Objective: This study evaluated the competency of nursing leaders and managers in Spain regarding evidence‐based practice (EBP) and identified factors that affect its implementation in clinical environments. Background: EBP is essential for enhancing healthcare quality; however, there are still gaps between theoretical knowledge and its practical application. Nursing leaders are crucial in promoting EBP, yet their competence levels and obstacles have not been thoroughly examined in Spain. Material and methods: A cross‐sectional study surveyed 159 nurse managers across 16 autonomous communities in Spain, utilizing the validated EBP‐COQ Prof tool. The questionnaire assessed four competency domains—attitude, knowledge, skills, and utilization—using a 1 to 5 Likert scale. Predictors of EBP competency, including training, mentorship, and organizational affiliation, were analyzed using multivariate linear regression. Results: Participants demonstrated a strong overall EBP competence, with an average total score of 143.77 out of 175. The highest scores were in the attitude domain (36.26/40) and knowledge (43.09/55), whereas utilization scores were relatively lower (37.57/50). This indicates that applying EBP in practice still lags behind positive attitudes and knowledge. Key factors predicting higher EBP competence included EBP training, consistent reading of scientific literature, mentoring nursing students, and working in a BPSO center. These results also imply that organizational constraints may continue to impede the integration of EBP competence into routine managerial practice. Conclusions: Spanish nurse managers possess strong EBP knowledge but continue to encounter difficulties in applying it clinically. The study highlights four adjustable factors of EBP competency that could guide focused interventions. Implications for Nursing Management: Healthcare institutions should implement (1) training programs for addressing knowledge‐to‐practice gaps, especially for nonspecialist managers; (2) mentorship systems pairing EBP‐competent leaders with novices; (3) protected time for EBP activities; and (4) expanded BPSO accreditation to institutionalize evidence‐based care. Future initiatives should include EBP metrics in performance evaluations, and research should explore factors such as leadership styles and the impact of resource allocation on patient outcomes through longitudinal designs.

Introduction: Interprofessional simulation enhances both technical and nontechnical skills among healthcare professionals, improving their clinical practice. Co‐debriefing, where two facilitators lead debriefing sessions, is a common approach in these trainings. This study aims to assess educational aspects of interprofessional simulation and co‐debriefing in postgraduate medical and emergency nursing students. Methods: A descriptive cross‐sectional study with a mixed‐methods approach was conducted among postgraduate students ( n = 46). A mixed‐methods design was used, combining quantitative questionnaire data with qualitative content analysis of open‐ended responses, allowing integration of numerical trends with in‐depth learner perspectives. A valid and reliable ad hoc questionnaire was designed, and qualitative content analysis was used to examine participants’ free‐text responses. Results: Students’ perceptions were evaluated across six dimensions: applicability, satisfaction, motivation, safe environment, organization, and co‐debriefing. Significant differences were found between medical and nursing students in all dimensions except applicability and organization. Overall, students rated interdisciplinary sessions and co‐debriefing positively, though nurses highlighted areas for improvement, such as icebreaker activities, more dynamic simulations, and equal representation of both professions. Conclusions: While interprofessional simulation and co‐debriefing were well received, participants—especially nurses—identified areas for enhancement to ensure a more balanced and engaging learning experience. By integrating quantitative outcomes with qualitative insights, the study highlights when co‐debriefing adds value in interprofessional simulation and when single‐facilitator approaches may be sufficient.

Background/objectives: The most common foetal malposition is the occipital posterior (OP) position, which accounts for 33.3% of malpositions occurring during labour, and the rate of dystocia reaches 95%. The aim of this study was to describe observed outcomes of a mobilisation protocol in correcting posterior foetal head positions during labour. Methods: A pilot study was conducted using a cross-sectional, multicentre methodology involving 25 pregnant women with a posterior foetal position who were asked to follow a mobilisation protocol. The women’s level of satisfaction was measured using the validated questionnaire, the Childbirth Experience Questionnaire—CEQ (Spanish version). Results: Anterior rotation was observed in 68% of cases, but in the absence of a control group, these findings cannot be distinguished from spontaneous physiological rotation, and 88% of these achieved vaginal delivery with a 95% confidence interval (76–100%). Apgar scores of ≥9 at 5 min were recorded in 100% of newborns, with an average of 9.96 with a 95% confidence interval (9.88–10.04). Women’s level of satisfaction was moderate to high, with the ‘Professional support’ and ‘Participation’ subscales standing out in particular; 100% of women noted the support they received from the midwife, and 95.24% stated that they had been involved in decision-making. Regarding perineal outcomes, no third-degree tears were recorded among women who received the protocol, and 44% of participants maintained an intact perineum. Conclusions: The protocol was feasible to implement, and anterior rotation, vaginal deliveries, favourable neonatal outcomes, and moderate-to-high maternal satisfaction were observed in this small cohort. However, future research will need to demonstrate the protocol’s efficacy through randomised controlled trials comparing the protocol with standard care.

