Info-NAS: A Computer Program for the Calculation of Intensive Care Unit Nurse Workload.

The purpose of this study was to design an algorithm that allows automatic calculation of nursing workload in intensive care units, based on the Nursing Activities Score scale, through a computer program. Three methodological steps were used: (1) Delphi method (group of experts); (2) identification of the correspondence: Nursing Activities Score items-variables in the EHR, namely, standardized terminology, laboratory values, and prescriptions; and (3) weighting of variables independently by a group of experts. Finally, the algorithm of the computer program was tested. The results showed an algorithm that calculates the nursing workload in an ICU. The calculation is objective and automatic through the EHRs. This study shows the feasibility of the algorithm as a rapid and objective strategy to quantify adequate nurse staffing in intensive care units. Moreover, it provides nurses with a practical resource for the correct completion of records and is thus an incentive to maintain or improve their quality.

Risk factors of catheter- associated bloodstream infection: Systematic review and meta-analysis.

INTRODUCTION: The prevalence of catheter-associated bloodstream infections (CLABSI) is high and is a severe health problem associated with an increase in mortality and elevated economic costs. There are discrepancies related to the risk factors of CLABSI since the results published are very heterogeneous and there is no synthesis in the description of all the predisposing factors. OBJECTIVE: We aimed to perform a systematic review and meta-analysis to synthesize and establish the risk factors predisposing to CLABSI reported in the literature. METHOD: This is a systematic review of observational studies following the PRISMA recommendations. MEDLINE and CINAHL databases were searched for primary studies from 2007 to 2021. The protocol was registered in PROSPERO CRD42018083564. RESULTS: A total of 654 studies were identified, 23 of which were included in this systematic review. The meta-analysis included 17 studies and 9 risk factors were analyzed (total parenteral nutrition (TPN), chemotherapy, monolumen and bilumen catheters, days of catheterization, immunosuppression, kidney disease and diabetes mellitus) due to the homogeneity of their definitions and measurements. The risk factors found to increase the probability of developing CLABSI were TPN, multilumen devices, chemotherapy treatment, immunosuppression and the number of days of catheterization. On the other hand, monolumen devices presented a lower likelihood of triggering this infection.

Efectividad de una intervención hospitalaria para disminuir interrupciones durante la preparación y administración de medicación / Effectiveness of a hospital intervention for reducing interruptions during medication preparation and administration

Objetivo: valorar la efectividad del uso de chaleco de alerta en la reducción de interrupciones durante las rondas de preparación y administración de medicación en el entorno hospitalario, y recoger las experiencias de los profesionales de Enfermería en relación con ellosMétodo: estudio cuasiexperimental pre y posintervención sin grupo control. La intervención consistió en dar información al equipo asistencial, pacientes y familiares de la importancia de no interrumpir el proceso de medicación, colocación de carteles informativos en las unidades e implementación de chalecos de un solo uso para visibilizar esa actividad. Los datos se recogieron mediante observación directa pre y posintervención en cuatro unidades de hospitalización durante la ronda de medicación. Adicionalmente se realizó una encuesta de opinión a los participantes.Resultados: en el periodo preintervención se observaron a 29 profesionales durante 29,2 horas. Se produjeron 516 interrupciones, una cada 3,23 (DE:1,18) minutos. En el periodo posintervención se observaron a 26 profesionales durante 19 horas y se produjeron 210 interrupciones, una cada 5,26 (DE: 3,44) minutos de media (p= 0,001). Un 58,8% creía que no era una medida efectiva para la reducción de las interrupciones, el 61,8% pensaba que los pacientes/familiares no entendían bien la medida, y el 11,5% sugería buscar medidas más ecológicas.Conclusiones: los chalecos disminuyeron el número de interrupciones aumentando el tiempo entre ellas, aunque seguía siendo considerable. Esto, sumado a la baja satisfacción de los profesionales y al impacto medioambiental, supuso la desestimación del chaleco de alerta como medida efectiva en la reducción de las interrupciones en el proceso de medicación.(AU)

