Why Are Spanish Nurses Going to Work Sick? Questionnaire for the Measurement of Presenteeism in Nurses.

Presenteeism is defined as the presence of the worker at their workplace despite not being in optimal physical or mental conditions. Presenteeism is a phenomenon that has been poorly studied in the context of healthcare. Despite the many negative consequences associated with presenteeism, to date, no studies have investigated this issue in nurses in Spain. The objective was to develop and validate a questionnaire on presenteeism to be used by nursing staff in Spain. METHODS: A psychometric study for the development and validation of a questionnaire. The PRESENCA® questionnaire on presenteeism was created by a panel of experts, based on a survey comprised of 31 Likert-type items. RESULTS: In total, 355 nurses completed the questionnaire. The factorial analysis revealed the existence of 3 factors and confirmed appropriate levels of validity and reliability (alpha = 0.729). CONCLUSIONS: The PRESENCA® questionnaire is the first tool developed and validated in Spanish for the assessment of presenteeism in nursing. Our findings demonstrate that this scale has appropriate psychometric properties and its use may facilitate the detection of presenteeism among professionals. As a result, use of this questionnaire may contribute towards the improvement of clinical safety.

Characteristics of nursing interventions that improve the quality of life of people with chronic diseases. A systematic review with meta-analysis.

PURPOSE: The objective of this systematic review was to determine the characteristics of the interventions conducted by nurses that attempt to improve the health related quality of life (HRQoL) of people over 18 years of age with chronic diseases. METHODS: This systematic review with meta-analysis summarizes 24 studies, conducted in 10 countries, that evaluated HRQoL through the Short-Form Health Survey (SF). Five databases were accessed to find the available studies from December 31st, 2000 to May 22sd, 2017. Selected studies were coded according to the characteristics of the sample and the intervention. A model of random effects was adopted for the overall estimation and to explain the heterogeneity. RESULTS: Twenty-four studies were included in the systematic review and meta-analysis providing a sample of 4324 chronic patients aged 63.4 years. Among the 8 subscales and two summary measures that comprise the SF-36, only an overall significant effect size (ES) index was found in the Mental Health Component summary score (ES = 0.14; 95% CI:0.03 - 0.26; I2 = 44.6, p = 0.042) and the Mental Health subscale. This improvement on HRQoL was associated to interventions on "Case Management" and "Treatments and Procedures", which were based on a theory, were of shorter duration, and had a follow-up period. CONCLUSIONS: Interventions targeting people with chronic diseases resulted in a slight increase in the HRQoL that was not always significant, which suggests that there is a need for their continuous improvement.

Assessment of the Pneumatic Ischemia Technique Using the Limb Occlusion Pressure During Upper Limb Surgery.

PURPOSE: The purpose of our study was to evaluate effective ischemia and its associated complications using the limb occlusion pressure technique versus standard pneumatic ischemia technique. DESIGN: Single-centered randomized, controlled clinical trial. METHODS: One hundred sixty participants were randomized into two equal and parallel groups: (1) intervention group-LOP technique, and (2) control group-standard pneumatic ischemia technique. FINDINGS: Anesthetic incidences (need to administer analgesics for pain and/or hypnotics for anxiety) were similar in both groups. Statistically significant differences were observed for pain, hyperemia, and hospitalization, with higher values in the control group. Patients in the intervention group had, at 95% confidence, a 2.9 times greater chance of having optimal ischemia (assessed as 9 on the analog scale) than patients in the control group (odds ratio, 2.9; 95% confidence interval, 1.4 to 6.1). CONCLUSIONS: Intervention group patients had lower indexes of hyperemia, pain, and hospital stay.

