Efectividad de una intervención para reducir las interrupciones durante la preparación y administración de medicación / Efficacy of an intervention to reduce interruptions during the preparation and administration of medication

Objetivo: analizar la efectividad de la implementación del programa multi-intervención Programa Interrupciones Zero (PIZ) para disminuir las interrupciones durante el proceso de preparación y administración de medicamentos (PPAM) en el ámbito hospitalario y aumentar la satisfacción de los profesionales de Enfermería.Método: analítico cuasi-experimental pre-post intervención de grupo único en una unidad de cirugía traumatológica hospitalaria. Se recogieron datos sociodemográficos y profesionales de los participantes, número de interrupciones autorreferido según la persona origen de la interrupción, otros motivos y turno laboral en la que se produjeron, y variables de percepción del tiempo dedicado al PPAM y satistacción respecto al proceso. Se llevó a cabo un análisis descriptivo y una comparación de proporciones pre-post a los dos meses con la prueba t para muestras apareadas considerando una p< 0,05 como estadísticamente significativa.Resultados: participaron 23 enfermeras y siete enfermeros. Se registraron 839 interrupciones antes del PIZ y 484 tras él. Las personas que más interrupciones generaron fueron los técnicos en curas auxiliares de Enfermería (24,3% pre y 22,7% post) y los principales motivos no originados por personas fueron los relacionados con el tratamiento (24,3% y 22,2% respectivamente) (p> 0,05). La reducción de interrupciones fue significativa en el turno de día disminuyendo un 51,3% (p< 0,01) y en el turno de noche disminuyendo un 22,8% (p= 0,03). La satisfacción de los profesionales aumentó significativamente tras el PIZ (p= 0,01).Conclusiones: el PIZ demuestra ser eficaz para la disminución del número de interrupciones totales durante el PPAM y para aumentar el grado de satisfacción del equipo de Enfermería respecto a este proceso.(AU)

Objective: to analyze the efficacy of implementing the multi-intervention “Zero Interruptions Program” (ZIP) to reduce the number of interruptions during the process of preparation and administration of medications (PPAM) in the hospital setting, and to increase the satisfaction of Nursing professionals.Method: an analytical, quasi-experimental, pre-post intervention with a single arm in an Orthopedic Surgery Unit in the hospital setting. Sociodemographic and professional data were collected from the participants, as well as self-reported number of interruptions according to the person causing the interruption, other reasons, and work shift when these occurred, and variables of perception of time spent for PPAM and satisfaction regarding the process. A descriptive analysis was conducted, as well as a pre-post comparison of proportions at two months, with the t test for paired samples, considering p< 0.05 as statistically significant.Results: the study included 23 female nurses and seven male nurses. In total, 839 interruptions were recorded before the ZIP and 484 after it. The persons who generated more interruptions were Nursing Assistants (24.3% before and 22.7% after), and the main reasons not originated by persons were those associated with the treatment (24.3% and 22.2% respectively) (p> 0.05). There was a significant reduction in interruptions during the day shift, by 51.3% p< 0,01) and in the night shift, with a 22.8% reduction (p= 0,03). There was a significant increase in the satisfaction of professionales after the ZIP (p= 0.01).Conclusions: the ZIP has shown efficacy in the reduction of the total number of interruptions during the PPAM, and in the increase of the level of satisfaction of the Nursing team regarding this process.(AU)

Efectividad de una intervención educativa multidisciplinar en pacientes con fractura de fémur: estudio SWEET HOME / Effectiveness of a multidisciplinary educational intervention in patients with hip fracture: SWEET HOME study

