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3.
Cochrane Database Syst Rev ; 1: CD006440, 2021 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-33417236

RESUMEN

BACKGROUND: Many people with dementia are cared for at home by unpaid informal caregivers, usually family members. Caregivers may experience a range of physical, emotional, financial and social harms, which are often described collectively as caregiver burden. The degree of burden experienced is associated with characteristics of the caregiver, such as gender, and characteristics of the person with dementia, such as dementia stage, and the presence of behavioural problems or neuropsychiatric disturbances. It is a strong predictor of admission to residential care for people with dementia. Psychoeducational interventions might prevent or reduce caregiver burden. Overall, they are intended to improve caregivers' knowledge about the disease and its care; to increase caregivers' sense of competence and their ability to cope with difficult situations; to relieve feelings of isolation and allow caregivers to attend to their own emotional and physical needs. These interventions are heterogeneous, varying in their theoretical framework, components, and delivery formats. Interventions that are delivered remotely, using printed materials, telephone or video technologies, may be particularly suitable for caregivers who have difficulty accessing face-to-face services because of their own health problems, poor access to transport, or absence of substitute care. During the COVID-19 pandemic, containment measures in many countries required people to be isolated in their homes, including people with dementia and their family carers. In such circumstances, there is no alternative to remote delivery of interventions. OBJECTIVES: To assess the efficacy and acceptability of remotely delivered interventions aiming to reduce burden and improve mood and quality of life of informal caregivers of people with dementia. SEARCH METHODS: We searched the Specialised Register of the Cochrane Dementia and Cognitive Improvement Group, MEDLINE, Embase and four other databases, as well as two international trials registries, on 10 April 2020. We also examined the bibliographies of relevant review papers and published trials. SELECTION CRITERIA: We included only randomised controlled trials that assessed the remote delivery of structured interventions for informal caregivers who were providing care for people with dementia living at home. Caregivers had to be unpaid adults (relatives or members of the person's community). The interventions could be delivered using printed materials, the telephone, the Internet or a mixture of these, but could not involve any face-to-face contact with professionals. We categorised intervention components as information, training or support. Information interventions included two key elements: (i) they provided standardised information, and (ii) the caregiver played a passive role. Support interventions promoted interaction with other people (professionals or peers). Training interventions trained caregivers in practical skills to manage care. We excluded interventions that were primarily individual psychotherapy. Our primary outcomes were caregiver burden, mood, health-related quality of life and dropout for any reason. Secondary outcomes were caregiver knowledge and skills, use of health and social care resources, admission of the person with dementia to institutional care, and quality of life of the person with dementia. DATA COLLECTION AND ANALYSIS: Study selection, data extraction and assessment of the risk of bias in included studies were done independently by two review authors. We used the Template for Intervention Description and Replication (TIDieR) to describe the interventions. We conducted meta-analyses using a random-effects model to derive estimates of effect size. We used GRADE methods to describe our degree of certainty about effect estimates. MAIN RESULTS: We included 26 studies in this review (2367 participants). We compared (1) interventions involving training, support or both, with or without information (experimental interventions) with usual treatment, waiting list or attention control (12 studies, 944 participants); and (2) the same experimental interventions with provision of information alone (14 studies, 1423 participants). We downgraded evidence for study limitations and, for some outcomes, for inconsistency between studies. There was a frequent risk of bias from self-rating of subjective outcomes by participants who were not blind to the intervention. Randomisation methods were not always well-reported and there was potential for attrition bias in some studies. Therefore, all evidence was of moderate or low certainty. In the comparison of experimental interventions with usual treatment, waiting list or attention control, we found that the experimental interventions probably have little or no effect on caregiver burden (nine studies, 597 participants; standardised mean difference (SMD) -0.06, 95% confidence interval (CI) -0.35 to 0.23); depressive symptoms (eight studies, 638 participants; SMD -0.05, 95% CI -0.22 to 0.12); or health-related quality of life (two studies, 311 participants; SMD 0.10, 95% CI -0.13 to 0.32). The experimental interventions probably result in little or no difference in dropout for any reason (eight studies, 661 participants; risk ratio (RR) 1.15, 95% CI 0.87 to 1.53). In the comparison of experimental interventions with a control condition of information alone, we found that experimental interventions may result in a slight reduction in caregiver burden (nine studies, 650 participants; SMD -0.24, 95% CI -0.51 to 0.04); probably result in a slight improvement in depressive symptoms (11 studies, 1100 participants; SMD -0.25, 95% CI -0.43 to -0.06); may result in little or no difference in caregiver health-related quality of life (two studies, 257 participants; SMD -0.03, 95% CI -0.28 to 0.21); and probably result in an increase in dropouts for any reason (12 studies, 1266 participants; RR 1.51, 95% CI 1.04 to 2.20). AUTHORS' CONCLUSIONS: Remotely delivered interventions including support, training or both, with or without information, may slightly reduce caregiver burden and improve caregiver depressive symptoms when compared with provision of information alone, but not when compared with usual treatment, waiting list or attention control. They seem to make little or no difference to health-related quality of life. Caregivers receiving training or support were more likely than those receiving information alone to drop out of the studies, which might limit applicability. The efficacy of these interventions may depend on the nature and availability of usual services in the study settings.


