Conocimiento del personal de enfermería sobre prevención de la úlcera por presión en el Hospital General del ISSS

La ulcera por presión es una complicación principal de la hospitalización prolongada, principalmente en pacientes ancianos, inmovilizados y aquellos que padecen enfermedades severas agudas y déficits neurológicos. Incrementan costos de hospitalización y juegan un rol significativo en la diseminación de infecciones en el entorno clínico. El presente estudio tuvo por objetivo medir el nivel de conocimiento acerca de la prevención de ulceras por presión en personal de enfermería del Hospital General del ISSS. Métodos: Estudio descriptivo de tipo transversal, la recolección de datos se efectuó durante Julio 2015. Se utilizó un cuestionario estandarizado (Pieper Pressure Ulcer Knowledge Test: PUKT) que fue resuelto por 150 enfermeras que laboran en los servicios de hospitalización. Resultados: La totalidad de enfermeras tuvo conocimientos inadecuados acerca de las ulceras por presión. El promedio de aciertos obtenido por el grupo fue de 29.97 (73%). Los resultados por subescalas fueron: evaluación/clasificación, 6.5/8 (80.7%); prevención, 23.7/33 (72%). El servicio con mayor promedio de aciertos fue Cirugía General (80.1%) y el menor fue Medicina Interna 7º nivel (69.2%). Conclusiones: El personal de enfermería presenta déficits de conocimiento del tema en referencia. La identificación de las áreas deficientes puede orientar la planificación de estrategias que conlleven una mejora y fortalecimiento de los planes de prevención y manejo de esta entidad.

Eficacia del aceite de oliva en la prevención de úlceras por presión en pacientes inmovilizados en atención primaria. Ensayo clínico aleatorizado, multicéntrico, paralelo, triple ciego, de no inferioridad

