Catheter-related bloodstream infection: burden of disease in a tertiary hospital.

BACKGROUND: Surveillance programmes have become the most effective tool for controlling catheter-related bloodstream infections (CRBSI). However, few studies have investigated programmes covering all hospital settings. AIM: To describe the results of a control and prevention programme for CRBSI based on compliance with recommendations for insertion and maintenance, using annual burden of disease in a tertiary level hospital. METHODS: A CRBSI control and prevention programme involving all hospital settings was implemented. The programme consisted of CRBSI surveillance, direct observation of insertion and maintenance of catheters to determine performance, and education for healthcare workers. FINDINGS: In total, 2043 short-term catheters were inserted in 1546 patients for 18,570 catheter-days, and 279 long-term catheters were inserted in 243 patients for 40,440 catheter-days. The annual incidence density was 5.98 (first semester 6.40, second semester 5.64) CRBSI per 1000 catheter-days for short-term catheters, and 0.57 (first semester 0.66, second semester 0.43) CRBSI per 1000 catheter-days for long-term catheters. One hundred and forty insertion procedures were observed, with an average insertion time of 13 (standard deviation 7) min. Compliance with recommendations was as follows: hand hygiene, 86.8%; use of alcoholic chlorhexidine solution for skin disinfection, 35.5%; use of mask, 93.4%; use of gloves, 98.7%; use of gown, 75.0%; use of sterile cloth, 93.8%; use of cap, 92.2%; bandage application, 62.7%; and use of aseptic technique, 89.5%. Forty-five maintenance procedures were observed, and compliance rates were as follows: hand hygiene, 42.1%; use of gloves, 78.1%; and port disinfection with alcoholic chlorhexidine solution, 32.5%. CONCLUSION: The CRBSI control and prevention programme implemented at the study hospital has decreased the rate of CRBSI, provided important information about the total burden of disease, and revealed possible ways to improve interventions in the future.

[Satisfaction among patients attending outpatient preventive medicine clinic]. / Satisfacción de los pacientes atendidos en una consulta externa de medicina preventiva.

INTRODUCTION: To evaluate satisfaction among patients attending the outpatient clinics of a Preventive Medicine Department and to identify any problems with the care they receive. MATERIAL AND METHODS: We performed a cross-sectional study in outpatient clinics of the Preventive Medicine Department, at Hospital General Universitario in Alicante, during January 2009. A questionnaire was given to all patients after their visit. Patients were satisfied if the final score was > or = 8. Socio-demographic variables were: age, sex, educational level, marital status and type of user (external or internal). chi(2) were used to study the association between these variables and satisfaction. RESULTS: The response rate was 84.4% (119/141), 94.1% were correctly completed (112/119), and 82.1% had a final score of > or = 8. The worst aspects were: comfort of waiting room, signs and wait time (percentage dissatisfied: 54.5%, 46.4% and 30.4%, respectively). The rest of the items obtained the following satisfaction percentages: medical treatment (97.3%), privacy of care (95.5%), information received (93.7%), easy next appointment (93.7%), visit length (92.9%), clarity of information (92.9%), to arrange the first appointment (90.2%), nursing treatment (87.5%), time to date of appointment (81.2%). Educational level was the only variable significantly associated with satisfaction. CONCLUSIONS: General satisfaction was good, although aspects like waiting time and signs could be better, if changes were made to management of appointments and the signs in the Hospital Department were increased.

Conocimientos sobre gripe en personal sanitario que acude a vacunarse / No disponible

INTRODUCCIÓN: El objetivo del trabajo, es conocer el nivel de conocimientos sobre la Gripe y sus determinantes en el personal sanitario (PS) que se vacuna de la gripe. Material y MÉTODOS: Estudio transversal, en el que se incluyó al PS que se vacunó de la gripe en la temporada 2011-12, y cumplimentó un cuestionario de 10 preguntas. Se consideró nivel adecuado de conocimientos cuando se contestaron correctamente cinco o más preguntas. Para cuantificar la magnitud de la asociación se calculó la Odds Ratio con sus IC al 95%. RESULTADOS: Se encuestaron 634 trabajadores sanitarios. El 75,7% tenía un nivel adecuado de conocimientos. El tener menos de 45 años OR: 3,3 (2,1-5,2), el ser facultativo o personal de enfermería, OR: 4,1 (2,3-7,3) y OR: 3,1 (1,8-5,3) respectivamente, se asociaron con disponer de un nivel adecuado de conocimientos. CONCLUSIONES: La edad y el estamento son las variables que se asocian de manera independiente con el nivel de conocimientos sobre la Gripe en el PS. Un número importante del personal sanitario, desconoce aspectos relevantes acerca de la Gripe