Asunto(s)
/prevención & control , Cuidadores/educación , Demencia/enfermería , Afecto , Sesgo , Cuidadores/psicología , Familia , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Humanos , Institucionalización/estadística & datos numéricos , Casas de Salud/estadística & datos numéricos , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto
4.
Ann Fam Med ; 19(1): 44-47, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33431391

RESUMEN

We studied the changes in presented health problems and demand for primary care since the outbreak of coronavirus disease 2019 (COVID-19) in the Netherlands. We analyzed prominent symptom features of COVID-19, and COVID-19 itself as the reason for encounter. Also, we analyzed the number and type of encounters for common important health problems. Respiratory tract symptoms related to COVID-19 were presented more often in 2020 than in 2019. We observed a dramatic increase of telephone/e-mail/Internet consultations in the months after the outbreak. Contacts for other health problems such as prevention and acute and chronic conditions plummeted substantially (P <0.001); mental health problems stabilized.


Asunto(s)
/terapia , Medicina Familiar y Comunitaria/tendencias , Necesidades y Demandas de Servicios de Salud/tendencias , Pautas de la Práctica en Medicina/tendencias , Atención Primaria de Salud/tendencias , Humanos , Países Bajos/epidemiología , Derivación y Consulta/tendencias , Telemedicina/tendencias
6.
PLoS Med ; 18(1): e1003490, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33428624

RESUMEN

BACKGROUND: The COVID-19 epidemic in the United States is widespread, with more than 200,000 deaths reported as of September 23, 2020. While ecological studies show higher burdens of COVID-19 mortality in areas with higher rates of poverty, little is known about social determinants of COVID-19 mortality at the individual level. METHODS AND FINDINGS: We estimated the proportions of COVID-19 deaths by age, sex, race/ethnicity, and comorbid conditions using their reported univariate proportions among COVID-19 deaths and correlations among these variables in the general population from the 2017-2018 National Health and Nutrition Examination Survey (NHANES). We used these proportions to randomly sample individuals from NHANES. We analyzed the distributions of COVID-19 deaths by race/ethnicity, income, education level, and veteran status. We analyzed the association of these characteristics with mortality by logistic regression. Summary demographics of deaths include mean age 71.6 years, 45.9% female, and 45.1% non-Hispanic white. We found that disproportionate deaths occurred among individuals with nonwhite race/ethnicity (54.8% of deaths, 95% CI 49.0%-59.6%, p < 0.001), individuals with income below the median (67.5%, 95% CI 63.4%-71.5%, p < 0.001), individuals with less than a high school level of education (25.6%, 95% CI 23.4% -27.9%, p < 0.001), and veterans (19.5%, 95% CI 15.8%-23.4%, p < 0.001). Except for veteran status, these characteristics are significantly associated with COVID-19 mortality in multiple logistic regression. Limitations include the lack of institutionalized people in the sample (e.g., nursing home residents and incarcerated persons), the need to use comorbidity data collected from outside the US, and the assumption of the same correlations among variables for the noninstitutionalized population and COVID-19 decedents. CONCLUSIONS: Substantial inequalities in COVID-19 mortality are likely, with disproportionate burdens falling on those who are of racial/ethnic minorities, are poor, have less education, and are veterans. Healthcare systems must ensure adequate access to these groups. Public health measures should specifically reach these groups, and data on social determinants should be systematically collected from people with COVID-19.


