Background: Trauma is the most common cause of death and disability in the paediatric population. There are a huge number of variables involved in the care they receive from health care professionals.Aim: The aim of this study was to review the available evidence of initial paediatric trauma care throughout the health care process with a view to create quality indicators (QIs).Study Design: A systematic review was performed from Cochrane Library, Medline, Scopus and SciELO between 2010 and 2020. Studies and guidelines that examined quality or suggested QI were included. Indicators were classified by health care setting, Donabedian's model, risk of bias and the quality of the publication with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) assessment.Results: The initial search included 686 articles, which were reduced to 22, with 15 primary and 7 secondary research articles. The snowball sampling technique was used to add a further seven guidelines and two articles. From these, 534 possible indicators were extracted, summarizing them into 39 and grouping the prehospital care indicators as structure (N = 5), process (N = 12) and outcome (N = 3) indicators and the hospital care indicators as structure (N = 4), process (N = 10) and outcome (N = 6) indicators. Most of the QIs have been extracted from US studies. They are multidisciplinary and in some cases are based on an adaptation of the QIs of adult trauma care.Conclusions: There was a clear gap and large variability between the indicators, as well as low‐quality evidence. Future studies will validate indicators using the Delphi method.Relevance to Clinical Practice: Design a QI framework that may be used by the health system throughout the process. Indicators framework will get nurses, to assess the quality of health care, detect deficient areas and implement improvement measures.

Aim: To analyse the general ability of second‐degree nursing students at the ‐REDACTED‐ to calculate, prepare, and administer paediatric medication.Design: A descriptive, analytical and cross‐sectional study was carried out through a gamified educational innovation project: “Medication Contest” following the STROBE statement.Methods: The study included all 224 students enrolled in the second year of nursing. The expert faculty created and validated an ad hoc questionnaire with 30 multiple‐choice questions. These responses were analysed to evaluate mathematical, conceptual, and concentration‐related competencies. Secondary variables were calculated, and correlations with the total score were examined. All variables were correlated with the final score, and their predictive capacities were analysed. To differentiate competencies, the 50 highest scores were compared to the rest of the participants.Results: Out of the 224 participants, 50 qualified for the second phase, with 37 achieving the best results. The median final score was 3/30 (IQR 6.3), differentiating 8.8 and 2.3 (p < 0.001) between those included and not in the top 50. Twenty‐three primary variables and all secondary variables significantly correlated with the total score. Mathematical competence was the main predictor variable of the final score (R² = 0.609). All secondary variables were discriminatory.Public Contribution: The general ability to calculate, prepare, and administer paediatric medication in the 2nd year nursing population is deficient. Mathematical competence is the predictor variable of the final score, identifying an area of intervention and the evaluation on which to intervene.Tweetable Gamification enhances medication calculation training for nursing students through competitive quizzes and simulations.

To evaluate the effectiveness of a structured handover tool implemented in paediatric inpatient care. Poor communication during clinical handovers can compromise patient safety. The Situation, Background, Assessment, Recommendation tool adapted for Paediatric Inpatient Care (SBAR-HP) was designed to standardise and improve this process by addressing common barriers such as omission of critical information and lack of structure. A pre-post quasi-experimental study was conducted at Vall d'Hebron Barcelona Hospital Campus using the Handoff CEX Scale to assess quality, adherence, and satisfaction before and after implementing the SBAR-HP. Descriptive analyses and the Wilcoxon test were used to evaluate pre-post changes, alongside a logistic regression model. A total of 110 nurses participated before the implementation and 81 afterwards. Of the total participants, 92.7 % were women, with a mean age of 31.1 years (SD = 9.1). Handover quality improved significantly following the introduction of SBAR-HP: the setting dimension rose from 3.8 to 5.3 (p < 0.00001), organisation from 5.9 to 6.7 (p = 0.00354), and overall quality from 51.5 to 69 (p < 0.00001). A total of 70.3 % rated their adherence as ≥7/9, and 71.6 % positively assessed its applicability. A positive correlation was observed between self-assessed performance and handover quality, supporting the tool's effectiveness in structuring the process. The SBAR-HP is an effective tool for structuring nursing handovers, fostering clear and safe communication in paediatric settings. Its adoption may enhance both patient safety and staff satisfaction. Implementing the SBAR-HP tool in paediatric settings may enhance handover quality, promote safer communication among nurses, and foster a culture of structured clinical exchange.