Antecedentes y objetivo: La fractura de fémur (FF) es una lesión frecuente en personas de edad avanzada. El objetivo fue evaluar la efectividad de una intervención educativa multidisciplinar en pacientes con FF para favorecer el regreso al domicilio y disminuir las complicaciones hospitalarias. Material y método: Estudio cuasiexperimental con medidas repetidas al ingreso, al alta, a los 30días y al año de seguimiento. Se incluyeron pacientes ≥65años con FF ingresados en la unidad de ortogeriatría entre febrero de 2016 y enero de 2017. La intervención educativa constó de dos actuaciones coordinadas: una educación sanitaria durante la hospitalización y un soporte multimodal durante la transición al domicilio. Resultados: Se incluyeron 67 pacientes (77,6% mujeres; edad 84,19±7,78 años). Regresaron al domicilio el 70,1%, doblando la cifra de los años 2014-2015. Hubo un 8,5% de reingresos a los 30días y al año. Al año, el nivel de dependencia fue cercano al nivel prefractura (Barthel: 86,67±19,31; 94,33±14,66), la movilidad mejoró respecto al alta (Parker: 4,73±1,84; 6,73±2,76; Timed Up and Go test: 38,29±21,27; 21,91±10,97) y el rendimiento cognitivo no empeoró de forma significativa. La percepción de pacientes, cuidadores y profesionales fue que la educación sanitaria mejoró la autonomía del paciente. La satisfacción con el proceso asistencial fue alta. Conclusiones: Este estudio aporta como novedad, a los beneficios ya descritos en los modelos asistenciales ortogeriátricos, el incremento del número de pacientes que regresan al domicilio en condiciones de seguridad

Background and objective: Hip fracture is a common injury among elderly patients. The main goal of our study was to assess the effectiveness of a multidisciplinary educational intervention aimed at hip fracture patients to promote home discharges and reduce in-hospital complications. Material and method: A quasi-experimental study was performed by taking repeated measurements at hospital admission, at hospital discharge, and at both 30days and one year of discharge. Patients aged ≥65years with hip fracture who were admitted to the Orthogeriatric Service between February 2016 and January 2017 were included in the study. The educational intervention consisted in two coordinated actions: patient education administered during their hospitalization and multimodal support provided during their discharge home. Results: A total of 67 patients were included in the study (77.6% of whom were women; 84.19±7,78 years old). Of these, 70.1% were discharged home, which doubles the figures recorded in the 2014-2015 period. The rate of readmission at 30days and one year of the discharge was 8.5%. At the one-year follow-up, the patient's dependence to perform basic activities of daily living was nearer to the pre-fracture level (Barthel: 86.67±19.31; 94.33±14.66), their mobility had improved in comparison with the time of discharge (Parker: 4.73±1.84; 6.73±2.76; Timed Up and Go Test: 38.29±21.27; 21.91±10.97), and their cognitive function had not worsened significantly. The patient education measures improved the patients' autonomy as perceived by the patients, the caregivers, and the healthcare providers. Satisfaction with the healthcare received was high. Conclusions: As a novelty to the already described benefits in orthogeriatric care models, this study would contribute by proving an increase of the number of patients discharged home in a safe condition

Effectiveness of a multidisciplinary educational intervention in patients with hip fracture: SWEET HOME study. / Efectividad de una intervención educativa multidisciplinar en pacientes con fractura de fémur: estudio SWEET HOME.

BACKGROUND AND OBJECTIVE: Hip fracture is a common injury among elderly patients. The main goal of our study was to assess the effectiveness of a multidisciplinary educational intervention aimed at hip fracture patients to promote home discharges and reduce in-hospital complications. MATERIAL AND METHOD: A quasi-experimental study was performed by taking repeated measurements at hospital admission, at hospital discharge, and at both 30days and one year of discharge. Patients aged ≥65years with hip fracture who were admitted to the Orthogeriatric Service between February 2016 and January 2017 were included in the study. The educational intervention consisted in two coordinated actions: patient education administered during their hospitalization and multimodal support provided during their discharge home. RESULTS: A total of 67 patients were included in the study (77.6% of whom were women; 84.19±7,78 years old). Of these, 70.1% were discharged home, which doubles the figures recorded in the 2014-2015 period. The rate of readmission at 30days and one year of the discharge was 8.5%. At the one-year follow-up, the patient's dependence to perform basic activities of daily living was nearer to the pre-fracture level (Barthel: 86.67±19.31; 94.33±14.66), their mobility had improved in comparison with the time of discharge (Parker: 4.73±1.84; 6.73±2.76; Timed Up and Go Test: 38.29±21.27; 21.91±10.97), and their cognitive function had not worsened significantly. The patient education measures improved the patients' autonomy as perceived by the patients, the caregivers, and the healthcare providers. Satisfaction with the healthcare received was high. CONCLUSIONS: As a novelty to the already described benefits in orthogeriatric care models, this study would contribute by proving an increase of the number of patients discharged home in a safe condition.