Asunto(s)
/mortalidad , Disparidades en Atención de Salud/normas , Salud Pública , Determinantes Sociales de la Salud/estadística & datos numéricos , Factores Socioeconómicos , Anciano , Comorbilidad , Grupos Étnicos/estadística & datos numéricos , Femenino , Necesidades y Demandas de Servicios de Salud , Humanos , Masculino , Mortalidad , Salud Pública/métodos , Salud Pública/normas , Mejoramiento de la Calidad/organización & administración , Estados Unidos , Salud de los Veteranos/estadística & datos numéricos
8.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 34-40, jan.-dez. 2021. ilus
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1145901

RESUMEN

Objetivo: Conhecer como ocorre a comunicação de notícias difíceis por enfermeiros na atenção básica. Método: pesquisa exploratória, descritiva e de abordagem qualitativa com 15 Enfermeiros de 10 Unidades Básicas de Saúde no sul do país. A coleta de dados foi realizada através de entrevistas semiestruturadas. Os dados foram analisados conforme análise textual discursiva. Resultado: Foram geradas duas categorias: Comunicação como suporte as necessidades do cliente; Comunicação como elemento a suprir a demanda da atenção primária. Conclusão: os enfermeiros adotam alguns aspectos no momento da comunicação de notícia difícil, aspectos esses ancorados, por exemplo, através de empatia, compreensão da realidade do usuário, fala simplificada, privacidade, entre outros, sendo esses essenciais para uma comunicação adequada e humanizada que visa o conforto do usuário nesse momento da comunicação


Objective: To know how the communication of difficult news by nurses in primary care occurs. Method: exploratory, descriptive and qualitative approach with 15 Nurses from 10 Basic Health Units in the south of the country. Data collection was done through semi-structured interviews. Data were analyzed according to discursive textual analysis. Result: two categories were generated: Communication as support the client's needs; Communication as an element to supply the demand for primary care. Conclusion: nurses adopt some aspects at the moment of difficult news communication, aspects that are anchored, for example through empathy, understanding of the user's reality, simplified speech, privacy, among others, being essential for adequate and humanized communication that aims at the comfort of the user in this moment of communication


Objetivo: Conocer cómo ocurre la comunicación de noticias difíciles por enfermeros en la atención básica. Método: investigación exploratoria, descriptiva y de abordaje cualitativo con 15 Enfermeros de 10 Unidades Básicas de Salud en el sur del país. La recolección de datos se realizó a través de entrevistas semiestructuradas. Los datos fueron analizados según el análisis textual discursivo. Resultado: se generaron dos categorías: Comunicación como soporte a las necesidades del cliente; Comunicación como elemento a suplir la demanda de la atención primaria. Conclusión: los enfermeros adoptan algunos aspectos en el momento de la comunicación de noticias difícil, aspectos anclados, por ejemplo, a través de empatía, comprensión de la realidad del usuario, habla simplificada, privacidad, entre otros, siendo estos esenciales para una comunicación adecuada y humanizada que, se refiere a la comodidad del usuario en ese momento de la comunicación