Cuestionario para medir la participación de los profesionales de enfermería en la tutela de estudiantes / Questionário para medir a participação dos profissionais de enfermagem na tutela de estudantes / Questionnaire to Measure the Participation of Nursing Professionals in Mentoring Students

Objective. The aim herein was to validate a questionnaire to measure the level of participation of clinical nursing professionals in the mentorship of nursing students during clinical practices. Methods. Design and validation of a questionnaire. The psychometric properties of the tool were determined through four phases: 1- literature review; 2- evaluation of content validity; 3- pilot test, cognitive pretest and intra-observer reliability study; 4- construct validity study through an exploratory factor analysis of main components with varimax rotation in a sample of 249 nursing professionals from primary care and hospital care from different Spanish provinces. The internal consistency was studied with Cronbach's alpha coefficient. Results. The global content validity was above 0.8. The final version of the questionnaire had 33 items, with a global intraclass correlation coefficient of 0.852 and Cronbach's alpha of 0.837. Factor analysis explained 55.4% of the total variance, with a solution of five factors that made up the dimensions: Implication, Motivation, Satisfaction, Obstacles, and Commitment. Conclusion. The questionnaire evaluated has adequate validity and reliability to permit determining the level of nurse participation in the mentorship of students. (AU)

Objetivo. Validar un cuestionario para medir el nivel de participación de los profesionales de enfermería clínicos en la tutela de estudiantes de enfermería durante las prácticas clínicas. Métodos. Diseño y validación de un cuestionario. Se determinaron las propiedades psicométricas de la herramienta mediante cuatro fases: 1- revisión de la literatura; 2- evaluación de la validez de contenido; 3- prueba piloto, pretest cognitivo y estudio de la fiabilidad intraobservador; 4-, estudio de validez de constructo mediante un análisis factorial exploratorio de componentes principales con rotación varimax en una muestra de 249 profesionales de enfermería de atención primaria y de atención hospitalaria de diferentes provincias españolas. La consistencia interna se estudió con el coeficiente Alfa de Cronbach. Resultados. La validez de contenido global fue superior a 0.8. La versión final del cuestionario fue de 33 ítems, con un CCI global de 0.852 y un alfa de Cronbach de 0.837. El análisis factorial explicó el 55.4% de varianza total, con una solución de cinco factores que formaron las dimensiones Implicación, Motivación, Satisfacción, Obstáculos y Compromiso. Conclusión. El cuestionario evaluado tiene validez y fiabilidad adecuadas que permite determinar el nivel de participación de las enfermeras en la tutela de estudiantes. (AU)

Objetivo. Validar um questionário para medir o nível de participação dos profissionais de enfermagem clínicos na tutela de estudantes de enfermagem durante as práticas clínicas. Métodos. Desenho e validação de um questionário. Se determinaram as propriedades psicométricas da ferramenta mediante quatro fases: 1- revisão da literatura; 2- avaliação da validez de conteúdo; 3- prova piloto, pré-teste cognitivo e estudo da fiabilidade intra-observador; 4-, estudo de validez de construto mediante uma análise fatorial exploratório de componentes principais com rotação varimax numa amostra de 249 profissionais de enfermagem de atenção primária e de atenção hospitalar de diferentes províncias espanholas. A consistência interna se estudou com o coeficiente Alfa de Cronbach. Resultados. A validez de conteúdo global foi superior a 0.8. A versão final do questionário foi de 33 itens, com um CCI global de 0.852 e um alfa de Cronbach de 0.837. A análise fatorial explicou que 55.4% de variância total, com uma solução de cinco fatores que formaram as dimensões; Implicação, Motivação, Satisfação, Obstáculos e Compromisso. Conclusão. O questionário avaliado tem validez e fiabilidade adequadas que permite determinar o nível de participação das enfermeiras na tutela de estudantes. (AU)

Validation of the Spanish Version of the ICECAP-O for Nursing Home Residents with Dementia.