BACKGROUND: The objective of this work is to know the level knowledge on Influenza and its determinants on health personnel (HP). METHODS: Observational study, in which it included the PS that was vaccinated of the influenza in season 2011-12, and complimented a of 10 questions. Suitable level of knowledge, which was considered when well, answered five or more questions. For quantify the magnitude of the association was calculated Odds Ratio with its 95% CI. RESULTS: 634 HP surveyed them. 75.7% had a suitable level f knowledge. Having less than 4 years, OR: 3,3 (2,1-5,2), be physicians or nursing, OR: 4,1 (2,3-7,3) and OR: 3,1 (1,8-5,3) respectively, they were associated with having an suitable level of knowledge. Conclusions,: the age and the professional category are the variables that are associated of independent way, with the level of knowledge on Influenza in the HW. A significant number of health workers not known about important aspects of influenza

Satisfacción de los pacientes atendidos en una consulta externa de medicina preventiva / Patient and caregiver satisfaction with rehabilitation services after stroke

ObjetivoEvaluar la satisfacción con el programa rehabilitador del ictus de pacientes y cuidadores. Identificar los factores dependientes del propio paciente y del proceso asistencial relacionados con mayor insatisfacción en nuestra área.Material y métodosEstudio transversal en 74 pacientes ingresados en Rehabilitación con el diagnóstico de ictus (el 70,3% eran varones, con edad media de 65,4±12,2, índice de Barthel al alta de 70,5±27) desde junio de 2005 hasta junio de 2006. La satisfacción con la rehabilitación seguida durante el ingreso y el soporte al alta hospitalaria se evaluaron mediante el cuestionario de satisfacción de Pound, administrado telefónicamente 13 meses de media después del alta hospitalaria. Se entrevistó a 85 cuidadores, de los que el 71% era familiar directo (cónyuge o relación filial) y el 80,9% era de sexo femenino.ResultadosEl 52,9% de los pacientes cumplimentó el cuestionario: más del 80% refirió estar completamente satisfecho con el trato y la información recibidos durante el ingreso. En cuanto al tratamiento, el 52,7% se mostró satisfecho; la cantidad de tratamiento recibido fue el aspecto peor valorado. La menor satisfacción correspondió al soporte recibido tras el alta hospitalaria, con menos del 25% de satisfechos. Un 83,1% de cuidadores cumplimentó el cuestionario: el 74,1% estaba satisfecho con la información recibida, el 63,5% con la formación sobre el tratamiento del paciente y el 42,4% con el soporte al alta. Sólo la depresión y el tiempo de evolución tras el ictus se relacionaron con mayor insatisfacción (p<0,05).ConclusionesAunque la satisfacción de pacientes y cuidadores con la información recibida es alta, se detectan elevados porcentajes de insatisfacción con la cantidad de tratamiento recibido y el soporte social al alta hospitalaria, por lo que es necesario incluir medidas sistemáticas de información, formación y soporte al alta en el programa de rehabilitación del ictus(AU)

ObjectivesTo assess patient and caregiver satisfaction with the regular rehabilitation care after stroke. To identify patient features or aspects of the rehabilitation programme related to lower rates of satisfaction in our area.Material and methodsCross-sectional study of 74 stroke in-patients admitted from June 2005 to June 2006 (70.3% men, age 65.4±12.2 years, Barthel discharge 70.5±27). A telephone Satisfaction questionnaire (Pound 1999) was administered at 13.6±3.1 months to assess satisfaction regarding in-patient care, therapy and recovery, and services after hospital discharge. Three items addressed to caregiver satisfaction were also included. A total of 84 caregivers were identified: 71% relatives (partner or children), of which 80.9% were women.ResultsThe satisfaction questionnaire was completed by 52.9% of patients. Over 80% of interviewed patients were completely satisfied with in-patient care, and 52.7% were satisfied with therapy and recovery during admission, but more patients were dissatisfied with the amount of therapy received. The lowest rate of satisfaction was related to the services after discharge, with less than 25% of patients satisfied. A total of 83.1% of caregivers completed the questionnaire, of which 74.1% were satisfied with the information provided. Stroke educational training was given to 63.5% of caregivers, and 42.4% were given support after discharge. Only the presence of depression during admission and time passed after stroke were significantly related to patient satisfaction. (p<0.05).ConclusionsDissatisfaction with some aspects of stroke rehabilitation is considerable in our care area. Despite general patient and caregiver satisfaction regarding information provided, high dissatisfaction rates are also detected related to the amount of therapy and the social support provided after hospital discharge...(AU)