Segura López, Gabriel

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Segura López, Gabriel

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Open Access
Formación continuada: test de autoevaluación. Urgencias por frío: hipotermia(I) y por congelación(II).
(Murcia: Servicio de Publicaciones de la Universidad de Murcia, 2003) Jiménez Andreu, M.R.; Segura López, Gabriel
Open Access
Evidence-based practice competence among nurses in acute and critical care settings: a national cross-sectional study in Spain – The #Evidencer Project
(Elsevier, 2012-05-26) Segura López, Gabriel; Cayuela Fuentes, Pedro Simón; Leal Costa, César; Vera Pérez, José Antonio; Ruzafa Martínez, María; Ramos Morcillo, Antonio Jesús; Enfermería; Facultades de la UMU
Objectives: This study assessed EBP competence among critical care nurses in Spain and identified significant factors affecting the integration of EBP into clinical practice. Methods: A multicenter cross-sectional study involved nurses in emergency departments, pre-hospital emergency services, and intensive care units throughout Spain. Competence was assessed through self-report using the validated EBP-COQ Prof© questionnaire, comprising 35 items divided into four dimensions: attitude, knowledge, skills, and utilization. Descriptive, bivariate, and multivariate regression analyses were conducted to identify the predictors of EBP competence. Results: The sample comprised 847 nurses (78.5% female; mean age 39.89 years, SD = 9.13). The average total EBP competence score was 130.6 (SD = 17.29). Scores across dimensions were highest for attitude (37.1/40) and knowledge (38.0/55), while skills (23.0/30) and utilization (32.6/50) were lower. Key predictors of higher competence included EBP training (p < 0.001), regular reading of scientific articles (p < 0.001), postgraduate education (p < 0.001), mentorship roles (p = 0.018), and employment at Best Practice Spotlight Organization® (BPSO) centers (p = 0.001). Competence declined slightly with increasing professional experience (p = 0.037). Conclusions: Spanish critical care nurses exhibit moderate to high competence in evidence-based practice (EBP), showcasing solid attitudes and knowledge but lacking practical application. Healthcare institutions should emphasize organized EBP training to close this gap, encourage research involvement, and cultivate supportive environments by implementing initiatives such as BPSO programs. Tackling these elements can bolster EBP implementation and enhance patient outcomes in critical care environments. Implications for clinical practice: These findings emphasize the need for strategies to improve evidence-based practice (EBP) in critical care. Healthcare organizations should focus on structured EBP education, regular access to scientific literature, and mentorship, including BPSO® programs. Enhancing EBP skills among experienced nurses can boost decision-making, patient safety, and care quality in high-acuity settings environments.
Open Access
Assessing Evidence-Based Practice Competence in Nurse Leadership Roles in Spain
(Wiley, 2026) Pedro Simón Cayuela-Fuentes; César Leál-Costa; Serafín Fernández-Salazar; José Antonio Vera-Pérez; Antonio Jesús Ramos-Morcillo; María Ruzafa-Martínez; Segura López, Gabriel; Cayuela Fuentes, Pedro Simón; Leal Costa, César; Vera Pérez, José Antonio; Ramos Morcillo, Antonio Jesús; Ruzafa Martínez, María; Enfermería; Facultades de la UMU
ABSTRACT 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 afiliation, 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.
Open Access
Enfermería y educación para la salud en nutrición enteral domiciliaria.
(Murcia : Servicio de Publicaciones de la Universidad de Murcia, 2006) Martínez Martínez, M.I.; Cantero González, Mª. L.; Molino Contreras, J.L.; Cayuela Fuentes, Pedro Simón; Segura López, Gabriel
La nutrición enteral domiciliaria (NED) permite, además de garantizar un correcto tratamiento nutricional, favorecer la autonomía y el bienestar del paciente, junto con una reducción del coste sanitario por hospitalización. Debido al carácter domiciliario de esta terapéutica, adquiere especial importancia en este procedimiento la Educación para la Salud (EpS), que deberá manifestarse mediante un aprendizaje teórico-práctico al paciente, familia y/o cuidadores. Es por esto, que el profesional de Enfermería puede ser requerido para atender a este tipo de pacientes, no sólo desde el punto de vista asistencial, con la identificación y tratamiento de las complicaciones, sino por su papel de educador al paciente y a sus familiares.
Open Access
Technology-Facilitated Online Sexual Violence, Consent Negotiation, and Coping Among AdultWomen: A Qualitative Study
(MDPI, 2026-03-27) Martínez Díaz, Azucena; López Barranco, Pedro José; Guillén Martínez, Ascensión; Pérez Franco, Isabel María; Leal Costa, César; Jiménez Ruiz, Ismael; Cayuela Fuentes, Pedro Simón; Segura López, Gabriel; Enfermería
Background/Objectives: Online sexual violence is an increasingly prevalent form of genderbased harm facilitated by digital technologies, with significant consequences for the health, well-being, and rights of adult women. Despite growing attention to this phenomenon, women’s lived experiences remain underexplored, particularly regarding sexual consent and institutional responses. This study aimed to examine how adult women experience online sexual violence, how consent is negotiated or constrained in digital contexts, and how coping and institutional mechanisms are perceived. Methods: A qualitative study with a hermeneutic phenomenological approach was conducted. Data were collected through three focus groups with 23 women aged 21 to 42 years who were active users of social media. Results: Participants reported diverse forms of online sexual violence, including unsolicited sexual messages and images, persistent harassment, coercion, blackmail, and threats. Sexual consent was often undermined by emotional manipulation, social pressure, and fear, placing women in vulnerable positions. These experiences negatively affected well-being, contributing to anxiety, reduced self-esteem, fear, and difficulties in sexual and emotional relationships. Coping strategies were mainly individual, such as blocking perpetrators or reporting content, while social support was frequently perceived as insufficient. A generalized distrust of institutional responses emerged, with formal mechanisms viewed as ineffective or inaccessible. Conclusions: For the study participants, online sexual violence is increasingly normalized and concealed within digital environments, reinforced by anonymity and impunity. The findings highlight the need for continued research and the development of interventions that include early sexual and emotional education, awareness-raising initiatives, digital regulation, specialized professional training, and the strengthening of victim-centered support networks.
