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Article ; Online: Strategic lines in peripheral intravenous catheter care: where to direct our efforts?

Rodriguez-Calero, Miguel Ángel / Blanco-Mavillard, Ian

Enfermeria clinica (English Edition)

2022 Volume 32, Issue 4, Page(s) 213–216

MeSH term(s)	Catheterization, Peripheral ; Catheters
Language	English
Publishing date	2022-07-17
Publishing country	Spain
Document type	Editorial
ISSN	2445-1479
ISSN (online)	2445-1479
DOI	10.1016/j.enfcle.2022.06.005
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Classification of Pressure Injury Stages and Skin Damage Photographs by RNs and Nursing Students in Spain: An Observational Comparison Study.

Rodriguez-Calero, Miguel Angel / Fullana-Matas, Antonia / Miró-Bonet, Rosa

Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society

2021 Volume 48, Issue 5, Page(s) 403–409

Abstract: Purpose: The purpose of this study was to evaluate and classify pressure injuries (PIs) and other skin lesions according to the judgment of hospital-based RNs and nursing students who recently trained in wound care using photographs and comparing ... ...

Abstract	Purpose: The purpose of this study was to evaluate and classify pressure injuries (PIs) and other skin lesions according to the judgment of hospital-based RNs and nursing students who recently trained in wound care using photographs and comparing findings to those of wound care experts. Design: Cross-sectional observational survey. Subject and setting: RNs working at Manacor Hospital, Mallorca, Spain, and third-year nursing students from the University of the Balearic Islands. Data were collected in June 2017. Methods: The survey instrument was accompanied by a set of 24 photographs in 7 categories of skin lesions, such as PIs or moisture-associated skin damage, which the respondents were asked to classify. Descriptive analysis of the classifications was carried out, and levels of agreement using the chi-square test were compared with evaluations/classifications of a panel of experts. Results: In total, 314 surveys (199 RNs and 115 students) were included in the analyses. Findings showed a wide variability among participants with levels of agreement, with expert opinion ranging from 91.4% to 15.61%. The levels of agreement were substantially lower for unstageable PIs (47.92%), those caused by moisture (53.50%), and mixed etiology (38.37%) than for stages 1-4 PIs. Of note, 62.12% of RNs had not received PI training or continuing education during the previous 2 years. This lack of education was statistically significantly associated with the accuracy of the classification made by the RNs for some of the photographs evaluated such as moisture-associated skin damage. Conclusions: We found discrepancies in the classification of PIs and other wounds/lesions among experts, RNs, and students. The regular provision of up-to-date information in training and continuing education programs is imperative to maintain nurses' abilities to identify and classify PIs and other skin-related damage.
MeSH term(s)	Humans ; Cross-Sectional Studies ; Spain ; Students, Nursing ; Surveys and Questionnaires ; Pressure Ulcer
Language	English
Publishing date	2021-09-08
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	1188388-1
ISSN	1528-3976 ; 1071-5754
ISSN (online)	1528-3976
ISSN	1071-5754
DOI	10.1097/WON.0000000000000803
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Article ; Online: Advanced practice nurses and evidence-based practice. An opportunity for change.

Rodríguez Calero, Miguel Ángel / Villafáfila Gomila, Carlos Javier / Sastre Fullana, Pedro

Enfermeria clinica (English Edition)

2019 Volume 29, Issue 2, Page(s) 119–124

Abstract: In a context of aging of the population, increased prevalence of chronic diseases and increasing complexity, it is necessary to define new professional roles that can meet the health needs of the population. Added to this is the certainty that ... ...

