Seguridad del paciente e implicación de las enfermeras: encuesta en los hospitales de Cataluña / Patient safety and nursing implication: Survey in Catalan hospitals

OBJETIVO: El presente estudio pretende describir la implementación de los programas de seguridad del paciente (SP) de los hospitales catalanes y analizar el nivel de implicación de las enfermeras. MÉTODO: Estudio descriptivo multicéntrico y transversal. Para la obtención de los datos se elaboraron dos cuestionarios, uno dirigido a la dirección y otro al referente de SP que se distribuyeron entre los 65 hospitales de agudos de Cataluña en 2013. RESULTADOS: El cuestionario lo respondieron 43 direcciones de enfermería y 40 referentes de enfermería de SP. El 93% de los hospitales respondió disponer de programa de SP y el 81,4% monitoriza los resultados mediante un cuadro de indicadores específico. El referente en SP del centro es enfermera en el 55,8% de los centros. El 92,5% disponen de un sistema de notificación de efectos adversos con un promedio de 190,3 notificaciones anuales y el 86% de los centros dedican enfermeras a la SP aunque únicamente el 16% a jornada completa. Los referentes de enfermería valoran el grado de implementación del programa SP con un aprobado y proponen como mejora aumentar el personal con dedicación a SP y disponer de formación académica específica. CONCLUSIONES: El grado de implementación de los programas de SP es elevado en los hospitales catalanes aunque la estructura organizativa presenta una gran diversidad. En más de la mitad de los centros el referente en SP es una enfermera, confirmándose la implicación de las enfermeras en estos programas

OBJECTIVE: This study aims to describe the implementation of the patient safety (PS) programs in catalan hospitals and to analyze the level of nursing involvement. METHOD: Multicenter cross-sectional study. To obtain the data two questionnaires were developed; one addressed to the hospital direction and another to the nurse executive in PS. The survey was distributed during 2013 to the 65 acute care hospitals in Catalonia. RESULTS: The questionnaire was answered by 43 nursing directors and 40 nurse executive in PS.93% of the hospitals responded that they had a PS Program and 81.4% used a specific scoreboard with PS indicators. The referent of the hospital in PS was a nurse in 55.8% of the centres.92.5% had a system of notification of adverse effects with an annual average of 190.3 notifications. In 86% of the centres had a nurse involved in the PS program but only in the 16% of the centres the nurse dedication was at full-time. The nurse respondents evaluate the degree of implementation of the PBS program with a note of approved and they propound as improvement increase the staff dedicated to the PS and specific academic training in PS. CONCLUSIONS: The degree of implementation of programs for patient safety is high in Catalan acute hospitals, while the organizational structure is highly diverse. In more than half of the hospitals the PS referent was a nurse, confirming the nurse involvement in the PS programs

Patient safety and nursing implication: Survey in Catalan hospitals. / Seguridad del paciente e implicación de las enfermeras: encuesta en los hospitales de Cataluña.

OBJECTIVE: This study aims to describe the implementation of the patient safety (PS) programs in catalan hospitals and to analyze the level of nursing involvement. METHOD: Multicenter cross-sectional study. To obtain the data two questionnaires were developed; one addressed to the hospital direction and another to the nurse executive in PS. The survey was distributed during 2013 to the 65 acute care hospitals in Catalonia. RESULTS: The questionnaire was answered by 43 nursing directors and 40 nurse executive in PS. 93% of the hospitals responded that they had a PS Program and 81.4% used a specific scoreboard with PS indicators. The referent of the hospital in PS was a nurse in 55.8% of the centres. 92.5% had a system of notification of adverse effects with an annual average of 190.3 notifications. In 86% of the centres had a nurse involved in the PS program but only in the 16% of the centres the nurse dedication was at full-time. The nurse respondents evaluate the degree of implementation of the PBS program with a note of approved and they propound as improvement increase the staff dedicated to the PS and specific academic training in PS. CONCLUSIONS: The degree of implementation of programs for patient safety is high in Catalan acute hospitals, while the organizational structure is highly diverse. In more than half of the hospitals the PS referent was a nurse, confirming the nurse involvement in the PS programs.

