Evaluación de los formatos de supervisión de enfermería en una institución de tercer nivel de atención / Evaluation of nursing supervision formats in a tertiary care institution

Introducción: la supervisión en enfermería tiene como principales funciones: la gestión, liderazgo, dirección y control que se realiza para mejorar el entorno laboral y garantizar el logro de objetivos organizacionales mediante instrumentos que apoyan el supervisado como lo son los formatos. Objetivo: evaluar la reestructuración de los registros de supervisión en los distintos servicios en un hospital de tercer nivel para propiciar el mejoramiento continuo de la calidad de atención a la persona. Material y métodos: se utilizó la descripción narrativa por categorías. Se dividió en dos etapas, una: la recopilación de la información, junto con una prueba piloto sólo para las supervisoras generales, quienes elaboraron dichos formatos; y la otra: la reestructuración de los formatos y capacitación de las jefes de enfermería de servicio y las suplentes de servicio, del 28 de mayo al 3 junio 2019. Este trabajo se llevó a cabo en el INNN, en coordinación con las supervisoras de los turnos matutino, vespertino, nocturno en sus dos veladas, jornada especial diurna y nocturna. Resultados: al finalizar la prueba piloto se obtuvo que el 56 % dijo tener más observaciones en el nuevo registro del área crítica. En tanto, el 64 % del personal enfermero dirigente cita que los espacios de los formatos de hospitalización y área crítica son muy pequeños. Discusión: hasta hoy no existe un modelo universal establecido para llevar a cabo la supervisión. Si bien es cierto que la falta de supervisión es un agravante que ocasiona quejas. De tal manera, afirmamos, que dentro de la supervisión los formatos son parte de la calidad del cuidado enfermero, herramienta valiosa entre otras, que permite llevar a cabo el funcionamiento de los servicios en una institución. Conclusión: estamos conscientes que la constante en la supervisión es la mejora continua que nos lleva al éxito en todas sus formas, ofreciendo mejores cuidados al paciente liderados por la supervisora y así, maximizar las oportunidades de promoción de salud y cumplir con los estándares y protocolos, por ende, una parte importante para dichos propósitos son los formatos éstos son una evidencia de la atención al usuario

Introduction: nursing supervision has as main functions: management, leadership, direction and control that is carried out to improve the work environment and guarantee the achievement of organizational objectives through instruments that support the supervised person, such as formats. Objective: to evaluate the restructuring of supervision records in the different services in a tertiary hospital to promote continuous improvement of the quality of care for the person. Material and methods: the narrative description by categories was used. It was divided into two stages, one: the compilation of the information, together with a pilot test only for the general supervisors, who developed these formats; and the other: the restructuring of the formats and training of the nursing heads of service and the service substitutes, from May 28 to June 3, 2019. This work was carried out at the INNN, in coordination with the supervisors of the morning, evening, and night shifts in their two evenings, special day and night shift. Results: at the end of the pilot test, it was found that 56% said they had more observations in the new registry of the critical area. Meanwhile, 64% of the leading nursing staff cite that the spaces of the hospitalization and critical area formats are very small. Discussion: until today there is no established universal model to carry out supervision. While it is true that the lack of supervision is an aggravating factor that causes complaints. In this way, we affirm that within the supervision the formats are part of the quality of nursing care, a valuable tool among others, which allows the operation of services in an institution to be carried out. Conclusion: we are aware that constant supervision is continuous improvement that leads us to success in all its forms, offering better patient care led by the supervisor and thus, maximizing health promotion opportunities and complying with standards and protocols. Therefore, an important part for said purposes are the formats, these are an evidence of the attention to the user.

Significant differences in access to tests and treatments for multiple myeloma between public and private systems in Latin America. Results of a Latin American survey. GELAMM (Grupo de Estudio Latino Americano de Mieloma Múltiple).

The incidence of multiple myeloma (MM) has increased in the last 20 years, particularly in middle and low-middle income countries. Access to diagnostic and prognostic tests and the availability of effective care is highly variable globally. Latin America represents 10% of the world population, distributed in countries of varied size, population, and socio-economic development. In the last decade, great improvements have been made in the diagnosis and treatment of MM. Applying these advances in real life is a challenge in our region. Local data regarding MM standards of care and outcomes are limited. A survey was carried out among hematologists from 15 Latin American countries to describe access to MM diagnostic and prognostic tests and the availability of effective care options. This study provides real-world data for MM in our region, highlighting striking differences between public and private access to essential analyses and therapeutic options.

Physical violence against children and adolescents in Recife: a 5-year retrospective study.

