ABSTRACT
La enfermería es una disciplina que ha experimentado diversos cambios a lo largo de su historia. No obstante, las nuevas transformaciones en la forma de hacer sanidad pueden cambiar la idea de lo que hoy es esta profesión. Para intentar afrontar este futuro hemos optado por potenciar la labor de la filosofía de la enfermería, tratando de reflexionar sobre la razón de ser de esta: los cuidados. De este modo, nos hemos apoyado en el libro "El futuro del cuidado. Comprensión de la ética del cuidado y práctica enfermera" de Carmen Domínguez Alcón, Helen Kohlen y Joan Tronto, así como de otros libros y artículos de diferentes autores de interés. Este recorrido nos ayudará a comprender cómo los cuidados pueden ser una herramienta útil para situar a la enfermería en el rumbo de los nuevos cambios del presente
Nursing is a discipline that has undergone several changes along its story. Nevertheless, the new transformations in the way of doing health service can change the idea of what profession is today. With the purpose of facing this future we have opted to strengthen the task of the nursing's philosophy, trying to ponder on its reason to be: care. In this way, we have supported our ideas in the book "El futuro del cuidado. Comprensión de la ética del cuidado y práctica enfermera" by Carmen Domínguez Alcón, Helen Kohlen and Joan Tronto, as well as other books and articles of different authors of interest. This journey will help us to comprehend how the care can be an useful tool to place nursing into the course of the new changes of the present
Subject(s)
Humans , Social Desirability , Nursing Assessment , History of Nursing , Nursing/standards , Nursing Theory , Nursing Care/standards , Leadership , Nursing Services/history , Nursing Services/standards , Nursing, TeamABSTRACT
ABSTRACT Objective: To evaluate nurse safety culture in a teaching hospital, as well as to verify differences in the safety culture dimensions between services. Method: cross-sectional, quantitative study, conducted from October to December 2015, in a university hospital. The instrument Hospital Survey on Patient Safety Culture was applied. Results: A total of 195 nurses from four different services participated in the study. Significant difference between services were identified for five dimensions of safety culture: organizational learning (P=0.012); return of information and communication about error (P=0.014); management support for patient safety (P=0.001); general perceptions about patient safety (P=0.005); and frequency of event notification (P=0.003). Conclusion: The medical clinic service had the highest statistical difference between the dimensions. These evaluations allow managers to identify the differences between the same hospital's services, serving as a warning and assisting in the services' improvement.
RESUMEN Objetivo: Analizar la cultura de seguridad de los enfermeros de un hospital escuela y examinar las diferencias de los aspectos de esa cultura entre los servicios realizados. Método: Estudio transversal y cuantitativo, realizado de octubre a diciembre de 2015, en un hospital universitario. Se utilizó el instrumento Hospital Survey on Patient Safety Culture. Resultados: Participaron 195 enfermeros de cuatro servicios. Se identificó una diferencia significativa entre los servicios en los cinco aspectos de la cultura de seguridad: el aprendizaje organizacional (p = 0,012); la información de retorno y la comunicación con respecto al error (p = 0,014); el soporte de la gestión para la seguridad del paciente (p = 0,001); las percepciones generales sobre la seguridad del paciente (p = 0,005); y la frecuencia de comunicación de eventos (p = 0,003). Conclusión: El servicio en clínica médica presentó una mayor diferencia estadística entre los aspectos identificados. Estas evaluaciones pueden permitir que los gestores identifiquen las diferencias entre los servicios del mismo hospital, sirviendo como advertencia y perfeccionando los servicios.
RESUMO Objetivo: Avaliar a cultura de segurança dos enfermeiros de um hospital de ensino e verificar as diferenças das dimensões dessa cultura entre os serviços. Método: Estudo transversal e quantitativo, realizado em outubro a dezembro de 2015, em um hospital universitário. Foi aplicado o instrumento Hospital Survey on Patient Safety Culture. Resultados: Participaram 195 enfermeiros de quatro serviços. Identificou-se diferença significativa entre os serviços para cinco dimensões de cultura de segurança: aprendizado organizacional (p = 0.012); retorno da informação e comunicação a respeito de erro (p = 0.014); suporte da gestão para segurança do paciente (p = 0.001); percepções gerais sobre segurança do paciente (p = 0.005); e frequência da notificação de eventos (p = 0.003). Conclusão: O serviço de clínica médica apresentou maior diferença estatística entre as dimensões. Essas avaliações permitem que os gestores identifiquem as diferenças entre os serviços do mesmo hospital, servindo de alerta e aperfeiçoando os serviços.
