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BACKGROUND: The evolving healthcare landscape necessitates highly qualified nurses equipped with a myriad of soft skills, including decision-making. Traditional teaching models have led to innovative, active methods that prioritise student participation and enhance crucial soft skill development, such as decision- making. Considering the recognised importance of improving clinical decision-making skills and the need for innovative training, a literature gap is present in assessing the effect of real world and game-based learning on decision-making abilities. OBJECTIVES: This study aimed to investigate the effect of real-world and game-based learning, specifically using case-based learning and escape room, on decision-making competence in postgraduate nursing students in academic and clinical settings. DESIGN: A descriptive, cross-sectional, quantitative intervention study was conducted, combining case-based learning and escape room methods sequentially. SETTINGS: The study was conducted among postgraduate nursing students at the University of Navarra in Spain. PARTICIPANTS: Sixty-six postgraduate nursing students, mostly women, participated in the study. METHODS: The study integrated case-based learning and escape room sequentially. Data were collected through an ad hoc online questionnaire, recorded escape times from the escape room, and academic scores. RESULTS: The study enrolled 66 participants with an average professional experience of 4.2 years. Academic results showed high scores in case resolution (average: 8.34) and knowledge tests (average: 9.21). Out of 11 groups, 81.8 % successfully escaped the escape room within 30 min, with positive questionnaire responses indicating enthusiasm, enjoyment and perceived effectiveness of the activities. CONCLUSIONS: Real-world and game-based learning significantly enhanced decision-making competence in postgraduate nursing students across academic and clinical settings, demonstrating the importance of diverse teaching methods. Further research, including comparative studies and longitudinal analyses, is needed to evaluate the educational benefits of integrating case-based learning and escape room methods in nurse education and to refine assessment tools while monitoring long-term student progress.

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AIM: To explore experiences of frontline nurse managers during COVID-19. BACKGROUND: The COVID-19 pandemic has complicated care provision and healthcare management around the world. Nurse managers have had to face the challenge of managing a crisis with precarious resources. Little research has been published about the experiences of nurse managers during the COVID-19 pandemic. METHODS: A qualitative descriptive study of 10 frontline nurse managers at a highly specialized university hospital in Spain was carried out. Semi-structured interviews were conducted between June and September 2020. The Consolidated Criteria for Reporting Qualitative Research checklist was used for reporting. RESULTS: Six themes emerged: constant adaptation to change, participation in decision-making, management of uncertainty, prioritization of the biopsychosocial well-being of the staff, preservation of humanized care and 'one for all'. CONCLUSIONS: This study provides evidence for the experiences of nurse managers during the COVID-19 pandemic. In addition, analysing these experiences has helped identify some of the key competencies that these nurses must have to respond to a crisis and in their dual role as patient and nurse mediators. IMPLICATIONS FOR NURSING MANAGEMENT: Knowing about the experiences of frontline nurse managers during the pandemic can facilitate planning and preparing nurse managers for future health disasters, including subsequent waves of COVID-19.

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Understanding the unique experience of nursing students providing frontline support in COVID-19 hospital wards is crucial for the design of strategies to improve crisis management and mitigate future pandemic outbreaks. Limited research concerning this phenomenon has been published. This qualitative study aimed to understand the experience of providing support from COVID-19 frontline nursing students' perspective. Online interviews were conducted with nine nursing students from April to May 2020; interview data were analyzed by content analysis using Burnard's method. Six main categories emerged from the data analysis: "experiencing a rapid transition from student to professional," "fear and uncertainty of the unknown," "resilience throughout the crisis," "sense of belonging to a team," "shared responsibility," and "importance of the profession." Based on these findings, multicomponent strategies that function in parallel with practical contexts should be developed to enable students to diligently adapt their abilities to their new role and cope with health crises.

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Objetivo principal: Evaluar el nivel de satisfacción de las enfermeras nóveles con la simulación clínica de alta fidelidad en la formación de RCP, durante la Covid-19. Metodología: Estudio observacional descriptivo transversal. Se utilizó la Escala de Satisfacción en Simulación Clínica de Alta Fidelidad, cuestionario validado de 33 ítems con respuesta tipo Likert. Se utilizó estadística descriptiva, e inferencial no paramétrica (correlación de Spearman) para analizar la correlación entre las variables. Resultados principales: N=35 (100%). La satisfacción global media fue de 4,97±0,17. Los ítems relativos a la adecuación de los casos a los conocimientos de los participantes, la capacidad para proporcionar cuidados a los pacientes, el beneficio de la simulación e impacto en la mejora de sus habilidades técnicas fueron los mejores puntuados (media de 4,97). Se encontró una relación positiva y fuerte entre los ítems: 4-9, y 27-9 (rho= 0,804; p=0,000). Conclusión principal: El nivel de satisfacción de las enfermeras de nueva incorporación con la simulación clínica de alta fidelidad fue elevado, lo que confirma su utilidad en el proceso de aprendizaje en RCP durante la Covid-19 o brotes pandémicos de la misma naturaleza.(AU)

