Eficiencia en la prescripción enfermera en Andalucía. Un paso atrás en el sistema sanitario tras anulación por Real Decreto / No disponible

Objetivos: Analizar la eficiencia en la prescripción enfermera en Andalucía, España, entre 2009-2015, de productos sanitarios inherentes a su labor asistencial. Asimismo, analizar las alegaciones de la Organización Médica Colegial al Ministerio de Sanidad, Servicios Sociales e Igualdad al anteproyecto de ley de prescripción enfermera. Diseño. Revisión. Fuentes de datos: Se revisaron bases de datos bibliográficas de habla latina, española y extranjera: Fundación Index, Hemeroteca Doyma y Medline. Google Scholar con los mismos términos de búsqueda, añadiendo el término "Andalucía": "prescripción enfermera" AND "eficiencia" OR "Andalucía". Se buscó también en la literatura gris utilizando los mismos criterios en la web del Servicio Andaluz de Salud (SAS). Se complementó con una entrevista con la directora de cuidados del SAS. Extracción de datos: Se localizaron 617 artículos, de los que se seleccionaron 20. En la literatura gris se encontraron 52, de los cuales quedaron 4. Resultados: Los estudios sobre eficiencia en prescripción enfermera en Andalucía son escasos pero contundentes, como los datos aportados por la Dirección de Cuidados del Servicio Andaluz de Salud sobre los productos sanitarios inherentes a su profesión. La modificación del anteproyecto del Real Decreto 954/2015, por presiones de la Organización Médica Colegial, deja la competencia de prescripción enfermera exclusivamente a la indicación médica, quien diagnostica y prescribe y la elimina sin argumentación avalada por evidencia científica. Conclusiones: Podemos corroborar que la incorporación de la prescripción enfermera al sistema sanitario publico ha supuesto una mejora en la eficiencia del mismo. Por otro lado, las alegaciones de la Organización Medica colegial critican este acto sanitario sin que sus argumentos tengan una base científica

Objectives: To analyse the efficiency of nurse prescription of the health products inherent to their care work, in Andalusia, Spain, between the years 2009-2015. To also analyse the discussions by the Medical Colleges Organisation and the Ministry of Health, Social Services and Equality, before the draft bill on nurse prescription and their outcome. Design. Scoping review. Data source: Main bibliographic databases of Latin-American, Spanish, and foreign languages were reviewed, including, Fundación Index, Doyma, and Medline Library. Google Scholar was also used with the same search terms, adding to limit the search the term "Andalusia": "prescription nurse" AND "efficiency" OR "Andalusia". Another search was conducted in the grey literature using the same criteria in the Andalusian Health Service (SAS) web site. It was complemented with an interview with the care director of the SAS. Data extraction A total of 617 articles were found, of which 20 were selected. In the grey literature, 52 documents were found, of which 4 were used. Results: Few studies were found on the efficiency in nurse prescription in Andalusia, although they are as strong as the data provided by the Andalusian Health Care Directorate on the health products inherent in their profession. After modification of Royal Decree 954/2015, and under pressure from the Medical Colleges Organisation, it leaves the competence of prescription nurse exclusively to the medical indication, who diagnoses and prescribes and eliminates it without argument scientifically endorsed. Conclusions : We corroborate the incorporation of efficiency in the Health System through the nurse prescription, and the rupture with the Royal Decree 954/2015. The allegations of the Medical Colleges Organisation are without argument

Eficiencia en la prescripción enfermera en Andalucía. Un paso atrás en el sistema sanitario tras anulación por Real Decreto.

OBJECTIVES: To analyse the efficiency of nurse prescription of the health products inherent to their care work, in Andalusia, Spain, between the years 2009-2015. To also analyse the discussions by the Medical Colleges Organisation and the Ministry of Health, Social Services and Equality, before the draft bill on nurse prescription and their outcome. DESIGN: Scoping review. DATA SOURCE: Main bibliographic databases of Latin-American, Spanish, and foreign languages were reviewed, including, Fundación Index, Doyma, and Medline Library. Google Scholar was also used with the same search terms, adding to limit the search the term "Andalusia": "prescription nurse" AND "efficiency" OR "Andalusia". Another search was conducted in the grey literature using the same criteria in the Andalusian Health Service (SAS) web site. It was complemented with an interview with the care director of the SAS. DATA EXTRACTION: A total of 617 articles were found, of which 20 were selected. In the grey literature, 52 documents were found, of which 4 were used. RESULTS: Few studies were found on the efficiency in nurse prescription in Andalusia, although they are as strong as the data provided by the Andalusian Health Care Directorate on the health products inherent in their profession. After modification of Royal Decree 954/2015, and under pressure from the Medical Colleges Organisation, it leaves the competence of prescription nurse exclusively to the medical indication, who diagnoses and prescribes and eliminates it without argument scientifically endorsed. CONCLUSIONS: We corroborate the incorporation of efficiency in the Health System through the nurse prescription, and the rupture with the Royal Decree 954/2015. The allegations of the Medical Colleges Organisation are without argument.

Cura de úlcera en la pierna con miel. Caso clínico / Treating a leg ulcer with honey. Clinical case

Las lesiones vasculares de las extremidades inferiores constituyen un problema de salud con importantes consecuencias socioeconómicas y sanitarias, no existe un tratamiento único y efectivo para su curación. El propósito de este trabajo es contribuir al conocimiento existente sobre el uso tópico de la miel para la curación de este tipo de lesiones y su aplicación en la práctica clínica. Se presenta el caso clínico de A.M.L., de 80 años de edad, con úlcera venosa en miembro inferior derecho de dos meses de evolución. Diagnóstico enfermero: deterioro de la integridad cutánea manifestado por úlcera en cara externa tibial de tobillo derecho relacionado con insuficiencia venosa de miembros inferiores. Resultado esperado: cicatrización completa de la úlcera en seis meses (NOC: Curación de la herida: por segunda intención). Intervención enfermera: se establece el tratamiento de cura de la herida con la aplicación de miel sobre ella tres veces por semana (NIC: Cuidados de la herida).Tras una rápida cicatrización inicial de la cavidad de la herida y eliminación de los pequeños esfacelos del lecho, la lesión se complica y agrava y se establece cura con apósito hidrocoloide de silicona y compresión tres veces por semana. Se consiguió la completa cicatrización de la herida en tres meses y medio aproximadamente desde el inicio de la segunda intervención. Son necesarios más estudios para determinar el uso seguro y eficaz de la miel como tratamiento de las úlceras venosas en extremidades inferiores

Vascular lesions in lower limbs represent a health problem with major socioeconomic and healthcare consequences; there is not an unique and effective treatment for them. The purpose of this article is to contribute to the existing knowledge about the topical use of honey for treating this type of lesions, and its application on clinical practice. The clinical case of A.M.L. is presented: an 80-year-old patient with a venous ulcer in the right lower limb, with two months of evolution. Nursing diagnosis: deterioration of cutaneous integrity caused by an ulcer in the external face of the right ankle tibia, associated with venous insufficiency in lower limbs. Expected result: complete scarring of the ulcer within six months (NOC: Wound healing: by second intention). Nursing intervention: The treatment for wound healing is established by applying honey on it three times per week (NIC: Wound care). After a fast initial scarring of the wound cavity, and removal of the small sloughing in the wound bed, the lesion gets complicated and worsens, and healing is established with hydrocolloid dressing with silicone and compression three times per week. Complete wound scarring was achieved at approximately three months and a half since the initiation of the second intervention. More studies are required in order to establish the safe and effective use of honey as treatment for venous ulcers in lower limbs