Subject(s)
Humans , Male , Female , Adult , Safety Management/standards , Nurses/psychology , Nursing Services/standards , Brazil , Organizational Culture , Attitude of Health Personnel , Cross-Sectional Studies , Surveys and Questionnaires , Safety Management/statistics & numerical data , Statistics, Nonparametric , Hospitals, University/organization & administration , Hospitals, University/statistics & numerical data , Middle Aged , Nurses/standards , Nurses/statistics & numerical data , Nursing Services/statistics & numerical dataABSTRACT
ABSTRACT Objective: to describe our experience with a methodology for teaching nursing consultation in support of people with diabetes mellitus at a Family Health Unit. Method: experience report with four moments—submission of the proposal to the team; theorizing; nursing care for people with diabetes mellitus at home and at the health unit, and evaluation of learning. Results: the pedagogical process favored the integration between service and users, contributed to implement and apply the nursing process and strengthened professional training, based on the epidemiological profile of chronic diseases and its implications for nursing in primary care. Final considerations: the active methodology discussed here allowed for a resignification of knowledge and a qualification of nursing care, demonstrating to be an important instrument for integrating clinical practice and epidemiology in accordance to experienced reality.
RESUMEN Objetivo: Describir la experiencia con la metodología de la problematización para la enseñanza de la consulta de enfermería a las personas con diabetes mellitus en una Unidad de Salud de la Familia. Método: Relato de experiencia realizado en cuatro momentos -presentar la propuesta al equipo; teorizar; dar asistencia de enfermería a las personas con diabetes mellitus en los domicilios y en la unidad de salud; y evaluar el aprendizaje. Resultados: El proceso de enseñanza-aprendizaje favoreció la integración entre servicio y usuarios, contribuyó a implantar y aplicar el proceso de enfermería, y fortaleció la formación a partir del reconocimiento del perfil epidemiológico para el cuidado de enfermería a las enfermedades crónicas en la atención primaria. Consideraciones finales: La metodología activa propició la resignificación del conocimiento y la cualificación del cuidado de enfermería, constituyéndose como importante instrumento para unir la clínica a la epidemiología a partir de la realidad experimentada.
RESUMO Objetivo: Descrever a experiência da utilização de metodologia da problematização para o ensino da Consulta de Enfermagem junto a pessoas com Diabetes Mellitus de uma Unidade de Saúde da Família. Método: Relato de experiência realizado em quatro momentos: apresentação da proposta à equipe, teorização, aplicação da sistematização da assistência de enfermagem às pessoas com diabetes mellitus no domicilio dos usuários e na Unidade de Saúde e avaliação da aprendizagem. Resultados: O processo ensino-aprendizagem favoreceu a integração do ensino com o serviço e usuários, contribuiu para a implantação e aplicação do processo de enfermagem e fortaleceu a formação a partir do reconhecimento do perfil epidemiológico para o cuidado de enfermagem às doenças crônicas na atenção primária. Considerações finais: A utilização da metodologia ativa propiciou a ressignificação do conhecimento e a qualificação do cuidado de enfermagem, constituindo-se como um importante instrumento para a união da clínica à epidemiologia a partir da realidade vivenciada.
