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Objective: To identify findings in the scientific literature relevant to the strategic lines proposed by the Humanising Intensive Care Project in the context of paediatric intensive care units., Design: Narrative review., Methods: A literature search was conducted in the databases PubMed, Scopus, CINHAL, and Cochrane Library. Specific indexing terms and search strategies adapted to each database were designed. The inclusion of publications was based on two criteria: 1) related to the paediatric intensive care unit and 2) addresses at least one of the topics related to the strategic lines of the Humanising Intensive Care Project. Study selection was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the quality of the included studies was assessed using the Mixed Method Appraisal tool., Results: A total of 100 articles from 19 different countries were included, covering the period between 2019 and 2021. Nineteen different design types were identified. Thirty-two studies were cross-sectional observational studies, while 15 had an experimental approach. The articles were distributed among the seven strategic lines of the Humanising Intensive Care Project., Conclusions: Synthesising the knowledge related to humanisation in paediatric intensive care units will allow progress to be made in improving quality in these units. However, there is disparity in the amount of experimental research overall., Implications for Clinical Practice: There is a disparity in the available research related to the different strategic lines, and it is necessary to carry out more exhaustive research on topics such as the presence and participation of the family in care or the management of post-paediatric intensive care syndrome., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Health professionals can be 'second victims' of adverse patient events. Second victimhood involves a series of physical and psychological signs and symptoms of varying severity and is most prevalent among nurses and women and in intensive care units (ICUs). Previous research has described personal and organizational coping strategies., Aim: The objective of this research is to determine the prevalence of second victimhood, focusing on psychological distress, among Chilean adult intensive care nurses and its relationship with the support provided by their organizations., Study Design: A descriptive, correlational and cross-sectional study was conducted in seven intensive care units of Chilean hospitals., Results: Of a sample of 326 nurses, 90.18% reported having been involved in an adverse event and 67% reported psychological distress resulting from the adverse event. Embarrassment was the most prevalent psychological symptom (69%). Only 2.8% reported that their organization had an action plan for professionals in the event of a serious adverse event. Participants who had spent longer working in an ICU reported more support from their organization around adverse events., Conclusion: Two-thirds of Chilean adult intensive care unit nurses report psychological stress following an adverse event. These results should be assessed internationally because second victims have major implications for the well-being of health professionals and, therefore, for retention and the quality of care., Relevance to Clinical Practice: Critical care leaders must actively promote a safe environment for learning from adverse events, and hospitals must establish a culture of quality that includes support programmes for second victims., (© 2023 The Authors. Nursing in Critical Care published by John Wiley & Sons Ltd on behalf of British Association of Critical Care Nurses.)

Background: The satisfaction of critical care patients with the nursing care they receive is a key indicator of the quality of hospital care., Objectives: 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., Design: This was a prospective, descriptive correlational study., Setting and Methods: 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., Results: 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., Conclusion: 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., Competing Interests: Conflict of interest None., (Copyright © 2022 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

Objectives: To analyze the prevalence of care complexity factors (CCFs) in patients coming to an emergency department (ED) and to analyze their relation to 30-day ED revisits., Material and Methods: Observational, correlational, and cross-sectional study. Consecutive patients seeking care from a tertiarylevel hospital ED were included over a period of 6 months. The main variables studied were 30-day revisits to the ED and 26 CCFs categorized in 5 domains: psychoemotional, mental-cognitive, sociocultural, developmental, and comorbidity/complications. Data were collected from hospital records for analysis of descriptive and inferential statistics., Results: A total of 15 556 patient episodes were studied. A CCF was recorded in 12 811 patient records (82.4%), and 1088 (11.9%) of the patients discharged directly from the ED revisited within 30 days. The presence of more CCFs was associated with 30-day revisits (odds ratio, 1.26; 95% CI, 1.11-1.43; P .05). The CCFs that were significantly associated with revisits were incontinence, hemodynamic instability, risk for bleeding, anxiety, very advanced age, anxiety and fear, cognitive impairment, and illiteracy., Conclusion: The prevalence of CCFs is high in patients who seek ED care. Patients revisiting within 30 days of an episode have more CCFs. Early identification of such patients would help to stratify risk and develop preventive strategies to decrease the incidence of revisiting.

