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The satisfaction of critical care patients with the nursing care they receive is a key indicator of the quality of hospital care.The objectives of this study were to analyse the level of satisfaction of critical care patients in relation to the nursing care received and to determine the relationship between the level of satisfaction and sociodemographic, clinical, and organisational variables.This was a prospective, descriptive correlational study.The population consisted of all patients discharged from the intensive care units (ICUs) of 19 hospitals in Spain between December 2018 and December 2019. The level of satisfaction was measured using the validated Nursing Intensive Care Satisfaction Scale, and sociodemographic, clinical, and organisational data were collected.Participants' mean age (n = 677) was 59.7 (standard deviation: 16.1), and 62.8% of them were men (n = 426). Satisfaction with the nursing care received was 5.66 (SD: 0.68) out of a possible 6. The score for overall satisfaction presented statistically significant relationships with the hours of mechanical ventilation (p = 0.034), with the participant's perception of own health status (p = 0.01), with the participant's perceived degree of own recovery (p = 0.01), with the hospital's complexity level (p = 0.002), with the type of hospital (p = 0.005), and with the type of ICU (p = 0.004). Finally, the logistic regression model shows that the Nursing Intensive Care Satisfaction Scale score was not linked to age or sex but did have a statistically significant relationship with the perceived degree of recovery (p 0.001) and the type of ICU (p=0.001). The variables that predicted satisfaction were age, degree of recovery, and the type of ICU.Several studies show that patient satisfaction is related to the patient's perceived health status and perceived degree of recovery, a finding that is confirmed in our study. Our study moves beyond these outcomes to show that the hours of mechanical ventilation and the characteristics of the hospital also have a significant relationship with patients' satisfaction.

In January 2020, the Chinese authorities identified a new virus of the Coronaviridae family as the cause of several cases of pneumonia of unknown aetiology. The outbreak was initially confined to Wuhan City, but then spread outside Chinese borders. On 31 January 2020, the first case was declared in Spain. On 11 March 2020, The World Health Organization (WHO) declared the coronavirus outbreak a pandemic. On 16 March 2020, there were 139 countries affected. In this situation, the Scientific Societies SEMICYUC and SEEIUC, have decided to draw up this Contingency Plan to guide the response of the Intensive Care Services. The objectives of this plan are to estimate the magnitude of the problem and identify the necessary human and material resources. This is to provide the Spanish Intensive Medicine Services with a tool to programme optimal response strategies.

Patient satisfaction with nursing care is an indicator of patient satisfaction with the hospital stay in general. The Nursing Intensive Care Satisfaction Scale is the only scale about patient satisfaction with nursing care received in an intensive care unit that incorporates the critically ill patient's perspective into its design and validation. We validated the scale nationally, incorporating intensive care units at public and private hospitals of different levels of complexity in Spain.The objective of this study was to validate in Spanish intensive care units the Nursing Intensive Care Satisfaction Scale, a patient-centred questionnaire that evaluates recently discharged intensive care patients' satisfaction with the nursing care they received.We used a psychometric quantitative methodology and a descriptive cross-sectional design.The study was conducted in intensive care units at level II and III public and private hospitals throughout Spain. The study population was all patients discharged from intensive care units from December 2018 to December 2019 from the 19 participating hospitals. We used consecutive sampling until reaching a sample size of 677 patients. The assessment instruments were given to patients at discharge and 48 h later to measure temporal stability.The validation process included the analysis of internal consistency (Cronbach's α coefficient), temporal stability (test-retest), construct validity through a confirmatory factor analysis, and criterion validity using the Pearson correlation coefficient and three criterion items that assessed similar constructs.The reliability of the scale was 0.97, and the factors obtained values between 0.87 and 0.96. The intraclass correlation coefficient for the total scale was 0.83, indicating good temporal stability. Construct validity showed a good fit and a four-factor structure, in accordance with the theoretical model. Criterion validity presented a correlation that was between moderate and high (range: 0.46 to 0.57).The Nursing Intensive Care Satisfaction Scale has good psychometric properties, demonstrating its ability to accurately measure patient satisfaction across a range of contexts in Spain. Continuous monitoring of satisfaction will allow nurses to identify areas for improvement that can increase the quality of care.