Objective: to assess the effectiveness of the warning vest upon the reduction of interruptions during the medication preparation and administration rounds in the hospital setting, and to collect the experiences of Nursing professionals regarding this.Method: a quasi-experimental pre-and-post intervention study without control arm. The intervention consisted in giving information to the healthcare staff, patients and relatives, about the importance of not interrupting the medication process, as well as placing informative posters in the units, and implementing one-single-use vests to make this activity visible. Data were collected through direct observation pre-and-post intervention in four hospitalization units during medication rounds. Additionally, an opinion survey was conducted among participants.Results: in the pre-intervention period, 29 professionals were observed during 29.2 hours. There were 516 interruptions, one every 3.23 (SD:1.18) minutes. In the post-intervention period, 26 professionals were observed during 19 hours, and there were 210 interruptions, one every 5.26 (SD: 3.44) minutes as mean (p= 0.001). Of these professionals, 58.8% believed that this was not an effective measure for reducing interruptions, 61.8% thought that patients / relatives did not understand the measure well, and 11.5% suggested looking for measures which were more ecological.Conclusions: vests reduced the number of interruptions and increased the time between them, even though this continued being significant. Added on to the low satisfaction by professionals and its environmental impact, this entailed the rejection of warning vests as an effective measure for the reduction of interruptions during the medication process.(AU)

COVID-19 pandemic on health professionals in a third level hospital in Spain: job changes during the first wave, mental health at 4 months, and follow-up at 9 months.

OBJECTIVE: To determine the impact that the COVID-19 pandemic has had on health professionals, in terms of work changes and mental health. METHOD: 1) Cross-sectional study and 2) longitudinal prospective study on health professionals who worked directly with patients affected by COVID-19 pandemic during the period between March-June 2020 in a tertiary hospital in Barcelona. Baseline (July-November 2020) and follow-up (November 2020-March 2021) data were collected. Data related to the job and toxic habits were collected with ad hoc questionnaires, and data related to perceived stress, post-traumatic stress, depression, and anxiety using validated questionnaires. RESULTS: In the baseline group (cross-sectional study), 90 professionals participated, 76% nurses. More than a third were on sick leave or took drugs to manage stress. Half of smokers increased tobacco use, and one in 5 increased alcohol consumption. Habitual shift change is significantly associated with depression, professional profile with anxiety, and perceived stress with age. In the longitudinal prospective study, the follow-up group (n = 64) shows high levels of stress and anxiety, which are maintained or even significantly increased over time. CONCLUSIONS: The structural changes that occurred in the hospital during the first wave of the COVID-19 pandemic had a strong impact on professionals, many of them presenting an increase in toxic habits, as well as impaired mental health that is maintained over time.

Pandemia COVID-19 sobre profesionales sanitarios en un hospital de tercer nivel en España: cambios laborales durante la primera ola, salud mental a los 4 meses y seguimiento a los 9 meses / COVID-19 pandemic on health professionals in a third level hospital in Spain: job changes during the first wave, mental health at 4 months, and follow-up at 9 months

Objetivo: Determinar el impacto que ha tenido la pandemia COVID-19 en profesionales sanitarios, en términos de cambios laborales y de salud mental. Método: 1)Estudio transversal y 2) estudio longitudinal prospectivo sobre profesionales de la salud que trabajaron de forma directa con pacientes afectados por la pandemia COVID-19 durante el periodo comprendido entre marzo-junio de 2020 en un hospital de tercer nivel de Barcelona. Se recogieron datos basales (julio-noviembre de 2020) y de seguimiento (noviembre de 2020-marzo de 2021). Se recogieron datos relacionados con el puesto de trabajo y hábitos tóxicos con cuestionarios ad hoc, y de estrés percibido, estrés postraumático, depresión y ansiedad mediante cuestionarios validados. Resultados: En el grupo basal (estudio transversal) participaron 90 profesionales, 76% enfermeras. Más de un tercio estuvo de baja o tomó fármacos para gestionar el estrés. La mitad de los fumadores aumentó el consumo de tabaco, y uno de cada 5 aumentó el consumo de alcohol. Se asocia de forma significativa el cambio de turno habitual con la depresión, el perfil profesional con la ansiedad, y el estrés percibido con la edad. En el estudio longitudinal, el grupo de seguimiento (n=64) muestra niveles elevados de estrés y ansiedad, que se mantienen o incluso aumentan en el tiempo de forma significativa. Conclusiones: Los cambios estructurales acontecidos en el hospital durante la primera ola de la pandemia por la COVID-19 tuvieron un fuerte impacto en los profesionales, presentando muchos de ellos un aumento en los hábitos tóxicos, así como una salud mental alterada que se mantiene en el tiempo.(AU)