The aim of the present study was to analyze the prevalence results of physical violence against children and adolescents in a 5-year period in Recife, Brazil. Inter-personal violence is one of the most recognizable forms of child aggression and has become as an imperative public health issue. All violence related forensic reports performed between 2009 and 2013 in the clinical services of the Institute of Legal Medicine Antônio Percivo Cunha were analyzed. Victims were classified according to sex, age, relationship with perpetrator, injuries and year of occurrence. Statistical analysis was performed using the SPSS (version 22.0). Continuous variables were described and when appropriate, frequencies were displayed and compared. The association between variables was evaluated using chi-square and Fisher's exact test. The margin of error for the statistical tests was 5.0%. A total of 9783 occurrences were evaluated, involving mainly male subjects (n=5447, 55.7%). Victims' mean age was 13.9 years, the most common perpetrators were victims' acquaintances (n=2538, 25.9%). Facial injuries were the most frequent affecting a little over a fifth of the total sample (n=3673, 20.1%). These findings support the important role dentists can play in identifying and reporting physical violence against children and adolescents.

Impacto que genera el diagnóstico de VIH en mujeres trabajadoras de la Región de Antofagasta y Metropolitana / Impact of hiv diagnosis in working women in the Region of Antofagasta and the Metropolitan Region

El propósito del presente artículo expone como el diagnóstico de VIH ha afectado a mujeres chilenas en su rol de trabajadoras, conociéndolo desde su propia perspectiva. Es una investigación cualitativa, donde se entrevistan a 3 mujeres sero positivo de edad entre los 20 y 65 años, que cuentan con experiencia laboral previo al diagnóstico de VIH. Los resultados identifican un antes y después del diagnóstico de VIH, donde para mantener su rol de trabajadoras ocultan su diagnóstico al empleador y a sus compañeros de trabajo por miedo a ser discriminada; dan a conocer abiertamente su diagnóstico al contexto social que se desenvuelven para evitar prejuicios; o cambian su rubro laboral. De esta manera, se reconoce que la ley del SIDA de Chile no logra cubrir una protección real que permita el respeto, fiscalización y responsabilidad de estas normas, siendo vulnerados los derechos de las mujeres que viven con VIH. Las mujeres diagnosticadas sufren apartheid ocupacional e injusticia ocupacional, ya que no logran realizar su rol como trabajadoras debido a la desinformación que existe en la sociedad frente al VIH y a los estigmas que se encuentran en torno a ella, desencadenando prejuicios sociales históricos que han favorecido que mujeres vivan ocultando su realidad...

The purpose of this article is to present how an HIV diagnosis has affected Chilean women in their role as workers, from the perspective of the women themselves. It is qualitative research involving three interviews which HIV positive women between the ages of 20 and 65 who have work experience prior to receiving their HIV diagnosis. The results identify that there is a difference in the women’s experience pre- and post-diagnosis, whereby to maintain their role as workers they hide their diagnosis from their employer and colleagues for fear of discrimination; that the women openly disclose their diagnosis in the social context in which they operate to avoid bias; or that they change their job. Thus, it is clear that the AIDS Chile legislation fails to offer real protection to ensure respect, execution of, and accountability regarding these rules being violated for women living with HIV. The diagnosed women suffer an occupational apartheid and occupational injustice, as they are unable to perform their role as workers due to the misunderstandings that exist in society regarding HIV and to the stigmas that surround it and, moreover, are victims of historical social biases that have favored women live hiding their HIV reality...

Percepciones de las personas que participan en el programa adulto mayor dependiente de la Fundación Cerro Navia Joven: una mirada desde la ocupación / Perceptions of people that participate in the dependent elderly program of the Cerro Navia Foundation: an occupational point of view

Chile se encuentra siendo testigo de una creciente problemática asociada al envejecimiento poblacional: el aumento de las necesidades de cuidado en personas mayores en situación de dependencia. A partir de esto, existen iniciativas que buscan dar respuesta a esta realidad, siendo una de ellas el Programa de Adultos Mayores Dependientes de la Fundación Cerro Navia Joven, experiencia de carácter comunitaria en la que una persona mayor voluntaria realiza semanalmente una visita domiciliaria, junto a un equipo especializado, a personas mayores que se encuentran en situación de dependencia y su cuidador/a, pertenecientes a la misma comuna. Frente a esto, esta investigación tiene como propósito el conocer cuáles son las percepciones de las personas participantes de este programa, conformada por la tríada persona mayor en situación de dependencia, su cuidador/a y la persona mayor voluntaria. Para esto, se realizó un estudio de tipo cualitativo, utilizando la entrevista como instrumento de recolección de la información. El análisis de datos se realizó empleando la técnica del análisis de contenido. Dentro de los resultados se identificaron factores como cambios asociados a la rutina, valoración del rol de voluntario/a, acompañamiento, establecimiento de vínculo, percepción de los beneficios de las visitas, motivación, percepción de los cuidados y del apoyo social, los que fueron analizados bajo la mirada de la ocupación.

