[Impact of an anti-flu vaccination strategy for prevention of cardiovascular diseases]. / Impacto de una estrategia de vacunación antigripal en el servicio de prevención de enfermedades cardiovasculares.

INTRODUCTION: To evaluate the impact in the coverage of the cardiovascular diseases prevention service (PECV) after modifying the flu vaccination campaign (VAG) strategy. SECONDARY OBJECTIVE: to assess how this strategy affected the vaccine coverage against the flu and pneumococcus (VAN). MATERIAL AND METHOD: A before-after experimental study with a control group, carried out in the Campamento Health Centre (Madrid), with a population over 14 years old with indications for receiving VAG. An appointment was made for each patient who came during the morning shift (intervention group), with their reference nurse, to be vaccinated and to update the PECV service. CONTROL GROUP: afternoon shift, vaccination as in previous years (appointments were arranged for patients on a specific VAG/VAN date, attended by a different nurse each day). The coverage of the PECV service was measured in both groups before and after the 2007 campaign. As well as the VAG and VAN coverage in the 2006 campaign, and before-after in 2007. RESULTS: The PECV Service increased by 2.6% in the intervention group, which was more than 3 times that of the control group. In the first group, the VAG coverage was 10 points higher and for VAN, the intervention group vaccinated was almost double that of the control group. The intervention group also shows an improvement when comparing the groups in 2006 and 2007. CONCLUSIONS: Individualised VAG strategy using a reference nurse increases vaccination uptake and also helps to improve health care aimed at preventing cardiovascular diseases.

Impacto de una estrategia de vacunación antigripal en el servicio de prevención de enfermedades cardiovasculares / Impact of a flu vaccination campaign in the cardiovascular diseases prevention service

Introducción: Evaluar el impacto en la cobertura del servicio prevención de enfermedades cardiovasculares (PECV) tras modificar la estrategia de la campaña de vacunación antigripal (VAG). Objetivo secundario: comprobar cómo afectaría dicha estrategia a la cobertura vacunal contra la gripe y neumococo (VAN). Material y método: Estudio experimental antes-después con grupo control, realizado en el Centro de Salud Campamento (Madrid), con la población mayor de 14 años susceptible de recibir VAG. Se citó a cada paciente del turno de mañana (grupo de intervención) en consulta concertada con su enfermera de referencia para vacunar y actualizar el servicio PECV. Grupo control: turno de tarde, en que se vacunaba como en años anteriores (pacientes citados en agenda específica VAG/VAN, atendidos por una enfermera distinta cada día). Se midió la cobertura del servicio PECV en ambos grupos antes y después de la campaña 2007. También las coberturas VAG y VAN en la campaña 2006, y antes-después en 2007. Resultados: El servicio PECV se incrementó un 2,6% en el grupo de intervención, 3 veces más que en el de control. En el primer grupo, la cobertura de VAG fue 10 puntos superior y, respecto a la VAN, el grupo intervención vacunó a casi el doble que el control. Al comparar los grupos en 2006 y 2007, también mejora el de intervención. Conclusiones: La estrategia de VAG individualizada por enfermera de referencia favorece la captación oportunista y permite aumentar los cuidados orientados hacia la prevención de enfermedades cardiovasculares

Introduction: To evaluate the impact in the coverage of the cardiovascular diseases prevention service (PECV) after modifying the flu vaccination campaign (VAG) strategy. Secondary objective: to assesshow this strategy affected the vaccine coverage against the flu and pneumococcus (VAN).Material and method: A before-after experimental study with a controlgroup, carried out in the Campamento Health Centre (Madrid), with a population over 14 years old with indications for receiving VAG. An appointment was made for each patient who came during the morning shift (intervention group), with their reference nurse, to be vaccinated and to update the PECV service. Control group: afternoon shift, vaccination as in previous years (appointments were arranged for patients on a specific VAG/VAN date, attended by a differentnurse each day). The coverage of the PECV service was measured in both groups before and after the 2007 campaign. As well as the VAG and VAN coverage in the 2006 campaign, and before-after in 2007.Results: The PECV Service increased by 2.6% in the intervention group, which was more than 3 times that of the control group. In the first group, the VAG coverage was 10 points higher and for VAN, the intervention group vaccinated was almost double that of the control group. The intervention group also shows an improvementwhen comparing the groups in 2006 and 2007.Conclusions: Individualised VAG strategy using a reference nurse increases vaccination uptake and also helps to improve health care aimed at preventing cardiovascular diseases

Mejora de la calidad del trabajo enfermero en atención primariatras una estrategia organizativa / Quality improvement in Primary Care nursing following an organisational strategy

Objetivo: comprobar el impacto de un conjunto de medidas organizativas, tanto en relación a la comunicación médico-enfermera como al trabajo enfermero en la consulta, sobre la calidad asistencial de Enfermería .Material y método: estudio de intervención antes-después en el Centro de Salud Campamento (Madrid), sobre un cupo de población de 1.400 adultos y 200 niños. La intervención consistió en un conjunto de medidas organizativas. Los indicadores utilizados para determinar el impacto de las medidas fueron: frecuentación en consulta de Enfermería (demanda y concertada); cumplimentación de servicios de cartera; desarrollo de nuevos programas; valoración subjetiva de usuarios y profesionales implicados en la intervención y frecuentación en consulta de Medicina (demanda y concertada).Resultados: tras la intervención las citas de pacientes crónicos disminuyeron de 8 a 4 personas. La cita a demanda (espontánea y derivada) aumentó un 41%, la concertada disminuyó un 6,7% y desapareció la demora para citarse con Enfermería. Se consiguieron mejores resultados de la cartera de servicios en el cupo estudiado que en el resto, se ampliaron las actividades enfermeras y se aumentó la satisfacción de profesionales y usuarios. Conclusiones: la racionalización de la frecuencia de las revisiones apacientes crónicos y la adecuada organización del trabajo enfermero, aplicando criterios de calidad, permite tener más tiempo enfermero, mayor efectividad y mejor relación entre los miembros del equipo (AU)

Objective: to check the impact of a series of organisational measures covering the communication between the physician and nurse and the nursing tasks carried out at the consultation office on the quality of nursing care. Material and method: a “before and after” interventional study at the Campamento Healthcare Centre (Madrid) on a population sample comprising 1.400 adults and 200 children. The intervention consisted of a series of organisational measures. The indicators used to determine the impact of the organisational measures taken included: patient frequentation to the nursing office, meaning the frequency with which a patient makes use of healthcare services (walk ins/consultation upon demand and by appointment); fulfilment of portfolio services; development of new programmes; subjective assessment of users and professionals involved in the intervention and frequentation to a medical office (walk ins and appointment).Results: after the intervention, appointments for chronic patients dropped from 8 to 4 people. Consultation upon demand appointments (spontaneous and referred) increased by 41%, pre-arranged appointments decreased by6,7% and there was no delay to make an appointment with the nurse. Improved results were attained in the portfolio of services in the sample studied as compared to the rest of the registered patients. Nursing activities were extended and the level of professional and user satisfaction increased. Conclusions: rationalisation of the frequency of follow up visits of chronic patients and an adequate organisation of the nursing load by applying quality criteria allows for longer nursing time, higher efficiency and improved relationship among team members (AU)