UNSTRUCTURED Evidence-based Practice (EBP) is essential for ensuring optimal healthcare and improving patient outcomes. Despite its importance, nurses' competence in EBP remains limited globally. While self-directed digital education has emerged as a flexible alternative for professional development, there is a lack of qualitative research exploring how clinical nurses experience and perceive this specific learning modality within the EBP framework. To explore the learning expectations and experiences of clinical nurses who participated in the #Evidencer Project, a self-directed online training program focused on EBP. A qualitative study using inductive thematic analysis was conducted, following the COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines. Fifteen clinical nurses from primary and hospital care settings in Spain participated. They completed an 80-hour, 12-week self-directed online course structured around the seven steps of EBP. Data were collected through virtual semi-structured interviews, which were audio-recorded and transcribed verbatim. Analysis was performed using Braun and Clarke’s six-phase approach with MAXQDA 24 software until thematic saturation was achieved. Three main categories emerged: 1)Motivation and expectations: Nurses were primarily driven by intrinsic motivation, a desire for professional updating, and their responsibility as tutors for undergraduate and graduate students; 2) Experience with the training: Participants valued the nursing-specific design, clarity, and flexibility of the online platform. However, they identified the need for synchronous tutoring to resolve complex doubts and requested downloadable materials for future consultation; and 3) EBP worldview: Findings revealed a partial understanding of the EBP process, persistent confusion between research and EBP, and a perception that clinical implementation is complex and "distant" without institutional support. Self-directed online training is a well-received and effective tool for acquiring theoretical EBP knowledge. However, it is insufficient as a standalone intervention for clinical implementation. Healthcare institutions must provide structural support and integrated strategies within the clinical context to complement educational efforts and facilitate the application of evidence in daily practice.

Background/Objectives: This study examined the association between participation in a community-based multicomponent physical and recreational programme (ELDERPLAY) and changes in physical performance and frailty-related outcomes in adults aged 65 years and older, and estimated programme delivery costs. The study was designed as a quasi-experimental, non-randomized controlled evaluation conducted in a community setting. Methods: Community-dwelling older adults (n = 184) were allocated to an intervention group (n = 103) or a control group (n = 81) through voluntary enrolment and geographic matching. Participant enrolment and data collection were carried out between July 2022 and December 2023, after ethics approval had been obtained. The intervention consisted of 20 supervised sessions (two per week) combining Vivifrail-based multicomponent exercises with simple recreational activities. Primary outcomes were physical performance and frailty-related function, assessed using the Short Physical Performance Battery and the Timed Up and Go test. Secondary exploratory outcomes included actigraphy-derived daily step count, heart rate, and sleep parameters, recorded over seven consecutive days at a single intermediate assessment point. Analyses were conducted using analysis of covariance and generalized estimating equations adjusted for cholesterol, COVID-19 vaccination and Barthel Index score. Programme costs were estimated using an activity-based costing approach. Results: Compared with the control group, participants in the intervention group showed greater improvement over time in balance, gait performance, chair-stand performance and overall physical performance (time × group interaction: gait performance p < 0.001, partial eta squared 0.450; chair-stand performance p < 0.001, 0.306; SPPB total score p < 0.001, 0.361; Timed Up and Go p < 0.001, 0.224). At 10 weeks, the adjusted mean SPPB total score was 9.62 (95% CI 9.25–10.00) in the intervention group and 7.80 (95% CI 7.37–8.23) in the control group, and the adjusted mean Timed Up and Go was 8.85 s (95% CI 8.08–9.62) versus 12.04 s (95% CI 11.15–12.92). Higher daily step counts were also observed in the intervention group; heart rate and sleep parameters were recorded cross-sectionally at a single intermediate assessment point that coincided with the delivery of the programme and are reported only as descriptive values. The programme was delivered at a mean cost of €92.3 per participant, or €62.3 per participant when the research monitoring devices are excluded. Conclusions: Participation in a community-based multicomponent exercise programme incorporating recreational activities was associated with improvements in clinically relevant physical performance outcomes in community-dwelling older adults. The programme was delivered in full at a mean delivery cost of €92.3 per participant in a real-world community setting. Because allocation was not randomized, the groups differed at baseline, and outcome assessment was carried out by a single unblinded assessor who designed and coordinated the programme but did not deliver the sessions, these findings are associative and require confirmation in a randomized trial. Trial registration: ClinicalTrials.gov NCT07864831 (retrospectively registered).

El manual «Habilidades directivas y gestión de la calidad en Enfermería. Claves para la gestión eficiente y el liderazgo en los equipos de Enfermería» presenta una exposición ordenada del papel que la enfermera gestora desempeña en los servicios sanitarios contemporáneos. Parte de la premisa de que la complejidad creciente del sistema obliga a ampliar el tradicional enfoque asistencial hacia funciones de planificación, organización, dirección y control, siempre enmarcadas en la garantía de calidad y seguridad del paciente. El texto se dirige principalmente a estudiantes y profesionales de la Enfermería que deseen adquirir competencias avanzadas para optimizar procesos, coordinar equipos multidisciplinares e implantar estándares de seguridad y mejora continua en entornos clínicos. La obra se estructura en nueve capítulos que recorren, de forma progresiva, los fundamentos de la administración, la configuración de la empresa sanitaria, la evolución del pensamiento organizativo y el modelo de sistema de salud español. Sobre esta base describe con detalle las fases del proceso administrativo aplicadas a la enfermería—planificación estratégica, diseño organizativo, liderazgo de equipos y evaluación de resultados—y dedica el último tramo a los programas de calidad, la gestión del riesgo clínico y la salud laboral. En conjunto, el manual sintetiza los elementos clave de la gestión enfermera en España: define el marco administrativo, enumera los requisitos jurídicos y bioéticos, perfila las habilidades directivas necesarias e identifica los procesos de calidad y seguridad que afectan a la práctica diaria.