Las úlceras por presión representan un importante problema de salud pública y tienen un importante impacto económico en los sistemas de salud. La mayoría de los estudios para prevenir las úlceras por presión se han llevado a cabo en contextos hospitalarios, usando ácidos grasos hiperoxigenados (AGHO) y hasta la fecha, no se ha realizado ningún estudio específico con aceite de oliva virgen extra (AOVE) en el entorno domiciliario. Material y método Objetivo principal: evaluar si la utilización de AOVE no es inferior a los AGHO en la prevención de úlceras por presión (UPP) en pacientes inmovilizados en el entorno domiciliario. Diseño: Ensayo clínico aleatorizado multicéntrico, paralelo, a triple ciego, de no inferioridad. Ámbito: Población consultante de centros de salud andaluces. Muestra: 831 pacientes inmovilizados en riesgo de padecer UPP. Resultados El período de seguimiento fue de 16 semanas. En el análisis por protocolo, ninguna de las zonas evaluadas presentó diferencias de riesgo de incidencia de las úlceras por presión que superasen el valor delta establecido (10%). Sacro: AOVE 8 (2,55%) vs AGHO 8 (3,08%), RAR 0,53 (-2,2 a 3,26). Talón derecho: AOVE 4 (1,27%) vs AGHO 5 (1,92)%, RAR 0,65 (-1,43 a 2,73). Talón izquierdo: AOVE 3 (0,96%) vs AGHO 3 (1,15%), RAR 0.2 (-1,49 a 1,88). Trocánter Derecho: AOVE 0 (0%) vs AGHO 4 (1,54%), RAR 1,54 (0,04-3,03). Trocánter izquierdo: AOVE 1 (0,32%) vs AGHO 1 (0,38%), RAR 0.07 (-0,91 a 1,04). Discusión Este ensayo clínico pretendía evaluar si la prevención de las UPP usando una fórmula de AOVE no era inferior a la prevención de UPP con el uso AGHO, en el entorno domiciliario y con pacientes inmovilizados de alto riesgo. Los resultados han mostrado esta no inferioridad al no observarse diferencias que hayan superado el límite inferior del intervalo de confianza y convierte al aceite de oliva en un producto eficaz para la prevención de UPP en este tipo de pacientes. Se necesitan más estudios para investigar el mecanismo de acción del AOVE en la prevención de las UPP y relacionarlo con la etiopatogenia de éstas. Bibliografía 1. Gorecki C, Brown JM, Nelson EA, Briggs M, Schoonhoven L, Dealey C, et al. Impact of pressure ulcers on quality of life in older patients: a systematic review. J Am Geriatr Soc. 2009 Jul;57(7):1175–83. 2. Yamamoto Y, Hayashino Y, Higashi T, Matsui M, Yamazaki S, Takegami M, et al. Keeping vulnerable elderly patients free from pressure ulcer is associated with high caregiver burden in informal caregivers. J Eval Clin Pract. 2010 Jun;16(3):585–9. 3. Hanson D, Langemo DK, Anderson J, Thompson P, Hunter S. Friction and shear considerations in pressure ulcer development. Adv Skin Wound Care. 2010 Jan;23(1):21–4. 4. Soldevilla Agreda JJ, Torra i Bou J-E, Verdú Soriano J, López Casanova P. 3.er Estudio Nacional de Prevalencia de Úlceras por Presión en España, 2009: Epidemiología y variables definitorias de las lesiones y pacientes. Gerokomos. 2011 Jun;22(2):77–90. 5. Kottner J, Lahmann N, Dassen T. [Pressure ulcer prevalence: comparison between nursing homes and hospitals]. Pflege Z. 2010 Apr;63(4):228–31. 6. Wilborn D, Halfens R, Dassen T, Tannen A. [Pressure ulcer prevalence in German nursing homes and hospitals: what role does the National Nursing Expert Standard Prevention of Pressure Ulcer play?]. Gesundheitswesen Bundesverb Ärzte Öffentl Gesundheitsdienstes Ger. 2010 Apr;72(4):240–5. 7. Tubaishat A, Anthony D, Saleh M. Pressure ulcers in Jordan: a point prevalence study. J Tissue Viability. 2011 Feb;20(1):14–9. 8. James J, Evans JA, Young T, Clark M. Pressure ulcer prevalence across Welsh orthopaedic units and community hospitals: surveys based on the European Pressure Ulcer Advisory Panel minimum data set. Int Wound J. 2010 Jun;7(3):147–52. 9. Defloor T, Schoonhoven L, Katrien V, Weststrate J, Myny D. Reliability of the European Pressure Ulcer Advisory Panel classification system. J Adv Nurs. 2006 Apr;54(2):189–98

The treatment of oral lesions in Behçet's Syndrome: case report

Behçet's disease (BD) is a multi-systemic vascular disorder characterized by oral and genital ulcers, cutaneous, ocular, arthritic, vascular, central nervous system and gastrointestinal involvement. It usually affects young adults and the etiopathogenesis is unknown. A 21-year-old girl, Caucasian, with diagnostic BD, presented with rheumatoid arthritis, genital lesions and multiple recurrent ulcers inside the mouth, with an erythematous halo, covered by yellowish exudates exacerbated during menstrual periods, and in situations of stress and anxiety. The application of low power laser in ulcers was considered in order to decrease the inflammatory symptoms and pain, beyond getting the healing process accelerated. The proposed therapy was able to promote pain relief, increase local microcirculation and repair ulcerated lesions, eliminating the need for administration of systemic or topical medications, leading to improved quality of life.

Patologías podales infecciosas y no infecciosas en vacas lecheras

Las cojeras son una de las mayores causas de problemas en el bienestar animal de las vacas lecheras, y tienen diferentes orígenes: infecciosas (dermatitis digital, flemón digital); o lesiones causadas por discontinuidad en el crecimiento del cuerno de las pezuñas (hemorragias, úlcera podal, enfermedad de la línea blanca). Los factores de riesgo que inducen estas afecciones son multifactoriales y no siempre son detectables, difieren según el establecimiento, así como su prevalencia / incidencia. La prevención y la detección precoz mantiene estas patología tengan un impacto menor sobre las economía en la producción lechera.