Objective: To assess the satisfaction of novel nurses with high-fidelity clinical simulation in CPR training, during Covid-19. Methods: Cross-sectional descriptive observational study. Satisfaction Scale in High Fidelity Clinical Simulation was used, a validated 33-item questionnaire with a Likert-type response. Descriptive statistics and non-parametric inferential statistics (Spearman's correlation) were used to analyze the correlation between the variables. Results: N = 35 (100%). The mean overal satisfaction was 4.97 ± 0.17. The items related to the adequacy of the cases to the knowledge of the participants, the ability to provide care to patients, the benefit of simulation and the impact on improving their technical skills were the best scored (mean of 4.97). A positive and strong relationship was found between items: 4-9, and 27-9 (rho = 0.804; p = 0.000). Conclusions: Satisfaction level of novel nurses with the high-fidelity clinical simulation was high, confirming its usefulness in the CPR learning process during Covid-19 or pandemic outbreaks of the same nature.(AU)

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UNLABELLED: Patients admitted to the ICU are at risk of immobility and an early and important physical deconditioning. OBJECTIVE: To develop and to implement an early and safe protocol for ICU patients' mobilization. METHODOLOGY: The Evidence Based Practice Model for Staff Nurses was used. It encompasses Assessment, Problem Identification, Planning, Implementation and Evaluation, Integration and Maintenance in Practice. RESULTS: The research team (Advanced Practice Nurse and expert clinical nurses), along with the medical team and rehabilitation service, identified the need to develop the protocol. For its elaboration, a literature search on the data bases PubMed, CINA-HL and Cochrane Library was performed; a questionnaire was administered and structured observations were conducted. For the implementation training sessions were offered to nurses, posters were placed in the unit and protocol was included in the computer program. Finally, an assessment of the knowledge, perceptions and practices of nurses in the unit and a recording of adverse events related to the mobilization will take place. CONCLUSIONS: The development and implementation of a protocol for early mobilization of ICU patients has facilitated the integration of this care in daily practice. This model of evidence-based practice allows nurses an active part in changing the culture in terms of the integration of research into practice.

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El paciente ingresado en la UCI tiene riesgo de inmovilidad y de un deterioro temprano e importante de su función física. Objetivo. Desarrollar e implementar un protocolo para la movilización temprana y segura del paciente en UCI. Metodología. Se utilizó el Evidence Based Practice Model for Staff Nurses que engloba: Valoración, Identificación del problema, Planificación, Implementación y evaluación e Integración y mantenimiento en la práctica. Resultados. El equipo investigador (la enfermera de práctica avanzada y enfermeras asistenciales expertas), junto con el equipo médico y el servicio de rehabilitación, detectó la necesidad de elaborar este protocolo. Para ello, se realizó una búsqueda bibliográfica en las bases de datos PubMed, CINAHL y Cochrane Library, se administró un cuestionario y se llevaron a cabo observaciones estructuradas. Para la implementación se impartieron sesiones de formación al personal de enfermería, se colocaron pósteres en la unidad y se incluyó el protocolo en el programa informático. Por último, se realizará una evaluación de los conocimientos, percepciones y prácticas de las enfermeras de la unidad y un registro de los eventos adversos relacionados con la movilización. Conclusiones. El desarrollo e implementación de un protocolo para la movilización temprana del paciente en UCI ha facilitado la integración de este cuidado en la práctica diaria. Este modelo de práctica basada en la evidencia permite que el personal de enfermería forme parte activa en el cambio de cultura en cuanto a la integración de la investigación en la práctica (AU)

Patients admitted to the ICU are at risk of immobility and an early and important physical deconditioning. Objective. To develop and to implement an early and safe protocol for ICU patients’ mobilization. Methodology. The Evidence Based Practice Model for Staff Nurses was used. It encompasses Assessment, Problem Identification, Planning, Implementation and Evaluation, Integration and Maintenance in Practice. Results. The research team (Advanced Practice Nurse and expert clinical nurses), along with the medical team and rehabilitation service, identified the need to develop the protocol. For its elaboration, a literature search on the data bases PubMed, CINAHL and Cochrane Library was performed; a questionnaire was administered and structured observations were conducted. For the implementation training sessions were offered to nurses, posters were placed in the unit and protocol was included in the computer program. Finally, an assessment of the knowledge, perceptions and practices of nurses in the unit and a recording of adverse events related to the mobilization will take place. Conclusions. The development and implementation of a protocol for early mobilization of ICU patients has facilitated the integration of this care in daily practice. This model of evidence-based practice allows nurses an active part in changing the culture in terms of the integration of research into practice (AU)

