¿Qué hemos hecho en nuestra UCI de Anestesia para mantener la comunicación en la pandemia? / What have we done in our anesthesia ICU to maintain communication in the pandemic?

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Recorded infection control messages delay inter-professional communication but are not associated with COVID-19 prevalence or mortality: insights from a national switchboard analysis.

Appropriate dissemination of information to the general public is a key component of the pandemic response. In 2018, recorded infection control advice messages were affixed to 30% of England's automated hospital switchboards during the seasonal influenza and norovirus outbreaks. As the majority of messages were mandatory for all callers, healthcare professionals using the hospital switchboard - including during time-critical emergencies - had their enquiries significantly delayed by these measures. Importantly, published analyses did not demonstrate an association between these messages and patient outcomes. As of May 2020, 85% of NHS trusts made use of infection control messages; on average, these delayed healthcare professionals by 59.4 seconds per call, but had no clear association with patient outcomes from COVID-19. An ongoing national switchboard quality improvement project seeks to establish a gold standard whereby healthcare professionals with urgent enquiries can press 'X' to skip past infection control messages and have their calls triaged immediately.

Paging the Right Resident the First Time on General Internal Medicine: A Quality Improvement Project.

BACKGROUND: Interprofessional hospital communication is vital for high-quality patient care. However, staff have reported that nursing pages are often sent to the wrong residents, leading to service delays, interruptions, and safety risks. The aim of this quality improvement project was to reduce day shift pages to general internal medicine (GIM) teams by 25% over 10 months by helping nurses page the right residents the first time. METHODS: This study was conducted at a Canadian tertiary academic hospital and involved three GIM teams on seven inpatient wards. The Model for Improvement was used to explore root causes and redesign how nurses and switchboard operators contacted residents. Multiple change ideas were tested: posting daily resident assignments on digital monitors, redirecting switchboard pages to internal medicine residents, and forwarding pagers in learning sessions. The primary outcome was the average number of pages/team/week to GIM residents. Evaluation was conducted with statistical process control charts and qualitative feedback. RESULTS: A total of 19,925 pages were reviewed from 226 resident shifts over 39 weeks. Average pages/team/week (Monday to Friday, 08:00 to 17:00) decreased by 38.3% (133 to 82) postimplementation. More nurses reported often or always knowing which residents were assigned to patients, increasing from 0% to 38.1%. Fewer residents reported often or always receiving pages about another resident's patient, decreasing from 50.0% to 26.7%. CONCLUSION: Quality improvement methods were used to streamline the paging process on GIM wards, resulting in fewer pages and improved communication efficiency.

Descripción de las herramientas de comunicación utilizadas en el área quirúrgica y la perspectiva de los instrumentadores quirúrgicos / Description of communication tools practices in the surgical area and the perspective of surgical instrumenters

La comunicación efectiva dentro de las organizaciones es uno de los factores más importantes para lograr un trabajo positivo y eficaz. Se realizó una investigación cuyo objetivo fue identificar y describir las herramientas de comunicación en el área de Quirófano Central del Hospital Italiano de Buenos Aires y las distintas perspectivas de los instrumentadores quirúrgicos respecto de su utilización. Métodos: se realizó un estudio de corte transversal con un componente de observación participativa de los medios de comunicación y una encuesta a los instrumentadores quirúrgicos de la institución. Resultados: se identificaron ocho tipos de herramientas de comunicación en el área quirúrgica. El correo electrónico (e-mail) como herramienta de comunicación es muy utilizado según los instrumentadores quirúrgicos, pero estos sugirieron otras herramientas más directas, como reuniones y capacitaciones solas o en combinación para determinados tipos de información. Conclusiones: los instrumentadores quirúrgicos utilizan una amplia gama de medios de comunicación en el área quirúrgica. La distribución de preferencias según el tipo de información indica que la elección de estos medios debería ser personalizada. (AU)