Background: The satisfaction of critical care patients regarding the nursing care received is a key indicator of the quality of hospital care. It is, therefore, essential to identify the factors associated with the level of satisfaction of critical care patients. Objectives: To analyse the level of satisfaction of critical care patients in relation to the nursing care received and to determine the relationship between the level of satisfaction and the sociodemographic and clinical variables. Methods: This is a prospective and descriptive correlational study. The population were all patients discharged (January 2013 to January 2015) from three intensive care units of a third-level hospital (n = 200). The data on the satisfaction level were collected using the previously validated Nursing Intensive-Care Satisfaction Scale, and the sociodemographic and clinical data were recorded by means of a questionnaire. Results: Mean participants' age in the study (n = 200) was 65.9 years (standard deviation 13.4 years), with a 66% proportion of men (n = 132). There was a very high level of satisfaction regarding the nursing care received during the patients' stay in the intensive care unit, with a rating of 5.73 (standard deviation 0.41). There is no correlation between the level of satisfaction and the sociodemographic variables collected. However, there were statistically significant differences in the average score of the overall level of satisfaction (rho = 0.182, p = 0.010) with respect to the perception of the state of health. Conclusion: Critical care patients expressed very high rates of satisfaction, for both the scale as a whole and each of the factors. A high level of satisfaction is strongly influenced by the perception of the state of health. (C) 2018 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Objectives To determine nurses’ knowledge level regarding physical restraint use in intensive care units and its associated factors. Method A cross-sectional multicentre study was carried out in 12 critical care units of 8 hospitals in Spain (n = 354 nurses). An ‘ad-hoc’ knowledge survey was developed, and their content was validated by experts. The survey obtained a test-retest stability of ICC = .71 (95% CI: .57–.81) in a previous pilot study. A final 8-item tool was designed. Sociodemographic and professional variables from the participants were collected; as well as structural and clinical variables from the units analysed. A descriptive and association analysis between variables was performed. A p-value Results Two hundred and fifty nurses answered the survey (70.62%). Mean age of the participants was 36.80 (SD 9.54) with 10.75 (SD 8.38) years of professional experience in critical care. Seventy-three point six percent had never received previous training about physical restraints. Knowledge mean value was 4.21 (SD 1.39) (range 0–8). Knowledge level was associated with the referral hospital (p Conclusions Further training regarding physical restraint use is needed for critical care nurses. The work environment where nursing care is given has a great influence on nurses’ knowledge level about this intervention.

Resumen Objetivos Determinar el grado de conocimientos de las enfermeras sobre el uso de contenciones mecanicas en las unidades de criticos y los factores relacionados. Metodo Estudio multicentrico, observacional, en 12 unidades de criticos de 8 hospitales en Espana (n = 354 enfermeras). Se elaboro una encuesta ad-hoc de conocimientos cuyo contenido fue validado por expertos. La encuesta obtuvo una estabilidad test-retest de CC I = 0,71 (IC 95%: 0,57-0,81) en un estudio piloto previo. El instrumento final quedo conformado por 8 items. Se recogieron datos sociodemograficos y profesionales de los participantes, asi como variables estructurales y clinicas de las unidades a estudio. Se llevo a cabo un analisis descriptivo y de asociacion entre variables. Se considero estadisticamente significativo un valor de p Resultados Respondieron 250 enfermeras (70,62%), con una edad media de 36,8 (DE 9,54) anos y una media de 10,75 (DE 8,38) anos de experiencia profesional en unidades de criticos. El 73,6% no habia recibido formacion previa sobre contenciones mecanicas. La media de conocimientos fue de 4,21 (DE 1,39) (rango 0-8). El grado de conocimientos se asocio al hospital de referencia (p Conclusiones Es necesaria una mayor formacion de las enfermeras sobre el uso de contenciones mecanicas. El entorno de trabajo donde se desarrollan los cuidados tiene una gran influencia en el grado de conocimientos de las enfermeras sobre esta intervencion.