Subject(s)
Humans , Referral and Consultation/standards , Diabetes Mellitus/therapy , Primary Health Care/methods , Primary Health Care/standards , Referral and Consultation/trends , Problem-Based Learning/methods , Problem-Based Learning/standards , Nursing Services/standards , Nursing Services/trendsABSTRACT
No disponible
Subject(s)
Humans , Nursing/organization & administration , Nursing/statistics & numerical data , Nursing Care/organization & administration , Employment , Population Dynamics , Nursing Care/statistics & numerical data , Nursing Services , Nursing Services/standards , Nursing Staff/organization & administration , United States/epidemiologyABSTRACT
No disponible
Subject(s)
Humans , Critical Care , Critical Care/trends , Intensive Care Units , Congresses as Topic/organization & administration , Congresses as Topic/standards , Nursing Staff/organization & administration , Nursing Staff, Hospital/organization & administration , Societies/organization & administration , Societies/standards , Nursing Care/methods , Nursing Care/standards , Nursing Service, Hospital , Nursing Services/standardsSubject(s)
Humans , Primary Health Care/standards , Clinical Protocols/standards , Practice Patterns, Nurses'/standards , Ambulatory Care/standards , Nursing Assessment/standards , Nursing Service, Hospital/standards , Guideline Adherence/standards , Primary Care Nursing , Nursing Services/standardsABSTRACT
La enfermería es una profesión de reclamo internacional, en especial bajo los marcos de la cooperación estudiantil y profesional promovidos por la Unión Europea. El alto porcentaje de movilidad de los profesionales pone de manifiesto la necesidad de facilitar su preparación e integración en un mercado laboral más allá de las fronteras nacionales. La Escola Superior de Saúde del Instituto Politécnico de Portalegre organizó el 2 y 3 de septiembre de 2015 la Reunión Internacional de Ciencias de la Salud ESS 2015 («Promoviendo lazos - Un nuevo reto para el futuro de las profesiones de la salud en Europa») para favorecer el intercambio y discutir los retos de la enfermera a nivel europeo. La diversidad laboral a la que se enfrentan las enfermeras en los distintos países pone de manifiesto la necesidad de crear una conciencia europea de la profesión que facilite la creación de lazos, la formación y una plataforma científica de intercambio para abordar la realidad actual del mercado laboral en la enfermería (AU)
Professional nurses are internationally sought after, a fact reinforced under the frames of exchange and cooperation promoted by the European Union. Given the high percentage of mobility shown by health professionals, nurses need a thorough preparation to facilitate their integration in the countries where they are likely to develop their professional careers. In order to promote exchange and facilitate discussion between nurses from different European countries, the Health School of the Polytechnic Institute of Portalegre (Portugal), organized on the 2nd and 3rd of September the International Health Sciences Meeting ESS 2015 («Promoting bonds - A new challenge for the future of health professions in Europe»). The diverse working conditions that nurses are faced with in different countries highlight the need to foster awareness of the profession at European level, facilitating ties, exchange and scientific platforms to address the current reality of the labor market (AU)
Subject(s)
Female , Humans , Male , Professional Role , Nurse's Role , Nurse Clinicians/economics , Nurse Clinicians/organization & administration , Nurse Clinicians/standards , Nursing Assessment/history , Nursing Assessment/organization & administration , Nursing Assessment/standards , Ethics, Nursing/education , Ethics, Nursing/history , Nursing Care/organization & administration , Nursing Care/standards , Nursing Services/organization & administration , Nursing Services/standards , Europe/epidemiologyABSTRACT
Esta es una reflexión acerca de los cambios paradigmáticos que han influido e influyen en la construcción de un proceso de cuidar en enfermería. Hemos tratado de delinear la profesión de enfermería en cada uno de los momentos históricos que transformaron el modelo científico, construyendo y reconstruyendo el conocimiento, la forma de hacer ciencia y el modo de cuidar en enfermería (AU)
Trata-se de um estudo reflexivo a respeito das mudanças paradigmáticas que influenciaram e influenciam a construção do processo de cuidar em enfermagem. Buscou-se delinear a profissão de enfermagem em cada um dos momentos históricos que transformaram o modelo científico, construindo e reconstruindo o conhecimento, a forma de se fazer ciência e o modo de cuidar em enfermagem