BACKGROUND: Measurement of health-related quality of life (HRQoL) is important for a chronic disease, such as dementia, which impairs the quality of life of affected patients in addition to their length of life. This is important in the context of economic evaluations when interventions do not (only) affect HRQoL and these other factors also affect overall quality of life. OBJECTIVE: To validate the Spanish translation of the ICECAP-O's capability to measure Health-related quality of life in elderly with dementia who live in nursing homes. METHOD: Cross-sectional study. For 217 residents living in 8 Spanish nursing homes, questionnaires were completed by nursing professionals serving as proxy respondents. We analyzed the internal consistency and other psychometric properties. We investigated the convergent validity of the ICECAP-O with other HRQoL instruments, the EQ-5D extended with a cognitive dimension (EQ-5D+C), the Alzheimer's Disease Related Quality of Life (ADRQL) measures, and the Barthel Index measure of activities of daily living (ADL). RESULTS: The ICECAP-O presents satisfactory internal consistency (alpha 0.820). The factorial analysis indicated a structure of five principal dimensions that explain 66.57% of the total variance. Convergent validity between the ICECAP-O, EQ-5D+C, ADRQL, and Barthel Index scores was moderate to good (with correlations of 0.62, 0.61, and 0.68, respectively), but differed between dimensions of the instruments. Discriminant validity was confirmed by finding differences in ICECAP-O scores between subgroups based on ADL scores (0.70 low, 0.59 medium, and 0.39 high level care), dementia severity (0.72 mild, 0.63 medium, and 0.50 severe), and ages (0.59 below 75 years and 0.84 above 75 years). CONCLUSIONS: This study presented the first use of a Spanish version of the ICECAP-O. The results indicate that the ICECAP-O appears to be a reliable Health-related quality of life measurement instrument showing good convergent and discriminant validity for people with dementia.

Questionnaire to Measure the Participation of Nursing Professionals in Mentoring Students.

OBJECTIVES: The aim herein was to validate a questionnaire to measure the level of participation of clinical nursing professionals in the mentorship of nursing students during clinical practices. METHODS: Design and validation of a questionnaire. The psychometric properties of the tool were determined through four phases: 1- literature review; 2- evaluation of content validity; 3- pilot test, cognitive pretest and intra-observer reliability study; 4- construct validity study through an exploratory factor analysis of main components with varimax rotation in a sample of 249 nursing professionals from primary care and hospital care from different Spanish provinces. The internal consistency was studied with Cronbach's alpha coefficient. RESULTS: The global content validity was above 0.8. The final version of the questionnaire had 33 items, with a global intraclass correlation coefficient of 0.852 and Cronbach's alpha of 0.837. Factor analysis explained 55.4% of the total variance, with a solution of five factors that made up the dimensions: Implication, Motivation, Satisfaction, Obstacles, and Commitment. CONCLUSIONS: The questionnaire evaluated has adequate validity and reliability to permit determining the level of nurse participation in the mentorship of students.

Complications of Peripherally Inserted Central Venous Catheters: A Retrospective Cohort Study.

BACKGROUND AND AIM: The use of venous catheters is a widespread practice, especially in oncological and oncohematological units. The objective of this study was to evaluate the complications associated with peripherally inserted central catheters (PICCs) in a cohort of patients. MATERIALS AND METHODS: In this retrospective cohort study, we included all patient carrying PICCs (n = 603) inserted at our institute between October 2010 and December 2013. The main variables collected were medical diagnosis, catheter care, location, duration of catheterization, reasons for catheter removal, complications, and nursing care. Complications were classified as infection, thrombosis, phlebitis, migration, edema, and/or ecchymosis. RESULTS: All patients were treated according to the same "nursing care" protocol. The incidence rate of complications was two cases per 1000 days of catheter duration. The most relevant complications were infection and thrombosis, both with an incidence of 0.17 cases per 1000 days of the total catheterization period. The total average duration of catheterization was 170 days [SD 6.06]. Additionally to "end of treatment" (48.42%) and "exitus", (22.53%) the most frequent cause of removal was migration (displacement towards the exterior) of the catheter (5.80%). CONCLUSIONS: PICCs are safe devices that allow the administration of long-term treatment and preserve the integrity of the venous system of the patient. Proper care of the catheter is very important to improve the quality life of patients with oncologic and hematologic conditions. Therefore, correct training of professionals and patients as well as following the latest scientific recommendations are particularly relevant.

