Triggers of Agitation in Psychiatric Hospitalization Ward According to Professional Experience Questionnaire.

AIM: To create and analyze an instrument to assess the possible agitation triggers of hospitalized psychiatric patients. BACKGROUND: No tools exist for identifying according to a professional's experience. METHODS: Descriptive and cross-sectional study. The questionnaire of possible triggers of agitation behaviors of patients hospitalized in psychiatric wards according to professional experience (TAPE) was designed and analyzed. RESULTS: The questionnaire was provided to 156 mental health workers (76.9% women, average work experience: 10.15 ± 8 years, 46.8% were nurses specialized in mental health, and 21.2% psychiatrists). A good internal consistency was obtained, with a Cronbach α value of 0.791 in the initial test, and 0.892 in the retest. The factorial analysis found four factors: factor 1 "personnel", factor 2 "routines", factor 3 "norms-infrastructure", and factor 4 "clinic". Factor 1 obtained the highest value, with a mean of 4.16 ± 0.63, highlighting the item "lack of specialized personnel" (mean 4.38 ± 0.81). The specialized professionals provided higher scores to the items from the factors associated with the training of the personnel and routines (p = 0.017; p = 0.042). CONCLUSIONS: The TAPE questionnaire is useful for identifying the possible triggers that could lead to situations of agitation of hospitalized patients.

Sedation with Propofol plus Paracetamol in External Cephalic Version: An Observational Study.

Although the influence of neuraxial anesthesia or sedation with remifentanil in external cephalic version (ECV) is widely known, ECV results using propofol have not been previously analyzed. This study aimed to evaluate ECV outcomes when propofol was used. An observational analysis of ECV was performed between 1 January 2018 and 31 December 2020. ECV was accomplished with tocolysis and propofol. One hundred and thirty-one pregnant women were recruited. The propofol mean dose was 156.1 mg (SD 6.1). A cephalic presentation was achieved in 61.1% (80/131) of the pregnant women. In total, 56.7% (38/67) of pregnant women with cephalic presentation at labor had a spontaneous delivery, 26.9% (18/67) had an operative delivery, and an intrapartum urgent cesarean section was performed in 16.4% (11/67). In total, 46 pregnant women (35.9%) were scheduled for an elective cesarean section due to non-cephalic presentation. The emergency cesarean section rate during the following 24 h was 10.7% (14/131). A major ECV complication arose in 15 cases (11.5%). ECV outcomes when propofol was used seems to be similar to those with other anesthetic adjunct, so sedation with propofol could be an adequate option for ECV. More studies are needed to compare its effectiveness with neuraxial techniques.

Variabilidad en los errores preanalíticos del laboratorio entre centros periféricos de extracción: un reto para la seguridad del paciente / Variability of preanalytical errors between decentralized phlebotomy centers: A challenge for patient safety

Objetivo. Mostrar el número y tipo de incidencias preanalíticas en los centros de extracción periférica (CEP) del Departamento de Salud 17 de la Agencia Valenciana de Salud Método. El estudio se ha llevado a cabo durante 35 meses (mayo 2005–marzo 2008) sobre las 362.054 solicitudes y las 2.880.742 pruebas que se han recibido de los 16 CEP de Atención Primaria del Departamento de Salud 17. Método. Las incidencias son registradas en el sistema de información de laboratorio mediante un resultado codificado específico en la prueba solicitada. La procedencia de la muestra afectada se conoce mediante el número de petición que es específico para cada CEP. Método. Los resultados codificados y las muestras afectadas son recogidos automáticamente mediante un software basado en cubos On-Line Analytical Processing (OLAP) (Omnium®, Roche Diagnostics®). Calculamos las incidencias (expresadas en defectos por millón de oportunidades) para cada tipo de muestra en cada uno de los CEP. Se clasificaron los errores preanalíticos en dos grandes grupos: errores debidos a la pericia extractora (muestra coagulada, insuficiente o hemolizada) y error debido a fallo de proceso (muestra no disponible). El tratamiento de los datos obtenidos se ha realizado mediante Microsoft Excel 2003. Las variables son expresadas como frecuencia y porcentaje. Resultados. El mayor número de incidencias tuvo lugar en las muestras de orina (5.358 [52%]), seguidas por las de coagulación (2.164 [21%]), hematología (1.752 [17%]) y bioquímica (1.030 [10%]). Con respecto al tipo de error, la mayor proporción de errores fue debida a fallos de proceso (7.007 [62%]). Conclusiones. La alta incidencia de errores preanalíticos y su variabilidad entre centros sugieren que existe una necesidad de homogeneizar la práctica de la extracción de muestras(AU)