Title translation	Enfermeras de práctica avanzada y práctica basada en evidencias. Una oportunidad para el cambio.
Abstract	In a context of aging of the population, increased prevalence of chronic diseases and increasing complexity, it is necessary to define new professional roles that can meet the health needs of the population. Added to this is the certainty that variability in clinical practice, as well as in health management, makes it necessary to use best evidence as the basis for decision-making. But the application of clinical practice based on evidence in a specific context implies a broad mastery of the available evidence, its applicability and limitations, as well as a deep understanding of the particular characteristics of the area where it is to be applied, from the "macro" (health policies, framework regulations, strategic lines, social values, etc.) to the "micro" level (local culture, user preferences, etc.). The "Health Service of the Balearic Islands", in collaboration with the Faculty of Nursing and Physiotherapy from the University of the Balearic Islands, proposes the development of new advanced practice nursing roles that focus their efforts on the planned implementation of evidence in clinical settings. Advanced practice nurses have managed naturally, thanks to their competence development, to exercise the role of promoting organizational and attitudinal changes that facilitate the implementation of evidence in organizations and complex environments.
MeSH term(s)	Advanced Practice Nursing/standards ; Evidence-Based Nursing ; Humans ; Spain
Language	Spanish
Publishing date	2019-02-26
Document type	Journal Article
ISSN	2445-1479
ISSN (online)	2445-1479
DOI	10.1016/j.enfcli.2018.12.007
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Article ; Online: Reliability of the use of photographs for the classification of dependence-related lesions.

Rodríguez-Calero, Miguel Ángel / Fullana Matas, Antonia / Miró Bonet, Rosa

Enfermeria clinica (English Edition)

2019 Volume 30, Issue 2, Page(s) 114–118

Abstract: Objective: To examine the reliability of the classification of dependence-related lesions using photography.: Method: A panel of 5 experts carried out a blind, anonymous and independent assessment of 24 photographs. Images were sent by electronic ... ...

Title translation	Fiabilidad del uso de fotografías en la clasificación de heridas relacionadas con la dependencia.
Abstract	Objective: To examine the reliability of the classification of dependence-related lesions using photography. Method: A panel of 5 experts carried out a blind, anonymous and independent assessment of 24 photographs. Images were sent by electronic mail, together with an anonymous questionnaire that was sent back to a referee of the research group. We suggested 8 options for classification: pressure ulcer (categories I, II, III, IV, or 'suspect of deep-tissue damage'), moisture-associated damage, pressure-moisture combined aetiology and multifactorial lesion. Concordance index was calculated for every photography. Cohen's Kappa index with 'jackknife' technique were calculated for every photograph and category. We used the statistical programme Epidat 4.2. Results: Observed agreement was variable, between 4 and 1 depending on the photography. A consensus of 100% was observed in 6 images. Global Kappa resulted as moderate: 0.5202 (IC95%: 0.3850- 0.6542). Intra-group concordance resulted moderate in 4 categories, low in 3, and high only for pressure ulcer category II (Kappa 0.8924. IC 95%: 0.7388-1.0456). Inter-observer concordance was 0.6602 (IC 95%: 0.4969-0.8081). Conclusions: The reliability of the use of photographs for the categorization of dependence-related lesions is moderate, being higher for category II pressure ulcers and low for more complex wounds. This method must be used with care, and education on the subject is required.
MeSH term(s)	Humans ; Observer Variation ; Photography ; Pressure Ulcer/diagnosis ; Reproducibility of Results ; Surveys and Questionnaires
Language	Spanish
Publishing date	2019-06-14
Document type	Case Reports ; Journal Article
ISSN	2445-1479
ISSN (online)	2445-1479
DOI	10.1016/j.enfcli.2019.05.004
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Article ; Online: Interventions to reduce peripheral intravenous catheter failure: An international e-Delphi consensus on relevance and feasibility of implementation.

Blanco-Mavillard, Ian / Personat-Labrador, Celia / Castro-Sánchez, Enrique / Rodríguez-Calero, Miguel Ángel / Fernández-Fernández, Ismael / Carr, Peter J / Armenteros-Yeguas, Victoria / Parra-García, Gaizka / de Pedro-Gómez, Joan

Journal of infection and public health

2023 Volume 16, Issue 12, Page(s) 1994–2000

Abstract: Background: Around 1 billion peripheral intravenous catheters (PIVC) fail annually worldwide before prescribed intravenous therapy is completed, resulting in avoidable complications, dissatisfaction, and avoidable costs surging to ∼€4bn. We aimed to ... ...