Cultural analysis of surgical safety checklist items in Spain and Argentina. / Análisis cultural de los ítems de dos listas de verificación quirúrgica de España y Argentina.

OBJECTIVE: To compare the agreement between two surgical checklists implanted in two hospitals in Spain and Argentina, using the international classification for patient safety as a framework. METHOD: This was an expert opinion study carried out using an ad hoc questionnaire in electronic format, which included 7 of the 13 categories of the international classification for patient safety. Fifteen surgical security experts from each country participated in this study by classifying the items on the checklists into the selected ICPS categories. The data were analyzed with SPSS V20 software. RESULTS: There was a greater percentage of classifications in fields related to the prevention of critical events. The category "clinical processes and procedures" was mentioned most frequently in both lists. CONCLUSION: The implementation of the surgical safety checklist is variable. Experts considered that the Argentinian list was clearer in every dimension.

Prevalencia de genotipos del virus del papiloma humano de alto riesgo no vacunables dentro del programa de Detección Precoz de Cáncer de Cérvix en Cantabria / Prevalence of non-vaccinable high risk genotypes of human papillomavirus in the Early Detection of Cervical Cancer Program in Cantabria

OBJETIVO: Estimar la prevalencia de infección por genotipos del virus del papiloma humano (VPH) de alto riesgo no vacunables. DISEÑO: Estudio descriptivo transversal. Emplazamiento: Siete centros de salud de Cantabria seleccionados aleatoriamente. PARTICIPANTES: Se incluyó a todas las mujeres con una citología vaginal valorable (n = 3.359) entre 2010-2011. MEDICIONES PRINCIPALES: Se recogieron diagnóstico citológico, resultado de PCR y método anticonceptivo. Los resultados de las citologías se clasificaron con el sistema Bethesda. Para la tipificación de VPH según el riesgo oncogénico se utilizó la clasificación de Muñoz et al. Se estimaron proporciones y odds ratio (OR) con sus correspondientes intervalos de confianza al 95% (IC95%). RESULTADOS: La prevalencia de infección por VPH fue del 2,71% (IC95%: 2,15-3,27). La prevalencia de genotipos de VPH de alto riesgo oncogénico fue del 2,26%; (IC95%: 1,75-2,78). El genotipo más frecuente fue el 16 (28,89%). Más de la mitad de las mujeres fueron positivas para algún genotipo de alto riesgo no vacunable: 51 (18,89%) o 58 (13,33%) o 68 (12,22%) o 31 (11,11%). En el 23,33% de las mujeres coexistieron al menos 2 genotipos de alto riesgo no vacunables. Las mujeres más jóvenes (≤ 30 años) tuvieron 2 veces más riesgo de infección por cualquier VPH: OR 2,01; (IC95%: 1,02-3,96); y 2 veces más probabilidad de usar anticonceptivos hormonales frente al preservativo: OR 2,09; (IC95%: 1,64-2,67). CONCLUSIONES: Atendiendo al alto porcentaje de VPH de alto riesgo oncogénico no vacunable, habría que replantear la estrategia de prevención en la población, que podría tener una falsa sensación de protección

OBJECTIVE: To assess the persistence of treatment with monthly risedronate and know the reasons of persistence and nontherapeutic persistence and the profile of the non-persistent patients. Desing: Observational, postmarketin and prospective study. LOCATION: Primary care, traumatology, rheumatology, gynecology and geriatrics of Catalonia. PARTICIPANTS: Women with osteoporosis treated with monthly risedronate that previously had abandoned weekly bisphosphonate therapy. MAIN MEASUREMENTS: Percentage of patients on persistent monthly risedronate year of their prescription, reasons for persistent and non persistent and profile of non persistent patients in relation to biodemographic data, clinical data and risk factors for fracture. RESULTS: 289 evaluable patients with a mean age of 68.3. At 12 months of initiation with monthly risedronate, 58.1% of patients remained on treatment. Most frequent reasons for leaving: fear of having side effects and belief that the disease is typical of the age. Reasons remarkable persistence: comfort/ease and dosage. Significant differences were observed between persistent and non-persistent patients relative to: employment status, number of concomitant therapy and height; however the results of possible associated factors must be contextualized within the study characteristics and the difference in size does not seem clinically relevant. CONCLUSIONS: The administration of therapeutic patterns more comfortable as monthly risedronate in osteoporosis, could facilitate persistence in patients improving the effectiveness of the drug. However in that persistence can also influence biodemographic and clinical variables and diverse of various kinds