Provision of care services for rheumatic and musculoskeletal diseases-related foot and ankle problems: a survey from sixteen european countries

Background: The increased prevalence of foot and ankle pathologies in Rheumatic and Musculoskeletal diseases (RMDs) is well documented1, however the provision of foot & ankle (F&A) healthcare services for people with RMDs in Europe has not been evaluated. Objectives: To assess the current healthcare systems for providing foot & ankle healthcare services for people with RMDs in Europe. Methods: A survey was undertaken to evaluate current provision of F&A health care services for people with RMDs across Europe. A questionnaire was distributed to all 22 country presidents representing HP associations within EULAR. The questionnaire used was developed and piloted (in 7 countries) by the EULAR F&A Study Group, and structured to capture the provision and type of F&A services for people with RMDs. When the HP presidents felt unable to answer specific questions they were encouraged to consult a colleague who may be better placed to provide the answers. Results: Sixteen questionnaires were completed (Norway, Ireland, Sweden, Hungary, Netherlands, UK, Denmark, Portugal, Italy, Switzerland, Austria, France, Czech Republic, Spain, Belgium, Malta). Of the 16, 13 respondents indicated provision of F&A health care services in their country, but only three countries had services specialising in RMD-related F&A problems (Netherlands, UK, Malta). The professions providing the care for patients with RMD-related F&A problems were different depending on the pathology and the country (Table1). Podiatrists provided care for F&A pain and deformity problems in 11 countries, but provided F&A ulcer care in only 8 countriesConclusions: Only 3 countries have F&A health care services specialised to the needs of people with RMDs. The professions providing the care varied between countries, and also depended on the F&A pathology. Interestingly, F&A healthcare services were provided by professions that do not solely specialised in F&A care. Further research is needed to assess the variation of F&A healthcare services between and within European countries and the impact on healthcare of various F&A healthcare service designs. References: Woodburn, J. & Helliwell, P. Foot problems in rheumatology. Rheumatology 36, 932-934 (1997).

Prevalence of celiac disease among first degree relatives of Brazilian celiac patients

Background - Several studies have shown that celiac disease, an autoimmune disorder that occurs in genetically susceptible individuals, is highly prevalent among relatives of celiac patients. Aim - To determine the prevalence of celiac disease in a group of first degree relatives of Brazilian celiac patients. Methods - First degree relatives of celiac patients attending the Brasilia University Hospital Pediatric Gastroenterology Outpatient Clinic or the Celiac Disease Investigation Center, Brasília, DF, Brazil, between March 2001 and November 2004 were invited to undergo serological screening for celiac disease applying the IgA anti-endomysium antibody test (IgA-EMA). All positive IgA-EMA sera underwent a second screening using the IgA anti-tissue transglutaminase antibodies test. Duodenal or small intestinal biopsies were performed in all subjects positive to serological testing. Biopsy samples were classified as type (O) normal, (I) infiltrative, (II) infiltrative hyperplastic, (III) flat destructive, and (IV) atrophic hypoplastic. The final diagnosis was ascertained in subjects showing positive serological tests and a grade I to III small intestinal lesion. Results - Nine new cases of celiac disease were found among the 188 first degree relatives tested (4.8%). Conclusion - The present study confirms the high prevalence of celiac disease among first degree celiac patients’ relatives and reinforces the need of extensive diagnostic screening in this specific group.

Endoscopic band ligation without resection in selected patients for small and superficial upper gastrointestinal tract lesions