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Comunicación , Empatía , Relaciones Enfermero-Paciente/ética , Atención Primaria de Salud , Comprensión , Investigación Cualitativa , Necesidades y Demandas de Servicios de Salud , Enfermeras y Enfermeros
12.
Adv Gerontol ; 33(4): 616-624, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-33342091

RESUMEN

The article discusses the causal relationship between the low efficiency of state policy in extending the period of active longevity. It is characterized by the absence of a correlation between basic and applied research in the field of aging and the use of an unsystematic approach to the development, implementation of targeted federal and regional programs aimed improving the quality of life older citizens. It is shown that the current negative situation, characterized by an aggravating decline in the quality and accessibility of state medical, social and psychological assistance to elderly citizens, is largely due to the incompleteness of existing laws and regulations in the field of their social support. The lack of both scientific justification for programs and terminological correctness allows officials to use a formalized, extensive approach when planning the development of the healthcare and social protection sectors, which do not take into account population aging. The problem of positioning gerontology as a scientific discipline that provides a synthesis of natural science, applied and socio-humanitarian knowledge, a complex of four scientific areas: biology, medicine, psychology, sociology is considered. The unity of the components of gerontology provides scientific background for improving public policy aimed on adapting socio-economic development to the demographic processes of population aging.


Asunto(s)
Geriatría , Geriatría/tendencias , Necesidades y Demandas de Servicios de Salud , Servicios de Salud para Ancianos , Humanos , Política Pública , Calidad de Vida , Federación de Rusia
15.
Medicine (Baltimore) ; 99(52): e23845, 2020 Dec 24.
Artículo en Inglés | MEDLINE | ID: mdl-33350774

RESUMEN

ABSTRACT: COVID-19 pandemic caused a major crisis, affecting and straining health care systems, including some very advanced ones. The pandemic may have also indirectly affected access to health care for patients with other conditions, not related to COVID-19, even in countries not overwhelmed by an outbreak.We analyzed and compared visits to the emergency room (ER) department during the same calendar period of 2019 and 2020 (from March 1 to March 31 of each year) in our hospital, a medium size, tertiary center, located in the center of Athens, which is not a referral center for COVID-19.Total ER visits were reduced by 42.3% and the number of those requiring hospitalization by 34.8%. This reduction was driven by lower numbers of visits for low risk, non-specific symptoms and causes. However, there was a significant decrease in admissions for cardiovascular symptoms and complications (chest pain of cardiac origin, acute coronary syndromes, and stroke) by 39.7% and for suspected or confirmed GI hemorrhage by 54.7%. Importantly, number of ER visits for infections remained unchanged, as well as the number of patients that required hospitalization for infection management; only few patients were diagnosed with COVID-19.During the initial period of the pandemic and lock-down in Greece, there was a major decrease in the patients visiting ER department, including decrease in the numbers of admissions for cardiovascular symptoms and complications. These observations may have implications for the management of non-COVID-19 diseases during the pandemic.


Asunto(s)
/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Centros de Atención Terciaria/estadística & datos numéricos , Adulto , Anciano , Femenino , Grecia/epidemiología , Accesibilidad a los Servicios de Salud , Necesidades y Demandas de Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Pandemias
16.
S Afr Med J ; 0(0): 13185, 2020 12 15.
Artículo en Inglés | MEDLINE | ID: mdl-33334393