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UNLABELLED: The need for information to the families of critically ill patients is still not covered by the professionals involved. OBJECTIVE: Develop and implement a new process of informing relatives of critically ill patients. DESIGN: Participatory Action Research guided by the PEPPA Model (A Participatory, Evidence-Based, Patient-Focused Process for Advanced Practice Nursing Role Development, Implementation, and Evaluation). Field of study: general ICU of a tertiary university hospital (December 2011-May 2012). SAMPLING: convenience. SAMPLE: 11 relatives, 10 nurses and 8 doctors with more than one year of experience in ICU. DATA COLLECTION: semi-structured interviews and 10 participant observations. DATA ANALYSIS: content analysis of the interviews, observations and field notes. RESULTS: The EPA identified the need to systematize and structure the information process to families. Having received approval and commitment from the major stakeholders (doctors and nurses), we designed an algorithm and protocol performance, based on the results and on the best available evidence, to improve the process information to families of critically ill patients. To do this, EPA developed the following skills: direct clinical practice, coaching and guidance, consultation, collaboration, leadership, research and ethical decision making. CONCLUSIONS: A plan to improve the relatives of critically ill patients'process of information has been developed and implemented by the EPA. By the evaluation, it will be able to see the benefits of incorporating the advanced role and encourage its implementation in Spain.

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La necesidad de información a los familiares de los pacientes críticos continúa sin cubrirse por parte de los profesionales. Objetivo. Desarrollar e implementar un nuevo proceso de información a los familiares del paciente crítico. Metodología. Diseño: Investigación-Acción Participativa (IAP) guiada por el modelo PEPPA (Proceso Participativo para la Enfermería de Práctica Avanzada -EPA-, centrado en el Paciente y basado en la Evidencia). Ámbito de estudio: UCI polivalente de un hospital universitario terciario. Muestreo: conveniencia. Muestra: 11 familiares, 10 enfermeras y 8 médicos de más de un año de experiencia en UCI. Recogida de datos: 10 observaciones participantes y 29 entrevistas semiestructuradas. Análisis de datos: análisis de contenido de entrevistas, observaciones y notas de campo. Resultados. La EPA detectó la necesidad de sistematizar y estructurar el proceso de información a las familias. Una vez recibida la aprobación y el compromiso por parte de los principales stakeholders (médicos y enfermeras), se diseñó un algoritmo de actuación y un protocolo, basado en los resultados y en la evidencia disponible, para mejorar el proceso de información a las familias de los pacientes críticos. Para ello, la EPA desarrolló las siguientes competencias: práctica clínica directa, coaching, consulta, colaboración, liderazgo, investigación y toma de decisiones éticas. Conclusiones. A través de este estudio, la EPA ha desarrollado e implementado un plan de mejora del proceso de información de los familiares del paciente crítico que se prevé evaluar próximamente. De este modo, se podrán percibir los beneficios de la incorporación de la práctica avanzada y favorecer su implantación en España (AU)

The need for information to the families of critically ill patients is still not covered by the professionals involved. Objective. Develop and implement a new process of informing relatives of critically ill patients. Methodology. Design: Participatory Action Research guided by the PEPPA Model (A Participatory, Evidence-Based, Patient-Focused Process for Advanced Practice Nursing Role Development, Implementation, and Evaluation). Field of study: general ICU of a tertiary university hospital (December 2011-May 2012). Sampling: convenience. Sample: 11 relatives, 10 nurses and 8 doctors with more than one year of experience in ICU. Data collection: semi-structured interviews and 10 participant observations. Data analysis: content analysis of the interviews, observations and field notes. Results. The EPA identified the need to systematize and structure the information process to families. Having received approval and commitment from the major stakeholders (doctors and nurses), we designed an algorithm and protocol performance, based on the results and on the best available evidence, to improve the process information to families of critically ill patients. To do this, EPA developed the following skills: direct clinical practice, coaching and guidance, consultation, collaboration, leadership, research and ethical decision making. Conclusions. A plan to improve the relatives of critically ill patients’ process of information has been developed and implemented by the EPA. By the evaluation, it will be able to see the benefits of incorporating the advanced role and encourage its implementation in Spain (AU)

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