Aim: Validate the Nursing Intensive-Care Satisfaction Scale in ICUs throughout Spain. Identify the improvement strategies recommended by the patients and professionals., Design: Quantitative psychometric methodology and a cross-sectional descriptive correlational design., Methods: The study population will be all patients discharged from 19 participating ICUs in Spain. Consecutive sampling (n = 564). Once discharged from the ICUs, they will receive the questionnaire and then, after 48 hours it will be given to them again to analyse the temporal stability. To validate the questionnaire, the internal consistency (Cronbach's Alpha) and temporal stability (test-retest) will be analysed., Results: Improve the quality of nursing care by modifying, changing or strengthening behaviours, skills, attitudes or areas for improvement involved in the process., (© 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Background: 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., Objectives: 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., Design: We used a psychometric quantitative methodology and a descriptive cross-sectional design., Setting and Participants: 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., Methods: 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., Results: 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)., Conclusions: 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., (Copyright © 2022 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

Objectives: To assess the impact of a nurse-driven patient empowerment intervention on anxiety and depression of patients during ICU discharge., Design: A prospective, multicenter, randomized clinical trial., Setting: Three ICUs (1 medical, 1 medical and surgical, and 1 coronary) of three tertiary hospitals., Patients: Adults admitted to the ICU greater than 18 years old for greater than or equal to 48 hours with preserved consciousness, the ability to communicate and without delirium, who were randomized to receive the nurse-driven patient empowerment intervention (NEI) (intervention group [IG] or standard of care [control group (CG)]) before ICU discharge., Intervention: The NEI consisted of an individualized intervention with written information booklets, combined with verbal information, mainly about the ICU process and transition to the ward, aimed at empowering patients in the transition process from the ICU to the general ward., Measurements and Results: Patients completed the Hospital Anxiety and Depression Scale before and after (up to 1 wk) ICU discharge. IG ( n = 91) and CG ( n = 87) patients had similar baseline characteristics. The NEI was associated with a significant reduction in anxiety and depression ( p < 0.001) and the presence of depression ( p = 0.006). Patients with comorbidities and those without family or friends had greater reductions in anxiety and depression after the NEI. After the intervention, women and persons with higher education levels had lower negative outcomes., Conclusions: We found that a NEI before ICU discharge can decrease anxiety and depression in critically ill survivors. The long-term effect of this intervention should be assessed in future trials., Trial Registration: NCT04527627 ( https://clinicaltrials.gov/ct2/show/NCT04527627 )., Competing Interests: Drs. Cuzco, Ruiz García, Benito Aracil, Carmona Delgado, and Delgado-Hito received support for article research from the Nurse and Society Foundation as a part of the Nurse Research Projects Grants (PR-248/17). The remaining authors have disclosed that they do not have any potential conflicts of interest., (Copyright © 2022 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.)

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% (AdR 2 ) of the variance in anxiety and 38% (AdR 2 ) 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., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Intensive care unit (ICU) patients can experience emotional distress and post-traumatic stress disorder when they leave the ICU, also referred to as post-intensive care syndrome. A deeper understanding of what patients go through and what they need while they are transitioning from the ICU to the general ward may provide input on how to strengthen patient-centred care and, ultimately, contribute to a positive experience., Aim: To describe the patients' experience while transitioning from the ICU to a general ward., Design: A descriptive qualitative study., Method: Data were gathered through in-depth interviews and analysed using a qualitative content analysis. The qualitative study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines., Findings: Forty-eight interviews were conducted. Impact on emotional well-being emerged as a main theme, comprising four categories with six subcategories., Conclusion: Transition from the ICU can be a shock for the patient, leading to the emergence of a need for information, and an impact on emotional well-being that has to be planned for carefully and addressed prior to, during, and following transition from the ICU to the general ward., Relevance to Clinical Practice: It is essential that nurses understand patients' experiences during transfer, identifying needs and concerns to be able to develop and implement new practices such as ICU Liaison Nurse or Nurse Outreach for the follow-up of these patients, the inclusion of a consultant mental health nurse, and the application of patient empowerment during ICU discharge., (© 2021 The Authors. Nursing in Critical Care published by John Wiley & Sons Ltd on behalf of British Association of Critical Care Nurses.)