This is a reflective about the paradigmatic changes that have influenced and influence the construction of a nursing care study process. We attempted to delineate the nursing profession in each of the historical moments that transformed the scientific model, constructing and reconstructing knowledge, the way of doing science and how nursing care (AU)
Subject(s)
Humans , Male , Female , History of Nursing , Nursing Care/methods , Nursing Care/organization & administration , Nursing Care/standards , Nursing Process/history , Nursing Process/organization & administration , Nursing Process/standards , Nursing Process/trends , Nursing Services/organization & administration , Nursing Services/standards , Nursing Services , Nursing Staff/organization & administration , Nursing Staff/standardsABSTRACT
INTRODUCCIÓN. Se analiza, mediante un estudio descriptivo, el traslado y cierre del Hospital Básico de Defensa, junto al cambio y reestructuración del Hospital Universitario Santa María del Rosell, al nuevo Hospital Universitario Santa Lucía, coincidiendo con la creación de la Gerencia Única del Área de Salud II. El objetivo es estudiar el proceso de apertura de un complejo hospitalario coincidiendo con la remodelación del Área Sanitaria. METODOLOGÍA. Se examina toda la labor de planificación, formación y traslado que afectó a más de 600 camas y a 275.000 habitantes, profundizando en las actuaciones desarrolladas en infraestructuras, logística y formación. Todo el proceso se hace desde el punto de vista de enfermería, como colectivo profesional implicado en el conocimiento de las funciones tanto de hospitales como de personal. El periodo de estudio comprende desde octubre de 2010, inicio de la actividad en el nuevo hospital, a noviembre de 2011, culminación efectiva del traslado. RESULTADO. El resultado fue el traslado a las nuevas instalaciones y la reestructuración de las anteriores en un tiempo breve para la magnitud del proceso (once meses). Todos los pacientes se trasladaron sin ningún incidente. CONCLUSIÓN. Durante todo el proceso se dio continuidad asistencial y se ocasionó el menor impacto tanto económico como en los pacientes y profesionales. Desde el punto de vista de futuro e implicaciones prácticas, se han sentado las bases para una prestación moderna y de calidad, y obtenido de los medios que se han puesto por la sociedad a nuestra disposición el mejor resultado en calidad asistencial (AU)
INTRODUCTION. This paper analyzes, by a descriptive study, the closing of the Basic Hospital of the Defence the restructuration of the Santa María del Rosell University Hospital, and the moving of both to a new hospital: the Santa Lucía University Hospital. This process was carried out in coordination with a coincident objective: the creation of an only management staff for the area. The aim is the analysis of the opening of a hospital complex that coincided with the restructuration of the health area. METHODOLOGY. This paper analyzes the actions in relation to the scheduling, training and moving, that concerned above 600 hospital beds and 275.000 inhabitants. Analyzes the intervention in infrastructures, logistics and training. The whole process is seen from de nursery point of view, as a professional stratus that knows the roles of the hospital and personnel. The period of the study comprises since October 2010, beginning of the activity in the new hospital, to November 2011, moment of the effective culmination of the move. RESULT. The result of the works carried out was the transfer of people and roles in a very short time (eleven months). All the patients were moved without any event. CONCLUSION. During the whole process healthcare continuity was obtained, whit the less economic impact, as in patients and professionals. From the point of view of future and practical implications, the basis for a modern and qualified provision of services have been established; and best results from means provided have been obtained in relation to health care quality (AU)
Subject(s)
Humans , Male , Female , Hospitals , Nurse Clinicians/organization & administration , Nurse Clinicians/standards , Nursing Care/organization & administration , Nursing Care/standards , Nursing, Practical/organization & administration , Nursing Service, Hospital/organization & administration , Nursing Service, Hospital/standards , Nursing Service, Hospital , Nursing Services/organization & administration , Nursing Services/standards , Nursing Staff/standards , Nursing Staff , Nursing Staff, Hospital/organization & administration , Nursing Staff, Hospital/standardsABSTRACT
