular access globally has experienced exponential development in recent years in all aspects. The speed with which these advances have become part of clinical practice recommendations requires quick and easy communication between professionals, accessibility to impact scientific publications, updating of procedural protocols and the implementation of new models of care to guarantee the quality of health care. In a world full of social, economic and demographic challenges, initiatives that promote the int</div><div>egration of scientific evidence into clinical practice in a standardized manner are essential. Under this premise, the Global Vascular Access Network (GloVANet), together with the World Congress on Vascular Access (WoCoVA) seeks to establish a platform for the dissemination of knowledge, training and research in vascular access, while formalizing the role of professionals specialized in this field.</div></div>","PeriodicalId":46453,"journal":{"name":"Enfermeria Clinica","volume":"35 4","pages":"Article 502166"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiencias de los pacientes en cuanto a inserción ecoguiada de un catéter intravenoso: estudio cualitativo","authors":"Renz Rivera ,&nbsp;Steve He ,&nbsp;Craig McManus ,&nbsp;Nicholas Mifflin ,&nbsp;Ton Tran ,&nbsp;Lorenza Harrowell ,&nbsp;Karla Kuzmins ,&nbsp;John Rihari-Thomas ,&nbsp;Peta Drury ,&nbsp;Steven A. Frost ,&nbsp;Evan Alexandrou","doi":"10.1016/j.enfcli.2024.09.002","DOIUrl":"10.1016/j.enfcli.2024.09.002","url":null,"abstract":"<div><h3>Background</h3><div>Peripheral intravenous catheter (PIVC) insertion is the most performed invasive procedure in healthcare. However, it often presents challenges in patients with non-visible or non-palpable veins, leading to unsuccessful cannulation attempts and associated complications. Ultrasound-guided PIVC insertion is a promising solution for patients with difficult venous access (DiVA). However, there remains a gap in the literature regarding patient experiences with this technique.</div></div><div><h3>Aim</h3><div>This study aimed to describe the characteristics and experiences of patients referred to a specialised DiVA team for ultrasound-guided PIVC insertion and compare their experiences with previous traditional cannulation.</div></div><div><h3>Method</h3><div>A qualitative study was conducted at an Australian 980-bed metropolitan tertiary referral centre. Thirteen patients were recruited through purposive sampling and interviewed post-ultrasound-guided cannulation. Data collection was conducted using one-on-one interviews followed by thematic analysis.</div></div><div><h3>Results</h3><div>The study identified three major themes: the improved patient experience resulting from the expertise of the DiVA team with ultrasound cannulation; the impact of limited equipment and trained personnel on patient experience and outcomes; and the significance of acknowledging patients’ prior cannulation experiences. Participants reported a stark contrast in their experiences between ultrasound-guided and traditional cannulation, with the former significantly reducing physical discomfort, stress and anxiety and improving success rates.</div></div><div><h3>Conclusions</h3><div>Ultrasound-guided PIVC insertion by trained clinicians significantly enhances the experience for patients with DiVA. However, challenges remain, including the availability of equipment and trained staff. The study highlights the need for policy changes and training in ultrasound-guided cannulation to improve patient care and outcomes. Future research should focus on broader and more diverse populations to validate these findings.</div></div>","PeriodicalId":46453,"journal":{"name":"Enfermeria Clinica","volume":"35 4","pages":"Article 102149"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preservación de la integridad y salud del árbol vascular: consideraciones clave sobre los riesgos del acceso vascular","authors":"Nancy Moureau","doi":"10.1016/j.enfcli.2025.502302","DOIUrl":"10.1016/j.enfcli.2025.502302","url":null,"abstract":"<div><div>Vascular access is the most common invasive procedure in hospitalized patients, with over 90% requiring intravenous therapy. Despite its routine nature, improper selection and management of acceso vascular devices (VADs) can lead to complications such as infections, thrombosis, and device failure. Preserving the integrity of the vascular system is essential for ensuring safe and effective treatment delivery across healthcare settings.