Effective communication within organizations is one of the most important factors to achieve a positive and effective work. An investigation was carried out and its objective was to identify and describe the communication tools in the surgical area of the Hospital Italiano de Buenos Aires and the different perspectives of the surgical nurses regarding its use. Methods: a cross-sectional study was carried out with a component of participative observation of the communication tools and a survey of the surgical nurses of the institution. Results: eight types of communication tools were identified in the surgical area. The implementation of email as a communication tool is widely used by surgical nurses, but they suggested other more direct tools such as meetings and training sessions alone or in combination for certain types of information. Conclusions: Surgical nurses use a wide range of communication tools in the surgical area. The distribution of preferences according to the type of information indicates that the choice of these tools should be personalized. (AU)

[Securing patients pathways treated by oral antitumoral: Guidelines for better organization of departments and management of incoming calls]. / Sécurisation des parcours des patients sous traitement anti-tumoraux oraux : recommandations pour une meilleure organisation des services et gestion des appels entrants.

The emergence of oral cancer treatment in oncology has shifted patient follow-up from the hospital to the home. This trend has resulted in an increase in phone and e-mail interactions initiated by patients, but also by pharmacists, by liberal nurses, by general practitioners, and an increase in calls to the emergency response services (SAMU) both for real or perceived emergencies. This increased volume of patient and pharmacist communication has caused significant disruption in the daily activity of affected oncology departments and in particular of the secretariats. The procedures for formulating and securing appropriate responses within a short time frame are generally not established, and as a result, there is a risk that decisions made could be inappropriate for the patient's situation, especially in the case of complications.. Tracking responses to phone calls is necessary and answers should be noted in the medical file, including side effects, in particular the serious AEs for a good quality of care. This guideline describes best practices for oncologists who manage "incoming" calls from patients or professionals involved in the care pathway.

Communication for patient safety in pediatric hospitalizations. / Comunicação para a segurança do paciente em internações pediátricas.

OBJECTIVE: To analyze the perception of health professionals and companions/family about the development of communication for patient safety in pediatric hospitalizations. METHOD: It is an exploratory-descriptive study with a qualitative approach, performed in pediatric clinical-surgical hospitalization units of three hospitals in Porto Alegre, RS, Brazil. 44 health professionals and 94 companions of hospitalized children participated in the study, to a total of 138 participants. Data collection took place between 2016 and 2017, through semi-structured interviews. A thematic content analysis was used. RESULTS: Two categories emerged: "Barriers to an effective communication", addressing the failures and difficulties in the communication process and "Tools to improve communication", that present recommendations for improvements, especially instrumentalization of the companion/family member. CONCLUSIONS: The barriers to an effective communication involve several factors, and effective communication strategies can assist in the development of improvements for pediatric patient safety.

Effective communication for patient safety: transfer note and Modified Early Warning Score. / Comunicação efetiva para a segurança do paciente: nota de transferência e Modified Early Warning Score.

OBJECTIVE: To analyze the registry of the Transfer Note (NT) and the emission of the Modified Early Warning Score (MEWS) performed by the nurse in adult patients transferred from the Emergency Service as an effective communication strategy for patient safety. METHOD: A cross-sectional retrospective study developed at a teaching hospital in the South of Brazil that evaluated 8028 electronic medical records in the year 2017. A descriptive analysis was performed. RESULTS: NT reached the institutional target of 95% in January and February, falling below the target in other months. The MEWS measurement was performed in 85.6% (n = 6,870) of the medical records. Of these patients, 96.8% (n = 6,652) had unchanged MEWS. CONCLUSION: NT and MEWS are inserted in the work of the nurse, however, actions are needed to qualify patient safety, improving effective communication and therefore reducing the possibility of occurrence of adverse events.

Usability of and Satisfaction With Vocera Wireless Communication.