El objetivo de este estudio es describir las características de la literatura científica sobre la seguridad de los pacientes en relación con la gestión de la seguridad y la cultura de la organización, el tipo de publicación, año, vehículo de publicación, país, idioma y tema. La recolección de datos se llevó a cabo en junio de 2012, en la Biblioteca Virtual en Salud (BVS), utilizando los descriptores seguridad del paciente, gestión de la seguridad y cultura organizacional. Los resultados evidenciaron 106 indicaciones en siete años (2006 a 2012). 50,9% de las publicaciones fueron artículos de los Estados Unidos de América, 84,9% de las publicaciones eran en lengua inglesa, el 74% eran artículos originales y el tema principal fue la mala praxis. Llegamos a la conclusión de que la producción científica fue mayor y continua en los últimos 3 años. La autoría fue predominantemente estadounidense y publicado en revistas científicas en los Estados Unidos, lo que indica la necesidad de desarrollar la investigación sobre el tema en Brasil (AU)
O objetivo deste estudo é descrever as características da produção científica sobre segurança do paciente relacionada a gerenciamento de segurança e cultura organizacional, quanto ao tipo de publicação, ano, veículo de publicação, país, idioma e temática abordada. A coleta de dados foi realizada em junho de 2012, na Biblioteca Virtual em Saúde (BVS) utilizando os descritores segurança do paciente, gerenciamento de segurança e cultura organizacional. Os resultados evidenciaram106 indicações num período de sete anos (2006 a 2012). Das publicações 50,9% foram artigos provenientes dos Estados Unidos da América; 84,9% publicações foram na língua inglesa; 74% foram de artigos originais e a principal temática foi o erro médico. Concluímos que a produção científica foi maior e contínua nos últimos 3 anos. A autoria foi predominantemente americana e publicada em periódicos científicos nos Estados Unidos, o que indicou a necessidade de desenvolver pesquisas sobre o assunto no Brasil
The objective of this study is to describe the characteristics of scientific literature on patient safety related to security management and organizational culture, the type of publication, year, and vehicle of publication, country, language and theme. Data collection was conducted in June 2012, the Virtual Health Library (VHL) using the keywords patient safety, safety management and organizational culture. The results show 106 indications in seven years (2006 to 2012). 50.9% of the publications were articles from the United States, 84.9% publications were in English, 74% were original articles and the main theme was the malpractice. We conclude that the scientific production was higher and continuous in the last 3 years. The authorship was predominantly American and published in scientific journals in the United States, which indicated the need to develop research on the subject in Brazil (AU)
Subject(s)
Humans , Male , Female , Patient Safety/economics , Patient Safety/statistics & numerical data , Patient Safety/standards , Bibliometrics , Patient Care Planning/organization & administration , Patient Care Planning/standards , Patient Care Planning , Patient Safety/legislation & jurisprudence , Occupational Risks , Nursing Care/organization & administration , Nursing Care/standards , Nursing Services/organization & administration , Nursing Services/standards , Nursing Staff/organization & administration , Nursing Staff/standards , Nursing StaffABSTRACT
Introducción y objetivos: el manejo de la enfermedad inflamatoria intestinal (EII) por enfermería es muy relevante, sin embargo, existe una gran variabilidad en su práctica clínica. El objetivo de esta investigación es desarrollar estándares de calidad asistencial del manejo de la EII por enfermería, para elaborar un Instrumento de Evalua - ción de la Calidad Asistencial de la EII por Enfermería (IEC-EII). Métodos: tras una búsqueda bibliográfica del manejo de la EII por enfermería se elaboró un cuestionario de 178 ítems de calidad asistencial. Con este cuestionario, se realizaron dos estudios Delphi a dos rondas: Delphi A dirigido a 27 profesionales sanitarios en EII y Delphi B a 12 pacientes. Con los ítems de ambos estudios Delphi, se elaboró una lista que, junto con la opinión experta del Comité Científico, contribuyó a desarrollar el IEC-EII. Resultados: el IEC-EII se compone de 90 ítems, subdivididos en 13 dimensiones que miden aspectos del manejo de la EII por enfermería como: infraestructura, servicios, recursos humanos, tipo de organización, competencias asumidas por enfermería, información de enfermería al paciente, formación de enfermería, revisiones anuales de la actividad de enfermería e investigación de enfermería de EII. La evaluación de estos aspectos mediante el IEC-EII permite clasificar la calidad asistencial en EII por enfermería en 4 categorías de la A a la D. Siendo A el nivel de calidad superior y D el inferior. Conclusiones: el IEC-EII puede contribuir a aumentar la calidad asistencial de enfermería en EII y reducir su variabilidad, puesto que la evaluación ayudará a detectar sus deficiencias mejorables (AU)