Background and aim: The aim of this study was to evaluate the efficacy of endoscopic band ligation (EBL) in carefully selected patients who would benefit from this method of resection. Methods: Patients with early upper gastrointestinal and small (< 15 mm) lesions treated with EBL (Duette® Multi-Band Mucosectomy) were prospectively recruited and retrospectively analyzed between 2010 and 2015. All cases were discussed in a multidisciplinary cancer committee and it was concluded that, owing to patient conditions, surgery was not possible and that not conducting histology would not change the clinical management. A first endoscopic control with biopsies was planned at 4-8 weeks. If there was no persistence of the lesion, new controls were programmed at 6 and 12 months. Results: The group (n = 12) included 5 esophagus lesions (adenosquamous carcinoma, n = 1; carcinoma squamous, n = 2; adenocarcinoma, n = 2); 4 gastric lesions (high grade dysplasia, n = 1; adenocarcinoma, n = 2; neuroendocrine tumor [NET], n = 1), and 3 duodenal lesions (NETs) (n = 3). The mean tumor diameter was 9.6 ± 2.8 mm (range 4-15). Only one minor adverse event was described. At first follow-up (4-8 weeks), there was 91.6% and 75% of endoscopic and histological remission, respectively. At 6-month follow-up there was 70% of both endoscopic remission and negative biopsies. And at 12 months, there was 100% and 75% of endoscopic and histological remission, respectively. Persisting lesions were T1 cancers. The median follow-up was 30.6 months. Conclusion: EBL without resection is an easy and safe technique that should be considered in patients with multiple morbidities and small superficial UGI lesions.

Characterization of patients undergoing noninvasive ventilation admitted in unit intermediate care

Non-invasive ventilation (NIV) is the application of a ventilatory support without resorting to invasive methods. Today it’s considered a credible therapeutic option, with enough scientiic evidence to support its application in various situations and clinical settings related to the treatment of acute respiratory disease, as well as chronic respiratory disease. Objectives: Characterize patients undergoing NIV admitted in Unit Intermediate Care (ICU) in the period from October 1st 2015 to June 30th 2016. Methods: Prospective study conducted in ICU between October 2015 and June 2016. In this study were included all patients hospitalized in this unit (ICU) and in that time period a sample of 57 participants was obtained. As data collection instruments we used a questionnaire for sociodemographic and clinical data and the Braden scale. Results: Participants were mostly male 38 (66.7%), the average age 69.5 ± 11.3 years, ranging between 43 and 92 years. They weighed on average 76.6 kg (52 and 150), with an average body mass index of 28.5 kg/m2 (20 to 58.5). With skin intact 28 (49.1%) with abnormal perfusion 12 (21.1%), with altered sensitivity 11 (19.3%) and a high risk of ulcer on the scale of Braden 37 (65%). The admission diagnosis was respiratory failure 33 (57.3%) and had different backgrounds. We used reused mask 53 (93.0%), the average time of NIV was 7.1 days (1-28), 4.8 days of hospitalization (1-18) and an average of 7.8 IPAP pressure. 11 (19.3%) of the participants developed face ulcer pressure.Conclusions: The NIV is used in patients with advanced age, obesity, respiratory failure and high risk of face ulcer development.

Terminal interruption of relux source technique in the treatment of active venous ulcers

Introduction: The treatment for venous ulcers in most cases is unsatisfactory, with recurrences and poor healing. Objective: to evaluate adjuvant therapy in the treatment of active venous ulcers. Methods: We analyzed 20 patients with active venous ulcers attending the general Surgery outpatient clinic at the “Dr. José eleuterio gonzález” University Hospital from October 2012 to January 2013. they were randomly divided into 2 groups: group A (11 patients) underwent compression therapy and group B (9 patients) underwent compression therapy plus removal of the vein that gives terminal relux to the ulcer, guided by ultrasound (microphlebectomy). Patients were evaluated weekly (8 weeks). At each assessment, photographs and lesion measurements were taken and pain was evaluated using the visual analog scale. Results: No significant differences were found between the study groups in terms of age, weight, height, body mass index (BMi), ankle-brachial index, and baseline measurement of the ulcer (p>0.05). Group B showed a greater reduction in ulcer size and a statistically signiicant lower score on the visual analog pain scale (p<0.05) from the second and third week of treatment, respectively. Conclusions: the results obtained in patients with surgical procedure (group B) are consistent with the reported eficacy of chronic venous ulcer treatment with saphenectomy (conventional surgery), the difference is that in this study we used a minimally invasive procedure (microphlebectomy).

Prevalencia del Helicobacter Pylori y factores asociados en escolares de la etnia Shuar del cantón Sucúa –Morona Santiago, 2014.