[Prevalence of non-vaccinable high risk genotypes of human papillomavirus in the Early Detection of Cervical Cancer Program in Cantabria]. / Prevalencia de genotipos del virus del papiloma humano de alto riesgo no vacunables dentro del programa de Detección Precoz de Cáncer de Cérvix en Cantabria.

OBJECTIVE: To estimate the prevalence of infection with non-vaccinable high risk genotypes of human papillomavirus (HPV). DESIGN: Cross-sectional study. LOCATION: Seven randomly selected health centres in Cantabria (Northern Spain). PARTICIPANTS: All women with an evaluable vaginal smear (n=3,359) between 2010 and 2011. MAIN MEASURES: The variables collected were cytological diagnosis, PCR results, and family planning method. The vaginal smear results were classified with the Bethesda system. The classification by Muñoz et al. was used for typing as oncogenic risk HPV. Proportions and odds ratio (OR) were estimated with corresponding confidence intervals at 95% (95% CI). RESULTS: The prevalence of HPV infection was 2.71% (95% CI: 2.15 to 3.27). The prevalence of high oncogenic risk HPV genotypes was 2.26%; (95% CI: 1.75 to 2.78). The most frequent genotype was 16 (28.89%). More than half of the women were positive for one of the non-vaccinable high risk genotypes: 51 (18.89%) and 58 (13.33%) and 68 (12.22%) or 31 (11.11%). At least two non-vaccinable high-risk genotypes co-existed in 23.33% of women. Younger women (≤30 years) had twice the risk of any HPV infection: OR 2.01 (95% CI: 1.02 to 3.96); and were twice as likely to use condoms compared to hormonal contraceptives, OR 2.09 (95% CI: 1.64 to 2.67). CONCLUSIONS: According to the high percentage of non-vaccinable high oncogenic risk HPV types, there should be a re-think of the prevention strategy in the population, who may have a false sense of protection.

Análisis cultural de los ítems de dos listas de verificación quirúrgica de España y Argentina / Análise cultural dos itens de duas listas de verificação cirúrgica de Espanha e Argentina / Cultural analysis of surgical safety checklist items in Spain and Argentina

RESUMEN Objetivo Comparar la concordancia entre dos listas de verificación quirúrgica implantadas en dos hospitales en España y Argentina utilizando como marco de referencia la Clasificación Internacional para la Seguridad de Pacientes. Método Estudio basado en el juicio de expertos realizado con un cuestionario ad hoc en soporte electrónico que abarca 7 de las 13 categorías de la Clasificación Internacional para la Seguridad de Pacientes. Participaron 15 expertos en seguridad quirúrgica de cada país, asociando cada ítem de las listas de verificación con las dimensiones seleccionadas. Los datos se analizaron con el programa SPSS V20. Resultados Se evidencia un mayor porcentaje de coincidencias con campos relacionados con prevención de eventos críticos. La dimensión Procesos clínicos y procedimientos obtuvo una mayor frecuencia de asignación en ambas listas. Conclusión Existe variabilidad en la implantación de las listas de verificación quirúrgica. Los expertos consideran la lista argentina más clara en cada dimensión.