Background and aims: nursing management of inflammatory bowel disease (IBD) is highly relevant for patient care and outcomes. However, there is evidence of substantial variability in clinical practices. The objectives of this study were to develop standards of healthcare quality for nursing management of IBD and elaborate the evaluation tool Nursing Care Quality in IBD Assessment (NCQ-IBD) based on these standards. Methods: a 178-item healthcare quality questionnaire was developed based on a systematic review of IBD nursing management literature. The questionnaire was used to perform two 2-round Delphi studies: Delphi A included 27 IBD healthcare professionals and Delphi B involved 12 patients. The NCQ-IBD was developed from the list of items resulting from both Delphi studies combined with the Scientific Committees expert opinion. Results: the final NCQ-IBD consists of 90 items, organized in 13 sections measuring the following aspects of nursing management of IBD: infrastructure, services, human resources, type of organization, nursing responsibilities, nurse-provided information to the patient, nurses training, annual audits of nursing activities, and nursing research in IBD. Using the NCQ-IBD to evaluate these components allows the rating of healthcare quality for nursing management of IBD into 4 categories: A (highest quality) through D (lowest quality). Conclusions: the use of the NCQ-IBD tool to evaluate nursing management quality of IBD identifies areas in need of improvement and thus contribute to an enhancement of care quality and reduction in clinical practice variations (AU)
Subject(s)
Humans , Male , Female , Professional Review Organizations/standards , Professional Review Organizations , Inflammatory Bowel Diseases/diagnosis , Inflammatory Bowel Diseases/nursing , Inflammatory Bowel Diseases/rehabilitation , Nursing Services/organization & administration , Nursing Services/standards , /organization & administration , Quality of Health Care/standards , Quality of Health Care , Surveys and QuestionnairesABSTRACT
El presente trabajo intenta describir y caracterizar el departamento de enfermeria del Sanatorio Allende a la vez de un diagnostico situacional de una unidad de enfermeria. considera importante contextualizar la institucion donde se encuentra, su esencia, su filosofia, politicas, sus objetivos como asi tambien a las personas que trabajan en la misma.(AU)
Subject(s)
Humans , Nursing Services , Nursing Services/organization & administration , Nursing Services/supply & distribution , Nursing Services/standards , Nursing Staff/organization & administrationABSTRACT
El presente trabajo intenta describir y caracterizar el departamento de enfermeria del Sanatorio Allende a la vez de un diagnostico situacional de una unidad de enfermeria. considera importante contextualizar la institucion donde se encuentra, su esencia, su filosofia, politicas, sus objetivos como asi tambien a las personas que trabajan en la misma.
Subject(s)
Humans , Nursing Staff/organization & administration , Nursing Services/standards , Nursing Services/organization & administration , Nursing Services/supply & distribution , Nursing ServicesABSTRACT
O estudo tem por objetivos analisar a organização tecnológica do trabalho dos enfermeiros na produção do cuidado em Unidades de Pronto Atendimento, analisar as atividades dos enfermeiros, descrevendo a constituição da dimensão assistencial e gerencial no seu processo de trabalho; identificar o objeto do cuidado e a finalidade do trabalho dos enfermeiros e identificar os saberes tecnológicos e o conjunto de instrumentos utilizados pelos enfermeiros na produção de cuidados em Unidades de Pronto Atendimento (UPA). A estratégia de investigação foi à pesquisa de métodos mistos, do tipo explanatório sequencial. Na etapa quantitativa foi utilizado um questionário para a coleta de dados com 47 enfermeiros e, na etapa qualitativa, foi utilizada a técnica de observação por amostragem de eventos, referente às atividades dos enfermeiros em uma unidade de pronto atendimento selecionada. Os dados quantitativos foram analisados com o auxílio do Programa Statistical Package for the Social Sciences (SPSS), pela utilização de técnicas da estatística descritiva. Os dados qualitativos foram analisados pela técnica de Análise Temática de Conteúdo, contemplando os núcleos de sentido que compõem a comunicação e interpretação dos seus significados. O agrupamento dos dados quantitativos e qualitativos originou quatro núcleos de análise: trabalho dos enfermeiros, finalidade do trabalho dos enfermeiros, instrumentos de trabalho dos enfermeiros e os desafios e perspectivas do trabalho dos enfermeiros nos serviços de pronto atendimento. Na dimensão assistencial do trabalho destacaram-se as atividades de acolhimento com avaliação e classificação de risco e o registro dos dados clínicos em prontuários, caracterizados pelo atendimento partindo da queixa, com aprofundamento, enriquecendo a conduta, contudo as intervenções de enfermagem não extrapolaram seu caráter instrumental.
Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged, 80 and over , Emergency Medical Services , Prehospital Care , Nursing Services/economics , Nursing Services/standards , Nursing Services/organization & administration , Nursing Services/trends , Nursing Services , Health ServicesABSTRACT
Introducción: la presencia de tejido necrótico en la herida, la elevada carga bacteriana y los altos niveles de exudado se han identificado como las principales barreras para la cicatrización. El cadexómero yodado, recientemente comercializado en España, permite realizar un desbridamiento osmótico autolítico, gestionar el exudado y controlar la infección. Este estudio pretende evaluar en condiciones clínicas reales y de modo exploratorio, la utilidad del cadexomero yodado en el tratamiento de las heridas con importante carga necrótica. Material y método: estudio descriptivo observacional de una serie de casos clínicos. Se incluyeron aquellos pacientes con heridas con tejido desvitalizado y signos clínicos de infección local, con heridas crónicas o cronificadas de cualquier etiología, tratados con cadexómero yodado (Iodosorb®). Los pacientes fueron seguidos durante 10 cambios de apósito o hasta cicatrización si ésta se produce antes de los 10 cambios de apósito. Resultados: el 70% de las lesiones con tejido desvitalizado pasó a tejido sano de granulación o epitelial en 10 cambios de apósito, lo que indica heridas limpias y preparadas para cicatrizar. El manejo de la infección y el exudado también presentó buenos resultados. Los signos clínicos de infección prácticamente desaparecieron a partir del quinto cambio de apósito, dato que se confirma totalmente en el octavo. En relación al control de la infección y del exudado, más del 70% de las lesiones ya no estaban infectadas en el segundo cambio de apósito y más del 50% había pasado a tener un exudado ligero o ninguno. El eritema y la maceración de la piel perilesional también presentaron una mejora importante. Un dato de valor añadido es que seis de las 21 lesiones cicatrizaron durante el estudio y que el dolor se redujo drásticamente, pasando de una puntuación de 6,5 a 3 en el segundo cambio de apósito y a cero a partir del quinto, traduciéndose en una mejora sustancial de la calidad de vida de estas personas. Discusión y conclusiones: este estudio sugiere que el cadexómero yodado resulta de utilidad para desbridar las lesiones, a la vez que reduce los signos clínicos compatibles con infección local de la herida, así como los niveles de exudado normalmente asociados a estas situaciones(AU)
Introduction: presence of necrotic tissue in the wounds, high bacterial load and high levels of exudate have been identified as the main barriers to wound healing. Iodinated cadexómer, recently marketed in Spain, allows osmotic-autolytic debridement, exudate management and infection control. This study aims to assess, in real clinical conditions and in an exploratory way, the utility of iodinated cadexomer in the treatment of wounds with significant necrotic tissue. Methods: observational descriptive study of a series of clinical cases with patients presenting chronic wounds with devitalized tissue and clinical signs of local infection, with wounds of any etiology and treated with iodinated cadexómer (Iodosorb®). Patients were followed for 10 dressing changes or until healing if it was before 10 dressing changes. Results: 70% of the lesions presented clean granulation tissue with 10 dressing changes. The management of infection and exudation also had good results. The clinical signs of infection disappeared after the fifth change of dressing, a fact which was entirely confirmed in the eighth. In relation to the management of exudate, more than 70% of the injuries were no longer infected in the second change of dressing and over 50% of the injuries had happened to have a slight or no exudate. Erythema and maceration of surrounding skin also showed significant improvement. An added value of the data is that six of the 21 lesions healed during the study and that pain was reduced sharply, from a score of 6.5 to 3 on the second change of dressing and from zero to five, resulting in a substantial improvement in quality of life of these people. Discussion and Conclusions: this study suggests that iodinated cadexómer is useful for wound debridement, while reduces clinical signs of local infection and exudate levels normally associated with these situations(AU)