Introducción: Según la OMS, más del 50% de la población adulta está infectada con el Helicobacter Pylori, con prevalencias de hasta el 90%. La mayoría de contagios se produce antes de los 10 años de edad. Desde el descubrimiento del H. Pylori (1983), se lo ha relacionado con la úlcera péptica, gastritis, reflujo gastroesofágico e incluso, cáncer gástrico. Metodología: Se realizó un estudio transversal analítico. La muestra estuvo conformada por 250 niños escolares de la etnia Shuar del cantón Sucúa. La prueba utilizada para la detección del Helicobacter pylori es la identificación de antígenos en las heces por inmunocromatografía. Para establecer la significancia de asociación de variables se utilizó el OR con su intervalo de confianza al 95%. Resultados: El promedio de edad fue de 8.8 años (DS 2.0), con predominio de las mujeres (54.4%). El 56.4% consume agua potable, el 71.65% vive en hacinamiento, el 42% tiene servicios de letrinización y el 49.2% cuenta con servicios de alcantarillado. Se encontró asociación significativa con el nivel de instrucción OR 1.68, IC95% (1 – 2.84), p=0.049; letrinización OR 1.99, IC95% (1.17 – 3.36), p=0.01; deposiciones al aire libre OR 4.32, IC95% (2.13 – 8.77), p=0.000. Conclusiones: La prevalencia de Helicobacter pylori es alta en la población escolar de la etnia Shuar; está asociada a un nivel bajo de instrucción de los progenitores y una inadecuada infraestructura de servicios básicos.

Primary Antibiotic Resistance to Helicobacter pylori Strains Isolated From Children in Northern Iran: A Single Center Study

Background: Initial resistance to antibiotics is the main reason for the failure of Helicobacter pylori (H. pylori) eradication in children. Objectives: As we commonly face high antibiotic resistance rates in children, we aimed to determine the susceptibility of H. pylori to common antibiotics. Patients and Methods: In this cross-sectional in vitro study, 169 children younger than 14 years with clinical diagnosis of peptic ulcer underwent upper gastrointestinal endoscopy. Biopsy specimens from stomach and duodenum were cultured. In isolated colonies, tests of catalase, urease, and oxidase as well as gram staining were performed. After confirming the colonies as H. pylori, the antibiogram was obtained using disk diffusion method. Results: Culture for H. pylori was positive in 12.3% of the specimens, urease test in 21.3%, serological test in 18.9% and stool antigen test was positive in 21.9%. We could show high specificity but moderate sensitivity of both histological and H. pylori stool antigen tests to detect H. pylori. The overall susceptibility to metronidazole was 42.9%, amoxicillin 95.2%, clarithromycin 85.7%, furazolidone 61.9%, azithromycin 81.0%, and tetracycline 76.2% with the highest resistance to metronidazole and the lowest to clarithromycin. Conclusions: In our region, there is high resistance of H. pylori to some antibiotics including metronidazole and furazolidone among affected children. To reduce the prevalence of this antibiotic resistance, more controlled use of antibiotics should be considered in children.

Development of the Andalusian Registry of Patients Receiving Community Case Management, for the follow-up of people with complex chronic diseases.