RESUMO Objetivo Comparar a concordância entre duas listas cirúrgicas, implantadas em dois hospitais na Espanha e na Argentina, usando como quadro de referência a classificação internacional para a segurança do paciente. Método Estudo baseado na opinião de especialistas, realizado através de um questionário ad hoc em formato eletrônico, que inclui 7 das 13 categorias da classificação internacional para a segurança do paciente. Participaram 15 especialistas em segurança cirúrgica de cada país, associando cada item das listas de verificação nas dimensões selecionadas. Os dados foram analisados com o programa SPSS V20. Resultados Uma porcentagem mais elevada de coincidências é evidente com domínios relacionados à prevenção de eventos críticos. A dimensão Processos clínicos e procedimentos apresentou uma maior frequência de atribuição em ambas as listas. Conclusão Há variabilidade na implantação das listas cirúrgicas de verificação. Especialistas acreditam que a lista da Argentina é mais clara em todas as dimensões.

ABSTRACT Objective To compare the agreement between two surgical checklists implanted in two hospitals in Spain and Argentina, using the international classification for patient safety as a framework. Method This was an expert opinion study carried out using an ad hoc questionnaire in electronic format, which included 7 of the 13 categories of the international classification for patient safety. Fifteen surgical security experts from each country participated in this study by classifying the items on the checklists into the selected ICPS categories. The data were analyzed with SPSS V20 software. Results There was a greater percentage of classifications in fields related to the prevention of critical events. The category “clinical processes and procedures” was mentioned most frequently in both lists. Conclusion The implementation of the surgical safety checklist is variable. Experts considered that the Argentinian list was clearer in every dimension.

Continuing Education in Patient Safety: Massive Open Online Courses as a New Training Tool.

OBJECTIVES: Describe the use of two massive open online courses designed to provide education on patient safety. Review follow-up evaluation data from the courses. DISCLOSURE STATEMENT: Neither the planners nor the authors have any conflicts of interest to disclose. BACKGROUND: The Nursing School of the University of Cantabria conducted a training session on patient safety through two massive open online courses (MOOCs) aimed at the general population and especially Spanish-speaking health professionals. This study aimed to analyze the profile of health professionals who have completed the courses, their degree of satisfaction, and the percentage of completion. METHOD: In this retrospective and observational study, two MOOCs on clinical safety were created through an online platform (MiríadaX). Quantitative analysis of the profile of health professionals, their degree of satisfaction, and the percentage of completion was performed. RESULTS: A total of 12,400 students were enrolled, and the average completion rate was 32%. The profile of the average student was female, 37 years old, college educated, a nurse in a hospital, and interested in the course because it may be useful for performing her work. Fifty-five percent of students were very satisfied with the course. CONCLUSION: MOOCs are considered to be effective and easily accessible, with quality content for professional continuing education that encourages interdisciplinary work and meeting professionals from around the world.

La importancia de una cirugía segura / The importance of safe surgery

La prioridad fundamental en la asistencia clínica es la seguridad del paciente, de ahí que la Organización Mundial de la Salud (OMS) haya emprendido múltiples iniciativas para mejorar la seguridad de la cirugía. La Iniciativa Mundial para la Atención de Emergencia y Quirúrgica Esencial, así como sus directrices para la atención traumatológica básica, se centraron en el acceso y la calidad, y el segundo Reto Mundial por la Seguridad del Paciente, La Cirugía Salva Vidas, aborda la seguridad dela atención quirúrgica. La Alianza Mundial para la Seguridad del Paciente empezó a trabajar en este reto en enero de 2007. El objetivo es mejorarla seguridad de la cirugía en todo el mundo, definiendo para ello un conjunto básico de normas de seguridad que puedan aplicarse en todos los estados miembros de la OMS. La cirugía es una actividad realmente compleja, puesto que entraña riesgos potenciales para los que no existe una forma capaz de garantizar la ausencia de estos, ya que se dan tanto factores inherentes al sistema como actuaciones humanas. Precisamente por esta complejidad y todos los aspectos que abarca la seguridad clínica, el presente trabajo se centra en la descripción de las fases del proceso quirúrgico y para ello se ha realizado una búsqueda bibliográfica para revisar y actualizar la información básica disponible, y para proponer actuaciones que eviten poner en peligro la seguridad clínica del paciente, a fin de contribuir a implantar una cultura de seguridad en los profesionales que desarrollan la atención (AU)