Abstract	Background: Around 1 billion peripheral intravenous catheters (PIVC) fail annually worldwide before prescribed intravenous therapy is completed, resulting in avoidable complications, dissatisfaction, and avoidable costs surging to ∼€4bn. We aimed to provide an international consensus on relevance and feasibility of clinical practice guideline recommendations to reduce PIVC failure. Methods: e-Delphi study with three rounds through an online questionnaire from March-September 2020 recruiting a multispecialty panel formed by clinicians, managers, academic researchers, and experts in implementation from seven developed and three developing countries, reflecting on experience in PIVC care and implementation of evidence. Further, we included a panel of chronic patients with previous experience in the insert, maintenance, and management of PIVC and intravenous therapy from Ireland and Spain as public and patient involvement (PPI) panel. All experts and patients scored each item on a 4-point Likert scale to assess the relevance and feasibility. We considered consensus descriptor in which the median was 4 with less than or equal to 1,5 interquartile intervals. Findings: Over 90% participants (16 experts) completed the questionnaire on all rounds and 100% PPI (5 patients) completed round 1 due to high consensus they achieved. Our Delphi approach included 49 descriptors, which resulted in an agreed 30 across six domains emerged from the related to (i) general asepsis and cutaneous antisepsis (n = 4), (ii) catheter adequacy and insertion (n = 3), (iii) catheter and catheter site care (n = 6), (iv) catheter removal and replacement strategies (n = 4), (v) general principles for catheter management (n = 10), and (vi) organisational environment (n = 3). Conclusion: We provide an international consensus of relevant recommendations for PIVC, deemed feasible to implement in clinical settings. In addition, this methodological approach included substantial representation from clinical experts, academic experts, patient and public expertise, mitigating uncertainty during the implementation process with high-value recommendations to prevent PIVC failure based contextual and individual features, and economic resources worldwide.
MeSH term(s)	Humans ; Delphi Technique ; Feasibility Studies ; Consensus ; Surveys and Questionnaires ; Catheters
Language	English
Publishing date	2023-10-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2467587-8
ISSN	1876-035X ; 1876-0341
ISSN (online)	1876-035X
ISSN	1876-0341
DOI	10.1016/j.jiph.2023.10.004
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Article ; Online: Analysis of palliative care needs in hospitalized patients.

Julià-Móra, Joana Maria / Blanco-Mavillard, Ian / Prieto-Alomar, Araceli / Márquez-Villaverde, Enriqueta / Terrassa-Solé, Margalida / Leiva-Santos, Juan Pablo / Rodríguez-Calero, Miguel Ángel

Enfermeria clinica (English Edition)

2023 Volume 33, Issue 4, Page(s) 261–268

Abstract: Aim: To determine the prevalence of palliative care needs in patients in an acute care hospital and to analyze the profile of these patients.: Design: We conducted a prospective cross-sectional study in an acute care hospital, in April 2018. The ... ...