Objective: To determine the impact that the COVID-19 pandemic has had on health professionals, in terms of work changes and mental health. Method: 1) Cross-sectional study and 2) longitudinal prospective study on health professionals who worked directly with patients affected by COVID-19 pandemic during the period between March-June 2020 in a tertiary hospital in Barcelona. Baseline (July-November 2020) and follow-up (November 2020-March 2021) data were collected. Data related to the job and toxic habits were collected with ad hoc questionnaires, and data related to perceived stress, post-traumatic stress, depression, and anxiety using validated questionnaires. Results: In the baseline group (cross-sectional study), 90 professionals participated, 76% nurses. More than a third were on sick leave or took drugs to manage stress. Half of smokers increased tobacco use, and one in 5 increased alcohol consumption. Habitual shift change is significantly associated with depression, professional profile with anxiety, and perceived stress with age. In the longitudinal prospective study, the follow-up group (n=64) shows high levels of stress and anxiety, which are maintained or even significantly increased over time. Conclusions: The structural changes that occurred in the hospital during the first wave of the COVID-19 pandemic had a strong impact on professionals, many of them presenting an increase in toxic habits, as well as impaired mental health that is maintained over time.(AU)

[COVID-19 pandemic on health professionals in a third level hospital in Spain: job changes during the first wave, mental health at 4 months, and follow-up at 9 months]. / Pandemia COVID-19 sobre profesionales sanitarios en un hospital de tercer nivel en España: cambios laborales durante la primera ola, salud mental a los 4 meses y seguimiento a los 9 meses.

Objective: To determine the impact that the COVID-19 pandemic has had on health professionals, in terms of work changes and mental health. Method: 1) Cross-sectional study and 2) longitudinal prospective study on health professionals who worked directly with patients affected by COVID-19 pandemic during the period between March-June 2020 in a tertiary hospital in Barcelona. Baseline (July-November 2020) and follow-up (November 2020-March 2021) data were collected. Data related to the job and toxic habits were collected with ad hoc questionnaires, and data related to perceived stress, post-traumatic stress, depression, and anxiety using validated questionnaires. Results: In the baseline group (cross-sectional study), 90 professionals participated, 76% nurses. More than a third were on sick leave or took drugs to manage stress. Half of smokers increased tobacco use, and one in 5 increased alcohol consumption. Habitual shift change is significantly associated with depression, professional profile with anxiety, and perceived stress with age. In the longitudinal prospective study, the follow-up group (n = 64) shows high levels of stress and anxiety, which are maintained or even significantly increased over time. Conclusions: The structural changes that occurred in the hospital during the first wave of the COVID-19 pandemic had a strong impact on professionals, many of them presenting an increase in toxic habits, as well as impaired mental health that is maintained over time.

Descripción de una intervención para prevenir lesiones cutáneas por presión provocadas por los equipos de protección personal (EPIs) durante la atención de pacientes con COVID-19 / Description of an intervention to prevent pressure-induced skin lesions caused by personal protective equipment (PPE) during the care of patients with COVID-19

