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1.
Artigo em Inglês | MEDLINE | ID: mdl-31835653

RESUMO

This study aims to evaluate the effectiveness of advanced practice nurses with respect to complex chronic wounds (APN-CCWs) in the care of patients with venous ulcers. A multicentric, quasi-experimental pre-post study was conducted without a control group in the sanitary management areas where the APN-CCW program is being piloted. The intervention consisted of a mass training of clinical nurses from the participating districts on the proper management of injuries and the use of compression therapy. The data were collected through a specifically constructed questionnaire with questions regarding descriptive variables of injuries and their treatment. A total of 643 professionals responded (response rate of 89.1%), attending to a total population of 707,814 inhabitants. An increase in multilayer bandage use by 15.67%, an increase in elastic bandage use by 13.24%, and a significant decrease in the referral of patients to consultation with hospital specialists was achieved, from 21.08% to 12.34%. The number of patients referred to the APNs was 13.25%, which implied a resolution rate of 94.08% of their injuries. In conclusion, the coordination by the APN-CCWs in patients with venous ulcers was effective in improving the continuity of care, in the optimization of resources, and in their care role.

2.
Enferm. clín. (Ed. impr.) ; 29(6): 370-375, nov.-dic. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184658

RESUMO

Los sistemas sanitarios tienen la responsabilidad de dar respuesta a las nuevas necesidades de salud de la población, que se caracterizan por factores como el envejecimiento, la cronicidad y/o las situaciones de dependencia y que requieren de cuidados de calidad, especializados y adaptados a diferentes ámbitos donde la atención se presta, cuidados ofertados por profesionales formados y cada vez más cualificados para mejorar los resultados en salud de las personas que cuidan. En el año 2016, en Andalucía se publica el marco normativo por el que se crea la categoría profesional estatutaria de enfermero/a especialista, entre las que se incluye la especialidad de Enfermería de Salud Mental en el Servicio Andaluz de Salud. En el ámbito de la Salud Mental, el desarrollo de este marco normativo y la definición y ocupación de puestos permitirá al sistema sanitario conjugar el papel de las enfermeras especialistas con el de las enfermeras que prestan cuidados generales, enfermeras de Grado, en pro de avanzar en la mejor respuesta a las necesidades de salud de la ciudadanía en este ámbito de atención. El desarrollo de la especialidad podrá suponer un valor añadido tanto para la mejora de los resultados en salud de las personas con problemas de salud mental como para mejorar la calidad asistencial, la eficiencia y la sostenibilidad de los sistemas sanitarios


Health systems have a responsibility to respond to the new health needs of the population, which are characterized by factors such as aging, chronicity and/or dependency situations and which requires quality and specialized care adapted to different areas where care is provided, care offered by trained and increasingly qualified professionals to improve the health outcomes of the caregivers. In 2016, in Andalusia the regulatory framework by which is created the statutory professional category of nurse/specialists is published, including the specialty of Mental Health Nursing in the Andalusian Health Service. In the field of Mental Health, the development of this normative framework and the definition and occupation of positions, will allow the health system to combine the role of nurse specialist nurses with that of nurses who provide general care, registered nurses, in order to advance in the best response to the health needs of citizens in this area of care. The development of the specialty will be an added value both to improve the health outcomes of people with mental health problems, and to improve the quality of care, efficiency and sustainability of health systems


Assuntos
Humanos , Especialidades de Enfermagem , Enfermagem Psiquiátrica/métodos , Enfermagem em Saúde Comunitária/métodos , Enfermagem em Saúde Comunitária/organização & administração , Saúde Mental , Sistemas de Saúde/organização & administração
3.
Enferm Clin ; 29(6): 370-375, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31668452

RESUMO

Health systems have a responsibility to respond to the new health needs of the population, which are characterized by factors such as aging, chronicity and/or dependency situations and which requires quality and specialized care adapted to different areas where care is provided, care offered by trained and increasingly qualified professionals to improve the health outcomes of the caregivers. In 2016, in Andalusia the regulatory framework by which is created the statutory professional category of nurse/specialists is published, including the specialty of Mental Health Nursing in the Andalusian Health Service. In the field of Mental Health, the development of this normative framework and the definition and occupation of positions, will allow the health system to combine the role of nurse specialist nurses with that of nurses who provide general care, registered nurses, in order to advance in the best response to the health needs of citizens in this area of care. The development of the specialty will be an added value both to improve the health outcomes of people with mental health problems, and to improve the quality of care, efficiency and sustainability of health systems.

