Impact of the Case Management Model through Community Liaison Nurses.

The objective of the present study is to assess the model's impact on patients and their families in terms of outcomes and the efficiency results for the health system in Tenerife, Canary Islands, selecting a period of eight years from the time interval 2002-2018. The employed indicators were collected on a monthly basis. They referred to home care and its impact on clinical outcomes and on the use of resources. The comparison between the indicators' tendencies with and without the liaison nurse model was done with the F-test by Snedecor. All these tests are bilateral, with a level of significance of p < 0.05. In those areas with community liaison nurse (CLN), improvements have been found in indicators that describe: (1) the management of the clinical status of patients, (2) the efficiency of the use of resources, and (3) the quality and compliance with the process that also includes home visits and social risk detection and management. It can be said that in the basic areas of primary health care where the work of the CLN develops there are improvements in the management of the patients' clinical condition as well as in the quality and efficiency of care.

Diseño y validación de un cuestionario para el diagnóstico enfermero psicosocial en Atención Primaria / Design and validation of a questionnaire for psychosocial nursing diagnosis in Primary Care

Objetivo Construir un cuestionario válido, fiable y de fácil manejo para el diagnóstico enfermero psicosocial. Método El estudio se realizó en 2 fases: diseño-construcción del cuestionario y pruebas de validez-fiabilidad. Se construyó un banco de ítems con una escala tipo Likert y dicotómicas, empleando como marco de referencia la clasificación NANDA. La combinación de respuestas conformó reglas diagnósticas para asignar hasta 28 etiquetas. Las pruebas de validez de contenido las realizó un grupo de expertos. Para las pruebas de validez de criterio se emplearon otros instrumentos validados como patrones de referencia. Cuarenta y cinco enfermeras de Atención Primaria de Tenerife (España) administraron de forma independiente el cuestionario, en 3 ocasiones, y los otros instrumentos validados en una única ocasión a 188 pacientes en un intervalo de 3 semanas. Resultados Las pruebas de validez de constructo confirmaron las 6 dimensiones del cuestionario con un 91% de varianza total explicada. Las pruebas de validez de criterio indicaron una especificidad del 66-100% y mayores puntuaciones de los instrumentos de referencia cuando se asignaron etiquetas diagnósticas por nuestro cuestionario. Las pruebas de fiabilidad indicaron grados de acuerdo test-retest del 56%-91% (p<0,001) y una consistencia interna del 93%. El Cuestionario para el Diagnóstico Enfermero Psicosocial, denominado CdePS, quedó conformado por 61 ítems. Conclusiones El CdePS es un instrumento válido, fiable y de fácil empleo en Atención Primaria para facilitar el diagnóstico enfermero psicosocial (AU)

Aim To develop a valid, reliable and easy-to-use questionnaire for a psychosocial nursing diagnosis. Method The study was performed in two phases: first phase, questionnaire design and construction; second phase, validity and reliability tests. A bank of items was constructed using the NANDA classification as a theoretical framework. Each item was assigned a Likert scale or dichotomous response. The combination of responses to the items constituted the diagnostic rules to assign up to 28 labels. A group of experts carried out the validity test for content. Other validated scales were used as reference standards for the criterion validity tests. Forty-five nurses provided the questionnaire to the patients on three separate occasions over a period of three weeks, and the other validated scales only once to 188 randomly selected patients in Primary Care centres in Tenerife (Spain).Results Validity tests for construct confirmed the six dimensions of the questionnaire with 91% of total variance explained. Validity tests for criterion showed a specificity of 66%-100%, and showed high correlations with the reference scales when the questionnaire was assigning nursing diagnoses. Reliability tests showed agreement of 56%-91% (P<.001), and a 93% internal consistency. The Questionnaire for Psychosocial Nursing Diagnosis was called CdePS, and included 61 ítems. Conclusions The CdePS is a valid, reliable and easy-to-use tool in Primary Care centres to improve the assigning of a psychosocial nursing diagnosis (AU)

[Design and validation of a questionnaire for psychosocial nursing diagnosis in Primary Care]. / Diseño y validación de un cuestionario para el diagnóstico enfermero psicosocial en Atención Primaria.