The essential priority in clinical care is patient safety; that is why the World Health Organization (WHO) has undertaken multiple initiatives in order to improve surgical safety. The Global Initiative for Emergency and Essential Surgical Care, as well as its guidelines for basic orthopedic care, focused on access and quality; and The Second Global Patient Safety Challenge: Safe Surgery Saves Lives addresses safety in surgical care. The World Alliance for Patient Safety started working in this challenge in January, 2007. The objective is to improve the safety of surgery throughout the world, by defining a basic set of safety rules which might be implemented in all WHO member countries. Surgery is a really complex activity, because it entails potential risks for which there is no way to guarantee their absence, because there are factors inherent to the system as well as human actions. Precisely due to this complexity and all actions included in clinical safety, this paper focuses on the description of the surgical process phases; to that end, a bibliographic search has been conducted to review and update all available basic information, and to suggest actions which may prevent endangering the clinical safety of patients, with the aim to help to implement a safety culture in those professionals in charge of care (AU)

El checklist: avance hacia la excelencia en calidad asistencial / The checklist: an advance towards excellence in healtcare quality

En España aún existe un déficit en conocimientos respecto a la cultura de seguridad del paciente. El checklist está implantándose paulatinamente en los hospitales españoles, siendo los profesionales enfermeros los más implicados en su realización. El checklist es un instrumento fácil y eficaz dirigido a la prevención de efectos adversos en los actos quirúrgicos. El sistema de verificación quirúrgica consiste en describir de forma esquemática toda la secuencia de los acontecimientos que han de comprobarse: evaluación preoperatoria del paciente, intervención quirúrgica y los cuidados postoperatorios que va a requerir el enfermo. Todo el control ha de ser efectuado por una persona responsable de ello, generalmente un profesional de la Enfermería. Está apoyado por la evidencia científica como uno de los instrumentos del siglo XXI que ha conseguido una mayor reducción de los problemas que pueden aparecer en quirófano y que pueden vulnerar la seguridad del enfermo (AU)

In Spain there is still an unmet need in knowledge regarding patient safety culture. The checklist is gradually being implemented in Spanish hospitals, and nurses are the professionals more involved in its conduction. The checklist is an easy and effective tool which aims to prevent adverse events in surgical procedures. The system of surgical verification consists in describing in a systematic way the whole sequence of events to be checked: evaluation of the patient before the procedure, surgical procedure, and post-operatory care that the patient will require. The whole control must be conducted by a person in charge, generally a nursing professional. This is supported by scientific evidence as one of the XXI century tools which has achieved a higher reduction of problems which may appear in the operating room and which may affect patients’ safety (AU)

Procedimiento de colocación del catéter de bomba de insulina / Procedure for placing an insulin pump catheter

La terapia con Infusión Subcutánea Continua de Insulina (ISCI) o bomba de insulina puede ser una buena alternativa terapéutica para las personas con diabetes tipo 1 en situaciones concretas. El aprendizaje de esta técnica ha de realizarse mediante un programa de educación sanitaria impartido por un equipo multidisciplinar, con el que se capacita al paciente en el manejo del dispostivo y en cuidado de la zona de la inserción de la cánula. Cumpliendo estas condiciones básicas, la persona puede obtener beneficios, tanto en el control glucémico como en la reducción de la incidencia de hipoglucemias y, por lo tanto, una mejoría en su calidad de vida.El objetivo de este artículo consiste en explicar las indicaciones, el equipo necesario y el procedimiento de autoaplicacion de la bomba de insulina,así como las posibles complicaciones asociadas, con el fin de garantizarlas máximas condiciones de seguridad y las mínimas incomodidades para la persona que sigue este tipo de tratamiento (AU)