Abstract	Aim: To determine the prevalence of palliative care needs in patients in an acute care hospital and to analyze the profile of these patients. Design: We conducted a prospective cross-sectional study in an acute care hospital, in April 2018. The study population consisted of all patients over 18 years of age admitted to hospital wards and intensive care units. Variables were collected on a single day by six micro-teams using the NECPAL CCOMS-ICO© instrument. The descriptive analysis, on patient mortality and length of stay, was performed at a one-month follow-up. Results: We assessed 153 patients, of whom 65 (42.5%) were female, with a mean age of 68.17±17.03 years. A total of 45 patients (29.4%) were found to be SQ+, of which 42 were NECPAL+ (27.5%), with a mean age of 76.64±12.70 years. According to the disease indicators, 33.35% had cancer, 28.6% had heart disease, and 19% had COPD, resulting in a ratio of 1:3 between patients with cancer and non-cancer disease. Half of the inpatients in need of palliative care were in the Internal Medicine Unit. Conclusions: Almost 28% of patients were identified as NECPAL+, most of them not identified as under palliative care in clinical records. Greater awareness and knowledge from healthcare professionals would facilitate the early identification of these patients and avoid overlooking palliative care needs.
MeSH term(s)	Humans ; Female ; Adolescent ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Male ; Palliative Care ; Prospective Studies ; Cross-Sectional Studies ; Health Services Needs and Demand ; Risk Assessment/methods
Language	English
Publishing date	2023-07-05
Publishing country	Spain
Document type	Journal Article
ISSN	2445-1479
ISSN (online)	2445-1479
DOI	10.1016/j.enfcle.2023.06.001
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Article ; Online: What fuels suboptimal care of peripheral intravenous catheter-related infections in hospitals? A qualitative study of decision-making among Spanish nurses.

Blanco-Mavillard, Ian / Castro-Sánchez, Enrique / Parra-García, Gaizka / Rodríguez-Calero, Miguel Ángel / Bennasar-Veny, Miquel / Fernández-Fernández, Ismael / Lorente-Neches, Harri / de Pedro-Gómez, Joan

Antimicrobial resistance and infection control

2022 Volume 11, Issue 1, Page(s) 105

Abstract: Background: Peripheral intravenous catheters (PIVC) are commonly used in hospital worldwide. However, PIVC are not exempt from complications. Catheter-related bloodstream infections (CRBSI) increase morbidity and mortality rates, and costs for the ... ...

Abstract	Background: Peripheral intravenous catheters (PIVC) are commonly used in hospital worldwide. However, PIVC are not exempt from complications. Catheter-related bloodstream infections (CRBSI) increase morbidity and mortality rates, and costs for the healthcare organization. PIVC care is shaped by the complex mix of professional and organizational culture, such as knowledge gaps, low perception of impact of PIVCs on patient safety, or lack of hospital guidelines. Aim: To explore determinants of decision-making about the prevention of PIVC-BSI among nurses in Spanish hospitals. Methods: We conducted a descriptive qualitative study with semi-structured interviews in three public hospitals, the Balearic Islands Health Care Service in Spain. We considered hospital ward nurses working routinely with inpatients at any of the three hospitals for enrolment in the study. We approached relevant informants to identify suitable participants who recruited other participants through a 'snowball' technique. Fourteen inpatient nurses from the hospital took part in this study between September and November 2018. We employed several triangulation strategies to underpin the methodological rigour of our analysis and conducted the member checking, showing the information and codes applied in the recording of the interviews to identify the coherence and any discrepancies of the discourse by participants. We used the COREQ checklist for this study. Findings: We identified four major themes in the analysis related to determinants of care: The fog of decision-making in PIVC; The taskification of PIVC care; PIVC care is accepted to be suboptimal, yet irrelevant; and chasms between perceived determinants of poor PIVC care and its solutions. Conclusion: The clinical management of PIVCs appear ambiguous, unclear, and fragmented, with no clear professional responsibility and no nurse leadership, causing a gap in preventing infections. Furthermore, the perception of low risk on PIVC care impact can cause a relevant lack of adherence to the best evidence and patient safety. Implementing facilitation strategies could improve the fidelity of the best available evidence regarding PIVC care and raise awareness among nurses of impact that excellence of care.
MeSH term(s)	Catheter-Related Infections/etiology ; Catheter-Related Infections/prevention & control ; Catheterization, Peripheral/adverse effects ; Hospitals, Public ; Humans ; Patient Safety ; Spain
Language	English
Publishing date	2022-08-19
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2666706-X
ISSN	2047-2994 ; 2047-2994
ISSN (online)	2047-2994
ISSN	2047-2994
DOI	10.1186/s13756-022-01144-5
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Article: Impact of advanced practice nurses in hospital units on compliance with clinical practice guidelines: a quasi-experimental study.