AIM: To develop a valid, reliable and easy-to-use questionnaire for a psychosocial nursing diagnosis. METHOD: The study was performed in two phases: first phase, questionnaire design and construction; second phase, validity and reliability tests. A bank of items was constructed using the NANDA classification as a theoretical framework. Each item was assigned a Likert scale or dichotomous response. The combination of responses to the items constituted the diagnostic rules to assign up to 28 labels. A group of experts carried out the validity test for content. Other validated scales were used as reference standards for the criterion validity tests. Forty-five nurses provided the questionnaire to the patients on three separate occasions over a period of three weeks, and the other validated scales only once to 188 randomly selected patients in Primary Care centres in Tenerife (Spain). RESULTS: Validity tests for construct confirmed the six dimensions of the questionnaire with 91% of total variance explained. Validity tests for criterion showed a specificity of 66%-100%, and showed high correlations with the reference scales when the questionnaire was assigning nursing diagnoses. Reliability tests showed agreement of 56%-91% (P<.001), and a 93% internal consistency. The Questionnaire for Psychosocial Nursing Diagnosis was called CdePS, and included 61 items. CONCLUSIONS: The CdePS is a valid, reliable and easy-to-use tool in Primary Care centres to improve the assigning of a psychosocial nursing diagnosis.

Estudio microbiológico de las comidas servidas en los comedores escolares de la Isla de Tenerife / Microbiological study of the meals served in school lunchrooms on the Island of Tenerife, Spain

Fundamento: Valorar la calidad higiénico-sanitaria de las comidas servidas en comedores escolares con la finalidad de conocer si es adecuada o por el contrario su ingesta puede representar un grave problema de salud para este colectivo de alto riesgo. Métodos: Estudio epidemiológico descriptivo transversal. Se analizan 898 muestras de alimentos recogidos en comedores de 101 colegios de Tenerife, seleccionados por un muestreo probabilístico aleatorio estratificado, 58 con elaboración propia de los alimentos (gestión directa) y 43 con comidas servidas por un catering (elaboración contratada).Resultados: En ninguna de las muestras analizadas se aislaron los patógenos Salmonella spp. y Listeria monocytogenes. El 79 por ciento de los alimentos estudiados presentó recuentos para este parámetro, (91 por ciento) de ensaladas y (85 por ciento) de segundos platos. Para Enterobacteriaceae totales, el 15 por ciento de las muestras analizadas fueron positivas. Escherichia coli se aisló en el 24 por ciento de las ensaladas, el 4 por ciento de los complementos y el 1 por ciento de los segundos platos y Staphylococcus aureus se aisló en tres alimentos. Los recuentos más elevados se obtuvieron para los microorganismos aerobios mesófilos totales. Del total de muestras analizadas un 8,24 por ciento de las mismas superaron uno o más de los límites establecidos para los parámetros estudiados. Conclusiones: La calidad microbiológica de las comidas servidas en los comedores escolares es aceptable, si bien al existir un porcentaje de alimentos que superan los límites establecidos en microorganismos indicadores y testigos de falta de higiene y al ser los escolares un colectivo de alto riesgo, será necesaria la revisión de la vigilancia en los puntos de control crítico (AU)

[Microbiological study of the meals served in school lunch rooms on the island of Tenerife, Spain]. / Estudio microbiológico de las comidas servidas en los comedores escolares de la isla de Tenerife.