Background: Complex chronic diseases are a challenge for the current configuration of Health services. Case management is a service frequently provided for people with chronic conditions and despite its effectiveness in many outcomes, such as mortality or readmissions, uncertainty remains about the most effective form of team organization, structures, and the nature of the interventions. Many processes and outcomes of case management for people with complex chronic conditions cannot be addressed with the information provided by electronic clinical records. Registries are frequently used to deal with this weakness. The aim of this study was to generate a registry-based information system of patients receiving case management to identify their clinical characteristics, their context of care, events identified during their follow-up, interventions developed by case managers, and services used. Methods and design: The study was divided into three phases, covering the detection of information needs, the design and its implementation in the healthcare system, using literature review and expert consensus methods to select variables that would be included in the registry. Objective: To describe the essential characteristics of the provision of ca re lo people who receive case management (structure, process and outcomes), with special emphasis on those with complex chronic diseases. Study population: Patients from any District of Primary Care, who initiate the utilization of case management services, to avoid information bias that may occur when including subjects who have already been received the service, and whose outcomes and characteristics could not be properly collected. Results: A total of 102 variables representing structure, processes and outcomes of case management were selected for their inclusion in the registry after the consensus phase. Total sample was composed of 427 patients, of which 211 (49.4%) were women and 216 (50.6%) were men. The average functional level (Barthel lndex) was 36.18 (SD 29.02), cognitive function (Pfeiffer) showed an average of 4.37 {SD 6.57), Chat1son Comorbidity lndex, obtained a mean of 3.03 (SD 2.7) and Social Support (Duke lndex) was 34.2 % (SD 17.57). More than half of patients include in the Registry, correspond lo immobilized or transitional care for patients discharged from hospital (66.5 %). The patient's educational level was low or very low (50.4%). Caregivers overstrain (Caregiver stress index), obtained an average value of 6.09% (SD 3.53). Only 1.2 % of patients had declared their advanced directives, 58.6 had not defined the tutelage and the vast majority lived at home 98.8 %. Regarding the major events recorded at RANGE Registry, 25.8 % of the selected patients died in the first three months, 8.2 % suffered a hospital admission at least once time, 2.3%, two times, and 1.2% three times, 7.5% suffered a fall, 8.7% had pressure ulcer, 4.7% had problems with medication, and 3.3 % were institutionalized. Stroke is the more prevalent health problem recorded (25.1%), followed by hypertension (11.1%) and COPD (11.1%). Patients registered by NCMs had as main processes diabetes (16.8%) and dementia (11.3 %). The most frequent nursing diagnoses referred to the self-care deficit in various activities of daily living. Regarding to nursing interventions, described by the Nursing Intervention Classification (NIC), dementia management is the most used intervention, followed by mutual goal setting, caregiver and emotional support. Conclusions: The patient profile who receive case management services is a chronic complex patient with severe dependence, cognitive impairment, normal social support, low educational level, health problems such as stroke, hypertension or COPD, diabetes or dementia, and has an informal caregiver. At the first follow up, mortality was 19.2%, and a discrete rate of readmissions and falls.

Atritis gotosa como causa de pie de riesgo

INTRODUCCIÓN: La gota es una manifestación común de la artritis, cuya inflamación se debe al depóstido de cristales de uratao monosódico en articulaciones y tejidos blandos por un aumento de ácido úrico en sangre y su padecimiento muestra una relación creciente con la edad. OBJETIVOS: Analizar las características fisiopatológicas de la artritis gotosa en el pie así como justificar la repercusión negativa que tiene su padecimiento en la calidad de vida de la población basándose en la simple afectación del pie. METODOLOGÍA: Se realizó una revisión bibliográfica basada en la búsqueda en las bases de datos PubMed y Scopus empleando los descriptores "gout", "gouty arthritis", "foot", "healing", "ulcer" y "wound". Se filtraron los artículos publicados posteriormente al año 2010 en inglés y castellano. RESULTADOS: Los niveles altos de ácido úrico en úlceras están relacionados con su gravedad y la mala cicatrización. La artritis gotosa en el pie se manifiesta mayoritariamente en la 1ª AMTF, siendo esto más común en hombres (68,6%) que en mujeres (31,8%). La manifestación en el pie se da al inicio de la enfermedad en el 43-76% de los casos. Su repercusión a nivel biomecánico-postural da lugar a zonas de presión anormales en el pie pudiendo causar complicaciones secudndarias (por ejemplo úlceras). DISCUSIÓN/CONCLUSIONES: La gota se relaciona íntimamente con la obesidad, el envejecimiento, la diabetes, patologías vasculares y más enfermedades concomicantes que están muy ligadas a la aparición de úlceras y su infeccción. ÇEl pie se ve afectado tanto en su función articular como muscular en este tipo de pacientes y el calzado es una interveción eficaz para reducir la discapacidad, deterioro, dolor y mejorar la marcha. Tanto en esto último como en la curaión de las zonas ulceradas y en la prevención de la artritis gotosa, el podólogo juega un papel fundamental.