Pol-Castañeda, Sandra / Rodriguez-Calero, Miguel Angel / Villafáfila-Gomila, Carlos Javier / Blanco-Mavillard, Ian / Zaforteza-Lallemand, Concepción / Ferrer-Cruz, Francisco / De Pedro-Gómez, Joan Ernest

BMC nursing

2022 Volume 21, Issue 1, Page(s) 331

Abstract: Background: Incorporating the best available evidence into clinical practice is a determining challenge for healthcare professionals and organisations. The role of advanced practice nurses is viewed as a facilitator to adapt guideline recommendations to ...

Abstract	Background: Incorporating the best available evidence into clinical practice is a determining challenge for healthcare professionals and organisations. The role of advanced practice nurses is viewed as a facilitator to adapt guideline recommendations to suit specific contexts and to overcome barriers to implementation. In this study, we evaluate the impact of advanced practice nurses on clinical indicators of hospitalised patients and on adherence to recommendations derived from two clinical practice guidelines (pressure ulcer prevention and treatment and vascular access device management). Methods: Quasi-experimental study in five intervention (IU) and five control (CU) hospital units at three hospitals in Spain (period 2018-19). Five advanced practice nurses were incorporated into IU, with the intention that would produce attitudinal changes and enhance the skills and knowledge of the nursing team regarding 18 clinical practice recommendations. In this study, 41 indicators were evaluated through direct observation of all patients admitted, at monthly intervals for 1 year. Outcomes were assessed by means of a descriptive, multi-line regression and association analysis. Results: The study population was composed of 3742 inpatients admitted for pressure ulcer assessment and 2631 fitted with vascular access devices. By the end of the study period, all variables had improved in the IU, where average compliance with recommendations was statistically significantly higher (pressure ulcer guidance 7.9 ± 1.9 vs 6.0 ± 1.7. OR 1.86, 95% CI 1.67-2.05; vascular access devices guidance 5.4 ± 1.4 vs 4.4 ± 1,6. OR 1.06, 95% CI 0.95-1.17). The prevalence of pressure lesions and catheter-related adverse events decreased statistically significantly in the IU compared to the CU. The prevalence of pressure ulcers decreases (5.7% in IU vs 8.7% in CU p < 0.005) as well as the prevalence of adverse events related to the catheter (14% In IU vs 21.6% in CU p < 0.005). The unnecessary catheters decressed in IU 10.9% VS CU 15.8% (p < 0.005). Conclusions: The incorporation of an advanced practice nurse statistically significantly improves clinical indicators related to the prevention and treatment of pressure ulcers and to the management of vascular access devices. Trial registration: ISRCTN18259923 retrospectively registered on 11/02/2022.
Language	English
Publishing date	2022-11-29
Publishing country	England
Document type	Journal Article
ZDB-ID	2091496-9
ISSN	1472-6955
ISSN	1472-6955
DOI	10.1186/s12912-022-01110-x
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Article ; Online: Care of peripheral intravenous catheters in three hospitals in Spain: Mapping clinical outcomes and implementation of clinical practice guidelines.

Blanco-Mavillard, Ian / Parra-García, Gaizka / Fernández-Fernández, Ismael / Rodríguez-Calero, Miguel Ángel / Personat-Labrador, Celia / Castro-Sánchez, Enrique

PloS one

2020 Volume 15, Issue 10, Page(s) e0240086

Abstract: Background: Peripheral intravenous catheters (PIVCs) are the most widely used invasive devices worldwide. Up to 42% of PIVCs are prematurely removed during intravenous therapy due to failure. To date, there have been few systematic attempts in European ... ...