BACKGROUND: School lunchrooms and catered meals are of major importance from the Public Health standpoint. This study is aimed at evaluating the microbiological quality of the meals served in school lunchrooms for the purpose of ascertaining whether it is suitable or, to the contrary, the intake thereof may involve a serious health problem for this high-risk group. METHODS: A transversal descriptive epidemiological study. An analysis was conducted of a total of 898 food samples collected from the lunchrooms at 101 schools in Tenerife, selected by a stratified random probabillistic sampling procedure, fifty-eight of which were prepared at the school proper (direct management) and 43 involving meals served by a catering firm (prepared under contract). RESULTS: No disease-causing Salmonella spp. or Listeria monocytogenes bacteria were isolated from any of the samples. A total 79% of the foods studies showed counts for this parameter, (91%) in salads and (85%) in main courses. A total 15% of the samples analyzed tested positive for total Enterobacteriaceae. Escherichia coli was isolated in 24% of the salads, in 4% of the side dishes and in 1% of the main dishes. Staphylococcus aureus having in isolated in three foods. The highest counts were found for the total aerobic mesophyllic microorganisms. A total 8.24% of the samples analyzed exceeded one or more of the limits stipulated for the parameters studies. CONCLUSIONS: The microbiological quality of the meals served in these school lunchrooms is acceptable, although due to a certain percentage of the foods having exceeded the stipulated limits for microorganisms indicative of and revealing a lack of hygiene, and school-children being a high-risk group, a revision of the surveillance related to critical checkpoints will be necessary.

Low prevalence of vancomycin-resistant enterococci in clinical samples from hospitalized patients of the Canary Islands, Spain.

Over the last decade vancomycin-resistant enterococci (VRE) have emerged as nosocomial pathogens. The aim of this study was to determine the prevalence of VRE in clinical samples from hospitalized patients in the Canary Islands. From April to November 2000, 437 enterococci were isolated from patients hospitalized at the four main health care centers in those islands. Identification to the species level was performed with the GPS-TA (Vitek 1) or the Wider I system. A PCR assay was used to determine the genotype of glycopeptide resistance ( vanA, vanB, vanC1, and vanC2/C3 genes). Only three (0.7%) VRE were detected: one vanA Enterococcus faecalis, and two vanC1 Enterococcus gallinarum. To our knowledge, this is the first VRE study carried out in the Canary Islands hospitals, and the results showed a low prevalence of VRE.

Low prevalence of vancomycin-resistant enterococci in clinical samples from hospitalized patients of the Canary Islands, Spain

Over the last decade vancomycin-resistant enterococci (VRE) have emerged as nosocomial pathogens. The aim of this study was to determine the prevalence of VRE in clinical samples from hospitalized patients in the Canary Islands. From April to November 2000, 437 enterococci were isolated from patients hospitalized at the four main health care centers in those islands. Identification to the species level was performed with the GPS-TA (Vitek 1) or the Wider I system. A PCR assay was used to determine the genotype of glycopeptide resistance ( vanA, vanB, vanC1, and vanC2/C3 genes). Only three (0.7%) VRE were detected: one vanA Enterococcus faecalis, and two vanC1 Enterococcus gallinarum. To our knowledge, this is the first VRE study carried out in the Canary Islands hospitals, and the results showed a low prevalence of VRE (AU)

No disponible

Conclusiones de la encuesta de nutrición de Canarias (1997-98): bases para una política de nutrición en Canarias / Conclusions of the Canary Island nutririon survey (1997-98): foundations for nutrition policy in the Canary Islands

Se presentan las conclusiones más importantes de la Encuesta Nutricional de Canarias (ENCA), 1997-98. Dicha encuesta tenía por objetivos el estudio de los hábitos alimentarios y la evaluación del estado nutricional mediante parámetros dietéticos, antropométricos y bioquímicos de la población de las Islas Canarias junto con el estudio de estilos de vida y de la prevalencia de los principales factores de riesgo cardiovascular. Además, también se realizó un cuestionario de conocimientos y actitudes en relación a la alimentación. Para ello se diseñó y llevó a cabo un estudio transversal en una muestra representativa de la población canaria de 6 a 75 años de edad (n=1747). En este artículo además de las conclusiones relativas a estos objetivos también se incluyen las posibles recomendaciones a desarrollar en el marco de una política de nutrición y de salud de Canarias surgidas a raíz de los resultados de la encuesta. Para ello es necesario confeccionar unas guías alimentarias para los nutrientes vulnerables o dianas basadas en el consumo de alimentos