Objective To analyse the critical thinking skills of students enrolled in the four academic years of the nursing degree at a public university belonging to the European Higher Education Area. Design Cross-sectional, quantitative, descriptive study. Using the Critical Thinking Questionnaire to analyse the critical thinking skills in their substantive and dialogic dimension. Setting Faculty of Nursing, Valladolid Public University in Spain, belonging to the European Higher Education Area. Participants The sample consisted of 215 first-year, second-year, third-year and fourth-year undergraduate nursing students. Main outcomes The students of the four academic years were positively disposed towards critical thinking. The students of the final courses obtained higher average scores. Results The study sample was 215 students, 19.1% men/80.9% women. The average score in the substantive dimension (3.81±0.53 points) was higher than that in the dialogic dimension (3.48±0.51 points) (p<0.001). They had a greater ability in listening and speaking (3.77±0.61 points) with respect to writing (3.65±0.61 points) and reading (3.52±0.43 points) (p<0.001). There are significant differences in the critical thinking average scores across academic years. Conclusions Nursing students displayed a greater critical thinking ability in its substantive dimension compared with the dialogic one. This reflects a greater ability in actions related to provide reasons and evidence that support their point of view. Identifying critical thinking skills in nursing students will help establish specific teaching methodologies focused on improving these skills.

Barriers to implementing training strategies for the improvement of evidence-based practice competence of nurses in hospital practice environments still persist. The aim of the study was to evaluate the impact of a specific training within the framework of the Best Practice Spotlight Organization® programme, on nurses' evidence-based practice competence and the practice environment in two hospitals. This is a observational cross-sectional study assessing evidence-based practice competence and perceptions of Practice Environments. The study sample were 204 nurses working at medical and surgical inpatient units at two hospitals involved in the Best Practice Spotlight Organization® programme. The study was conducted from February 2020 to May 2020. Three questionnaires were used to collect data: a sociodemographic/occupational questionnaire, a questionnaire exploring evidence-based practice skills, and a questionnaire exploring nurses' perceptions of their hospital practice environments. A total of 204 nurses participated. They were classified into two groups: those who had received specific training within the framework of the programme, called trained-champions (n = 66), and those who had not yet received training, control group (n = 138). The trained-champions exhibited better evidence-based practice competence values than the control group in all dimensions (p < 0.001), with a higher difference in means in the "Utilisation" dimension (-0.80; CI:-0.99,-0.60) and the "Knowledge" dimension (-0.63; CI:-0.88,-0.38). Trained-champions also had a more positive perception of the practice environments than the controls in all dimensions (p ≤ 0.001). The largest differences in means were in the "Participation" dimension (-0.48; CI:-0.66,-0.31) and in the "Leadership" dimension (-0.41; CI:-0.59,-0.23). Specific EBP training within the framework of the Best Practice Spotlight Organization® programme has succeeded in nurses (trained-champions) obtaining better EBP competence than others without this training. This could have contributed to increase nurses' abilities to integrate evidence into decision making in their clinical practice, while positively influencing them to perceive their PEs more favorably.

The Virginia Henderson model, integrated in the computer application GACELA Care, helps to standardise the nursing assessment and establish precise and personalised nursing diagnoses. The aim was to determine the extent of completion of the initial patient assessment record after nurses following a training programme on nursing methodology. A quasi-experimental, retrospective, randomised, observational, single-group study was performed in two stages: pre-training and post-training. Voluntary training sessions were held for the nurses that work with GACELA Care. The completion of the initial patient assessment using the needs of Virginia Henderson and the Norton scale was evaluated before and after the training sessions. Completion of the needs of Virginia Henderson in the initial patient assessment increased from 94.2% to 100% (p = 0.014). Completion of “hygiene/skin” increased significantly from 83.3% to 95.8% (pre-training and post-training, respectively). The remaining needs did not show statistical significance. Recording of the Norton scale increased from 63.13% to 92.5% (p < 0.001). The training sessions on nursing methodology have improved the completion of records and inclusion of normal characteristics, defining characteristics and risk factors, and improving pressure ulcer risk assessment through the Norton scale.

Background/Objective: Ageing favours the onset of cardiovascular diseases, frailty, and risk of falls. In the hospital setting, 47.7% of patients may be frail, and the incidence of falls may be as high as five per thousand. This study seeks to determine the relationship between frailty, risk of falls, and length of hospital stays in hospitalised older adults with heart disease. Methods: An observational study was conducted of a cohort of patients aged ≥60 years admitted to a cardiology unit (2022–2024). Frailty was assessed using Fried’s phenotype, risk of falls using the J.H. Downton scale, and level of dependency using the Barthel index. Clinical variables, anthropometric measurements, and length of stay were analysed. Statistical analysis: quantitative variables were expressed as means and standard deviations, and categorical variables as frequencies. Associations were analysed using Student’s t-tests, chi-squared tests, and Kruskal–Wallis tests for comparisons of three or more groups. Relationships between frailty, risk of falls, and other variables were examined using univariate binary logistic regression, with a 95% confidence interval and statistical significance set at p < 0.05. Results: A total of 144 patients were recruited (mean age = 73.08 years [SD = 7.95]) (women = 33.30%). Frailty was associated with waist circumference in men (p = 0.01) and diastolic blood pressure in women (p = 0.05). Frailty was further linked to Downton scores (odds ratio [OR] = 1.565; 95% CI: 1.156–2.120; p = 0.004), age (OR = 1.114; 95% CI: 1.058–1.173; p = 0.000), Barthel index (OR = 0.902; 95% CI: 0.854–0.953; p = 0.000), and length of stay (OR = 1.101; 95% CI: 1.021–1.186; p = 0.012). Conclusions: Frailty appears to be related to Downton scores and impacts the length of hospital stays in older adults hospitalised with cardiac conditions.

The implementation and sustainability of evidence-based practice (EBP) is a complex process. Best practice guidelines (BPGs) can facilitate the translation of knowledge from theory into practice, but they require working groups to adapt recommendations and encourage adherence to them. The aim of this study was to identify facilitators and barriers of BPGs in the Registered Nurses’ Association of Ontario^®, within the framework of Best Practice Spotlight Organisations^® (BPSOs^®), in a hospital setting. Methods: This study was conducted using the modified Delphi method (two rounds) with a cohort of BPSO^® Best Practice Champions. The facilitators and barriers included in the first round were identified through a bibliographic search. The degree of concordance was determined in the second round using the highest mean resulting values. Results: A total of 44 nurses responded, with a mean age of 42.57 ± 8.563. The facilitators included the following: work environment; working in a hospital that encourages research; and dedicating time to EBP (p < 0.001). The barriers included the following: excessive workload; professional mobility (p < 0.001); and lack of time (p = 0.002). Implications for practice: As such, it is necessary to approach human resource management by implementing new policies that guarantee systemic sustainability. The BPSO^® programme is an excellent framework for promoting the translation of theoretical knowledge into practice and effecting institutional change.