</div><div>This paper describes the key principles of the Vessel Health and Preservation (VHP) model, highlighting its implementation as a structured, evidence-based clinical pathway for optimizing vascular access outcomes, preserving vascular integrity, and reducing complications. It also outlines a stepwise approach to vascular access planning, device selection, management, and escalation based on patient-specific factors and risk profiles.</div><div>The VHP model is structured around four main stages: assessment and device selection, insertion, management, and outcome evaluation. Key findings and recommendations include early device planning within 24<!--> <!-->hours of admission and placement within 48<!--> <!-->hours, daily reassessment to align access with evolving treatment needs, use of clinical pathways to guide device selection based on diagnosis, therapy type, and duration, emphasis on minimizing the number of device lumens, choosing the least invasive device, and using vascular access teams for assessment and the identification of high-risk patients requiring specialty placement and escalation to interventional radiology or surgical teams.</div><div>Implementing a VHP program across institutions requires leadership support, interprofessional education, and integration into electronic health records. Adopting this proactive model improves first-attempt insertion success, reduces delays in therapy, and lowers complication rates. In complex cases, timely advancement to specialty placement ensures continued vascular health while maintaining access to essential treatments.</div></div>","PeriodicalId":46453,"journal":{"name":"Enfermeria Clinica","volume":"35 4","pages":"Article 502302"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percepción de cuidado humanizado otorgado por las enfermeras: adaptación cultural y validación del cuestionario ECCOE-Es","authors":"Laia Wennberg-Capellades ,&nbsp;Montserrat Rus-García ,&nbsp;Laia Cruells-Francisco ,&nbsp;Rosa María Collado-Cabezas ,&nbsp;Xavier Teixidó-Huertas ,&nbsp;Maria Luisa Martin-Ferreres","doi":"10.1016/j.enfcli.2025.502250","DOIUrl":"10.1016/j.enfcli.2025.502250","url":null,"abstract":"<div><h3>Aims</h3><div>To adapt and validate for use in Spain the ECCOE questionnaire for assessing nurse caring behaviours from the perspective of nurses; to apply the adapted questionnaire to a sample of hospital registered nurses in Spain and to examine the perceptions of humanised care behaviours.</div></div><div><h3>Methods</h3><div>Multi-centre cross-sectional study. Validity evidence based on the ECCOE-Es internal structure through confirmatory factor analysis and convergent and divergent validity in the relationships with moral sensitivity and burnout, respectively. Reliability was also examined through Cronbach's alpha and temporal stability with Pearson's correlation of test scores. Descriptive and comparative analysis of nurses’ responses to the ECCOE-Es was performed.</div></div><div><h3>Results</h3><div>A total of 462 nurses’ questionnaires were analysed. Temporal stability (r<!--> <!-->=<!--> <!-->0.908) and internal consistency were adequate (α<!--> <!-->&gt;<!--> <!-->0.76 for the subscales and α<!--> <!-->=<!--> <!-->0.96 for the total scale). Confirmatory factor analysis supported the structure of the original instrument with 7 subscales. ECCOE-Es were positively correlated with moral sensitivity (r<!--> <!-->=<!--> <!-->0.454) and negatively correlated with burnout (r<!--> <!-->=<!--> <!-->−0.265). Humanism subscale was perceived as the most important, whereas items related to individualised care were less frequently endorsed.</div></div><div><h3>Conclusions</h3><div>ECCOE's Spanish adaptation has adequate psychometric properties, and its original properties and structure are confirmed as a suitable tool for assessing nurses’ perceptions of humanised care. Overall, they perceived themselves as delivering humanised care, and there was a scope for improvement in this respect.</div></div>","PeriodicalId":46453,"journal":{"name":"Enfermeria Clinica","volume":"35 3","pages":"Article 502250"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calidad de vida y estado emocional de los pacientes candidatos a terapia CAR-T: rol de la enfermera de práctica avanzada","authors":"Mercedes Montoro-Lorite ,&nbsp;Gloria García ,&nbsp;Cristina Moreno-García ,&nbsp;Ariadna Domènech ,&nbsp;Pilar Ayora ,&nbsp;Carla Ramos","doi":"10.1016/j.enfcli.2024.502188","DOIUrl":"10.1016/j.enfcli.2024.502188","url":null,"abstract":"<div><h3>Introduction</h3><div>CAR-T therapy is indicated in patients with refractory disease who usually present comorbidities, toxicities associated with previous treatments, and disease instability. Additionally, they must travel close to the infusion center, incurring financial and psychosocial costs. Our study aims to describe the quality of life and psycho-emotional state of candidates for CAR-T therapy.