Développement d'instruments de mesure pour l'évaluation des facteurs influençant l'adoption des pratiques exemplaires pour le traitement de la mise en décharge de l'ulcère du pied diabétique

L'ulcère du pied diabétique (UPD) affecte 15 à 25 % des personnes diabétiques. Le traitement recommandé de la mise en décharge de l'ulcère est peu appliqué, entraînant des délais de guérison excessifs et des coûts élevés pour le système de santé. Peu d'études abordent le sujet des facteurs responsables de la faible adoption des pratiques exemplaires pour le traitement de décharge de l'UPD en soins de première ligne. Les objectifs spécifiques de ce projet de maîtrise sont d'élaborer et de valider deux questionnaires, un dédié aux patients et un dédié aux professionnels de la santé, explorant les facteurs influençant l'adoption des pratiques exemplaires pour le traitement de la mise en décharge de l’UPD en soins de première ligne. En guise de référence à l'élaboration des questionnaires, un guide de développement d'instrument de mesure, inspiré de la théorie du comportement planifié, a été utilisé. L'analyse de deux types de validation a été entreprise, soit l'analyse de la validité de contenu et de la stabilité temporelle. Les résultats ont démontré des scores particulièrement élevés de validité de contenu et des scores de stabilité temporelle satisfaisants pour le questionnaire dédié aux patients. Le questionnaire dédié aux professionnels de la santé a aussi remporté des scores de validité de contenu particulièrement élevés, mais les items ont obtenu des scores de stabilité temporelle faibles. Le niveau de connaissance des participants sur le sujet exploré a eu une influence majeure sur les résultats de stabilité temporelle. Pour la version finale des questionnaires, seulement les items obtenant des scores élevés de validité de contenu et de stabilité temporelle ont été conservés. Cette étude a fait l'objet d'un article de recherche intitulé Development of Survey Tools to Explore Factors Influencing the Adoption of Best Practices for Diabetic Foot Ulcer Offloading et a été soumis à la revue Journal of Wound Ostomy & Continence Nursing. Les réponses obtenues aux items remportant des coefficients de validité forts sont brièvement examinées à la partie discussion. Les résultats de ce projet de maîtrise permettent de souligner la nécessité de recourir à une méthodologie rigoureuse pour l'obtention d'instruments de mesure valides; un élément trop souvent négligé dans les études sur les soins de santé.

Prevalencia de punto de úlceras por presión y nivel de riesgo en el Hospital Universitario Fundación Santa Fe de Bogotá

Las úlceras por presión causadas por una presión sostenida sobre la piel y sus tejidos adyacentes es una problemática considerada de salud pública, dada su alta prevalencia, se presentan mayormente en personas que tienen restricción en su movilidad, en el 3 a 10 % de los pacientes hospitalizados; con una tasa de incidencia que oscila entre 7,7 y 26,9 %, con consecuencias para la institución por altos costos, la comunidad, el paciente y su familia. En Colombia solo se cuenta con algunos estudios en instituciones en Bogotá, Cartagena, Bucaramanga y Medellín. Los estudios de prevalencia son importantes porque permiten visualizar la situación de la problemática, incentiva la implementación de medidas preventivas y la formulación de políticas institucionales que promuevan la seguridad del paciente y la calidad de la atención. En el Hospital Universitario Fundación Santa Fe de Bogotá no se conoce con exactitud la prevalencia pero se sabe que está presente por las complicaciones y consecuencias ya mencionadas, por ende el objetivo de este estudio fue determinar la prevalencia de punto de úlceras por presión en los pacientes hospitalizados, y al finalizar ser insumo para un estudio posterior que genere un Programa de Piel Sana institucional. El estudio se realizó mediante la medición en 1 día donde se valoró todos los pacientes hospitalizados, se realizó un análisis descriptivo de cada variable, y con un análisis bivariado se obtuvo medidas de asociación para identificar la relación entre los factores de riesgo y el desarrollo de ulceras por presión.