Open Access
Aplicabilidas del rediseño de procesos en el ámbito hospitalario público.
(Murcia : Servicio de Publicaciones de la Universidad de Murcia, 2007) Giménez Andreu, María del Rosario; Segura López, Gabriel
Las nuevas tendencias gerenciales en la administración publica sanitaria abogan por un mayor protagonismo de los ciudadanos en la toma de decisiones de los procesos asistenciales y por una mejora de la calidad de los servicios hospitalarios ofrecidos. Conscientes de esta realidad, las direcciones hospitalarias se están caracterizando por el creciente interés en desarrollar proyectos de mejora de sus procesos asistenciales básicos, utilizando para ello en algunos casos herramientas como la denominada Reingeniería o Rediseño de Procesos que supone una demolición controlada y drástica de los procesos estratégicos de valor agregado y de los sistemas, las políticas y las estructuras organizacionales que los sustentan para optimizar los flujos del trabajo y la actividad de una organización. En este artículo estudiamos el Rediseño de Procesos desde un punto conceptual, revisando las fases necesarias para su puesta en marcha y analizando su aplicabilidad potencial en el ámbito Hospitalario Público. Concluimos resaltando que la práctica del rediseño de procesos no es, según sus principios conceptuales, factible desde un punto de vista ejecutivo en los hospitales públicos, lo que nos indica que las prácticas así denominadas, rigurosamente no pueden ser tales en realidad y se inclinan más bien a otras orientaciones organizativas.
Open Access
Learners’ perspectives on interprofessional simulation and co-debriefng: an exploratory mixed-methods study
(Wiley, 2026-02-26) Díaz Agea, José Luis; Ros-Romero, Álvaro; Leal Costa, César; Vera Pérez, José Antonio; Cánovas-Pallarés, Juan Manuel; Piñero Zapata, Manuel; Cinesi-Gómez, César; Adánez Martínez, María de Gracia; Pujalte-Jesús, María José; Cayuela Fuentes, Pedro Simón; Segura López, Gabriel; José Luis Díaz-Agea; Enfermería
Introduction: Interprofessional simulation enhances both technical and nontechnical skills among healthcare professionals, improving their clinical practice. Co-debriefng, where two facilitators lead debriefng sessions, is a common approach in these trainings. This study aims to assess educational aspects of interprofessional simulation and co-debriefng 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 openended 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-debriefng. Signifcant diferences were found between medical and nursing students in all dimensions except applicability and organization. Overall, students rated interdisciplinary sessions and co-debriefng 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-debriefng were well received, participants—especially nurses—identifed areas for enhancement to ensure a more balanced and engaging learning experience. By integrating quantitative outcomes with qualitative insights, the study highlights when co-debriefng adds value in interprofessional simulation and when singlefacilitator approaches may be sufcient.
Open Access
The expository phase of debriefing in clinical simulation: a qualitative study
(BioMed Central, 2025-04-30) Fenzi, Giulio; Alemán Jiménez, Carolina; Leal Costa, Cesar; Díaz Agea, José Luis; Cayuela Fuentes, Pedro Simón; Segura López, Gabriel; Enfermería
Background Clinical simulation fosters reflective, experiential learning in a safe environment, allowing participants to learn from mistakes without patient risk. Debriefing, essential for reflection, is typically facilitator driven. The MAES© methodology (Self-Learning Methodology in Simulated Environments) shifts the focus to students, guiding them through six sequential phases: group identity creation, topic selection, objective setting, competency establishment, scenario design, simulation, and debriefing. MAES© introduces an expository phase in debriefing, where students present theoretical and practical content. The facilitator assumes a significant, yet secondary role, fostering increased student-led learning opportunities and, at times, enabling even trained real patients to co-facilitate the debriefing. Objective To explore participants’ experiences and perceptions regarding the expository phase of debriefing within the MAES© methodology framework, with specific focus on the student-led debriefing component. Method A descriptive qualitative inductive approach with thematic content analysis was used. Open-ended questionnaires from 151 undergraduate final year and post-graduate nursing students, captured their experiences with the MAES© expository phase. Open-ended questionnaires allow participants to freely and anonymously express their perspectives and experiences. Responses were transcribed, independently coded, and analyzed using MaxQDA® v18. Data were coded and analyzed based on absolute and relative frequencies of emerging categories. The study adhered to the SRQR (Standards for Reporting Qualitative Research) guidelines. Results The analysis revealed several key themes in student evaluations. Satisfaction with the methodology emerged strongly, with over one-third of participants expressing no desired changes. The reflective nature of the approach was prominently valued, along with its effectiveness for concept clarification and fostering collaborative learning. Participants particularly noted developmental outcomes in communication competencies and technical skills, while appreciating the motivational learning environment and evidence-based focus. The suggested improvements focused on three main aspects: increased session dynamism, a greater use of visual and interactive elements, and reduced dependence on slide-based presentations. Conclusion The study highlights the value of the expository phase in the MAES© methodology, emphasizing its effectiveness in clarifying concepts, fostering collaboration, and developing technical and communication skills. It also promotes student autonomy through active engagement. However, participants suggested improvements,