Qualitative reports of hands-free communication devices highlight numerous improvements in communication. The purpose of this study was to assess both usability and satisfaction scores at approximately 1 year after the implementation of a hands-free communication device at two different large military facilities. To do this, a survey that included the System Usability Scale and questions to assess satisfaction with regard to use, quality, and user satisfaction was provided to staff at both of these facilities. System usability scores indicated moderate satisfaction (61.7 at facility A, 63.8 at facility B). User satisfaction rated highest levels of agreement with the hands-free devices as an important system and being useful (35%-37% at facility A, 46% at facility B). Scores regarding improving the quality of work (A = 12%, B = 16%); safety of patients (A = 23%, B = 29%); and ability to do their job in a timely manner (A = 23%, B = 29%) were the lowest. The results highlight the potential benefits of Vocera for improving communication within the healthcare team. Given the large percentage of staff turnover at both of these facilities, the sustained benefit of hands-free devices will require ongoing training and continued evaluation of workflow processes.

Comunicação para a segurança do paciente em internações pediátricas / Comunicación para la seguridad del paciente en hospitalización pediátricas / Communication for patient safety in pediatric hospitalizations

Resumo OBJETIVO Analisar a percepção de profissionais de saúde e acompanhantes/familiares quanto ao desenvolvimento da comunicação para a segurança do paciente em internações pediátricas. MÉTODO estudo exploratório-descritivo, qualitativo, realizado em unidades de internação clínico-cirúrgicas pediátricas de três hospitais de Porto Alegre, RS, Brasil. Participaram do estudo 44 profissionais de saúde e 94 acompanhantes de crianças hospitalizadas, totalizando 138 participantes. A coleta ocorreu no período de 2016 a 2017, por meio de entrevistas semiestruturadas. Realizou-se análise de conteúdo do tipo temática. RESULTADOS Emergiram duas categorias: "Barreiras para a Comunicação Efetiva" que abordou as falhas e dificuldades no processo de comunicação e "Ferramentas para Qualificar a Comunicação" que apresenta recomendações para as melhorias, em especial, instrumentalização do acompanhante/familiar. CONCLUSÕES As barreiras para a comunicação efetiva envolvem múltiplos fatores e as estratégias de comunicação efetiva podem auxiliar no desenvolvimento de melhorias para a segurança do paciente pediátrico.

Resumen OBJETIVO Analizar la percepción de profesionales de salud y acompañantes/familiares con respecto al desarrollo de la comunicación para la seguridad del paciente en internaciones pediátricas. MÉTODO Estudio exploratorio-descriptivo, cualitativo, realizado en unidades de internación clínico-quirúrgicas pediátricas de tres hospitales de Porto Alegre, RS, Brasil. Participaron del estudio 44 profesionales de salud y 94 acompañantes de niños hospitalizados, totalizando 138 participantes. La recolección ocurrió en el período de 2016 a 2017, por medio de entrevistas semiestructuradas. Se realizó un análisis de contenido del tipo temático. RESULTADOS Surgieron dos categorías: "Barreras para la comunicación efectiva" que abordo las fallas y dificultades en el proceso de comunicación y "Herramientas para calificar la comunicación" que presenta recomendaciones para mejorías, em particular, instrumentalización del acompañante/familiar. CONCLUSIONES Las barreras para la comunicación efectiva envuelven diversos factores y las estrategias de comunicación efectiva pueden ayudar en el desarrollo de mejorías para la seguridad del paciente pediátrico.

Abstract OBJECTIVE To analyze the perception of health professionals and companions/family about the development of communication for patient safety in pediatric hospitalizations. METHOD It is an exploratory-descriptive study with a qualitative approach, performed in pediatric clinical-surgical hospitalization units of three hospitals in Porto Alegre, RS, Brazil. 44 health professionals and 94 companions of hospitalized children participated in the study, to a total of 138 participants. Data collection took place between 2016 and 2017, through semi-structured interviews. A thematic content analysis was used. RESULTS Two categories emerged: "Barriers to an effective communication", addressing the failures and difficulties in the communication process and "Tools to improve communication", that present recommendations for improvements, especially instrumentalization of the companion/family member. CONCLUSIONS The barriers to an effective communication involve several factors, and effective communication strategies can assist in the development of improvements for pediatric patient safety.