RESUMEN

BACKGROUND: Current evidence indicates that children are relatively spared from direct COVID-19-related morbidity and mortality, but that the indirect effects of the pandemic pose significant risks to their health and wellbeing. OBJECTIVES: To assess the impact of the local COVID-19 outbreak on routine child health services. METHODS: The District Health Information System data set for KwaZulu-Natal (KZN) provincial health services was accessed, and monthly child health-related data were extracted for the period January 2018 - June 2020. Chronological and geographical variations in sentinel indicators for service access, service delivery and the wellbeing of children were assessed. RESULTS: During April - June 2020, following the start of the COVID-19 outbreak in KZN, significant declines were seen for clinic attendance (36%; p=0.001) and hospital admissions (50%; p=0.005) of children aged <5 years, with a modest recovery in clinic attendance only. Among service delivery indicators, immunisation coverage recovered most rapidly, with vitamin A supplementation, deworming and food supplementation remaining low. Changes were less pronounced for in- and out-of-hospital births and uptake rates of infant polymerase chain reaction testing for HIV at birth, albeit with wide interdistrict variations, indicating inequalities in access to and provision of maternal and neonatal care. A temporary 47% increase in neonatal facility deaths was reported in May 2020 that could potentially be attributed to COVID-19-related disruption and diversion of health resources. CONCLUSIONS: Multiple indicators demonstrated disruption in service access, service delivery and child wellbeing. Further studies are needed to establish the intermediate- and long-term impact of the COVID-19 outbreak on child health, as well as strategies to mitigate these.


Asunto(s)
Servicios de Salud del Niño , Accesibilidad a los Servicios de Salud , Control de Infecciones , Atención Perinatal , /epidemiología , Salud del Niño/normas , Servicios de Salud del Niño/organización & administración , Servicios de Salud del Niño/estadística & datos numéricos , Preescolar , Recursos en Salud/normas , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/tendencias , Necesidades y Demandas de Servicios de Salud , Humanos , Lactante , Mortalidad Infantil , Recién Nacido , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Atención Perinatal/normas , Atención Perinatal/estadística & datos numéricos , Sudáfrica/epidemiología
17.
BMJ Open ; 10(12): e044197, 2020 12 29.
Artículo en Inglés | MEDLINE | ID: mdl-33376182

RESUMEN

AIM: To explore indigenous communities' responses to the COVID-19 pandemic and its consequences for maternal and neonatal health (MNH) care in the Peruvian Amazon. METHODS: Mamás del Río is a community-based, MNH programme with comprehensive supervision covering monthly meetings with community health workers (CHW), community leaders and health facilities. With the onset of the lockdown, supervisors made telephone calls to discuss measures against COVID-19, governmental support, CHW activities in communities and provision of MNH care and COVID-19 preparedness at facilities. As part of the programme's ongoing mixed methods evaluation, we analysed written summaries of supervisor calls collected during the first 2 months of Peru's lockdown. RESULTS: Between March and May 2020, supervisors held two rounds of calls with CHWs and leaders of 68 communities and staff from 17 facilities. Most communities banned entry of foreigners, but about half tolerated residents travelling to regional towns for trade and social support. While social events were forbidden, strict home isolation was only practised in a third of communities as conflicting with daily routine. By the end of April, first clusters of suspected cases were reported in communities. COVID-19 test kits, training and medical face masks were not available in most rural facilities. Six out of seven facilities suspended routine antenatal and postnatal consultations while two-thirds of CHWs resumed home visits to pregnant women and newborns. CONCLUSIONS: Home isolation was hardly feasible in the rural Amazon context and community isolation was undermined by lack of external supplies and social support. With sustained community transmission, promotion of basic hygiene and mask use becomes essential. To avoid devastating effects on MNH, routine services at facilities need to be urgently re-established alongside COVID-19 preparedness plans. Community-based MNH programmes could offset detrimental indirect effects of the pandemic and provide an opportunity for local COVID-19 prevention and containment.