Aim: To analyze personal and organizational strategies described in the literature for dealing with the second victim phenomenon among healthcare providers., Background: The second victim phenomenon involves many associated signs and symptoms, which can be physical, psychological, emotional, or behavioral. Personal and organizational strategies have been developed to deal with this phenomenon., Materials and Methods: A systematic review was carried out in PubMed, Cochrane Library, Web of Science, Scopus, PsycINFO, Science Direct, and Cumulative Index to Nursing and Allied Health Literature databases, searching for evidence published between 2010 and 2019 in Spanish, English, German, and Portuguese., Results: Seven hundred and eighty-three articles were identified. After eliminating duplicates, applying inclusion and exclusion criteria and critical analysis tools of the Joanna Briggs Institute, 16 research articles were included: 10 quantitative studies (design: descriptive, correlational, systematic, or integrative review) and six qualitative studies (descriptive, systematic review). There are several different personal and organizational strategies for dealing with the second victim phenomenon. Among these, peer support and learning from adverse events are highly valued. In personal strategies stands out the internal analysis of the adverse event that the professional performs to deal with the generated negative feelings. In organizational strategies, the most valued are second victim support programs with rapid response teams and made up of peers., Conclusions: The main organizational coping strategies for tackling this phenomenon are online programs in countries such as the United States, Spain, and other European countries. Formal evaluation of these programs and research is required in Latin America., Implications for Nursing and Health Policies: Adequately coping with the second victim phenomenon allows health professionals and organizations to learn from adverse events. Furthermore, by supporting health professionals who suffer from the second victim phenomenon, the organization takes care of its most valuable resource, its human capital. This contributes toward building a culture of healthcare quality in organizations, which will reduce adverse events in the future., (© 2021 The Authors. International Nursing Review published by John Wiley & Sons Ltd on behalf of International Council of Nurses.)

Aim: (a) To understand patients' lived experience at intensive care unit (ICU) discharge and (b) to evaluate the impact of a nursing empowerment intervention (NEI) on patients' anxiety and depression levels at ICU discharge., Design: A mixed-methods approach will be applied., Methods: In the qualitative phase, the hermeneutic phenomenological method will be used. Participants will be patients from three university hospitals who will be selected by purposive sampling. Data will be gathered through in-depth interviews and analysed using content analysis. The qualitative data obtained will be employed to develop the nursing intervention. Subsequently, a multicenter, parallel-group, experimental pre-test/post-test design with a control group will be used to measure the effectiveness of the nursing empowerment intervention in the quantitative phase by means of the Hospital Anxiety and Depression Scale (HADS). Simple random probabilistic sampling will include 172 patients in this phase., (© 2021 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Intensive care unit discharge is an important transition that impacts a patient's wellbeing. Nurses can play an essential role in this scenario, potentiating patient empowerment. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (the PRISMA Statement. Embase), PubMed/MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), CUIDEN Plus, and LILACS databases; these were evaluated in May 2021. Two independent reviewers analyzed the studies, extracted the data, and assessed the quality of evidence. Quality of the studies included was assessed using the Cochrane risk-of-bias tool. Of the 274 articles initially identified, eight randomized controlled trials that reported on nursing interventions had mainly focused on patients' ICU discharge preparation through information and education. The creation of ICU nurse-led teams and nurses' involvement in critical care multidisciplinary teams also aimed to support patients during ICU discharge. This systematic review provides an update on the clinical practice aimed at improving the patient experience during ICU discharge. The main nursing interventions were based on information and education, as well as the development of new nursing roles. Understanding transitional needs and patient empowerment are key to making the transition easier.