Comunicação efetiva para a segurança do paciente: nota de transferência e Modified Early Warning Score / Comunicación efectiva para la seguridad del paciente: nota de transferencia y Modified Early Warning Score / Effective communication for patient safety: transfer note and Modified Early Warning Score

Resumo OBJETIVO Analisar o registro da Nota de Transferência (NT) e a emissão do Modified Early Warning Score (MEWS) realizados pelo enfermeiro em pacientes adultos transferidos do Serviço de Emergência como estratégia de comunicação efetiva para a segurança do paciente. MÉTODO Estudo transversal retrospectivo desenvolvido em um hospital de ensino no Sul do Brasil que avaliou 8028 prontuários eletrônicos no ano de 2017. Procedeu-se a análise descritiva. RESULTADOS A realização da NT atingiu a meta institucional de 95% nos meses de janeiro e fevereiro, ficando abaixo da meta nos demais meses. A mensuração do MEWS foi realizada em 85,6% (n=6.870) dos prontuários. Destes pacientes, 96,8% (n=6.652) possuíam MEWS não alterado. CONCLUSÃO A NT e o MEWS estão inseridos no trabalho do enfermeiro, no entanto, são necessárias ações com vistas a qualificar a segurança do paciente, melhorando a comunicação efetiva e, por conseguinte, diminuindo a possibilidade de ocorrências de eventos adversos.

Resumen OBJETIVO Analizar el registro, realizado por el enfermero, la Nota de Transferencia (NT) y la emisión del Modified Early Warning Score (MEWS) en pacientes adultos transferidos del Servicio de Emergencia como estrategia de comunicación efectiva para la seguridad del paciente. MÉTODO Estudio transversal retrospectivo desarrollado en un hospital de enseñanza en el sur de Brasil que evaluó 8028 históricos electrónicos en el año 2017. Se llevó a cabo el análisis descriptivo. RESULTADOS La realización de la NT alcanzó la meta institucional del 95% en los meses de enero y febrero, quedando por debajo de la meta en los demás meses. La medición del MEWS se realizó en el 85,6% (n = 6.870) de los históricos. De estos pacientes, el 96,8% (n = 6.652) poseía MEWS no alterado. CONCLUSIÓN La NT y el MEWS están insertos en el trabajo del enfermero, sin embargo es necesario acciones con miras a calificar la seguridad del paciente, para mejor la comunicación efectiva y, por consiguiente, disminuir la posibilidad de ocurrencia de eventos adversos.

Abstract OBJECTIVE To analyze the registry of the Transfer Note (NT) and the emission of the Modified Early Warning Score (MEWS) performed by the nurse in adult patients transferred from the Emergency Service as an effective communication strategy for patient safety. METHOD A cross-sectional retrospective study developed at a teaching hospital in the South of Brazil that evaluated 8028 electronic medical records in the year 2017. A descriptive analysis was performed. RESULTS NT reached the institutional target of 95% in January and February, falling below the target in other months. The MEWS measurement was performed in 85.6% (n = 6,870) of the medical records. Of these patients, 96.8% (n = 6,652) had unchanged MEWS. CONCLUSION NT and MEWS are inserted in the work of the nurse, however, actions are needed to qualify patient safety, improving effective communication and therefore reducing the possibility of occurrence of adverse events.