Asunto(s)
Control de Enfermedades Transmisibles , Servicios de Salud Comunitaria , Salud del Lactante , Salud Materna , Adulto , /prevención & control , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/normas , Servicios de Salud Comunitaria/métodos , Servicios de Salud Comunitaria/organización & administración , Servicios de Salud Comunitaria/normas , Transmisión de Enfermedad Infecciosa/prevención & control , Femenino , Conocimientos, Actitudes y Práctica en Salud , Necesidades y Demandas de Servicios de Salud , Servicios de Salud del Indígena/tendencias , Humanos , Salud del Lactante/estadística & datos numéricos , Salud del Lactante/tendencias , Recién Nacido , Masculino , Salud Materna/estadística & datos numéricos , Salud Materna/tendencias , Perú/epidemiología , Embarazo , Servicios Preventivos de Salud/métodos
19.
An. pediatr. (2003. Ed. impr.) ; 93(5): 313-322, nov. 2020.
Artículo en Español | IBECS | ID: ibc-192557

RESUMEN

INTRODUCCIÓN: SARS-CoV-2, responsable de la enfermedad por coronavirus 2019 (COVID-19), fue detectado por primera vez en España el 31 de enero de 2020. El 14 de marzo fue declarado el estado de alarma con el objetivo de controlar la pandemia. El objetivo de este estudio es analizar las consecuencias de esta crisis sanitaria sobre el patrón de demanda asistencial, así como el manejo y las características de los pacientes con sospecha de COVID-19 en el Servicio de Urgencias Pediátricas. PACIENTES Y MÉTODOS: Estudio retrospectivo observacional en niños y adolescentes menores de 18 años, atendidos en nuestro Servicio de Urgencias Pediátricas durante el periodo comprendido desde el 14 de marzo hasta el 17 de abril de 2020. RESULTADOS: Durante el periodo de estudio se atendieron 1.666 pacientes, un 65,4% menos que en el mismo periodo de 2019. La edad media fue de 5,4 años y el 51,2% eran varones. El 39,9% fueron clasificados con niveles de alta prioridad, un 6,5% más que en 2019. Los principales motivos de consulta fueron fiebre (26,5%), síntomas respiratorios (16,1%) y traumatismos (15,2%). Un total de 218 pacientes (13%) fueron diagnosticados de posible COVID-19, confirmándose la infección en el 18,4%. El 44% (96/218) fueron diagnosticados de infección respiratoria inferior y el 33,9% (74/218), superior. El 23,8% (52/218) fueron hospitalizados. CONCLUSIONES: Durante el brote epidémico SARS-CoV-2 disminuyó la demanda de asistencia pediátrica urgente, aumentando la proporción de casos con niveles de triaje de alta prioridad. La mayoría de los pacientes con sospecha o confirmación microbiológica de COVID-19 cursaron con clínica respiratoria leve


INTRODUCTION: SARS-CoV-2, coronavirus that causes coronavirus disease 2019 (COVID-19), was first detected in Spain on 31 January 2020. On 14 March 2020, a state of emergency was declared in Spain in a bid to control the spread of the COVID-19 pandemic in the country. The aim of our study is to analyse the impact on emergency medicine attendance after the national lockdown, as well as the clinical presentation and the management of patients with suspected COVID-19 in the Paediatric Emergency Department. PATIENTS AND METHODS: This retrospective observational study included children and adolescents under the age of 18, attended in our Paediatric Emergency Department during the period March 14 to April 17, 2020. RESULTS: A total of 1,666 patients were attended during the study period, 65.4% less than in the same period of 2019. Just over half (51.2%) were males, and mean age was 5.4 years. In triage, 39.9% were high priority levels, 6.5% more than 2019. Most frequent reasons for consultation at the Paediatric Emergency Department were fever (26.5%), respiratory symptoms (16.1%), and trauma (15.2%). A total of 218 patients (13%) received a diagnosis of possible COVID-19, with SARS-CoV-2 infection confirmed in 18.4%, and 23.8% (52/218) were hospitalised. At discharge, 44% (96/218) were diagnosed with lower, and 33.9% (74/218) with upper respiratory infection. CONCLUSIONS: During the SARS-CoV-2 outbreak, the demand for urgent paediatric care decreased, with the proportion of cases with high priority triage levels increasing. Most of the patients with suspected or microbiological confirmation of COVID-19 had mild respiratory symptoms