Continuous subcutaneous insulin infusion (CSII) therapy or an insulinpump can be a good therapeutic alternative for people with type 1 diabetes in specific situations.The learning of this technique must be performed by means of a health education programme taught by a multidisciplinary team, in which thepatient is taught to manage the device and to care for the cannula’s insertion area. If the patient adheres to these basic conditions, he/she can reap the benefits, both in glycemic control and in the reduction of the incidence of hypoglycaemias, which in turn improves his or her quality of life.The objective of this article is to explain the indications, the equipment that is needed and the self-application procedure for the insulin pump, as well as possible complications, in order to guarantee the best safety conditions and to decrease the discomfort experienced by the patient who undergoes this type of treatment (AU)

Primer contacto con una bomba de insulina. Caso clínico / First contact with an insulin pump. Clinical case

Las bombas de insulina son unos dispositivos que infunden la insulina de forma similar a la secreción pancreática, continuamente y con infinidad de posibilidades para adaptarse a horarios, comidas y actividad física, otorgando a los diabéticos la posibilidad de llevar una vida con muchas menos ataduras debido a su enfermedad. Además de la libertad que les proporciona, esta terapia permite un control más exacto de las glucemias, mejorando notablemente el autocontrol general y con ello la calidad de vida de estas personas, reduciendo la aparición de complicaciones a largo plazo. Aunque todos los diabéticos reciben a lo largo de su enfermedad infinidad de pautas y recomendaciones para un óptimo control, los pacientes incluidos en este protocolo tienen que estar especialmente concienciados e implicados en su autocontrol, ya que el tratamiento les exige una gran implicación, tanto para aprender a utilizar el dispositivo como para tomar decisiones una vez se está utilizando. Se presenta el caso clínico de una paciente diabética tipo 1 de 21 años de evolución, durante un día de ingreso en el hospital para llevar a cabo la implantación de un infusor continuo de insulina subcutánea (bomba de insulina). Para ello, elaboramos el plan de cuidados de la paciente siguiendo los pasos del método científico y apoyándonos en la taxonomía NANDA, así como en la NOC y NIC para delimitar objetivos e intervenciones enfermeras, respectivamente (AU)

Insulin pumps are devices that inject insulin continuously into the body in a similarway to the pancreatic secretion, and with endless possibilities to adjust schedules, meals and physical activities, giving diabetics the chance to lead a life with many less restraints due totheir illness. Besides giving them this freedom, the therapy allows more precise control of blood glucose, significantly improving the overall self-control and thus the quality of life of the diabetics, reducing the appearance of long-term complications. Although all diabetics receive many guidelinesand recommendations for optimal control throughout their illness patients included in this protocolmust be especially aware and involved in self-control, since the treatment demands more involvement both when learning to use the device as well as making decisions once they are using it. We present the case of a type 1 diabetic patient, twenty-one years of onset, who while admitted to hospital for a day, had a continuous subcutaneous insulin infusion pump implanted (insulin pump). To this end, we developed a patient care plan of patient following the steps of scientific method and relying on the NANDA taxonomy and on the NOC and NIC to design goals and nursing interventions, respectively (AU)

[First contact with an insulin pump. Clinical case]. / Primer contacto con una bomba de insulina. Caso clínico.

Insulin pumps are devices that inject insulin continuously into the body in a similar way to the pancreatic secretion, and with endless possibilities to adjust schedules, meals and physical activities, giving diabetics the chance to lead a life with many less restraints due to their illness. Besides giving them this freedom, the therapy allows more precise control of blood glucose, significantly improving the overall self-control and thus the quality of life of the diabetics, reducing the appearance of long-term complications. Although all diabetics receive many guidelines and recommendations for optimal control throughout their illness patients included in this protocol must be especially aware and involved in self-control, since the treatment demands more involvement both when learning to use the device as well as making decisions once they are using it. We present the case of a type 1 diabetic patient, twenty-one years of onset, who while admitted to hospital for a day, had a continuous subcutaneous insulin infusion pump implanted (insulin pump). To this end, we developed a patient care plan of patient following the steps of scientific method and relying on the NANDA taxonomy and on the NOC and NIC to design goals and nursing interventions, respectively.