Traspaso de información en Medicina Intensiva / Handover in Intensive Care

El traspaso de información (TI) es una tarea frecuente y compleja que lleva implícito el traspaso de la responsabilidad del cuidado del paciente. Las deficiencias en este proceso se asocian a importantes brechas en la seguridad clínica e insatisfacción de pacientes y profesionales. Los esfuerzos por estandarizar el TI se han incrementado en los últimos años, dando pie a la aparición de herramientas mnemotécnicas. Globalmente las prácticas locales del TI son heterogéneas y el nivel de formación, bajo. El objetivo de esta revisión es enfatizar la importancia del TI y proporcionar una estructura metodológica que favorezca el TI efectivo en las UCI, reduciendo el riesgo asociado a este proceso. Específicamente, se hace referencia al TI durante los cambios de guardia y los turnos de enfermería, durante el traslado de los pacientes a otras áreas diagnósticas y terapéuticas y en el momento del alta de UCI. También se contemplan las situaciones de urgencia y se señala la potencial participación de pacientes y familiares. Por último, se proponen fórmulas para la medición de la calidad y se mencionan posibles mejoras en este proceso, especialmente en el ámbito de la formación

Handover is a frequent and complex task that also implies the transfer of the responsibility of the care. The deficiencies in this process are associated with important gaps in clinical safety and also in patient and professional dissatisfaction, as well as increasing health cost. Efforts to standardize this process have increased in recent years, appearing numerous mnemonic tools. Despite this, local are heterogeneous and the level of training in this area is low. The purpose of this review is to highlight the importance of IT while providing a methodological structure that favors effective IT in ICU, reducing the risk associated with this process. Specifically, this document refers to the handover that is established during shift changes or nursing shifts, during the transfer of patients to other diagnostic and therapeutic areas, and to discharge from the ICU. Emergency situations and the potential participation of patients and relatives are also considered. Formulas for measuring quality are finally proposed and potential improvements are mentioned especially in the field of training

Circuito informático en la CMA. Proyecto en el área III-IV de la Comunidad de Cantabria / Computer managment in day surgery unit. Analysis in area III-IV of Cantabria, North of Spain

La comunicación con el paciente se ha considerado como el factor decisivo para asegurar su satisfacción. Se ha considerado que es más probable que un paciente satisfecho cumpla con las recomendaciones médicas y busque activamente ayuda médica. Si el paciente siente la insatisfacción, esta se relaciona con el coste de la atención sanitaria, con la ineficacia del tratamiento, con la ausencia de información comprensible, con la falta de interés del profesional sobre el caso o con la petición de un número excesivo de pruebas complementarias. La decisión de un paciente de acudir a una consulta médica estaría condicionada por la necesidad o urgencia de curarse tanto mayor en procesos agudos, incapacitantes o dolorosos, la calidad profesional y humana que el paciente atribuye al médico y que podría estar basada únicamente en el comentario de otros pacientes, la presión de sus familiares para que busque ayuda médica o para que acuda a esa consulta en concreto, la percepción de control que tiene el paciente y que hace que piense que puede ir (conoce teléfono de contacto, puede pagar la consulta, etc.), el balance de costes y beneficios que intuye pueden producirse al acudir a la consulta y, finalmente, el nivel de satisfacción cuando se trata de un paciente que ya conoce a ese médico. Pero surgen las nuevas tecnologías de la información que facilitan la telecomunicación y que en un futuro temprano cambien el concepto de consulta médica, permitiendo mejor satisfacción del paciente

Communication with the patient has been considered as the decisive factor to ensure their satisfaction. It has been considered that a satisfied patient is more likely to comply with medical recommendations and actively seek medical help. When experiencing dissatisfaction, this is related to the cost of health care, ineffective treatment, lack of understandable information, lack of professional interest in the case or the request for an excessive number of complementary tests. The decision of a patient to go to a medical consultation would be conditioned by the need or urgency to heal so much in acute, disabling or painful processes, the professional and human quality that the patient attributes to the physician and that could be based solely on the comment Of other patients, the pressure of their relatives to seek medical help or to go to that particular query, the patient’s perception of control and that makes him think he can go (he knows contact phone, he can pay the consultation, etc.), the balance of costs and benefits that intuitively can occur when going to the consultation and, finally, the level of satisfaction when it comes to a patient who already knows that doctor. But new information technologies arise that facilitate telecommunication and in the early future change the concept of medical consultation, allowing better patient satisfaction

Pilot study of a new comprehensive radiology report categorization (RADCAT) system in the emergency department.