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Pandemias , Prioridades en Salud , Servicio de Urgencia en Hospital/estadística & datos numéricos , Urgencias Médicas , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Triaje/estadística & datos numéricos , Estudios Retrospectivos , España
20.
Metas enferm ; 23(9): 62-68, nov. 2020. graf, ilus
Artículo en Español | IBECS | ID: ibc-195353

RESUMEN

La pandemia por COVID-19 ha mostrado la capacidad de adaptación del sistema sanitario español, poniendo en marcha medidas excepcionales e innovadoras como la creación de hoteles medicalizados. El objetivo a alcanzar consistía en liberar camas de hospital y garantizar el aislamiento de personas que o bien no disponían en sus domicilios de infraestructura para poder realizarlo tras el alta hospitalaria, o bien porque compartían hogar con personas vulnerables o frágiles, evitando de esta forma el contagio de los convivientes. El objetivo del presente trabajo es presentar la experiencia de haber medicalizado un hotel en la ciudad de Madrid vinculado al Hospital Universitario Gregorio Marañón (HGUGM) durante la primera ola pandémica de la COVID-19, desde el 19 de marzo hasta el 31 de mayo de 2020. Se aborda la puesta en marcha, contemplando los recursos materiales y humanos que se necesitaron, la organización, el desarrollo de la actividad y la humanización; así como los resultados de la experiencia. Fueron atendidos un total de 465 pacientes, con una estancia media de 10 días. La progresión de la ocupación se correspondió con la curva de contagios (pico máximo primera semana de abril: 146 pacientes). El personal de Enfermería realizó una media de 10 PCR por día, con un total de 817 pruebas. La participación en el estudio de seroprevalencia (Servicio de Microbiología del HGUGM) fue superior al 89% del personal de Enfermería, con un resultado de tres PCR positivas. En el contexto de la pandemia COVID-19, las enfermeras de la Comunidad de Madrid han demostrado estar capacitadas para habilitar espacios y lugares de atención a los pacientes en márgenes de tiempo de 48 h. Se formaron equipos multidisciplinares que funcionaron de forma eficiente, resolutiva y sin ningún conflicto


The COVID-19 pandemic has shown the adaptation ability of the Spanish Health System, through the implementation of exceptional and innovative measures such as the creation of medicalized hotels. The objective to be reached was the release of hospital beds, and ensuring isolation for people who had no infrastructure at home to be isolated after hospital discharge, or shared their home with vulnerable or fragile persons, thus preventing contagion among those living together. The objective of the present article is to present the experience of medicalizing a hotel in the city of Madrid, linked to the Hospital Universitario Gregorio Marañón (HGUGM), during the first wave of the COVID-19 pandemic, from March, 19th to May, 31st, 2020. Its implementation is addressed, considering the material and human resources required, its organization, the development of the activity and humanization, as well as the outcomes of the experience. In total, 465 patients were managed, with a mean 10-day stay. The occupation progression corresponded with the contagion curve (maximum peak during the first week of April: 146 patients). The Nursing staff performed a mean 10 PCR tests per day, with 817 tests in total. There was a >89% participation in the Seroprevalence Study (Microbiology Unit of the HGUGM) by the Nursing staff, with three positive PCR tests as outcome. In the context of the COVID-19 pandemic, the Community of Madrid nurses have demonstrated being qualified to provide spaces and places for patient care within a 48-hour margin. Multidisciplinary teams were formed, which worked in an efficient and operative way and without any conflicts


Asunto(s)
Humanos , Saneamiento de Hoteles , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Betacoronavirus , Pandemias/prevención & control , Sistemas de Salud/organización & administración , Aislamiento de Pacientes/organización & administración , Personal de Enfermería/organización & administración , Humanización de la Atención , España , Registros Electrónicos de Salud , Necesidades y Demandas de Servicios de Salud/organización & administración , Necesidades y Demandas de Servicios de Salud/normas
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