[Validation of a questionnaire for the analysis of digital competence in patients with type 1 diabetes mellitus]. / Validación de un cuestionario para analizar la capacidad digital de pacientes con diabetes mellitus tipo 1.

OBJECTIVE: Validation of a questionnaire designed to stratify the level of digital competence in chronic patients. METHOD: Cross-sectional study, carried out in the Endocrinology and Nutrition Section of the Complejo Asistencial Universitario de León (CAULE). We selected the digital competencies section of the Cambados questionnaire, designed for the identification of digital chronic patient, with a maximum score of 20 points. The questionnaire was completed for validation by patients for whom were prescribed a digital tool for glycemic control. Reliability was assessed by assessing the correct use of the prescribed tool and internal consistency. RESULTS: The questionnaire was completely filled in by 171 patients, with a mean age of 44.36 (SD 17.36). The mean score obtained in the questionnaire was 11.04 (SD 4.74) and a score over 12 was the most appropriate cut-off point to discriminate between patients according to their level of digital competence. 48.54% of the patients made adequate use of the tool. The scale showed good internal consistency with a Cronbach's alpha of 0.77. CONCLUSIONS: The results reached in the present study allow us to affirm that the responses obtained from the patients in the digital competency definition questionnaire are a good indicator of the use of digital tools.

[Evaluation of contingency plans in the care of patients in intensive care units in the COVID-19 pandemic]. / Evaluación de los planes de contingencia en la atención a pacientes en Unidades de Cuidados Intensivos en la pandemia por COVID-19.

BACKGROUND: The expansion of intensive care areas has been one of the most significant measures in this forced adaptation to the evolution of the different phases of the COVID-19 pandemic. The objective is to evaluate the deployment of contingency plans in the care of patients admitted to intensive care units during the period from March 19 to April 20, 2020, in a public hospital, reference for 300,000 inhabitants belonging to the Galician Health Service. MATERIALS AND METHODS: Qualitative research from focus groups, with systematic sampling. Based on the adaptation to the health environment of the 10 measures recommended by Deloitte to face a pandemic, an evaluation was carried out by the quality unit of the Health Area. As outcome indicators, the number of COVID-19 patients, % of patients admitted to hospital, % patients admitted to intensive care units, as well as the number of deaths from COVID-19, were evaluated in seven health areas in the period March 19 to April 20, 2020. RESULTS: The qualitative evaluation identified 2 areas for improvement (communication and risk assessment) of the 10 recommended measures. The Health Area has the lowest relative (2.6%) and absolute (16) rate of deceased patients, as well as the lowest relative (7.9%) and absolute (24) rate of patients admitted to intensive services for COVID-19. The infection rate in professionals has been 4.4%. CONCLUSIONS: The simplicity and identification of areas for improvement added to the low consumption of resources are strengths of this proposal. This self-assessment can be helpful in identifying areas for improvement.

Efectividad de un programa de alta precoz tras parto normal / Effectiveness of an early discharge program after normal childbirth

Objetivo. Implantar un programa de alta precoz hospitalaria en el parto sin complicaciones para mejorar la efectividad, garantizando la seguridad clínica y la aceptabilidad de los pacientes. Material y métodos. Estudio descriptivo de la efectividad de un programa de alta precoz en el parto sin complicaciones entre febrero de 2012 y septiembre de 2013. Población a estudio: puérperas y recién nacidos con ingreso en el Hospital Universitario de Fuenlabrada, con una duración inferior a 24h, tras parto sin complicaciones que cumplieran los criterios de inclusión definidos. La satisfacción se evaluó mediante una encuesta con escala Likert. La efectividad del programa se monitorizó mediante indicadores de seguridad, productividad, adecuación y continuidad asistencial. Resultados. El 20% de los casos susceptibles de alta precoz del Hospital Universitario de Fuenlabrada completaron el programa. El 94% fueron partos eutócicos. Los 188 casos incluidos —sobre 911 pacientes con parto no complicado— representaron el 6,5% del total de los 2.857 partos atendidos. La estancia media de las pacientes incluidas presentó una disminución del 50% (2,4 a 1,2 días). La continuidad asistencial tras el alta hospitalaria fue seguida por la totalidad de las pacientes. En el 4,8% se reprogramó una consulta de revisión. El 2% de las pacientes reingresaron antes de 96h por problemas no graves. Cuatro recién nacidos (2%) precisaron atención en urgencias (madre o recién nacido) antes de 96h. La evaluación de la satisfacción de las pacientes alcanzó 4,5 sobre 5. Conclusiones. El programa logró una disminución de la estancia media en un 50%, favoreciendo la autonomía de las matronas. Su nivel de aceptación está en línea con intervenciones similares. El despliegue realizado puede ser útil para otras modificaciones de procesos asistenciales (AU)