PURPOSE: The purpose of this study was to describe a new, broadly applicable radiology report categorization (RADCAT) system that was developed collaboratively between radiologists and emergency department (ED) physicians, and to establish its usability and performance by interobserver variation. METHODS: In collaboration with our ED colleagues, we developed the RADCAT system for all imaging studies performed in our level-1 trauma center, including five categories that span the spectrum of normal through emergent life-threatening findings. During a pilot phase, four radiologists used the system real-time to categorize a minimum of 400 reports in the ED. From this pool of categorized studies, 58 reports were then selected semi-randomly, de-identified, stripped of their original categorization, and recategorized based on the narrative radiology report by 12 individual reviewers (6 radiologists, and 6 ED physicians). Interobserver variation between all reviewers, radiologists only, and ED physicians only was calculated using Cohen's Kappa statistic and Kendall's coefficient of concordance. RESULTS: Altogether, agreement among radiologists and ED physicians was substantial (κ = 0.73, p < 0.0001) and agreement for each category was substantial (all κ > 0.60, p < 0.0001). The lowest agreement was observed with RADCAT-3 (κ > 0.61, p < 0.0001) and the highest agreement with RADCAT-1 (κ > 0.85, p < 0.0001). A high trend in agreement was observed for radiologists and ED physicians and their combination (all W > 0.90, p < 0.0001). CONCLUSIONS: Our RADCAT system is understandable between radiologists and ED physicians for categorizing a wide range of imaging studies, and warrants further assessment and validation. Based upon these pilot results, we plan to adopt this RADCAT scheme and further assess its performance.

Creation of a virtual antidotes network between pharmacy departments of catalan hospitals / Creación de una red virtual de antídotos entre los servicios de farmacia de los hospitales de Cataluña

Objective: To design a virtual antidote network between hospitals that could help to locate on-line those hospitals that stocked those antidotes with the highest difficulty in terms of availability, and ensured that the medication was loaned in case of necessity. Methods: The application was developed by four hospital pharmacists and two clinical toxicologists with the support of a Healthcare Informatics Consultant Company. Results: The antidotes network in Catalonia, Spain, was launched in July 2015. It can be accessed through the platform: www.xarxaantidots.org. The application has an open area with overall information about the project and the option to ask toxicological questions of non-urgent nature. The private area is divided into four sections: 1) Antidotes: data of interest about the 15 antidotes included in the network and their recommended stock depending on the complexity of the hospital, 2) Antidote stock management: virtual formulary, 3) Loans: location of antidotes through the on-line map application Google Maps, and virtual loan request, and 4) Documentation: As of June, 2016, 40 public and private hospitals have joined the network, from all four provinces of Catalonia, which have accessed the private area 2102 times, requested two loans of silibinin, one of hydroxocobalamin, three of antiophidic serum and three of botulism antitoxin. Thirteen toxicological consultations have been received. Conclusions: The implementation of this network improves the communication between centers that manage poisoned patients, adapts and standardizes the stock of antidotes in hospitals, speeds up loans if necessary, and improves the quality of care for poisoned patients (AU)