Objetivos: Describir los resultados de una estrategia diseñada para evitar lesiones cutáneas por presión relacionadas con la utilización de los equipos de protección individual (EPIs). Metodología: Estudio descriptivo observacional prospectivo realizado entre marzo y junio de 2020 en profesionales del Parc de Salut Mar (PSMAR) que utilizaron EPIs en áreas de pacientes diagnosticados de COVID-19. Un servicio de vigilancia multidisciplinar se activó con el fin de realizar una detección precoz. Se suministró de forma individualizada a 1044 profesionales materiales para prevención de lesiones por presión, fricción y humedad de los EPIs sobre la piel de la cara. Resultados: De todos los profesionales, 32 fueron citados para una valoración presencial por lesiones: 6 presentaron úlceras por presión en estadios III y IV, 24 dermatitis, foliculitis y eczemas. La tasa de presentación de úlceras fue del 0,57% y la de dermatitis del 2,30% de la población de estudio. Conclusión: Los resultados de la aplicación de las medidas especificadas indican que han sido eficaces para prevenir úlceras por presión en la región de la cara provocadas por los EPIs. La adopción de medidas de prevención no solo para prevenir ulceras por presión sino para la prevención de dermatitis se hacen imprescindibles en situaciones en las que se requiere el uso continuado de EPIs en la región de la cara (AU)

Objective: To describe a strategy designed to avoid pressure-related skin lesions related to the use of personal protective equipment (PPE). Methods: This was a prospective descriptive observational study. Study population: healthcare professionals at the Parc Salut Mar (Barcelona) who used PPE for protection against COVID-19 between March 30 and June 15, 2020. Intervention: Each professional was provided with an individual kit to prevent PPE-induced lesions, friction, or moisture. A multidisciplinary surveillance team was deployed for the early detection of these adverse events. Results: Individual kits were provided to 1044 professionals, 32 of whom were scheduled for in-person medical assessments. Six participants (0.57%) developed Stage III or IV pressure ulcers, 24 (2.3%) had dermatitis, folliculitis, eczema and two participants did not show for their appointments. The overall rate of pressure ulcers was 0.57%; for dermatitis it was 2.3%. Conclusions: The use of preventive measures appears to be effective in preventing facial pressure ulcers induced by EPIs among healthcare professionals. Our resultsalso underscore the importance of expanding preventive measures to include not only pressure ulcers but also dermatitis (AU)

Los movimientos activistas del VIH / sida en el cine / HIV/AIDS activist movements in movies

A principios de 1980 la irrupción del VIH / sida generó miedos, discriminación y estigmatización hacia personas y colectivos afectados. Como respuesta, aparecieron movimientos activistas para defender los derechos de las personas con VIH / sida y promover la introducción de tratamientos efectivos y accesibles. Tras más de tres décadas de epidemia, se han filmado varias películas sobre dichos movimientos. Sin embargo, son escasos los estudios que analicen el valor de la participación ciudadana en la lucha del VIH / sida dentro del cine. El objetivo del artículo es describir y analizar las películas más representativas de este fenómeno. Se analizan How to survive a plague, Larry Kramer In Love and Anger, The Normal Heart, 120 battements par minute y Dallas Buyers Club y se discuten con otras relacionadas. Estas películas nos muestran la fuerza de los movimientos activistas para promover la implicación de los gobiernos, las farmacéuticas y los profesionales en la lucha del VIH / sida. Por ello, se proponen unos objetivos para su debate en entornos docentes de las ciencias sociales y de la salud, para continuar apoyando el compromiso y las estrategias de la sociedad civil en los avances de la investigación, los autocuidados y los tratamientos del VIH / sida

Early 80's the emergence of VIH generated popular fear coupled with discrimination and stigmatization for patients. In this context, HIV / AIDS activist movements emerged to establish and protect patients´ rights and foster the development of effective and affordable treatments. While three decades of related movie production depicts and described in length the role activists’ movements, academic research has been slow in addressing this question. More specifically, the role of citizen participation in the fight against HIV / AIDS through filmmaking is unknown. This article covers this gap by analysing the following movies about HIV / AIDS activist movements: How to survive a plague, Larry Kramer In Love and Anger, The Normal Heart, 120 battements par minute y Dallas Buyers Club. These movies show the struggle of Activist movements in encouraging national governments, pharmaceutical companies, and HIV / AIDS workers to fight against HIV / AIDS. We conclude by suggesting objectives to foster current debates about HIV / AIDS in medical and social sciences, more specifically the strategy of civil society to advance research, self-care, and HIV / AIDS treatments