Subject(s)
Humans , Male , Female , Wound Healing , Wound Infection/nursing , Wounds and Injuries/nursing , Nursing Care/organization & administration , Primary Nursing/methods , Signs and Symptoms , Patient Satisfaction/statistics & numerical data , Quality of Life , Nursing Service, Hospital/trends , Nursing Services/standardsABSTRACT
PURPOSE: The purposes of this study were to explore the functional status of elderly residents and to analyze time use, and finally identify factors to predict nursing care needs in relation to functional status and health related variables. METHODS: In this study a descriptive-correlational design was used. Functional status of participants was obtained through interviews, and nursing care time was examined using a 1 min time-motion study with a standardized instrument developed by Korea Long-Term Care Planning Committee (2005). RESULTS: The mean total functional score was 65 (range 28-125) and mean total nursing care time was 144.15 min per day. There were significant positive relationships between total nursing care time, marital status, back pain, dementia, and vision impairment. Multiple regression analyses showed that a liner combination of number of illnesses, types of primary disease, ADL, IADL, cognitive function, nursing demand, and rehabilitation demand explained 42.8% of variance of total nursing time. ADL (beta=-.533) was the most significant predictor of nursing service need. CONCLUSION: Identifying factors that result in variations of service need has implications for adequate nursing service, estimation of optimum nurse to patient ratio, quality of care and patient safety.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Activities of Daily Living , Geriatric Assessment , Health Services Needs and Demand , Health Status , Interviews as Topic , Needs Assessment , Nursing Homes , Nursing Services/standards , Predictive Value of Tests , Quality of Health Care , Surveys and QuestionnairesABSTRACT
Determinar si la aplicación del proceso enfermero (PE), adoptando el modelo conceptual de Virginia Henderson (VH), resulta más efectivo y proporciona algún valor añadido (calidad en los cuidados y seguridad-satisfacción profesional) respecto a la aplicación de otros métodos que no adoptan dicho modelo, en el ámbito de la Atención Domiciliaria
The authors determine if applying the nurse process, by adopting Virginia Henderson´s conceptual model, is more effective and provides any added value in terms of quality care and security or professioanl satisfaction in comparison to the application of other methods which do not adopt Henderson´s model in the field of at home care
Subject(s)
Humans , History, 20th Century , History, 21st Century , Models, Nursing , Nursing Services/standards , Home Nursing/organization & administration , SpainABSTRACT
PURPOSE: This study was designed to develop Nursing Service Quality Indicators(NSQIs) in nursing homes that would lead to an appropriate evaluation and improvement of nursing service quality. METHODS: The preliminary NSQIs were developed through literature reviews and analysis of existing quality indicators. A content validity testing was done twice by using a panel of experts who were from academia and the clinical areas. The final NSQIs were confirmed and applied in three nursing homes to test feasibility. RESULTS: The preliminary NSQIs had 4 domains and 31 indicators. Two content validity testings were performed. The indicators scoring over .80 CVI for each testing were selected and modified by experts' opinions. The final NSQIs consisted of7 domains and 33 indicators. They were applied in three nursing homes and it was revealed that all the indicators were applicable. CONCLUSION: In this study, it is shown that this new 'Nursing Service Quality Indicators in Nursing Homes' is suitable for a holistic evaluation of nursing service quality of elderly patients in nursing homes. This NSQIs will be able to provide a basis for establishing nursing care standards and improving the nursing care quality in nursing homes.