ABSTRACT
En comparación con los adultos, la piel de los pacientes pediátricos presenta importantes diferencias que les hacen susceptibles de padecer determinadas lesiones con mayor facilidad, especialmente los neonatos. Entre ellas destacan las úlceras por presión (UPP), las dermatitis asociadas a incontinencia (DAI) y las lesiones por extravasación periférica. En todas ellas el papel de la enfermera es vital. El presente artículo describe y aporta pautas de actuación basadas en las últimas evidencias científicas para el diagnóstico precoz, la prevención y el tratamiento de estas lesiones que sirvan de ayuda a las enfermeras que atienden población pediátrica que presenta o tiene riesgo de presentar estas lesiones
Comparing to adults, children's skin has important differences that make them liable to suffer some skin lesions easily, specially neonates. Among these lesions stand out pressure ulcers, incontinence associated dermatitis and extravasation injuries. In all of them Nursing rol is vital. This article describes and provide standards of practice based in last scientific evidences for early diagnosis, prevention and treatment that are useful to nurses who cares pediatric patients with or at risk of these lesions
Subject(s)
Humans , Infant , Child, Preschool , Child , Diaper Rash/nursing , Pressure Ulcer/nursing , Extravasation of Diagnostic and Therapeutic Materials/complications , Diaper Rash/epidemiology , Pressure Ulcer/epidemiology , Urinary Incontinence/complications , Incontinence Pads/adverse effects , Wound Healing , Wounds and Injuries/nursing , Wound Closure Techniques/nursingABSTRACT
Solamente en apósitos para prevención y tratamiento de las heridas crónicas en Osakidetza-Servicio Vasco de Salud y el Departamento de Salud del Gobierno Vasco se invirtieron 7 millones de euros en 2009. Fue necesario el trabajo interdepartamental entre profesionales de enfermería expertos en este tipo de materiales y el Departamento de Suministros para llevar a cabo un concurso centralizado de apósitos y productos de cura en ambiente húmedo (APCAH). El objetivo de este trabajo es describir la nueva metodología seguida en el último concurso centralizado de estos materiales en el País Vasco, así como analizar el impacto económico que esto ha tenido en el gasto
Osakidetza-Basque Health Service and the Basque Health Department invested 7 million Euros in 2009 only in dressings for prevention and treatment of chronic wounds. Interdepartmental working among expert nurses at these products and the Supply Department to conduct a centralized purchase of dressing and products for moisture enviroment in wounds (DPMEW). The aim is to describe the new methodology followed in the last centralized purchase of DPMEW in the Basque Country, and also analyze the economic impact that this has had on expense
Subject(s)
Humans , Bandages/economics , Occlusive Dressings/economics , Skin Ulcer/epidemiology , Wound Closure Techniques/instrumentation , Group Purchasing/organization & administration , /statistics & numerical dataABSTRACT
Pressure between bony prominences and sleep surfaces, as well as pressure from the use of medical devices, put children admitted to pediatric intensive care units (PICUs) at risk of developing pressure ulcers (PUs). To assess the effect of two pediatric-specific, continuous and reactive low-pressure mattresses on the incidence of PUs, an observational, descriptive, prospective, longitudinal (2009-2011) study was conducted among PICU patients. The two pediatric mattresses - one for children weighing between 500 g and 6 Kg and another for children weighing more than 6 Kg - were provided to patients at risk for PUs (Braden-Q ≤16, Neonatal Skin Risk Assessment Scale [NSRAS] ≤13, or per nurse assessment of clinical need). Between 2009 and 2011, 30 children (13 [43.3%] girls and 17 [56.7%] boys), ages 0 to 10 years, at risk of developing PUs (NSRAS risk: n = 14 [13.2 ± 3.03] and Braden-Q risk: n = 10 [10.4 ± 2.4]) were placed on the study mattresses for a median of 4 (range 1 to 25) days. Primary reasons for PICU admission included disorders of the respiratory system (40%), infectious and parasitic diseases (23.3%), and illnesses of the musculoskeletal system and connective tissue (10%). All other PU prevention strategies (eg, repositioning, specialty devices) used as part of standard care protocols also were implemented. Of the 30 participants, only one (3.3%) (confidence interval [CI] 95% = 0.08 -17.2%) developed a nondevice-related PU. No adverse events occurred. A 2008 incidence study in the same PICU, before use of these special surfaces, found a cumulative incidence of 20% nondevice-related PUs. The observed incidence rate of nonmedical device-related PUs in this high-risk population placed on these mattresses is encouraging and warrants future research.
