Comportamiento del orificio de implantación del catéter en pacientes en diálisis peritoneal en relación a los cuidados

Infections of the catheter wound in peritoneal dialysis are the most frequent cause of morbility in patients who undergo this technique. There are a number of procedures for the care of the wound and it is not easy to define a single method that will guarantee good condition of the wound. In order to evaluate the behaviour of the wound related to the procedure used in their care, we studied 306 patients over 24 months, compiling socio-demographic and clinical variables. We found a high incidence of infections caused by gram-positive skin and mucous germs, with a strong correlation with the fact that the patient/family carer is a nasal carrier of staphylococcus aureus and that they appear more frequently in patients who do not remove the wound dressing in the shower. We also detected an increase in pseudomonas infections when the patient does not dry the wound with a hair-dryer

Guía de integración de la dimensión de género en los procesos asistenciales integrados [Recurso electrónico] : documentos de apoyo

El abordaje del género como enfoque transversal de las políticas sanitarias es un objetivo prioritario para la Consejería de Salud, porque el estado de salud de mujeres y hombres es diferente porque somos diferentes desde el punto de vista biológico y también porque hay factores sociales que actúan en la salud de las personas. Esta guía se ha elaborado con el fin de facilitar la introducción de la perspectiva de género en los procesos asistenciales, planes integrales de salud y planes de cuidados estandarizados de enfermería.

Guía de consejo dietético intensivo en atención primaria

Destinado a personal sanitario de Atención Primaria, principalmente personal de enfermería. Publicado en la página web de la Consejería de Salud y Bienestar social: www.juntadeandalucia.es/salud (Consejería de Salud y Bienestar Social / profesionales / Salud Pública / Promoción de la Salud / Actividad Física y Alimentación Equilibrada / Materiales) y (Consejería de Salud y Bienestar Social / Ciudadanía / Nuestra Salud / Vida sana)

Altered adaptive but not veridical decision-making in substance dependent individuals.

Drug addiction is associated with impaired judgment in unstructured situations in which success depends on self-regulation of behavior according to internal goals (adaptive decision-making). However most executive measures are aimed at assessing decision-making in structured scenarios, in which success is determined by external criteria inherent to the situation (veridical decision-making). The aim of this study was to examine the performance of Substance Abusers (SA, n = 97) and Healthy Comparison participants (HC, n = 81) in two behavioral tasks that mimic the uncertainty inherent in real-life decision-making: the Cognitive Bias Task (CB) and the Iowa Gambling Task (IGT) (administered only to SA). A related goal was to study the interdependence between performances on both tasks. We conducted univariate analyses of variance (ANOVAs) to contrast the decision-making performance of both groups; and used correlation analyses to study the relationship between both tasks. SA showed a marked context-independent decision-making strategy on the CB's adaptive condition, but no differences were found on the veridical conditions in a subsample of SA (n = 34) and HC (n = 22). A high percentage of SA (75%) also showed impaired performance on the IGT. Both tasks were only correlated when no impaired participants were selected. Results indicate that SA show abnormal decision-making performance in unstructured situations, but not in veridical situations.

"The 3/3 strategy": a successful multifaceted hospital wide hand hygiene intervention based on WHO and continuous quality improvement methodology.

BACKGROUND Only multifaceted hospital wide interventions have been successful in achieving sustained improvements in hand hygiene (HH) compliance. METHODOLOGY/PRINCIPAL FINDINGS Pre-post intervention study of HH performance at baseline (October 2007-December 2009) and during intervention, which included two phases. Phase 1 (2010) included multimodal WHO approach. Phase 2 (2011) added Continuous Quality Improvement (CQI) tools and was based on: a) Increase of alcohol hand rub (AHR) solution placement (from 0.57 dispensers/bed to 1.56); b) Increase in frequency of audits (three days every three weeks: "3/3 strategy"); c) Implementation of a standardized register form of HH corrective actions; d) Statistical Process Control (SPC) as time series analysis methodology through appropriate control charts. During the intervention period we performed 819 scheduled direct observation audits which provided data from 11,714 HH opportunities. The most remarkable findings were: a) significant improvements in HH compliance with respect to baseline (25% mean increase); b) sustained high level (82%) of HH compliance during intervention; c) significant increase in AHRs consumption over time; c) significant decrease in the rate of healthcare-acquired MRSA; d) small but significant improvements in HH compliance when comparing phase 2 to phase 1 [79.5% (95% CI: 78.2-80.7) vs 84.6% (95% CI:83.8-85.4), p<0.05]; e) successful use of control charts to identify significant negative and positive deviations (special causes) related to the HH compliance process over time ("positive": 90.1% as highest HH compliance coinciding with the "World hygiene day"; and "negative":73.7% as lowest HH compliance coinciding with a statutory lay-off proceeding). CONCLUSIONS/SIGNIFICANCE CQI tools may be a key addition to WHO strategy to maintain a good HH performance over time. In addition, SPC has shown to be a powerful methodology to detect special causes in HH performance (positive and negative) and to help establishing adequate feedback to healthcare workers.