Resumen Objetivo Evaluar el nivel de implementacion de los protocolos asociados a la prevencion de la debilidad muscular adquirida en la unidad de cuidados intensivos (UCI), asi como la presencia del fisioterapeuta en distintas UCI de Espana. Metodo Estudio descriptivo, transversal realizado en 86 UCI de adultos de Espana entre los meses de marzo a junio de 2017. Se excluyeron UCI neuroquirurgicas y de grandes quemados. Se utilizo encuesta multirrespuesta que incluia preguntas sobre los protocolos de: control de glucemia, sedacion, valoracion del dolor, prevencion del delirium, manejo del delirium y movilizacion precoz. La encuesta fue rellenada a traves de un aplicativo protegido por usuario y contrasena. Analisis inferencial con t de Student o U de Mann-Whitney y de correlacion con Pearson o Rho de Spearman. Resultados El 89,5% de las UCI tenian protocolo de control de glucemia, con rango predominante de 110-140 mg/dl. El 74,4% evaluaban el nivel de sedacion, si bien solo tenian protocolos de sedacion el 36% de ellas. Con relacion a la valoracion del dolor se realizaba en el 73,7% de los pacientes comunicativos, mientras que en los no comunicativos solo era del 47,5%. Solo el 37,2% realizaban screening diario para detectar el delirium, y disponian de protocolos de prevencion del delirium el 31,4% de las UCI, del manejo del delirium el 26,7% y de movilizacion precoz el 14% de las UCI. En el 34,9% de los casos se solicita interconsulta al servicio de rehabilitacion. Conclusiones La implementacion de los diferentes protocolos asociados a la prevencion de la debilidad muscular adquirida ha sido elevada en relacion con los protocolos de control de glucemia, valoracion del nivel de sedacion y del dolor de pacientes comunicativos, mientras que baja en los de movilizacion precoz y screening y prevencion del delirio. Asimismo, es poco frecuente la presencia del fisioterapeuta en la UCI.

Background: From the beginning, the COVID-19 pandemic increased ICU workloads and created exceptionally difficult ethical dilemmas. ICU staff around the world have been subject to high levels of moral stress, potentially leading to mental health problems. There is only limited evidence on moral distress levels and coping styles among Spanish ICU staff, and how they influenced health professionals' mental health during the pandemic. Objectives: To assess moral distress, related mental health problems (anxiety and depression), and coping styles among ICU staff during the first wave of the COVID-19 pandemic in Spain. Design: Cross-sectional. Settings and participants: The study setting consisted of intensive care unit and areas converted into intensive care units in public and private hospitals. A total of 434 permanent and temporary intensive care staff (reassigned due to the pandemic from other departments to units) answered an online questionnaire between March and June 2020. Methods: Sociodemographic and job variables, moral distress, anxiety, depression, and coping mechanisms were anonymously evaluated through a self-reported questionnaire. Descriptive and correlation analyses were conducted and multivariate linear regression models were developed to explore the predictive ability of moral distress and coping on anxiety and depression. Results: Moral distress during the pandemic is determined by situations related to the patient and family, the intensive care unit, and resource management of the organisations themselves. intensive care unit staff already reached moderate levels of moral distress, anxiety, and depression during the first wave of the pandemic. Temporary staff (redeployed from other units) obtained higher scores in these variables (p = 0.04, p = 0.038, and p = 0.009, respectively) than permanent staff, as well as in greater intention to leave their current position (p = 0.03). This intention was also stronger in health staff working in areas converted into intensive care units (45.2%) than in normal intensive care units (40.2%) (p = 0.02). Moral distress, coupled with primarily avoidance-oriented coping styles, explains 37% (AdR2) of the variance in anxiety and 38% (AdR2) of the variance in depression. Conclusions: Our study reveals that the emotional well-being of intensive care unit staff was already at risk during the first wave of the pandemic. The moral distress they experienced was related to anxiety and depression issues, as well as the desire to leave the profession, and should be addressed, not only in permanent staff, but also in temporary staff, redeployed to these units as reinforcement workers.

