The objective of the present study was to determine the subjective impact of the pandemic due to COVID-19 on communication, as perceived by nurses working at emergency services and Intensive Care Units at various hospitals in the Region of Murcia (Spain). A qualitative study was conducted based on the content analysis of 12 semi-structured individual interviews. The participant recruitment process was performed through a snowball sampling technique. Four main dimensions, eleven categories, and two sub-categories were obtained: (1) communication (communicative expressions, both verbal and non-verbal-, and limitations); (2) emotional aspects (positive, negative); (3) overload (first wave, second wave, and third wave); and (4) relationships (health professionals–patients, healthcare professionals, patients–family, and family–health professionals). The main findings of the study show that communication was slightly affected during the pandemic, especially the non-verbal kind, with verbal communication maintained and, in some occasions, strengthened. The lack of training in communication skills and its influence on the management of difficult periods was another important finding. Communication in general deteriorated during the pandemic, especially during the initial waves. Non-verbal communication was more affected due to the use of Personal Protective Equipment and the initial fear of infection, with this finding strongly observed in departments such as emergencies or critical care. The nurses who were interviewed underlined negative emotional aspects associated with a deficit in communication. The positive aspects described were associated with the creation of mutual support spaces and the group cohesion of the work teams during the pandemic. As an implication for current and future clinical practice, we recommend a coordinated institutional response to mitigate the potential emotional effects on workers by designing appropriate communication and emotional expression protocols.

Background: This study aims to explore the feelings and experiences of nursing staff when faced with the death of a pediatric patient in the ICU. Methodology: A qualitative study based on hermeneutic phenomenology was conducted through semi-structured interviews. Ten nurses (30% of staff) from the Pediatric Intensive Care Unit of a referral hospital were interviewed in April 2022. Text transcripts were analysed using latent content analysis. Results: Content analysis indicated that the interviewees had feelings of sadness and grief; they had a misconception of empathy. They had no structured coping strategies, and those they practiced were learned through personal experience, not by specific training; they reported coping strategies such as peer support, physical exercise, or strengthening ties with close family members, especially their children. The lack of skills to cope with the death and the absence of support from personnel management departments were acknowledged. This can lead to the presence of compassion fatigue. Conclusions: The feelings that PICU nurses have when a child they care for die are negative feelings and sadness, and they possess coping strategies focused on emotions learned from their own experience and without institutional training support. This situation should not be underestimated as they are a source of compassion fatigue and burnout.

Objective: To design, develop and validate a new tool, called NEUMOBACT, to evaluate critical care nurses' knowledge and skills in ventilator‐associated pneumonia (VAP) and catheter‐related bacteraemia (CRB) prevention through simulation scenarios involving central venous catheter (CVC), endotracheal suctioning (ETS) and mechanically ventilated patient care (PC) stations. Background: Simulation‐based training is an excellent way for nurses to learn prevention measures in VAP and CRB. Design: Descriptive metric study to develop NEUMOBACT and analyse its content and face validity that followed the COSMIN Study Design checklist for patient‐reported outcome measurement instruments. Methods: The first version was developed with the content of training modules in use at the time (NEUMOBACT‐1). Delphi rounds were used to assess item relevance with experts in VAP and CRB prevention measures, resulting in NEUMOBACT‐2. Experts in simulation methods then assessed feasibility, resulting in NEUMOBACT‐3. Finally, a pilot test was conducted among 30 intensive care unit (ICU) nurses to assess the applicability of the evaluation tool in clinical practice. Results: Seven national experts in VAP and CRB prevention and seven national simulation experts participated in the analysis to assess the relevance and feasibility of each item, respectively. After two Delphi rounds with infection experts, four Delphi rounds with simulation experts, and pilot testing with 30 ICU nurses, the NEUMOBACT‐FINAL tool consisted of 17, 26 and 21 items, respectively, for CVC, ETS and PC. Conclusion: NEUMOBACT‐FINAL is useful and valid for assessing ICU nurses' knowledge and skills in VAP and CRB prevention, acquired through simulation. Relevance for Clinical Practice: Our validated and clinically tested tool could facilitate the transfer of ICU nurses' knowledge and skills learning in VAP and CRB prevention to critically ill patients, decreasing infection rates and, therefore, improving patient safety. Patient or Public Contribution: Experts participated in the Delphi rounds and nurses in the pilot test.

Se ha implantado la simulación clínica avanzada en la Facultad de Enfermería de la UCAM como método complementario de aprendizaje y evaluación, dentro de los diferentes Practicum Clínicos. Utilizar la simulación como método de aprendizaje y evaluación por competencias en enfermería así como integrar la metodología científica que ofrece el proceso de enfermería con la práctica asistencial simulada han sido los principales objetivos para llevar a cabo esta experiencia. Se utilizan simuladores a escala real (SER) que reproducen de manera realista un paciente con diversos problemas de salud. La metodología de aprendizaje/evaluación se basa en la reproducción de casos clínicos basados en la práctica asistencial en entornos clínicos simulados y controlados. Mediante diferentes sesiones los alumnos escenifican los procedimientos y cuidados en la sala de simulación. Estas sesiones son grabadas en un sistema de vídeo y visionadas en tiempo real por otro grupo de alumnos. Posteriormente se analiza la situación de manera reflexiva por el grupo y el instructor (Debriefing). En las sesiones de evaluación se evalúan, por parte del instructor y del resto de alumnos, las competencias asociadas al Practicum Clínico correspondiente mediante simulación. La simulación clínica es una metodología complementaria útil, tanto para el aprendizaje como para la evaluación por competencias en los diferentes Practicum Clínicos replicando escenarios reales en entornos simulados con alumnos de Grado de Enfermería.

Introduction: Delirium in the pediatric population admitted to intensive care is a worrying reality due to its potential complications and the increase in associated costs. This study aims to explore the experiences of nursing staff of a Pediatric Intensive Care Unit after 15 months of starting a program to fight against childhood delirium in their unit. Methodology: A qualitative study was conducted through semi-structured interviews with Pediatric Intensive Care Unit (PICU) Key Informants. The Standards for Reporting Qualitative Research (SRQR) and the consolidated criteria for Reporting Qualitative Research (COREQ) were followed as quality measures for the study. Seven nurses (33% of the eligible population) from the PICU of a referral hospital were interviewed. Text transcripts were analyzed using the Interpretative Description and Qualitative Content Analysis method. Results: The interviewees indicated not identifying delirium as an important reality; with great deficiencies observed in what is related to the identification of delirium; identifying CAPD as an unreliable tool in their unit; and not sharing therapeutic objectives in this respect with the medical staff. Conclusions: The nursing staff presented a series of negative attitudes towards the phenomena of delirium in their unit, with gaps in training and in clinical management, and the diagnostic tool used, and did not see it as a priority objective of the unit, partly due to a resistance to change and a latent interprofessional communication conflict. A change at the formative, attitudinal, and relational levels is urgently needed for the success of the program and the well-being of the children in the unit.