Two researches of the multidisciplinary nursing research group of the Vall d'Hebron Research Institute (VHIR) have been selected for the 2023 Call for Nursing Research Grants awarded by the Official College of Nurses of Barcelona (COIB). The first, led by nurse Creu Regné, will provide a new tool to assess the degree of autonomy of teenage patients and personalise their transfer to the adult unit. The second, led by nurse Sara López, has analysed the value of the subjective impression of the nursing staff when predicting the deterioration of patients.

Easing the transition to the adult unit 

Creu Regné is working on the Adolescence to adulthood transition programme, a project aimed at supporting the chronic patient during the transition from paediatrics to adult medicine. The intervention begins between the ages of 12-14 and ends when the patient is considered to be fully integrated into the adult system, around the age of 20. This prevents treatment or medication drop-outs and other problems associated with the switch.

The team is constantly looking for new tools to improve and personalise the monitoring. For example, the study led by Regné proposes adapting the TRAQ 6.0 questionnaire to the Vall d'Hebron clinical context. The TRAQ 6.0 is used in the United States, Canada and Germany, where it has proven effective in assessing the degree of autonomy of teenage chronic patients. The proposal will be to translate the document into Catalan and Spanish, adapting it culturally and socially to the Barcelona setting. The new questionnaire will be evaluated with patients in the same hospital. If the results are positive, the new tool will be added to the current Vall d'Hebron transition protocol.

Assessing nursing staff's observations

Hospitals currently have active protocols in place to detect which patients are most at risk of acute deterioration and thus trigger measures to prevent it. These systems use algorithms that score different physiological, historical and medical parameters to assign the risk of sepsis, cardiorespiratory arrest or unplanned admission to the Intensive Care Unit, among others. Lopez's project seeks to add a new parameter to the equation: the subjective impression of the nursing staff. Nurses are the people who spend the most time in direct contact with patients and therefore can perceive warning signs sooner. Their assessment is already used in several centres, but there is a lack of a scientific study that systematically evaluates its clinical efficacy. The ultimate goal is to improve the detection of adverse clinical outcomes in order to treat them early and thus prevent or at least reduce them. The study will analyse nearly 40,000 patients in more than 20 inpatient units.