Abstract	Background: Peripheral intravenous catheters (PIVCs) are the most widely used invasive devices worldwide. Up to 42% of PIVCs are prematurely removed during intravenous therapy due to failure. To date, there have been few systematic attempts in European hospitals to measure adherence to recommendations to mitigate PIVC failures. Aim: To analyse the clinical outcomes from clinical practice guideline recommendations for PIVC care on different hospital types and environments. Methods: We conducted an observational study in three hospitals in Spain from December 2017 to April 2018. The adherence to recommendations was monitored via visual inspection in situ evaluations of all PIVCs inserted in adults admitted. Context and clinical characteristics were collected by an evaluation tool, analysing data descriptively. Results: 646 PIVCs inserted in 624 patients were monitored, which only 52.7% knew about their PIVC. Regarding PIVC insertion, 3.4% (22/646) patients had at least 2 PIVCs simultaneously. The majority of PIVCs were 20G (319/646; 49.4%) and were secured with transparent polyurethane dressing (605/646; 93.7%). Most PIVCs (357/646; 55.3%) had a free insertion site during the visual inspection at first sight. We identified 342/646 (53%) transparent dressings in optimal conditions (clean, dry, and intact dressing). PIVC dressings in medical wards were much more likely to be in intact conditions than those in surgical wards (234/399, 58.7% vs. 108/247, 43.7%). We identified 55/646 (8.5%) PIVCs without infusion in the last 24 hours and 58/646 (9.0%) PIVCs without infusion for more than 24 hours. Regarding PIVC failure, 74 (11.5%) adverse events were identified, all of them reflecting clinical manifestation of phlebitis. Conclusions: Our findings indicate that the clinical outcome indicators from CPG for PIVC care were moderate, highlighting differences between hospital environments and types. Also, we observed that nearly 50% of patients did not know what a PIVC is.
MeSH term(s)	Adult ; Catheterization, Peripheral/adverse effects ; Catheterization, Peripheral/standards ; Female ; Guideline Adherence/statistics & numerical data ; Hospitals/statistics & numerical data ; Humans ; Male ; Middle Aged ; Nurses/statistics & numerical data ; Practice Guidelines as Topic ; Spain ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2020-10-02
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0240086
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Article ; Online: Detección de necesidad de atención paliativa en una unidad de hospitalización de agudos. Estudio piloto.

Rodríguez-Calero, Miguel Ángel / Julià-Mora, Joana María / Prieto-Alomar, Araceli

Enfermeria clinica

2016 Volume 26, Issue 4, Page(s) 238–242

Abstract: Objectives: Previous to wider prevalence studies, we designed the present pilot study to assess concordance and time invested in patient evaluations using a palliative care needs assessment tool. We also sought to estimate the prevalence of palliative ... ...

Title translation	Detection of palliative care needs in an acute care hospital unit. Pilot study.
Abstract	Objectives: Previous to wider prevalence studies, we designed the present pilot study to assess concordance and time invested in patient evaluations using a palliative care needs assessment tool. We also sought to estimate the prevalence of palliative care needs in an acute care hospital unit. Methods: A cross-sectional study was carried out, 4 researchers (2 doctors and 2 nurses) independently assessed all inpatients in an acute care hospital unit in Manacor Hospital, Mallorca (Spain), using the validated tool NECPAL CCOMS-ICO©, measuring time invested in every case. Another researcher revised clinical recordings to analise the sample profile. Results: Every researcher assessed 29 patients, 15 men and 14 women, mean age 74,03 ± 10.25 years. 4-observer concordance was moderate (Kappa 0,5043), tuning out to be higher between nurses. Mean time per patient evaluation was 1.9 to 7.72 minutes, depending on researcher. Prevalence of palliative care needs was 23,28%. Conclusions: Moderate concordance lean us towards multidisciplinary shared assessments as a method for future research. Avarage of time invested in evaluations was less than 8 minutes, no previous publications were identified regarding this variable. More than 20% of inpatients of the acute care unit were in need of palliative care.
Language	Spanish
Publishing date	2016-07
Publishing country	Spain
Document type	English Abstract ; Journal Article
ISSN	1579-2013
ISSN (online)	1579-2013
DOI	10.1016/j.enfcli.2015.11.004
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