[Proposing a workload indicator for hospital at home patients in Osakidetza - Basque Public Health Service]. / Propuesta de un indicador de cargas de trabajo en la atención de pacientes en hospitalización a domicilio de Osakidetza ­ Servicio Vasco de Salud.

INTRODUCTION AND OBJECTIVES: The Hospital at Home (HaH) setting currently lacks adequate workload indicators. This study suggests an indicator that can help in improving professional resources allocation. MATERIALS AND METHODS: Prospective data was collected during May 2021 from patients treated in nine HaH units of Osakidetza-Basque Health Service (North of Spain). Direct care and travel times of healthcare staff was recorded. Data on inpatient days, number of visits, sociodemographic variables, health status, and patient pathologies, among others, were collected. The proposed indicator encompasses both the average visit time and the visit rates. It is called intensity and represents the average daily workload time per patient. RESULTS: A total of n = 1,171 users were included in the analyses. Their mean age was 69.8 years, 45.5% were women and 25% lived more than 12 km away from the corresponding HaH unit. Workload variations were observed for nursing-only and medical-nursing teams, depending on the type of day and patient classification group. The average nursing-only teams workload time on working days was 10.82 min and on non-working days it was 14.78 min. The average workload time for medical-nursing teams, during the same days, was 20.40 min and 4.59 min, respectively. It was observed that certain patient types, like those in palliative care, represented a high workload for medical-nursing teams on working days. CONCLUSIONS: The intensity indicator can help answering the question of how many patients can be assigned to a professional. It can also be used to adjust the staffing needs of the HaH units.

[Factors associated with the hospital at home workload: A Delphi consensus study]. / Factores relacionados con la carga de trabajo en hospitalización a domicilio: estudio de consenso Delphi.

OBJECTIVES: To identify and prioritize a list of factors that contribute to the workload of the hospital at home (HaH) professionals. MATERIAL AND METHODS: A qualitative methodology study performed between January and December 2019 in the 10 HAH units of the Basque Country. The data were obtained in 4phases: 1. Systematic literature search and review; 2. Expert group meeting; 3. Consensus method: Delphi technique (2 survey rounds) and nominal group meeting; 4. Meeting of the research team. RESULTS: In the systematic literature search and review 85 factors were initially identified. These were reduced to 38 after the 8-person expert group meeting, in which 10 new factors were added. After the 2 Delphi rounds (106 and 57 professionals, respectively), 17 factors were maintained and 12 remained in doubt. The latter were evaluated at the nominal group meeting, consisting of 13 professionals who decided to eliminate 5 factors, include 3, and keep 3 as doubt. After the 8-person research team meeting, 14 potential factors were finally selected. They are related to the place of residence, the health state and social situation of the patients, as well as the health care provided at home. CONCLUSIONS: The identified factors could serve for improving the organization and optimize the daily word of the HaH professionals.

Infección nosohusial por Pseudomonas putida / Nosohusial infection by Pseudomonas putida

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Pseudotumor cerebral en probable relación a ceftriaxona / Pseudomotor cerebri probably due to ceftriaxone

No disponible

Buscapina también para la sialorrea / Buscapine for sialorrhoea too

No disponible

Bacteriemia por Leuconostoc spp en un paciente con síndrome de pseudoostrucción intestinal / Leuconostoc spp bacteriemia in a patient with intestinal pseudo-obstruction

No disponible

[Ambulatory parenteral antimicrobial therapies. Five-year experience]. / Tratamientos antimicrobianos parenterales en domicilio. Experiencia de 5 años.

INTRODUCTION. To report the five-year experience in ambulatory parenteral antimicrobial treatments of a Hospital at Home (HH). METHODS. Prospective, descriptive study in which demographic data, infection types, antibiotics, dosages, treatment duration, administration methods, and complications were recorded. RESULTS. A total of 325 ambulatory parenteral antibiotic treatments were instituted. The mean age of patients was 56 years (range: 4-96). Patients included 225 men and 100 women. The mean duration of treatment was 16 days (range: 1-176 days). The total number of stays was 4,313 days. The sources of the treated infections included: respiratory tract, 40.3%; osteoarticular, 13.2%; digestive tract, 7%; cytomegalovirus, 6.4%; soft tissue, 5.5%; bacteremias, 5,2%; central nervous system, 4.9%; urinary tract, 4.6%; febrile syndromes, 3.7%; postsurgical, 3%; and endocarditis, 2.5%. Ceftriaxone was the antibiotic most widely used. Seventy-nine percent of treatments were throught the intravenous route. In the last two years infusion pumps were used. Treatment was completed in 93.3% of cases, three patients died and 19 patients required readmission. The most common complication was phlebitis, in 12.6% of cases. CONCLUSIONS. Currently, there is the possibility of safely treating a large number of infections at patient's home with parenteral antibiotics.

