Background: Nursing professionals working in intensive care units (ICU) are at high risk of developing negative emotional responses as well as emotional and spiritual problems related to ethical issues. The design of effective strategies that improve these aspects is determined by knowing the levels of burnout and ethical conflict of these professionals, as well as the influence that the practice environment might have on them.Objectives: To analyze the relationship between levels of burnout, the exposure to ethical conflicts and the perception of the practice environment among themselves and with sociodemographic variables of the different intensive care nursing professionals. Methods: Descriptive, correlational, cross-sectional, observational study in an ICU of a tertiary level university hospital. The level of burnout was evaluated with the Maslach Burnout Inventory Human Services Survey scale; the level of ethical conflict with the Ethical Conflict Questionnaire for Nurses; and the perception of the environment with the Practice Environment Scale of the Nursing Work Index. Descriptive and inferential statistics were performed. The association between categorical variables was analyzed using Fisher's exact chi-square test (x2)Results: 31 nurses and 8 nursing assistants were evaluated, which meant a participation rate of 82.93%. 31.10% of the nursing professionals presented signs of burnout, 14.89% considered that they work in an unfavorable environment and 87.23% presented a medium-high index of exposure to ethical conflict. The educational level (x2 = 11.084, P = .011) and the professional category (x2 = 5.007, P = .025) influenced the level of burnout: nursing assistants presented higher levels of this. When comparing the level of burnout with the environment and the index of ethical conflict, there were no statistically significant differences.Conclusions: The absence of association found in the study between burnout and ethical conflict with the perception of the practice environment suggests that personal factors may influence its development.

Introduction and objetive: Patients admitted to the Critical Care Unit (CCU) have a high mor-tality rate due to their complexity. Palliative care (PC) is a key aspect that can improve patient care. Because of the essential role of the nurse in providing this care, training, and including it in daily practice are needed. Our objective was to review the level of knowledge among the nurses in the CCU regarding PC and assess whether there is an association between each of the study variables. Methodology: We performed a descriptive observational cross-sectional study in the CCU of a tertiary level university hospital. The questionnaire Palliative Care Quiz for Nurses, previously validated and translated into Spanish, was used. This is a self-administered questionnaire con-sisting of 20 multiple-choice questions (True/False/Do not Know-Do not answer) which evaluates three aspects of PC: philosophy, psychosocial and control of pain and other symptoms. In addi-tion, sociodemographic data was collected. Descriptive and inferential statistics were used, a p < .05 was considered statistically significant in all cases. Results: The questionnaire was administered to 68 nursers, with an average age of 34.98 +/- 12.12 years, and 13.00 +/- 11.75 years of professional experience. Twelve nurses have Master studies and 28 nurses have received training in PC. The percent of correct answers of the questionnaire was 56.98%. There were no statistically significant differences between the total average score and the variables studied. However, looking at each aspect on the scale, an association was found between PC training and control of pain and other symptoms (p = .033). Conclusion: Critical care nurses have a basic knowledge of PC, it being insufficient in the psycho-logical sphere. Developing a training programme which identifies misconceptions and training deficits might improve the management of symptom control in palliative care patients, quality of care and its application. (c) 2022 Sociedad Espan similar to ola de Enfermeri ' a Intensiva y Unidades Coronarias (SEEIUC). Published by Elsevier Espan similar to a, S.L.U. All rights reserved.

Purpose/Aims To explore nurses' perceptions of clinical nurse specialist practice as implemented in a highly specialized university hospital in Spain. Design A descriptive qualitative study was carried out in 3 inpatient wards, with a clinical nurse specialist within the team, at a high specialized university hospital in Spain. Method Semistructured interviews were conducted by purposive sampling with 17 selected nurses with at least 2 years of professional experience who voluntarily agreed to participate and signed the informed consent form. Analysis of the qualitative data was conducted according to Burnard's method of content analysis. The Consolidated Criteria for Reporting Qualitative Research checklist was used. Results Four main categories emerged from the analysis of the data: "qualities of the role-holder," "role competencies in practice," "integration with the team," and "impact of the role" on nursing, the patient, and the organization. Conclusions The findings of this study have interesting implications for the development and implementation of clinical nurse specialist practice in healthcare organizations. They also provide evidence of the benefit of implementing clinical nurse specialist practice for improving the quality of care, patient outcomes, and healthcare efficiency.

Background: Intensive Care Units (ICU) usually treat patients with pain. Being close to patients makes nurses key professionals for guaranteeing an optimal assessment and treatment of pain, which are crucial to ensure quality care. Therefore this study aims to describe the knowledge and attitudes of ICU nurses about pain management in their clinical practice, and its relationship with socio-demographic data. Methods: Cross-sectional study carried out in a third level university teaching hospital ICU. The Knowledge and Attitudes Survey Regarding Pain (KARSP) translated into Spanish was used to obtain information about the knowledge and attitudes towards pain of nurses. Results: All nurses (n?=?37) working at the ICU answered the questionnaire. The mean score of the questionnaire was 5.87 over 10 (SD: 0.98, range: 7.89-3.68). There was not a statistically significant relationship among the questionnaire score and age, professional experience, time worked at the ICU, specialized training or pain training. However, nurses with a master's degree obtained significantly higher mean scores in the questionnaire (6.97; DE: 0.75 vs. 5.73; DE: 0.92; p?=?0.018). Conclusions: ICU nurses show insufficient knowledge and attitudes towards pain. Having a master's degree improves the results obtained in the questionnaire about knowledge and attitudes towards pain.

