<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2254-2884</journal-id>
<journal-title><![CDATA[Enfermería Nefrológica]]></journal-title>
<abbrev-journal-title><![CDATA[Enferm Nefrol]]></abbrev-journal-title>
<issn>2254-2884</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Enfermería Nefrológica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2254-28842018000300240</article-id>
<article-id pub-id-type="doi">10.4321/s2254-28842018000300005</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Mapeo de variabilidad sobre prácticas enfermeras relacionadas con el acceso vascular en el entorno de hemodiálisis. Estudio transversal]]></article-title>
<article-title xml:lang="en"><![CDATA[Mapping of variability on nursing practices in the hemodialysis environment. Cross-sectional study.]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Blanco-Mavillard]]></surname>
<given-names><![CDATA[Ian]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez-Calero]]></surname>
<given-names><![CDATA[Miguel Ángel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bolaños-Herrezuelo]]></surname>
<given-names><![CDATA[Gregorio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez-Barceló]]></surname>
<given-names><![CDATA[Aurora]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Parra-García]]></surname>
<given-names><![CDATA[Gaizka]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital de Manacor Unidad de calidad, docencia e investigación ]]></institution>
<addr-line><![CDATA[Manacor ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Servicio de Salud de las Islas Baleares  ]]></institution>
<addr-line><![CDATA[ Islas Baleares]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital de Manacor  ]]></institution>
<addr-line><![CDATA[Manacor ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital San Juan de Dios  ]]></institution>
<addr-line><![CDATA[Mallorca ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universitat de les Illes Balears Departamento de Enfermería y Fisioterapia ]]></institution>
<addr-line><![CDATA[ Islas Baleares]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2018</year>
</pub-date>
<volume>21</volume>
<numero>3</numero>
<fpage>240</fpage>
<lpage>248</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S2254-28842018000300240&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S2254-28842018000300240&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S2254-28842018000300240&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción:  La Variabilidad de la Práctica Asistencial se define como &#8220;aquella situación en la cual pacientes con una clínica similar no son cuidados ni tratados de la misma forma en diferentes niveles de atención, sin que exista una base sólida en conocimientos derivados del cumplimiento de guías de práctica clínica&#8221;.  Objetivo:  Analizar la adherencia de las enfermeras a recomendaciones basadas en evidencias, comparar la adherencia respecto a las características sociodemográficas e identificar intervenciones con mayor variabilidad en el manejo del acceso vascular.  Material y Método:  Estudio observacional transversal. Los sujetos de estudio fueron enfermeras de hemodiálisis que contestaron un cuestionario online ad hoc formado por 33 preguntas a través de GoogleForm, difundido por correo electrónico a nivel nacional durante los meses de octubre y noviembre de 2017. El cuestionario se organizó para dar respuesta a las variables del perfil sociodemográfico y a la adherencia a recomendaciones basadas en las guías KDOQI, detectando 7 dominios fundamentales para la práctica enfermera en hemodiálisis.  Resultados:  Se obtuvieron 217 encuestas válidas procedentes de 17 comunidades autónomas, lo que supone una tasa de respuesta del 16,69%. La adherencia a las recomendaciones resultó moderada, un 53,24% de las respuestas coincidieron con la evidencia emitida en las guías de práctica clínica. Las intervenciones con mayor incertidumbre y variabilidad están relacionadas con el uso del antiséptico, tipo y tiempo de apósitos y técnica de punción.  Conclusión:  Se obtuvo una adherencia moderada sobre las áreas de conocimiento que están produciendo mayor incertidumbre en los entornos de hemodiálisis, siendo el mapeo de variabilidad un instrumento útil para su detección.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  The Variability of the Care Practice is defined as &#8220;that situation in which patients with a similar clinical situation are not cared for or treated in the same way in different levels of care, without a solid base in knowledge derived from the compliance with clinical practice guidelines&#8221;.  Objective:  To analyze the adherence of nurses to recommendations based on evidence, to compare adherence in relation to sociodemographic characteristics and to identify interventions with greater variability in the management of vascular access.  Material and Method:  Cross-sectional observational study. The study subjects were hemodialysis nurses who answered an ad hoc online questionnaire formed by 33 questions through GoogleForm, disseminated by email at national level, during October and November 2017. The questionnaire was organized to respond the variable of the sociodemographic profile and adherence to recommendations based on the KDOQI guidelines, detecting 7 fundamental domains for nursing practice in hemodialysis.  Results:  217 valid surveys were obtained from 17 autonomous communities, which implies a response rate of 16.69%. Adherence to the recommendations was moderate, 53.24% of respondents agreed with the evidence issued in clinical practice guidelines. Interventions with greater uncertainty and variability are related to the use of the antiseptic, type and time of wound dressings, and puncture technique.  Conclusion:  A moderate adherence was obtained related to the areas of knowledge that are producing greater uncertainty in hemodialysis environments, being the mapping of variability a useful instrument for such detection.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[variabilidad asistencial]]></kwd>
<kwd lng="es"><![CDATA[hemodiálisis]]></kwd>
<kwd lng="es"><![CDATA[evaluación de procesos]]></kwd>
<kwd lng="es"><![CDATA[evaluación de resultado]]></kwd>
<kwd lng="es"><![CDATA[indicadores de calidad de la atención de salud]]></kwd>
<kwd lng="en"><![CDATA[clinical practice variation]]></kwd>
<kwd lng="en"><![CDATA[hemodialysis]]></kwd>
<kwd lng="en"><![CDATA[process assessment]]></kwd>
<kwd lng="en"><![CDATA[outcome assessment]]></kwd>
<kwd lng="en"><![CDATA[health care quality indicators]]></kwd>
</kwd-group>
</article-meta>
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