Objective. To implement a program of early hospital discharge after an uncomplicated birth, in order to improve the effectiveness, as well as ensuring clinical safety and patient acceptability. Material and methods. Descriptive study of the effectiveness of an early discharge program after uncomplicated delivery between February 2012 and September 2013. The populations are post-partum women and newborns admitted to the University Hospital of Fuenlabrada, with a duration of less than 24h after uncomplicated delivery that met the defined inclusion criteria. Satisfaction was assessed using a Likert scale. The effectiveness of the program was monitored by safety indicators, productivity, adaptation, and continuity of care. Results. A total of 20% of cases capable of early discharge from Fuenlabrada University Hospital completed the program. Almost all (94%) were normal deliveries. The 188 cases included were from 911 patients with uncomplicated childbirth, accounting for 6.5% of the 2,857 total births. The mean stay of patients included showed a decrease of 50% (2.4 to 1.2 days). All patients received continuity of care after hospital discharge. The review consultation was reprogrammed for 4.8% of cases, with 2% of patients re-admitted within 96h. with no serious problems. Four newborns (2%) required attention in the emergency department (mother or newborn) before 96h. The assessment of patient satisfaction achieved a score of 4.5 out of 5. Conclusions. The program achieved a decrease in the average stay by 50%, favouring the autonomy of midwives. This acceptance level is in line with similar interventions. The deployment of the program may be useful for other changes in care processes (AU)

[Effectiveness of an early discharge program after normal childbirth]. / Efectividad de un programa de alta precoz tras parto normal.

OBJECTIVE: To implement a program of early hospital discharge after an uncomplicated birth, in order to improve the effectiveness, as well as ensuring clinical safety and patient acceptability. MATERIAL AND METHODS: Descriptive study of the effectiveness of an early discharge program after uncomplicated delivery between February 2012 and September 2013. The populations are post-partum women and newborns admitted to the University Hospital of Fuenlabrada, with a duration of less than 24h after uncomplicated delivery that met the defined inclusion criteria. Satisfaction was assessed using a Likert scale. The effectiveness of the program was monitored by safety indicators, productivity, adaptation, and continuity of care. RESULTS: A total of 20% of cases capable of early discharge from Fuenlabrada University Hospital completed the program. Almost all (94%) were normal deliveries. The 188 cases included were from 911 patients with uncomplicated childbirth, accounting for 6.5% of the 2,857 total births. The mean stay of patients included showed a decrease of 50% (2.4 to 1.2 days). All patients received continuity of care after hospital discharge. The review consultation was reprogrammed for 4.8% of cases, with 2% of patients re-admitted within 96h. with no serious problems. Four newborns (2%) required attention in the emergency department (mother or newborn) before 96h. The assessment of patient satisfaction achieved a score of 4.5 out of 5. CONCLUSIONS: The program achieved a decrease in the average stay by 50%, favouring the autonomy of midwives. This acceptance level is in line with similar interventions. The deployment of the program may be useful for other changes in care processes.

Objetivos terapéuticos en la atención al paciente con diabetes tipo 2 en el CAP Breña Alta (isla de La Palma) / Therapeutic objectives in the care of patients with diabetes mellitus type 2 in the breña alta primary health center (island of La Palma)

Objetivo. Evaluar el cumplimiento de las recomendaciones de la European NIDDM Policy Group y otros criterios clínicos en la atención al paciente con diabetes mellitus tipo 2 (DM2).Diseño. Estudio descriptivo transversal. Emplazamiento. Equipo de Atención Primaria (EAP) de Breña Alta, en la Isla de La Palma, Tenerife. Participantes. Población con DM2 incluida en el censo del programa de DM a 31 de diciembre de 1996.Intervenciones. Se recogieron los datos mediante entrevista, exploración física y pruebas complementarias. Mediciones y resultados principales. Se evaluaron 199 pacientes (edad: 67,17 años; el 58,8 por ciento eran mujeres; 7,85 años de diagnóstico; el 20,10 por ciento se trató con insulina, y al 51,26 por ciento se le aplicó exclusivamente tratamiento oral). El 59,8 por ciento realiza autocontrol de su glucemia capilar (el 78,2 por ciento con más de una determinación semanal).Fueron clasificados como aceptable bueno los valores de HbA1c en el 71,1 por ciento, colesterol total en el 69,1 por ciento y HDL en el 82 por ciento, triglicéridos basales en el 68,1 por ciento e índice de masa corporal (IMC) en el 35 por ciento. Conclusiones. Un porcentaje muy alto se incluye en la categoría aceptable-bueno, incluso el autoanálisis fue uno de los más frecuentes descritos en los EAP. Un alto porcentaje de pacientes con DM2 presentó importantes factores de riesgo, como obesidad, hábito tabáquico y alteraciones del perfil lipídico (AU)