Objective To analyse whether adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia (VAP) is associated with nursing workload. Methods A prospective observational study performed in a single medical-surgical ICU. Nurses in charge of patients under ventilator support were assessed. Variables knowledge questionnaire, application of non-pharmacological VAP prevention measures, and workload (Nine Equivalents of Nursing Manpower Use Score). Phases: 1) the nurses carried out a educational programme, consisting of 60-minute lectures on non-pharmacological measures for VAP prevention, and at the end completed a questionnaire knowledge; 2) observation period; 3) knowledge questionnaire. Results Among 67 ICU-staff nurses, 54 completed the educational programme and were observed. A total of 160 observations of 49 nurses were made. Adequate knowledge was confirmed in both the initial and final questionnaires. Application of preventive measures ranged from 11% for hand washing pre-aspiration to 97% for the use of a sterile aspiration probe. The Nine Equivalents of Nursing Manpower Use Score was 50±13. No significant differences were observed between the association of the nurses' knowledge and the application of preventive measures or between workload and the application of preventive measures. Conclusions Nurses' knowledge of VAP prevention measures is not necessarily applied in daily practice. Failure to follow these measures is not subject to lack of knowledge or to increased workload, but presumably to contextual factors.

espanolObjetivo Analizar si el cumplimiento de las medidas no farmacologicas para la prevencion de la neumonia asociada a la ventilacion mecanica (NAV) se asocia a la carga de trabajo de las enfermeras. Metodo Estudio observacional prospectivo llevado a cabo en una UCI medico-quirurgica. Se evaluo a las enfermeras a cargo de pacientes con soporte ventilatorio. Variables: cuestionario de conocimiento, aplicacion de las medidas no farmacologicas de prevencion de la NAV, carga de trabajo medida mediante el Nine Equivalents of Nursing Manpower Use Score. Fases: 1) las enfermeras realizaron un programa educativo, basado en conferencias de 60 min sobre medidas no farmacologicas para la prevencion de NAV, completando al finalizar un cuestionario de conocimiento; 2) periodo de observaciones; 3) cuestionario de conocimiento. Resultados De un total de 67 enfermeras de UCI, 54 completaron el programa formativo y fueron incluidos en el estudio. Se llevaron a cabo un total de 160 observaciones de 49 enfermeros/as. El correcto conocimiento de las medidas de prevencion se confirmo tanto en el cuestionario inicial como final. La aplicacion de las medidas de prevencion vario desde el 11% para el lavado de manos preaspiracion hasta el 97% para el uso de sonda de aspiracion esteril. La puntuacion del Nine Equivalents of Nursing Manpower Use Score fue de 50±13. No se observaron asociaciones significativas entre el grado de conocimiento y la aplicacion de medidas de prevencion, ni entre la carga de trabajo y la aplicacion de dichas medidas. Conclusiones El conocimiento de las enfermeras de las medidas de prevencion de la NAV no se traslada necesariamente a la practica diaria. En la poblacion estudiada, la falta de aplicacion de estas medidas no esta sujeta a la falta de conocimiento ni a la carga de trabajo, sino probablemente a los factores contextuales EnglishObjective To analyse whether adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia (VAP) is associated with nursing workload. Methods A prospective observational study performed in a single medical-surgical ICU. Nurses in charge of patients under ventilator support were assessed. Variables: knowledge questionnaire, application of non-pharmacological VAP prevention measures, and workload (Nine Equivalents of Nursing Manpower Use Score). Phases: 1) the nurses carried out a educational programme, consisting of 60-minute lectures on non-pharmacological measures for VAP prevention, and at the end completed a questionnaire knowledge; 2) observation period; 3) knowledge questionnaire. Results Among 67 ICU-staff nurses, 54 completed the educational programme and were observed. A total of 160 observations of 49 nurses were made. Adequate knowledge was confirmed in both the initial and final questionnaires. Application of preventive measures ranged from 11% for hand washing pre-aspiration to 97% for the use of a sterile aspiration probe. The Nine Equivalents of Nursing Manpower Use Score was 50±13. No significant differences were observed between the association of the nurses’ knowledge and the application of preventive measures or between workload and the application of preventive measures. Conclusions Nurses’ knowledge of VAP prevention measures is not necessarily applied in daily practice. Failure to follow these measures is not subject to lack of knowledge or to increased workload, but presumably to contextual factors