Objetivo: Diseñar una red virtual de antídotos entre hospitales que permitiese localizar, de forma online, en qué hospitales están ubicados los antídotos con mayor dificultad de disponibilidad y facilitase el préstamo de la medicación en caso de necesidad. Método: La aplicación fue desarrollada por cuatro farmacéuticos de hospital, dos toxicólogos clínicos y el soporte de una empresa informática. Resultados: La red de antídotos de Cataluña entró en funcionamiento en julio de 2015. Puede accederse a través de la plataforma: www.xarxaantidots.org. La aplicación consta de una zona abierta con información general del proyecto y la posibilidad de realizar consultas toxicológicas de carácter no urgente. La zona privada se divide en cuatro secciones: 1) Antídotos: datos de interés de los 15 antídotos en red y dotación recomendada en función de la complejidad del hospital, 2) Gestión del stock de antídotos: botiquines virtuales, 3) Préstamos: localización de antídotos mediante el servidor de aplicaciones de mapas en la web, Google Maps, y solicitud de préstamo virtual y 4) Documentación: Hasta junio de 2016 son 40 los hospitales públicos y privados de las cuatro provincias de Cataluña adheridos; se han registrado 2.102 accesos a la zona privada, solicitado dos préstamos de silibinina, uno de hidroxocobalamina, tres de suero antiofídico y tres de suero antibotulínico. Se han recibido 13 consultas toxicológicas. Conclusiones: La puesta en marcha de la red mejora la comunicación entre centros que atienden a pacientes intoxicados, adecua y homogeneiza la dotación de antídotos de los hospitales, agiliza los préstamos en caso necesario y aumenta la calidad de la atención a los pacientes intoxicados (AU)

La información sanitaria en el proceso de la muerte: ¿a quién corresponde? / Giving information in the end-of-life-process. Whose responsibility?

ANTECEDENTES: Uno de los conflictos éticos más frecuentes y generadores de sufrimiento en la atención sanitaria es la información a pacientes y familias en el final de la vida. OBJETIVO: El objetivo de este trabajo es explorar e interpretar la visión de la enfermería respecto a la información sanitaria proporcionada a las personas en el proceso de la muerte. MÉTODO: Esta investigación se enmarca en el paradigma cualitativo y utiliza el método fenomenológico-hermenéutico interpretativo. El escenario de la investigación lo han conformado los Centros Sanitarios del Servicio Andaluz de Salud en Huelva y su provincia, siendo las personas informantes profesionales vinculados a los hospitales y Centros de Salud correspondientes. La información se ha obtenido a través de las técnicas de grupo nominal, grupo de discusión y la entrevista. RESULTADOS: En el ámbito de los cuidados paliativos no existe unanimidad entre los profesionales respecto a la conveniencia o no de facilitar información veraz a la persona enferma, siendo una de las dificultades importantes el miedo de los propios profesionales a hacer daño y a que esto se traduzca en una situación de inseguridad jurídica. La información se evidencia como una responsabilidad de enfermería que debe ser abordada en equipo

BACKGROUND: One of the most common ethical conflicts in health care and one which generates considerable suffering is whether or not to give clinical information to patients and their families at the end-of-life stage. AIM: The objective of this paper is to examine and interpret the giving of health information to people in the process of dying from the Nursing perspective. METHOD: This study is defined within the qualitative paradigm, and uses the interpretative hermeneutic-phenomenological method. The study setting is Andalusia Health Service health care centres in the city and province of Huelva, and carried out by health care professionals who work in Andalusia Health Service clinics and hospitals. Data have been gathered from contributions in a nominal group, discussion group, and interviews. RESULTS: There is no consensus among palliative care professionals about whether it is helpful to provide the dying patient with accurate information. One of main difficulties cited by health care professionals was the fear of harming the patient, which in turn might have legal consequences. Supplying information to the patient is seen as a Nursing responsibility that must be managed as a team

Promoting notification and linkage of HBs antigen and anti-HCV antibody-positive patients through hospital alert system.