</div></div><div><h3>Methods</h3><div>An observational study was conducted from January to December 2022. The inclusion criteria were being 18<!--> <!-->years or older, eligible for CAR-T therapy, and able to understand Spanish. Sociodemographic, clinical variables and Hospital Anxiety and Depression and Quality of Life scales were collected.</div></div><div><h3>Results</h3><div>One hundred and four participants were recruited, among them, seventy percent did not live in their usual residence. Seventy-five percent of the participants had depression, 76% anxiety, and 78% emotional function impairment. No statistically significant differences between the presence of anxiety/depression associated with not residing in their usual address (<em>P</em> <!-->=<!--> <!-->.056) or receiving psychological care in their center of origin (<em>P</em> <!-->=<!--> <!-->.583) were found. However, a correlation between the presence of anxiety/depression among participants referred to the psychology service by the Advanced Practice Nurse (APN) (<em>P</em> <!-->&lt;<!--> <!-->.001) was found.</div></div><div><h3>Conclusions</h3><div>In conclusion, assessing the quality of life and psycho-emotional state of candidates for CAR-T therapy with validated scales allows us to identify candidates presenting anxiety and depression with the goal of improving the management of their emotional health. The APN's role is crucial in detecting complications and facilitating early referral to the psychology team.</div></div>","PeriodicalId":46453,"journal":{"name":"Enfermeria Clinica","volume":"35 3","pages":"Article 502188"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calidad del sueño en pacientes ingresados en una unidad de cuidados intermedios","authors":"Paula Itxaso Sirera-Pérez ,&nbsp;Adriana Martín-Sanjoaquín ,&nbsp;Beatriz Juandeaburre-Pedroarena ,&nbsp;Itziar Luquin-Iturmendi ,&nbsp;Rosana Goñi-Viguria","doi":"10.1016/j.enfcli.2024.10.009","DOIUrl":"10.1016/j.enfcli.2024.10.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients admitted to critical care units (ICU) are subject to develop sleep disturbances, caused by multiple factors that are present in this type of units.</div></div><div><h3>Objetive</h3><div>Describe patients’ perceptions of night rest, to relate them to sociodemographic variables, and determine factors that interfere with their sleep quality.</div></div><div><h3>Methodology</h3><div>Descriptive, prospective, observational study in an ICU of a tertiary level university hospital. Sleep perception was assessed with the five-item Richards-Campbell Sleep Questionnaire (RCSQ). Sociodemographic and clinical variables were collected. A self-developed questionnaire with 9 questions addressing the main factors mentioned in the literature that influence sleep was utilized. Descriptive and inferential statistics were performed, being considered statistically significant p&lt;<!--> <!-->0,05.</div></div><div><h3>Results</h3><div>The sleep of 75 patients was studied, for 146 nights.</div><div>The sleep perception was rated as fair, with moderate ease in falling asleep, average awakenings, and moderate ease in returning to sleep. The mean RCSQ score was 60.22 (SD: 24.81).</div><div>It was observed that concern (p&lt;<!--> <!-->0.001), noise (p<!--> <!-->=<!--> <!-->0.016), pain (p<!--> <!-->=<!--> <!-->0.008), discomfort (p<!--> <!-->=<!--> <!-->0.001), ambient light (p<!--> <!-->=<!--> <!-->0.026), and the presence of nearby patients (p<!--> <!-->=<!--> <!-->0.027) significantly influenced in the sleep.</div></div><div><h3>Conclusions</h3><div>Patients’ perception of night sleep was fair. Keeping patients informed, minimizing ambient light and noise, optimizing analgesic guidelines, and promoting a comfortable position could facilitate night rest.