Aim/objective: To determine the development of competency acquisition, the satisfaction of the agents involved and recording incidents with a digital platform CliPrAS @UB on the Clinical Placements I and II courses in the second and third years of the Bachelor's Degree in Nursing., Background: The teaching of clinical practice subjects requires an analysis of the competence evolution, a management structure and an analysis of the satisfaction of the agents involved in the subject., Design: Prospective, analytical, observational cohort study., Methods: The study was carried out in a public university center in Barcelona with 387 students distributed in nine centers of the network of Health Institutions., Results: An increase of 2.32 points was observed in the competence dimensions of Professional Practice and with a reduction in the average score in the skills of care provision, therapeutic communication and professional development of more than 0.08 points. Regarding the seminars, a reduction of the average global score of 0.58 points was observed., Conclusions: The use of the CliPrAS @ UB computer platform has improved the implementation of the mandatory documents, the recording of incidents and the overall satisfaction of the students., (Copyright © 2021. Published by Elsevier Ltd.)

Background: Studies addressing critical care nurses' practices regarding physical restraints have focused on individual nurses' knowledge and attitudes but lack the understanding of other social influences that could affect nurses' intentions to use them., Objective: The objective of this study was to determine critical care nurses' attitudes, subjective norms, perceived behavioural control, and intentions to use physical restraints in intubated patients and the relationship between them and sociodemographic, professional, and contextual factors using a survey approach., Methods: A cross-sectional, multicentre study was conducted in a convenience sample of 12 intensive care units from eight hospitals in Spain (n = 354). The Physical Restraint-Theory of Planned Behaviour questionnaire and a researcher-developed survey were used to collect structural and clinical data from each unit. Multilevel model analysis was used., Results: Critical care nurses showed a moderate level of intention to use physical restraints 12.52 (standard deviation = 3.81) [3-21]. More than a half (52%) agreed restraints were safe. The highest perceived barrier against physical restraint use was patient cooperation. Although nurses did not feel that others expected them to use restraints, they did not perceive high levels of disapproval of such practice. Nurses who had received previous training on restraints and who worked in units with a flexible family visitation policy, an informed consent form for restraint use, analgosedation and restraint protocols, and nurse-driven analgosedation management reported lower levels of intention to use restraints. Working in smaller units (beta -1.81; 95% confidence interval [CI]: -0.18, -3.44) and working in units with a consent form for restraint use (beta -4.82; 95% CI: -2.80, -6.85) were the variables with the highest impact on nurses' intentions to use restraints., Conclusions: Critical care nurses' intentions to use physical restraints are moderate and are influenced by intrapersonal, patient, and contextual factors. Nurses who work in units with organisational policies and alternatives to restraints demonstrated lower levels of intention to use them., Competing Interests: Declaration of competing interest None., (Copyright © 2019 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

Objective: to analyze the student's progression in the acquisition of specific and transversal competences in relation to the competence dimensions.Method: the cross-sectional descriptive study was carried out in the clinical practice subjects included in the Nursing Degree. We included 323 students and we contemplated the development of competences through an ad-hoc questionnaire with 4 dimensions: delivery and care management, therapeutic communication, professional development and care management., Results: the academic results between the practice of the second and third year showed an improvement in care provision and therapeutic communication skills (Clinical Placements I: 12%-29%; Clinical Placements II: 32%-47%) and worsened in professional development and care management (Clinical Placements I: 44%-38%; Clinical Placements II: 44%-26%)., Conclusion: the correlations between these two years were high in all the dimensions analyzed. The evaluation of competence progression in the context of clinical practice in nursing university studies allows us to optimize these practices to the maximum and establish professional profiles with a greater degree of adaptation to the professional future.

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., (Copyright © 2018 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