Objective. The aim of the study is to show the most frequent preanalytical sample errors from distinct decentralized phlebotomy centers. Method. The study was conducted from May 2005 to March 2008. In this period 36,2054 requests and 2,880,742 tests were received from the 16 decentralized phlebotomy centers. When an unsuitable sample is received specific coded results are registered as test results to inform the physician that an error had occurred and a new specimen collection is recommended. We used the the request number, which is specific for each phlebotomy center to ascertain where the samples with errors had been drawn, The preanalytical errors were identified by looking for coded results and were collected automatically from the LIS using a software program based on OLAP's cube (Omnium® Roche Diagnostic®), obtaining number and type of preanalytical error for each sample. The errors are calculated as number per million samples requested. Analysis of data was carried out using Microsoft Excel 2003. Categorical variables were expressed as frequency and percentage.ResultsThe highest number of incidences occurred in urine samples (52%), followed by coagulation (21%), haematology (17%) and biochemistry (10%). With regard to the type of error, the largest proportion of errors was due to failures of process (62%). Conclusions. The high incidence of preanalytical errors and variability between centers suggests that there is a need to standardize the drawing practice(AU)

[Variability of preanalytical errors between decentralized phlebotomy centers: a challenge for patient safety]. / Variabilidad en los errores preanalíticos del laboratorio entre centros periféricos de extracción: un reto para la seguridad del paciente.

OBJECTIVE: The aim of the study is to show the most frequent preanalytical sample errors from distinct decentralized phlebotomy centers. METHOD: The study was conducted from May 2005 to March 2008. In this period 36,2054 requests and 2,880,742 tests were received from the 16 decentralized phlebotomy centers. When an unsuitable sample is received specific coded results are registered as test results to inform the physician that an error had occurred and a new specimen collection is recommended. We used the the request number, which is specific for each phlebotomy center to ascertain where the samples with errors had been drawn, The preanalytical errors were identified by looking for coded results and were collected automatically from the LIS using a software program based on OLAP's cube (Omnium Roche Diagnostic), obtaining number and type of preanalytical error for each sample. The errors are calculated as number per million samples requested. Analysis of data was carried out using Microsoft Excel 2003. Categorical variables were expressed as frequency and percentage. RESULTS: The highest number of incidences occurred in urine samples (52%), followed by coagulation (21%), haematology (17%) and biochemistry (10%). With regard to the type of error, the largest proportion of errors was due to failures of process (62%). CONCLUSIONS: The high incidence of preanalytical errors and variability between centers suggests that there is a need to standardize the drawing practice.

Bases para la elaboración de un consentimiento informado de Enfermería / Basis for the elaboration of an informed consent form in Nursing

En la actualidad, los cambios en la cultura occidental llevan a un predominiodel establecimiento de lo que se podría llamar “la sociedadde los derechos”, que en los sistemas sanitarios se traduce en ser elcentro sobre el que gira la filosofía de estos. Quien demanda asistenciapasa de ser sólo paciente a ser un ente dotado de unos derechos,que a veces van más allá de los que disfruta el resto de la sociedad,y que considera que deben ser, además, una obligación el quedeban ser satisfechos por parte del sistema. Este deber prestacionalde derechos recae, en un primer momento, sobre los profesionalesque están más próximos al paciente y por tanto a quienes se les vaa demandar su cumplimiento. Un mecanismo de salvaguarda que puedeservir al profesional de Enfermería puede ser el consentimientoinformado, instrumento con el que ya cuentan los médicos y queestá recogido en las diferentes legislaciones

At present, changes in occidental culture lead to the predominantestablishment of what could be called “a society of rights”, which interms of medical systems, translates as the axis upon which the philosophyof medical care revolves. Those who demand medical careare not just patients but individuals with inherent rights that sometimes, go beyond those enjoyed by the rest of society. Whatsmore,these rights are considered to be an obligation that the system hasto fulfil. This “deliverable” obligation of rights lies in first instance withthe professionals that are the closets to the patient and thus, it willbe these same professionals who will have to comply with such requiredobligation. A mechanism that safeguards the nursing professionalis the informed consent form, an instrument widely usedby physicians that is of mandatory enforcement in the different legislations

Juvenile granulosa cell tumor of the testis: case report and review of literature.

Juvenile granulosa cell tumor of the testis is an infrequent tumor of the gonadal stroma characteristic of the pediatric age. It usually appears as a scrotal mass and less frequently as an abdominal or inguinal mass. It may be associated with ambiguous genitalia and/or abnormal sex chromosomes. The recommended treatment is orchiectomy alone because local recurrence or metastasis have never been observed. We describe a patient with a juvenile granulosa cell tumor of the testis and review the literature.