</div></div>","PeriodicalId":46453,"journal":{"name":"Enfermeria Clinica","volume":"35 3","pages":"Article 102157"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La participación política de las enfermeras del trabajo: ¿una necesidad?","authors":"Javier González-Caballero","doi":"10.1016/j.enfcli.2025.502213","DOIUrl":"10.1016/j.enfcli.2025.502213","url":null,"abstract":"","PeriodicalId":46453,"journal":{"name":"Enfermeria Clinica","volume":"35 3","pages":"Article 502213"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproducibilidad del sistema de triaje pediátrico TRIPED-GM","authors":"M. Concepción Míguez-Navarro ,&nbsp;Gloria Guerrero-Márquez ,&nbsp;Carmen Ignacio Cerro","doi":"10.1016/j.enfcli.2025.502191","DOIUrl":"10.1016/j.enfcli.2025.502191","url":null,"abstract":"<div><h3>Introduction</h3><div>The triage system aims to determine the level of urgency of patients in order to provide appropriate care and reduce morbidity and mortality. It is essential that the system used is valid, reliable and easy to use. The TRIPED-GM system is a five-level classification system exclusively for pediatric age, which includes 6<!--> <!-->steps, 3<!--> <!-->of which are mandatory (PAT, guiding sign/symptom, and priority rectifiers).</div></div><div><h3>Objective</h3><div>To determine the reproducibility of the TRIPED-GM system when used on patients evaluated consecutively by 2<!--> <!-->nurses.</div></div><div><h3>Method</h3><div>Observational, descriptive, cross-sectional study involving 237 patients under 16 years of age who attended a third-level pediatric emergency service. Reliability was measured using kappa (κ), lineal kappa (κp), and quadratic kappa (κp²) índices, which compared the priority assigned by 2<!--> <!-->research nurses and 16 paediatric emergency nurses with over a year of experience in triage. Patients were classified consecutively and blindly.</div></div><div><h3>Results</h3><div>There was agreement in 221 (93.2%) patients. The overall concordance was: κ<!--> <!-->=<!--> <!-->0.84 (95%CI: 0.77-0.91), κp<!--> <!-->=<!--> <!-->0.85 (95%CI: 0.78-0.92), κp² <!-->=<!--> <!-->0.85 (95%CI: 0.78-0.92). There were no differences in the assignment of more than one priority level in any patient. Concordance in the mandatory steps was: Pediatric Assessment Triangle: κ<!--> <!-->=<!--> <!-->0.82 (95%CI: 0.68-0.96), Main reason for consultation: κ<!--> <!-->=<!--> <!-->0.76 (95%CI: 0.62-0.89), Rectifiers: κ<!--> <!-->=<!--> <!-->0.94 (95%CI: 0.88-1). Concordance was higher in patients who consulted for illness compared to those for trauma/accidents: κ<!--> <!-->=<!--> <!-->0.84 (95%CI: 0.76-0.92) vs. κ<!--> <!-->=<!--> <!-->0.79 (95%CI: 0.57-1).</div></div><div><h3>Conclusion</h3><div>The TRIPED-GM pediatric triage system is reliable for use in emergency services with patients of similar characteristics.</div></div>","PeriodicalId":46453,"journal":{"name":"Enfermeria Clinica","volume":"35 3","pages":"Article 502191"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparación de índices de validez de contenido para investigación en enfermería clínica: un caso práctico","authors":"Paulina Hurtado-Arenas ,&nbsp;Miguel R. Guevara ,&nbsp;Víctor M. González-Chordá","doi":"10.1016/j.enfcli.2025.502214","DOIUrl":"10.1016/j.enfcli.2025.502214","url":null,"abstract":"<div><h3>Objective</h3><div>To compare techniques to analyze the content validity of measurement instruments applicable to nursing care research through a practical case.</div></div><div><h3>Method</h3><div>Secondary study derived from validating the Hospital Survey on Patient Safety (HSOPS) in a Chilean hospital. The study setting was hospital care, with a population focused on nursing staff and a sample of 12 expert nurses who are teachers or have clinical experience in quality and patient safety. Design and content validity test based on three phases: identification of primary methods, calculation of methods, comparison of similarities and differences of methods.</div></div><div><h3>Results</h3><div>Lawsche, Tristan-López, Lynn, Polit et al. methods are similar. The modified kappa value is similar to the content validity index (I-CVI) value, with a slight variation when penalizing the value by probability according to chance. There are significant differences between all methods and Hernández Nieto's content validity coefficient (CVC).</div></div><div><h3>Conclusions</h3><div>The Polit et al. method is more rigorous, and its mathematical formulation is better justified, providing solidity to clinical nursing research. Furthermore, the Hernandez-Nieto method is suggested when validating more than one characteristic.</div></div>","PeriodicalId":46453,"journal":{"name":"Enfermeria Clinica","volume":"35 3","pages":"Article 502214"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}