Encuesta de las medidas de control de Staphylococcus aureusresistente a meticilina en los hospitales que participan en el programa VINCat / Survey of methicillin-resistant Staphylococcus aureus control measures in hospitals participating in the VINCat program

INTRODUCCIÓN: VINCat es un programa de vigilancia de la infección nosocomial en los hospitales de Cataluña. El objetivo del estudio fue evaluar el cumplimiento de las medidas de control de Staphylococcus aureus resistente a meticilina (SARM) en dichos centros. MÉTODOS: De enero a marzo de 2013 se realizó una encuesta por correo sobre las características de los hospitales y la aplicación de las medidas de control de SARM. RESULTADOS: Respondieron 53 hospitales (>500 camas: 7; 200-500 camas: 14;<200 camas: 32; tenían UCI: 29). Disponían de alerta informática de reingresos el 63%. Realizaban vigilancia activa de los traslados de otro hospital el 46,2%, o centro de larga estancia el 55,8%, siendo ambas medidas significativamente más frecuentes en hospitales con una tasa de SARM≤22% (mediana global). Observaban el cumplimento de higiene de manos el 77,4% de los centros y fue mayor al 50% en el 69,7%. Todos los hospitales aplicaban precauciones de contacto, aunque el 62,3% no disponían de material clínico de uso frecuente exclusivo. La limpieza de la habitación se realizaba más frecuentemente en el 54,7% y tenían programas de adecuación del uso de antibióticos el 67,9%. CONCLUSIONES: Este estudio informa sobre la implementación de medidas preventivas de SARM en hospitales del programa VINCat. Aunque la mayoría de los hospitales disponen de un protocolo específico, el cumplimento de las medidas es mejorable, especialmente la detección activa en pacientes de riesgo, la adherencia a la higiene de manos, la limpieza más frecuente de la habitación y la optimización del uso de antibióticos

INTRODUCTION: VINCat is a nosocomial infection surveillance program in hospitals in Catalonia. The aim of the study was to determine the surveillance and control measures of methicillin-resistant Staphylococcus aureus (MRSA) in these centres. METHODS: An e-mail survey was carried out from January to March 2013 with questions related to the characteristics of the hospitals and their control measures for MRSA. RESULTS: A response was received from 53 hospitals (>500 beds: 7; 200-500 beds: 14;<200 beds: 32; had ICU: 29). Computer alert of readmissions was available in 63%. There was active surveillance of patients admitted from another hospital (46.2%) or a long-term-care centre (55.8%), both being significantly more common measures in hospitals with a rate of MRSA≤22% (global median). Compliance with hand hygiene was observed in 77.4% of the centres, and was greater than 50% in 69.7% of them. All hospitals had contact precautions, although 62.3% did not have exclusive frequently used clinical material in bedrooms. The room cleaning was performed more frequently in 54.7% of hospitals, and 67.9% of them had programs for the appropriate use of antibiotics. CONCLUSIONS: This study provides information on the implementation of measures to prevent MRSA in hospitals participating in the VINCat program. Most of the centres have an MRSA protocol, however compliance with it should be improved, especially in areas such as active detection on admission in patients at risk, hand hygiene adherence, cleaning frequency and optimising the use of antibiotics

[Survey of methicillin-resistant Staphylococcus aureus control measures in hospitals participating in the VINCat program]. / Encuesta de las medidas de control de Staphylococcus aureus resistente a meticilina en los hospitales que participan en el programa VINCat.

INTRODUCTION: VINCat is a nosocomial infection surveillance program in hospitals in Catalonia. The aim of the study was to determine the surveillance and control measures of methicillin-resistant Staphylococcus aureus (MRSA) in these centres. METHODS: An e-mail survey was carried out from January to March 2013 with questions related to the characteristics of the hospitals and their control measures for MRSA. RESULTS: A response was received from 53 hospitals (>500 beds: 7; 200-500 beds: 14;<200 beds: 32; had ICU: 29). Computer alert of readmissions was available in 63%. There was active surveillance of patients admitted from another hospital (46.2%) or a long-term-care centre (55.8%), both being significantly more common measures in hospitals with a rate of MRSA≤22% (global median). Compliance with hand hygiene was observed in 77.4% of the centres, and was greater than 50% in 69.7% of them. All hospitals had contact precautions, although 62.3% did not have exclusive frequently used clinical material in bedrooms. The room cleaning was performed more frequently in 54.7% of hospitals, and 67.9% of them had programs for the appropriate use of antibiotics. CONCLUSIONS: This study provides information on the implementation of measures to prevent MRSA in hospitals participating in the VINCat program. Most of the centres have an MRSA protocol, however compliance with it should be improved, especially in areas such as active detection on admission in patients at risk, hand hygiene adherence, cleaning frequency and optimising the use of antibiotics.