Background: Despite the reported harms and ethical concerns about physical restraint use in the critical care settings, nurses' intention to apply them is unequal across countries. According to the theory of planned behaviour, eliciting nurses' beliefs regarding the use of physical restraints would provide additional social information about nurses' intention to perform this practice., Aim: To explore the salient behavioural, normative and control beliefs underlying the intention of critical care nurses to use physical restraints from the theory of planned behaviour., Research Design: A belief elicitation study was conducted., Participants and Research Context: Twenty-six critical care nurses were purposively sampled across gender, work-shift patterns and professional experience in five intensive care units of three hospitals in Spain. Data were obtained from a nine-item open-ended questionnaire and a focus group. Deductive content analysis was performed., Ethical Considerations: Ethical approval was obtained from the hospital ethics committee. Participants were assured their participation was voluntary., Findings: Nurses framed the use of restraints as a way of prioritising patients' physical safety. They referred to contextual factors as the main reasons to justify their application. Nurses perceived that their decision is approved by other colleagues and the patients' relatives. Some nurses started advocating against their use, but felt powerless to change this unsafe practice within an unfavourable climate. Control beliefs were linked to patients' medical condition, availability of alternative solutions, analgo-sedation policies and work organisation., Discussion: Safety arguments based on the surrounding work environment were discussed., Conclusion: Nurses' behavioural and control beliefs were related. Nurses should be trained in alternatives to physical restraint use. The impact of analgo-sedation protocols, relatives' involvement, leadership support and intensive care unit restraint policies on physical restraint practices need to be revised. Further research is required to explore why nurses do not act with moral courage to change this harmful practice.

Background: Continuity of care and care coordination are critical issues in virtually all healthcare systems. European guidelines for the quality of screening programs for breast and colorectal cancer describe process, structure, and outcome indicators, but none specifically evaluate coordination and continuity of care during the cancer screening process., Objective: The aim of this study was to identify indicators reflecting care coordination and continuity in population-based breast and colorectal cancer screening program., Methods: A two-round Delphi study was conducted in a sample of 30 cancer screening nurses to identify quality indicators., Results: The final Delphi consensus resulted in six core indicators for the cancer screening program: adequacy of the referral of the target population from the screening program to other health services, waiting time for referral to other health services, understanding of the screening program by professionals involved in the process, effective information flow between professionals involved in the process, participants' perception of the screening program, and, finally, participants' understanding of information about the program., Conclusion: The evaluation of indicators is crucial for quality improvement and should allow a measuring system to be established that would allow a comparison of outcomes for all population-based cancer screening programs.

Aim: The aim of this study was to develop and validate the Nursing Intensive-Care Satisfaction Scale to measures satisfaction with nursing care from the critical care patient's perspective., Background: Instruments that measure satisfaction with nursing cares have been designed and validated without taking the patient's perspective into consideration. Despite the benefits and advances in measuring satisfaction with nursing care, none instrument is specifically designed to assess satisfaction in intensive care units., Design: Instrument development., Methods: The population were all discharged patients (January 2013 - January 2015) from three Intensive Care Units of a third level hospital (N = 200). All assessment instruments were given to discharged patients and 48 hours later, to analyse the temporal stability, only the questionnaire was given again. The validation process of the scale included the analysis of internal consistency, temporal stability; validity of construct through a confirmatory factor analysis; and criterion validity., Results: Reliability was 0.95. The intraclass correlation coefficient for the total scale was 0.83 indicating a good temporal stability. Construct validity showed an acceptable fit and factorial structure with four factors, in accordance with the theoretical model, being Consequences factor the best correlated with other factors. Criterion validity, presented a correlation between low and high (range: 0.42-0.68)., Conclusions: The scale has been designed and validated incorporating the perspective of critical care patients. Thanks to its reliability and validity, this questionnaire can be used both in research and in clinical practice. The scale offers a possibility to assess and develop interventions to improve patient satisfaction with nursing care., (© 2018 John Wiley & Sons Ltd.)

Background: There are many descriptive studies regarding the needs of the family, as well as those regarding nursing care aimed directly at family members. However, there is no widespread application of such evidence in clinical practice. There has also been no analysis made of the evolution of patterns of knowing during the act of improving clinical practice. Therefore, the purpose of the study is to understand the change process aimed at improving care to critical patient's families, and to explore the evolution of patterns of knowing that nurses use in this process., Methods: Qualitative study with a Participatory Action Research method, in accordance with the Kemmis and McTaggart model. In this model, nurses can observe their practice, reflect upon it and compare it with scientific evidence, as well as define, deploy and evaluate improvement strategies adapted to the context. Simultaneously, the process of empowerment derived from the Participatory Action Research allows for the identification of patterns of knowing and their development over time. The research will take place in the Intensive Care Units of a tertiary hospital. The participants will be nurses who are part of the regular workforce of these units, with more than five years of experience in critical patients, and who are motivated to consider and critique their practice. Data collection will take place through participant observation, multi-level discussion group meetings and documentary analysis. A content analysis will be carried out, following a process of codification and categorisation, with the help of Nvivo10. The approval date and the beginning of the funding were December 2012 and 2013, respectively., Discussion: The definition, introduction and evaluation of care strategies for family members will allow for their real and immediate implementation in practice. The study of the patterns of knowing in the Participatory Action Research will be part of the theoretical and practical feedback process of a professional discipline. Also, the identification of the construction and evolution of knowledge will provide decision elements to managers and academics when choosing strategies for increased quality.