Background: Clinical narratives may be used as a means to improve the acquisition of clinical competences. Even though there are studies that recognize the potential value of clinical narratives to promote nursing professional development, there is no evidence that shows their value as a tool to improve nurses' competences to provide person-centred nursing care. Purpose: To evaluate the preliminary efficacy of narratives for the development of three nursing professional competences -respect, intentional presence and knowing the person- for providing person-centred care. Method: Using a pre-post quasi-experimental design, a pilot study with a total of 34 nurses enrolled in a training course of nursing specialization was conducted between September 2016 and June 2017. All the nurses received a multi-component intervention based on the Critical Reflective Inquiry model. The strategies of this programme consisted of writing three narratives, attending two masterclasses, participating in a discussion group, and participating in a face-to-face interview. The NarratUN Evaluation tool was used to assess the outcomes. Changes among nurses were analysed using the Wilcoxon signed Rank test. Results: The difference in the means between the pre- and post-intervention scores were statistically significant for respect [0.59 (95% CI 0.23-0.95; p = 0.001)], intentional presence [0.75 (95% CI 0.32-1.17; p < 0.0001)] and knowing the person [0.62 (95% CI 0.25-0.99; p = 0.001)]. The difference in the mean score for use of the narrative and reflection also increased significantly [0.65 (95% CI 0.32-0.98, p < 0.001)]. Conclusions: The use of narratives combined with other reflective strategies (masterclass sessions and discussion groups) proved to be effective for the development of professional competences of nurses.

Introduction: Pain assessment and treatment are essential for ensuring quality of care as well as for improving patient satisfaction and clinical outcomes. Objectives: 1) To describe pain perception of surgical patients admitted to our Intensive Care Unit(ICU). 2) To compare the patients' pain perception with the assessment carried out by nurses. 3) To correlate International Pain Outcomes Questionnaire results with socio-demographical data. Methodology: A prospective descriptive observational study was carried out in the ICU of a third level university hospital over a period of 3 months. Surgical patients' pain-perception was assessed 24 hours after their admission to the ICU using the Spanish translation of International Pain Outcomes Questionnaire. Results: The highest pain score recorded among 109 patients by nurses was 4.47 +/- 2.75, while, the lowest was.69 +/- 1,25. However, the highest and lowest pain scores reported by patients were 5.59 +/- 2.72 and 2.13 +/- 2.03, which showed significant differences (P < 0.001). The highest pain score seemed to be related to the type of surgery (P < 0.027). There are significant variations in the lowest pain score depending on age (P=0.005 r = 0.270). Likewise, the worst pain score correlated with the patients' sex (P=0.004). Patients who reported that pain made them feet very anxious or helpless scored highest with the worst pain, 7.35 1.98, 7.44 1.85 respectively. These differences were statistically significant (P = 0.001, P < 0.001). Regarding to the score of less pain, there is an association with feeling anxiety (P=0.032) and not with feeling helpless (P = -0.088). Conclusions: The post-surgical patients reported pain during the first 24 hours following admission to ICU (max score 5.59 +/- .26). The nurses underestimated the patients' reported pain. Improving nurses' education would provide them with assessment strategies for better pain management. Age, sex, anxiety and helplessness caused by pain, were variables that significantly influenced pain.

Introduction and objectives: Patients' sleep can be disturbed during their stay in an Intensive Care Unit. Many factors can explain this disturbance, both within the ICU environment and caused by patients' illnesses. There is evidence that patients' sleep can be improved within ICUs. The aim of this study is to describe patientsperceptions of a night's sleep and develop a care plan that promotes a night's sleep. Methodology: A prospective descriptive study was performed in the ICU of a training hospital. The sleep of 125 patients was explored. Sociodemographic and clinical variables were collected from patients' medical records. The 5-item Richards-Campbell Sleep Questionnaire was utilised to assess patients' perception of a night's sleep. In addition, an ad-hoc 9-item questionnaire was developed which included factors that can affect sleep according to the literature. Patients had to grade the level of interference of those factors with their night's sleep. Results: The sleep of patients in our Intensive Care Unit was moderately deep, with light arousals and ease in falling sleep again. The average value on the Richards-Campbell Sleep Questionnaire was 52.92 mm. The factors that significantly interfered with sleep were: pain (P=0.009), worries/anxiety (P=.01), staff voices (P=0.033), alarm/medical devices sounds (P-0.047) and peripheral intravenous lines (P-.036). Conclusions: Our patients' perception of a night's sleep in the ICU was fair. Optimising pain management, answering questions or worries, minimizing background noise and voices have the potential to improve sleep quality. (C) 2018 Sociedad Espanola de Enfermeria Intensiva y Unidades Coronarias (SEEIUC). Published by Elsevier Espana, S.L.U. All rights reserved.

Es de gran importancia estandarizar la información e incorporar al protocolo cómo enseñar a retirarse la mascarilla y asegurarse que sepan realizarlo. Además, habría que modiƒcar el plan de hidratación de piel y mucosas porque los resultados demuestran que es insuƒciente