Del artículo de revisión a la recomendación profesional: La uniformación y material de protección individual para los equipos del ámbito prehospitalario de urgencias y emergencias

The Spanish Society of Nursing Emergency (SEEUE) has several lines documentaries that can be consulted on its web page and that have been spread through various publications: Statutes, scientific recommendations, professional recommendations, statements and allegations, grounds for nursing emergency, guarantees and rules, documents of interest and legislation. Set this that composed the regulatory environment, legal and recommendations which society poses to the collective nurse from the area of the emergency, as well as the rest of actors associated with urgent assistance (institutional and administratively) and through what has been the work of conceptualization and definition in our area the past few years. Part of this documentation offer possibilities for scientific endorsement and professional and invites to continue building knowledge and evidence. It is in this sense in which this work can and should be defined from a literature review approach and under the scheme of "review article". The working Group in Primary Care (PC) of the SEEUE, decided to build a Professional Recommendation (PR) in one of the areas of "uncertainty/variability" in the employment context and historical demand of nurses and other emergency care team on security issues: "The uniform and personal protective equipment for professional teams on prehospital emergency areas”.

Continuidad De Cuidados y Comunicación interniveles entre equipos de emergencias sanitarias y Atención Primaria.

The gradual incorporation of the nurses to the extrahospital emergency teams give them a holistic aspect in the field of care. And this is not possible without addressing the possibility of continuity of care and communication with other levels of care. All efforts in this regard and made speeches themselves as nursing, "Refer" (Nic 8100) and "Exchange of information on health care" (Nic 7960), is the conceptual framework of this work, which objetives are to quantify and exposing the proceedings in this line taken by the nurses of emergency team.

Paciente transferido desde Equipo Móvil de Dispositivo de Cuidados Críticos y Urgencias (EM DCCU) a sistema de helitransporte sanitario (HEMS): Guía de actuación

Assistance and transfer of critical patients often takes place in an environment in which the medium response time, playing against an appropriate and definitive treatment at a center useful. The relationship in this sense arises between the resources of the level of primary care and the medical helicopter transport system (HEMS), is caused by the need to shorten those response times and referral in areas where initial care is taken to DCCU out by, despite being timedependent pathology that requires a fast transfer can not be offered by them with the possibility of optimization. The support in this sense of HEMS is essential: The knowledge of the environment and the establishment of policy guidance are necessary.

Guía para el desarrollo de Programas de intercambio de Jeringuillas (PIJ) desde la consulta de triage de los Dispositivos de Cuidados Críticos y Urgencias (DCCU)

There are exceptional situations where emergency services are required Primary Care in the application of material used by drug-dependent patients, being the response to this demand is something that many of the cases, to individual discretion and the randomness and variability every situation leads to an answer. It calls for a response commensurate to public services and preventive health philosophy in most cases will be carried out by the nurse to perform assistance Devices Critical Care (DCCU), often this first contact these patients and slots at the supply of resources diminishes the possibilities of acquisition of such material to them. That is why, and in the absence in this area of patient safety and professional, a workflow model and according to the prevailing philosophy of working in primary care in terms of prevention policies and recruitment of patients concerned, this project raises guidance for the development of a needle exchange program from the triage consultations DCCU.

Cirugía menor: desarrollo de nuevas competencias enfermeras

Publicado en la página web de la Consejería de Salud y Bienestar Social / Profesionales / Nuestro Compromiso por la Calidad / Estrategia de cuidados de Andalucía / Estrategia de cuidados de Andalucía

Research letter: is neuroticism a risk factor for postpartum depression?

Although the relationship between personality and depressive illness is complex (Shea, 2005), there is empirical evidence that some personality features such as neuroticism, harm avoidance, introversion, dependency, self-criticism or perfectionism are related to depressive illness risk (Gunderson et al. 1999).

Guía de práctica clínica para el cuidado de personas que sufren quemaduras

Publicaciones complementarias: Folleto: Guía de prevención y cuidados de las personas con quemaduras. Folleto desplegable: Guía rápida de consulta para el cuidado de personas que sufren quemaduras

Suicidal ideation and the risk of suicide in patients with fibromyalgia: a comparison with non-pain controls and patients suffering from low-back pain.

Fibromyalgia is associated with an increased rate of mortality from suicide. In fact, this disease is associated with several characteristics that are linked to an increased risk of suicidal behaviors, such as being female and experiencing chronic pain, psychological distress, and sleep disturbances. However, the literature concerning suicidal behaviors and their risk factors in fibromyalgia is sparse. The objectives of the present study were to evaluate the prevalence of suicidal ideation and the risk of suicide in a sample of patients with fibromyalgia compared with a sample of healthy subjects and a sample of patients with chronic low-back pain. We also aimed to evaluate the relevance of pain intensity, depression, and sleep quality as variables related to suicidal ideation and risks. Logistic regression was applied to estimate the likelihood of suicidal ideation and the risk of suicide adjusted by age and sex. We also used two logistic regression models using age, sex, pain severity score, depression severity, sleep quality, and disease state as independent variables and using the control group as a reference. Forty-four patients with fibromyalgia, 32 patients with low-back pain, and 50 controls were included. Suicidal ideation, measured with item 9 of the Beck Depression Inventory, was almost absent among the controls and was low among patients with low-back pain; however, suicidal ideation was prominent among patients with fibromyalgia (P<0.0001). The risk of suicide, measured with the Plutchik Suicide Risk Scale, was also higher among patients with fibromyalgia than in patients with low-back pain or in controls (P<0.0001). The likelihood for suicidal ideation and the risk of suicide were higher among patients with fibromyalgia (odds ratios of 26.9 and 48.0, respectively) than in patients with low-back pain (odds ratios 4.6 and 4.7, respectively). Depression was the only factor associated with suicidal ideation or the risk of suicide.