Subject(s)
Beds , Intensive Care Units, Pediatric , Pressure Ulcer/prevention & control , Child , Female , Humans , Longitudinal Studies , Male , Pressure , Prospective StudiesABSTRACT
La investigación en el cuidado de la salud por parte de las enfermeras está siendo un procesolento y contranatural, dada la limitación para el doctorado en muchas universidades a nivel internacional.A pesar de ello, la producción científica de las enfermeras españolas mantiene un crecimientoexponencial desde hace más de 30 años. En este sentido, se puede mencionar que ha existido ciertofomento de la investigación en cuidados por parte del Instituto Carlos III con un número crecientede proyectos financiados. No obstante, dicha financiación sigue siendo muy escasa y la producción científicagenerada lo es todavía más.En sus convocatorias, se observa un desequilibrio en las oportunidades de acceso para profesionalessanitarios no médicos, destacando: un baremo no acorde al área disciplinar para la evaluaciónde publicaciones considerando exclusivamente la base de datos MEDLINE, y la evaluación de la productividadde los investigadores sólo mediante el factor de impacto del Science Citation Index.Al mismo tiempo, esta situación está favoreciendo e incentivando la publicación científica en lenguainglesa (también en Medicina), que choca frontalmente con la política de promoción del español,que realiza el Ministerio de Cultura a través del Instituto Cervantes.La generación de conocimiento debe ser reconocida y valorada independientemente del área disciplinar,del idioma y de la base de datos donde se albergue la revista científica. Así, se echan en faltalas bases de datos IME, PsichoINFO,PSICODOC, ISOC-Sociología y CC. Políticas, CUIDEN o CINAHL;así como los índices bibliométricos desarrollados por el Instituto de Estudios Documentales de laCiencia (CSIC-Universidad de Valencia) y por la Fundación Index
Nursing care research is a low and counternatural process, once known the access limitationto phD studies in many international universities. Nevertheless, scientific publications producedby spanish nurses keep an exponential growth for the last 30 years. By the way, it can be mentioned that there has been some help by the Institute Carlos III for nursing research. However,nursing research funds has been short, and it has been even shorter the scientific publicationproduced from it.Research funds access is unbalanced, detrimentally to non-medical health professionals: Standardsare not adjusted to every professional for publications evaluation, considering just MEDLINE database;and researchers production evaluation is performed only via the impact factor from the Science CitationIndex.At the same time, this situation is helping and supporting scientific publication in english language(also in medicine), opposing to the promotion of Spanish which the Ministery of Culture carries outthrough the Cervantes Institute around the world.Knowledge generation must be recognised and valued independently of the disciplinary area, languageand database where the scientific journal is indexed. So, it is important to take into account: databasessuch as IME,PsichoINFO,PSICODOC,ISOC-Sociología y CC.Políticas,CUIDENor CINAHL,and bibliometric indexes developed by the Institute of Science Documental Studies (CSIC-Universityof Valencia) and by Index Foundation
Subject(s)
Research Support as Topic/methods , Primary Nursing/methods , Primary Nursing/organization & administration , Skilled Nursing Facilities/organization & administration , Skilled Nursing Facilities/supply & distribution , Bibliometrics , Research/instrumentation , Research/methods , Nursing Research/ethics , Nursing Research/methods , Research Support as Topic/standards , Palliative Care/methods , Research/education , Research , Nursing Research/organization & administration , Nursing Research/statistics & numerical data , Nursing Research/standards , Nursing Research/trendsABSTRACT
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