BACKGROUND: In Japan, approximately 0.9% and 1% of the whole population are infected with HBV and HCV, respectively. Doctors from departments other than gastroenterology often order viral hepatitis tests before an invasive examination or an operation. However, the notification of positive results to the patients and linkage to care is not appropriately performed. The in-hospital alert system was constructed to promote the notification and referral to gastroenterologists for patients with positive viral hepatitis tests, and its efficacy was evaluated. METHODS: The patients who tested HBsAg and anti-HCV antibody by chemiluminescent enzyme immunoassays and chemiluminescent immunoassays were investigated for whether they were notified of the positive results and if they were referred to gastroenterologists at our hospital. The notification and referral rate was compared before (from January to December 2014) and after the introduction of the alert system (from February to September 2016). RESULTS: HBsAg-positive rate was 1.1% (69/6543) before the introduction of the alert system and 0.8% (41/5403) after it. The notification rate has significantly improved from 46% to 73% (p = 0.0061) and the referral rate has improved from 16% to 27%, while not significant. Positive rate of anti-HCV antibody was 2.1% (139/6481) before the introduction of the alert system and 2.4% (128/5322) after it. The rate of notification and referral has significantly improved from 35% to 62% (p < 0.0001) and from 6% to 23% (p < 0.0001), respectively. CONCLUSIONS: The in-hospital alert system increased the rates of notification and referral of the patients with positive viral hepatitis tests. Enlightenment of doctors other than gastroenterologists on viral hepatitis and cooperation of medical staffs would be helpful to improve the notification and referral rates.

Webmail, herramienta de comunicación hospitalaria / Webmail, a tool for hospital communication

Objetivo: demostrar si una intervención formativa en el ámbito laboral aumentaba la frecuencia del uso del correo electrónico en el personal de Enfermería de las unidades de Medicina de un hospital terciario; y valorar su nivel de satisfacción al recibir el correo institucional vinculado al móvil y/u ordenador. Método: estudio cuasi experimental antes-después en un hospital público de alta tecnología. La población de estudio fueron las enfermeras, auxiliares de Enfermería y auxiliares sanitarios. Variable dependiente: frecuencia de consulta del correo corporativo. Variables independientes: sociodemográficas y laborales. Instrumento para la recogida de los datos: cuestionario ad hoc. Se realizó una intervención formativa orientada al fomento y buen uso del correo institucional. Análisis bivariante a través de Chi cuadrado y pruebas de contraste para muestras apareadas. Resultados: participaron 115 profesionales. Un 75,5% accedía al correo desde el hospital, un 49,6% desde casa y un 6,1% desde el móvil. El 89,6% tenía móvil con acceso a internet. El 84,8% creía que tener un acceso directo al webmail en el móvil es útil o muy útil y el 96,4% tenerlo instalado en el ordenador. La consulta del correo una o más veces por semana aumentó del 74,5% al 87% tras la intervención formativa (p= 0,002). Conclusiones: tras la realización de una adecuada intervención formativa orientada al manejo y acceso al correo institucional, la incorporación de accesos directos a los escritorios de los ordenadores y la vinculación del correo corporativo al móvil se consigue aumentar el uso del mismo (AU)

Objectives: to demonstrate if a training intervention in the work setting increased the frequency in the use of e-mail by the Nursing staff in the Medical Units of a tertiary hospital; and to value their level of satisfaction when receiving the institutional e-mail linked to their mobile and/or computer. Method: a quasi-experimental before-after study in a high technology public hospital. The study population were the nurses, nursing assistants, and healthcare assistants. The dependent variable was the frequency of consulting the corporate e-mail. The independent variables were sociodemographical and occupational. The tool for data collection: an ad hoc questionnaire. A training intervention was conducted, targeted to the promotion and good use of the institutional e-mail. Bivariate analysis through Chi Square, and contrast tests for paired samples. Results: the study included 115 professionals; 75.5% of them accessed their e-mail from hospital, 49.6% from home, and 6.1% from their mobile. From the participants, 89.6% had a mobile phone with access to internet; 84.8% of them thought that having direct access to webmail in their mobile phones was useful and very useful, and 96.4% thought the same about having it in their computer. Checking emails once or twice per week increased from 74.5% to 87% after the training intervention (p= 0.002). Conclusions: an increase in the use of institutional e-mail is achieved after conducting an adequate training intervention oriented to its management and access, the incorporation of direct accesses to computer desktops, and linking the corporate e-mail to the mobile phone (AU)