Aim: To investigate and understand patient's satisfaction with nursing care in the intensive care unit to identify the dimensions of the concept of 'satisfaction' from the patient's point of view. To design and validate a questionnaire that measures satisfaction levels in critical patients., Background: There are many instruments capable of measuring satisfaction with nursing care; however, they do not address the reality for critical patients nor are they applicable in our context., Design: A dual approach study comprising: a qualitative phase employing Grounded Theory and a quantitative and descriptive phase to prepare and validate the questionnaire., Methods: Data collection in the qualitative phase will consist of: in-depth interview after theoretical sampling, on-site diary and expert discussion group. The sample size will depend on the expected theoretical saturation n = 27-36. Analysis will be based on Grounded Theory. For the quantitative phase, the sampling will be based on convenience (n = 200). A questionnaire will be designed on the basis of qualitative data. Descriptive and inferential statistics will be used. The validation will be developed on the basis of the validity of the content, the criteria of the construct and reliability of the instrument by the Cronbach's alpha and test-retest approach. Approval date for this protocol was November 2010., Discussion: Self-perceptions, beliefs, experiences, demographic, socio-cultural epistemological and political factors are determinants for satisfaction, and these should be taken into account when compiling a questionnaire on satisfaction with nursing care among critical patients., (© 2013 John Wiley & Sons Ltd.)

Acute renal failure affects 25% of patients hospitalized in intensive care units. Despite technological advances, the mortality of these patients is still high due to its associated complications. Continuous renal replacement techniques are one of the treatments for acute renal failure because they make it possible to treat the complications and decrease mortality. The nurse's knowledge and skills regarding these techniques will be decisive for the success of the therapy. Consequently, the nurse's experience and training are key components. The objective of this article is to update the knowledge on continuous renal replacement techniques. Keeping this in mind, a review has been made of the physical and chemical principles such as diffusion and convection, among others. A description of the different continuous renal replacement techniques, a presentation of the main vascular access, and a description of the nursing cares and complications related to techniques used have also been provided., (Copyright © 2012 Elsevier España, S.L. y SEEIUC. All rights reserved.)

Introduction: Level of satisfaction is a key indicator of quality of care. There are many tools that measure satisfaction with nursing care, however they do not respond to the reality of the critical care patient or to our context., Objectives: To define and to identify the dimensions of the satisfaction of patients admitted to the intensive care unit of a tertiary hospital with nursing cares and to define and identify the dimensions of the concept of satisfaction from their point of view., Material and Methods: A qualitative research study was conducted according to the Grounded Theory Method in three Intensive Care Units with 34 individual boxes, with theoretical sampling. Nineteen patients remained after data saturation sampling. Data collection was obtained through recorded in-depth interviews and field logbook. Contents analysis was made according to the Grounded Theory. Guba and Lincoln rigor's criteria were followed. There was a favorable report from the Hospital's Ethics Committee and informed consent was obtained from the patients., Results: Four categories were found: The definition and dimensions of the satisfaction concept, expectations and life experiences. The participants included the following dimensions in their satisfaction definition: professional competences, human, technical and continuous cares. The combination of these elements produces feelings of security, calmness, being monitored, feeling like a person, perceiving a close relationship and trustfulness with the nurse who performs the individualized cares., Conclusions: The definition and dimensions of satisfaction concept from the patient's point of view show the important aspects of the person and also clarify their dimensions, allowing the construction of tools more in line with the context and real perception., (Copyright © 2012 Elsevier España, S.L. y SEEIUC. All rights reserved.)