Desde el momento en que se creo la primera Unidad de Cuidados Intensivos en Espana en la Fundacion Jimenez Diaz de Madrid en el ano 1965, las enfermeras del momento tomaron conciencia de la necesidad de una formacion especializada en esta area de cuidados, asi como la de crear una asociacion cientifica en la que se organizaran foros para intercambiar experiencias, diseminar nuevos conocimientos y se promoviera la formacion especializada. La primera agrupacion de esta asociacion, que auno a menos de 100 enfermeras, tuvo lugar en Madrid en 1974, en el seno del X Congreso Nacional de la Sociedad Espanola de Medicina Intensiva y Unidades Coronarias (SEMIUC). Se presentaron 3 comunicaciones y se decidio continuar haciendo reuniones en el marco de los congresos de los medicos intensivistas. Dos anos mas tarde se celebro el segundo encuentro en Barcelona; el tema principal del congreso fue el «distres respiratorio del adulto», y en esta ocasion, las enfermeras participaron presentando 12 comunicaciones orales. Al ano siguiente, en 1977, tuvo lugar en La Coruna la III Reunion Anual de Enfermeria de Cuidados Intensivos; se celebraron dos mesas redondas, una conferencia y hubo 23 comunicaciones orales. A partir de entonces y anualmente, de forma paralela a los congresos organizados por la SEMICYUC, las enfermeras de cuidados intensivos

En los ultimos anos hemos asistido a un incremento del uso de la ventilacion no invasiva (VNI) en nuestras Unidades de Cuidados Intensivos (UCI). Su uso esta indicado principalmente en casos de insuficiencia respiratoria aguda (IRA), con el objetivo de mejorar la oxigenacion arterial, aumentar la ventilacion alveolar, disminuir el trabajo respiratorio y evitar la intubacion traqueal. Por este motivo, hemos disenado un estudio con los objetivos de cuantificar el numero de pacientes que se han beneficiado de la VNI durante su ingreso, saber el tipo de VNI utilizado en estos pacientes y verificar si la utilizacion de VNI ha evitado la intubacion traqueal. Se realizo un estudio observacional descriptivo retrospectivo, en dos UCI polivalentes de un Hospital terciario, con 80 pacientes portadores de VNI durante su ingreso. Un 65% eran hombres y un 35% mujeres. Edad media: ±61 anos (47-75). Estancia media: ±10 dias (2-18). El modo de VNI utilizado fue el de doble presion positiva con Nellcor Puritan Bennett 840®. El 46% de los pacientes tratados con VNI preciso intubacion, alargando su estancia en UCI ± 6 dias. La mayoria de los pacientes tratados solo con VNI mostraban antecedentes de enfermedad pulmonar obstructiva cronica (EPOC) y/o eran portadores de VNI con presion positiva continua (CPAP) domiciliaria. Tras este analisis, se llego a la conclusion de que el tratamiento con VNI no evito la intubacion traqueal en un numero considerable de enfermos (37) diagnosticados de IRA y que la VNI resulto eficaz en enfermos con antecedentes de EPOC y/o CPAP domiciliaria.