The Importance of Rapid Influenza Testing in Pediatric Primary Care: Experience During Three Consecutive Influenza Seasons (2016-2019) in Barcelona (Catalonia, Spain).

Clinical diagnosis of influenza has low sensitivity in infants and children. Signs and symptoms are non-specific and similar to those of other respiratory viruses. Rapid influenza diagnostic tests (RIDTs) with adequate sensitivity and specificity used at the point of care can be useful for an etiologic diagnosis of influenza in primary care. This should have an impact on better management of these patients. We conducted a study during three consecutive influenza seasons (2016-2017, 2017-2018, and 2018-2019) in pediatric primary care settings collecting data from influenza point-of-care tests (POCTs)-confirmed ≤ 6-year-old patients. During the first two influenza seasons, antibiotic prescriptions and additional visits from influenza POCT-confirmed patients (Group_1) were compared to patients with influenza-like illness (ILI) (Group_2), or fever (2016 ICD-10 code R50) with no other signs of influenza (Group_3). Group_1 had 0.19 (2016-2017) and 0.23 (2017-2018) additional visits compared to 0.48 (2016-2017) and 0.49 (2017-2018) Group_2 p < 0.001 and 1.01 (2016-2017) and 0.80 (2017-2018) Group_3 p < 0.001. Antibiotic prescription was lower in Group_1 (10.2%) vs. Group_3 (17.2%) p < 0.002, difference statistically significant only for the 2017-2018 season. During the third season (2018-2019), RIDTs results were transmitted in real time to the reference laboratory ia the cloud, which strengthens the monitoring of circulating influenza viruses in the community. In our experience, the use of POCTs has a great potential in primary care specially in infants and young children in which the diagnosis maybe missed due to non-specific signs and symptoms.

Percepción de los profesionales sanitarios acerca de la cultura de seguridad en distintos servicios de pediatría hospitalaria / Perception by healthcare professionals about the safety culture in different hospital paediatric units

Objetivo: describir la percepción de los profesionales sanitarios de los diferentes servicios pediátricos de un hospital de Zaragoza acerca de la cultura de seguridad del paciente (SP).Método: estudio descriptivo, observacional, transversal realizado en profesionales de Medicina y Enfermería (n= 345) de servicios de pediatría de un hospital de tercer nivel. Se administró una encuesta sobre cultura de seguridad validada por el Ministerio de Sanidad, Consumo y Bienestar Social. En el análisis estadístico se empleó la prueba de Kruskal Wallis y la t-Student para identificar diferencias entre los profesionales de Medicina y los de Enfermería, asumiendo un nivel de significación p< 0,05.Resultados: participaron un total de 159 profesionales (46,08%). El 71,1% no poseía formación sobre SP. El 40,2% respondió que no existían actividades encaminadas a mejorar la SP, pero un 71,4% afirmaba que sí se activaban medidas ante un suceso para evitar su recurrencia. La mayoría (80,1%) aseguraba trabajar en equipo, pero un 65,4% destacaba la pérdida de información en los cambios de turno. La percepción global de los encuestados sobre la SP en este centro era mayoritariamente “Aceptable” (54,1%) y “Pobre” (34,6%). Se observaron diferencias significativas en las secciones de SP: “área/unidad de trabajo”, “jefe/supervisor” y “comunicación” y no en el resto.Conclusiones: más de la mitad de los profesionales tenía una percepción “Aceptable” de la SP del centro y, en general, no estaban formados sobre la cultura de seguridad ni se identificaba la SP como prioritaria para evitar y prevenir eventos adversos.(AU)

Objective: to describe the perception by healthcare professionals about the different paediatric units of a hospital in Zaragoza in terms of patient safety (PS) culture.Method: a cross-sectional, observational, descriptive study conducted on Medicine and Nursing professionals (n= 345) from Paediatric Units of a Third-Level hospital. A survey on safety culture was conducted, validated by the Ministry of Health, Consumer Affairs and Social Welfare. The Kruskal Wallis and t-Student tests were used during statistical analysis, in order to identify any differences between Medicine and Nursing, with a p< 0.05 significance level.Results: in total, 159 professionals (46.08%) were included; 71.1% had no PS training; 40.2% answered that there were no activities targeted to improving PS, but 71.4% claimed that measures were activated when faced with an event, in order to avoid its recurrence. The majority (80.1%) claimed that they worked as a team, but 65.4% highlighted loss of information in shift changes. The overall perception of the participants about PS in this centre was mostly “Acceptable” (54.1%) and “Poor” (34.6%). Significant differences were observed in the PS categories: “work area/ unit”, “head / supervisor”, and “communication”, and not in the rest.Conclusions: over half of professionals had an “Acceptable” perception of PS in their centre; and overall, they had no training on safety culture, and PS was not identified as a priority to avoid and prevent adverse events.(AU)