Tratamientos antimicrobianos parenterales en domicilio. Experiencia de 5 años / Ambulatory parenteral antimicrobial therapies. Five-year experience

Objetivo. Describir la experiencia en tratamientos antimicrobianos parenterales en domicilio de una Unidad de Hospitalización a Domicilio (UHD) en un período de 5 años. Metodología. Se realiza un estudio prospectivo, descriptivo, en el que se recogen datos demográficos, tipos de infección, antibióticos y posología utilizada, duración del tratamiento, método de infusión y complicaciones aparecidas. Resultados. Se han instaurado 325 tratamientos antibióticos parenterales a domicilio. La edad media fue 5 6 años (rango: 4 -9 6 años); por sexos, 2 2 5 varones y 1 0 0 mujeres. La duración media de los tratamientos fue de 1 6 días (rango: 1 -1 7 6 días). El número total de estancias fue 4 .3 1 3 días. Las infecciones tratadas han sido muy variadas: respiratorias, 4 0 ,3 %; osteoarticulares, 1 3 ,2 %; del aparato digestivo, 7 %; por citomegalovirus, 6 ,4 %; de tejidos blandos, 5 ,5 %; bacteriemias, 5 ,2 %; del sistema nervioso central, 4 ,9 %; urinarias, 4 ,6 %; síndromes febriles, 3 ,7 %; posquirúrgicas, 3 %, y endocarditis, 2,5%. El antibiótico más utilizado ha sido la ceftriaxona. El 7 9 % de los tratamientos fue endovenoso. En los 2 últimos años se han utilizado bombas de infusión. Se completó el tratamiento en un 9 3 ,3 % de los casos, falleciendo 3 pacientes y requiriendo reingreso 1 9 . La complicación más frecuente ha sido la flebitis en un 12,6% de los casos. Conclusiones. En la actualidad existe la posibilidad de tratar una gran número de infecciones en el domicilio del paciente con antibióticos parenterales de una manera segura (AU)

Objective. To report the five-year experience in ambulatory parenteral antimicrobial treatments of a Hospital at Home (HH). Methods. Prospective, descriptive study in which demographic data, infection types, antibiotics, dosages, treatment duration, administration methods, and complications were recorded. Results. A total of 325 ambulatory parenteral antibiotic treatments were instituted. The mean age of patients was 5 6 years (range: 4 -9 6 ). Patients included 2 2 5 men and 1 0 0 women. The mean duration of treatment was 1 6 days (range: 1 -1 7 6 days). The total number of stays was 4 ,3 1 3 days. The sources of the treated infections included: respiratory tract, 4 0 .3 %; osteoarticular, 1 3 .2 %; digestive tract, 7 %; cytomegalovirus, 6 .4 %; soft tissue, 5 .5 %; bacteremias, 5 ,2 %; central nervous system, 4 .9 %; urinary tract, 4 .6 %; febrile syndromes, 3 .7 %; postsurgical, 3 %; and endocarditis, 2 .5 %. Ceftriaxone was the antibiotic most widely used. Seventy-nine percent of treatments were throught the intravenous route. In the last two years infusion pumps were used. Treatment was completed in 9 3 .3 % of cases, three patients died and 19 patients required readmission. The most common complication was phlebitis, in 12.6% of cases. Conclusions. Currently, there is the possibility of safely treating a large number of infections at patient’s home with parenteral antibiotics (AU)

[Attitude to tobacco and prevalence of smokers among primary care physicians in Guipúzcoa]. / Actitud ante el tabaco y prevalencia de fumadores en médicos de atención primaria de Guipúzcoa.

OBJECTIVE: To discover the evolvement of Primary Care doctors' tobacco consumption in Guipuzcoa and their attitudes to tobacco dependency. DESIGN: A descriptive study of a crossover type. October 1992. SETTING: Primary Health care. PARTICIPANTS: 381 general physicians and paediatricians from Guipuzcoa province. MEASUREMENTS AND MAIN RESULTS: A self-filled questionnaire was distributed at Health Centres for subsequent return by mail. The reply rate was 60.89%, 42.3% were smokers; 33.6%, ex-smokers. 43% of smokers smoked in the Centre; 2% in front of patients. We found significant differences (p < 0.05) with a study carried out in 1988, where doctors who smoked were 52.4%, ex-smokers 19% and doctors who smoked in front of patients, 18.2%. 45.7% of women smoked, 39.2% of men. 78% of the doctors under study stated that they questioned patients about tobacco consumption. 95.2% did so when patients had specific pathologies. CONCLUSIONS: There has been a significant decline in tobacco smoking by doctors in Guipuzcoa. There are more women than men smokers. There is a higher proportion of ex-smokers among doctors than in the population as a whole. There has been a positive change of attitude as to smoking in front of patients. Centres should become more involved in the struggle against tobacco by offering to set up dependency counselling groups.