We are witnessing a growing problem associated with an aging population: increased care needs in older people in situations of dependency. Given this, there are initiatives that seek to respond to this reality, one being the Dependent Elderly Program of the Cerro Navia Joven Foundation, a community experience in which an elderly volunteer does a weekly home visit, accompanied by a specialized team, to elderly people who are in a dependency situation and the caregiver, from the same neighborhood. Thus, this research aims to compile the perceptions of the participants of this program, formed by the triad dependent elderly, caregiver and elderly volunteer. For this, a qualitative study was conducted using the interview as a tool for collecting information. The data analysis was carried out using the content analysis technique. Amongst the results were identified factors such as changes associated to routine, assessment of the role of the volunteer, assistance, linkage establishment, perception of benefits of the visits, motivation, perception of care and social support, which were analyzed under the point of view of the occupation.

The internal orbital facial breadth and middle facial breadth in Mongoloid crania from Peru and east Asia, with special reference to their significance as a racial criterion.

The internal orbital facial breadth (BIFMO), middle facial breadth (BIZM) and their dimensional relationship in 789 crania from 3 Peruvian and 7 East Asian series were examined to determine a Mongoloid criterion. The results confirmed that BIZM was invariably greater than BIFMO in the Peruvian and East Asian series, and clearly different from the quoted European and African populations (Ducros, 1965). Further discussion, which referred to world population data by Woo and Morant (1934), showed that the relationship between BIZM and BIFMO was useful as a simple racial criterion to distinguish the Mongoloid series, except in special cases such as the Oceanians.

[Incorporation of transferrin into the erythron in anemic and polycythemic conditions]. / Incorporación de la transferrina al eritrón en estados anémicos y policitémicos.

A ferrokinetic study was performed in 79 patients, 25 with absolute polycythaemia, 19 with relative polycythaemia and 35 presenting anaemia of different aetiology. The incorporation of transferrin into the erythron (ITE) was estimated on each case. The mean ITE values found in absolute primary and secondary polycythaemia and in secondary polycythaemia were, respectively, 281 +/- 85, 181 +/- 99 and 74 +/- 19 mumol/L tb/d (i.e., micromoles per litre of total blood per day). The mean ITE in iron deficiency anaemia was 110 +/- 43 mumol/L tb/d, in haemolytic anaemia this was 274 +/- 151 mumol/L tb/d, and in patients with myelodysplastic syndromes such values was 116 +/- 49 mumol/L tb/d. Significant differences were found for each group of patients with respect to a normal control group. Such findings are in accordance with the pathophysiology of the different pathologies studied. The values found in haemolytic anaemia and myelodysplastic syndromes are similar to those reported by others. The results of this study stress the advantages of evaluating the erythropoietic activity of the bone marrow by means of the ITE.

Ferritin determination in elderly people by enzyme immunoassay.

Iron is associated with important biological processes: Cellular and molecular oxidation, muscle contraction and infection resistance. Iron stores can be estimated by Ferritin (FTN) determination. FTN quantitation can be used in the early diagnosis of ferropenic anemia (precedes 3-6 months the clinical appearance of anemia) in pregnant women, children and elderly people. FTN serum levels are associated with high incidence diseases as malignant tumors and hepatopathies. Serum FTN concentration is in the range of ng/ml. So, high sensitivity techniques with radioactive, enzymatic, fluorescent or luminescent tracers are needed for FTN quantitation. An affinity antibody enzyme labelled procedure with a 2.5-500 ng/ml range, compatible with various plastic solid supports was developed to study Ferritinemia in elderly persons. Ferritinemia was found to be less than 20 ng/ml in 12% institutionalized elderly persons.

Liver storage iron in normal population of Cuba.

One hundred sixty-one liver specimens from subjects who died acute traumatic deaths were studied. Of these, 127 came from male subjects and 34 from female subjects. The liver storage iron values of subjects in the persent study dying acutely from traumas and the differences found are in agreement with those expected according to the iron physiological needs and the prevalence of anemia reported by this cause in the world. This substantiates that the study of nonheme iron contents in subjects who died acute traumatic deaths is a good method for assessing iron nutritional status in a population. It is interesting to note the significant increase of hepatic storage iron found in men 61 to 70 years old, although it would be important to increase the number of cases to obtain more representative data. Liver storage iron in the Cuban population is not essentially different from that reported in the United States, Sweden, and Australia and the deficiency percentage is one of the lowest in Latin America.