Introduction. The extreme fragility of neonatal skin, particularly in extremely preterm infants, underscores the need for effective preventive measures. This study aims to validate and design a decalogue for the prevention of dependency-related skin lesions (DRSL) in the neonatal population, based on existing consensus documents. Methods. The Delphi method was employed to validate the content of the decalogue through expert consultation across Spain. Key criteria—including relevance, clarity, ambiguity, simplicity, satisfaction, and applicability—were assessed using a 4-point Likert scale and a 10-point scale, with a 75% agreement threshold for validation. Descriptive statistics were used to analyze responses. Items not meeting the threshold were revised based on qualitative feedback and re-evaluated. The final list of interventions was established through consensus in the second round. Results. A total of 23 experts participated in the first round, and 20 in the second. Across both rounds, all items were validated with a high level of agreement. In the second round, all items exceeded 85% agreement for relevance, clarity, ambiguity, and simplicity. The average satisfaction (9.36–9.47) and applicability (9.09–9.42) revealed a high level of agreement concerning the clinical applicability of the Decalogue. The decalogue outlines essential measures for preventing DRSL in neonates, including risk assessment, postural changes, the use of specialized pressure-relieving surfaces, and monitoring of device-related pressure points. It also highlights the importance of tailored skin care based on neonatal maturity and the need for thorough documentation of preventive interventions. Discussion. Consensus achieved via the Delphi process substantiates the Decalogue’s capacity to effectively articulate key preventive strategies with clarity and brevity. Moreover, its implementation will foster evidence-based care practices, ultimately enhancing the quality of care in neonatal units. However, ongoing efforts are required to further improve DRSL prevention and continuously update strategies in light of emerging evidence.

This study aimed to obtain updated epidemiological indicators of dependence-related skin lesions (DRSLs) in neonatal units of Spanish hospitals and to analyze preventive interventions and risk factors associated with DRSL development. A multicentre, observational, cross-sectional prevalence study was conducted across three data collection phases in 12 Spanish hospitals with neonatal units, and included 398 hospitalised neonates. Data collection was based on direct observation, clinical record review, and caregiver interviews. The Neonatal Skin Risk Assessment Scale (e-NSRAS) was used to assess DRSL risk. Demographic variables, risk factors, and preventive measures were also analyzed. DRSL prevalence was 29.4 %. Moisture-related lesions (18.6 %) were the most common, especially in intermediate care, followed by pressure injuries (13.07 %), more prevalent in intensive care, and friction-related lesions (3.02 %). Non-invasive mechanical ventilation and urinary catheterisation were significantly associated with DRSL occurrence. Additionally, 34 % of neonates were classified as at risk of pressure injuries. A high DRSL prevalence was observed among hospitalised neonates, exceeding rates reported in other national and international studies. The e-NSRAS appears unsuitable for assessing all DRSL types. The use of multiple medical devices was associated with higher DRSL rates, and preventive measures were often applied late or inadequately. Study limitations include those typical of cross-sectional studies, such as representativeness, confounding factors, and sample size. DRSLs are a prevalent issue in Spanish neonatal units. The development and implementation of targeted preventive measures, along with the adaptation of assessment tools, are critical for enhancing the quality of neonatal care.

Background/Objectives: To identify existing evidence on strategies for standardising nursing handovers in paediatric hospital settings, given their impact on communication, safety, and quality of care. International bodies such as the WHO and The Joint Commission recommend standardisation as a key measure to reduce patient safety incidents. Methods: A scoping review was conducted in December 2022 using Medline, Cochrane Library, Scopus, and CINAHL databases. The search strategy included documents published between 2012 and 2022, in Spanish, English, Catalan, French, and/or Portuguese. We screened according to inclusion criteria (professional nurses and hospitalisation) and exclusion criteria (intensive care and medical professionals) and tabulated the results according to concurrent themes. The PRISMA-ScR guidelines were followed. Results: A total of 308 records were identified. After screening, 25 full-text articles were assessed for eligibility. Following quality appraisal, six were excluded for not meeting predefined criteria, resulting in 19 studies included in the final synthesis. The evidence mapped shows that most structured communication tools have been developed or validated in adult or medical contexts, with limited evaluation in paediatric nurse-to-nurse inpatient settings. Standardised structured communication tools used in hospital settings include SBAR, I-PASS, and Flex 11, while assessment instruments such as the Handoff CEX Scale and Handover Evaluation Scale have been applied to evaluate handover quality. Conclusions: Structured communication tools may contribute to improving information transfer and perceived quality of handover; however, paediatric nurse-specific evidence remains limited and frequently derives from non-nursing or adult contexts. Further adaptation and validation in paediatric inpatient nursing settings are required.