4.
Enferm. clín. (Ed. impr.) ; 29(2): 74-82, mar.-abr. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182596

RESUMO

Objetivo: Determinar el impacto de las enfermeras de práctica avanzada en heridas crónicas complejas (EPA-HCC) en la adecuación de los tratamientos de los pacientes con heridas crónicas y el consumo de apósitos en los distritos donde están implantadas. Método: Estudio de tipo cuasiexperimental de tipo pre-post sin grupo control con 3mediciones: preimplantación en 2015, al año de implantación en 2016 y a los 2 años postimplantación en 2017, en los distritos sanitarios donde se estaba pilotando la EPA-HCC en Andalucía. Las variables principales son: número de profesionales formados, número de consultorías, prevalencia de heridas crónicas, adecuación de los tratamientos y coste económico en materiales para cura de los DS participantes. Resultados: Se ha conseguido la formación de un total de 2.717 profesionales sanitarios con un total de 95.095 h lectivas; además, se han realizado un total de 3.871 consultorías y asesorías. La prevalencia de pacientes con lesiones en programa de atención domiciliaria y en residencias ha disminuido a la mitad. La adecuación de los tratamientos ha aumentado hasta el 90% y se ha conseguido un ahorro de más de 250.000 Euros en apósitos, en un período de 2años. Conclusión: La prevalencia de heridas crónicas durante los 2 años de implantación ha disminuido a la mitad, se ha conseguido una correcta adecuación del plan de formación y consultoría, consiguiendo racionalizar el gasto sanitario y una eficiente atención a las personas con heridas crónicas


Aim: To determine the impact of advanced practice nurses in chronic wound care in the adequacy of treatments for patients with chronic wounds and the consumption of dressings in the districts where they have been implemented. Method: A quasi-experimental pre-poststudy without a control group with 3 measurements: pre-implementation in 2015, one year after implementation in 2016, and 2 years post-implementation in 2017, in the health districts (HD) where the role of the advanced practice nurse in chronic wound care was piloted in Andalusia. The main variables were trained professionals, consultancies, prevalence of chronic wounds, adequacy of treatments and economic cost in materials for the participating HD. Results: The training of a total of 2,717 health teams with a total of 95,095 teaching hours was achieved. In addition, a total of 3,871 consultancies were performed. The prevalence of patients with injuries in the home care (HC) programme and in care homes diminished significantly, to almost half. The adequacy of the treatments increased to 90% and savings of more than 250,000 Euros in dressings were achieved in just 2 years. Conclusion: The prevalence of chronic wounds during the 2years of implementation decreased by almost half. Adequacy of training and consultancy was achieved, rationalising health expenditure and ensuring efficient care for patients with chronic wounds


Assuntos
Humanos , Prática Avançada de Enfermagem/métodos , Ferimentos e Lesões/enfermagem , Doença Crônica , Prevalência
5.
Enferm. clín. (Ed. impr.) ; 29(2): 83-89, mar.-abr. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182597

RESUMO

Los cambios socio-demográficos y epidemiológicos de nuestro entorno se caracterizan por el aumento del envejecimiento, la cronicidad, las comorbilidades y, con ello, una escalada progresiva de la demanda de cuidados. Estas nuevas demandas y expectativas de la ciudadanía se acompañan de una evolución de los sistemas sanitarios (avances tecnológicos, complejidad del entramado asistencial, recursos limitados), la necesidad de desarrollar nuevos roles y competencia en cuidados, junto a la oportunidad que supone el pleno desarrollo académico del grado y posgrado de Enfermería. Es por todo ello que, en la actualidad, se hace necesario reorientar los modelos de cuidados para lograr una atención sanitaria más ágil, eficiente y de calidad, adaptada a las necesidades y expectativas de la ciudadanía y a la sostenibilidad de los sistemas sanitarios. El Sistema Sanitario Público de Andalucía (SSPA) ha desarrollado, en las últimas décadas, diferentes roles enfermeros que incluyen nuevas competencias, con el objetivo de dar respuestas a las necesidades de la ciudadanía. El objetivo de este artículo es presentar cómo se ha venido configurando un marco de desarrollo competencial de las enfermeras y enfermeros en el SSPA, en el que se integran además las competencias de avance en cuidados y los perfiles avanzados de práctica (especialidades de Enfermería y Enfermería de Práctica Avanzada)


The socio-demographic and epidemiological changes of our environment are characterized by an increase in aging, chronic illness, comorbidities and with it, a progressive escalation of the demand for care. These new demands and expectations of citizenship are accompanied by an evolution of health systems (technological advances, complexity of the healthcare network, limited resources), the need to develop new roles and competence in care, together with the opportunity that full academic development implies: Nursing undergraduate and posgraduate degrees. This is why, at present, it is necessary to reorient care models in order to achieve health care for more agile, efficient and better quality care processes, adapted to the needs and expectations of citizens and to the sustainability of health systems. The Public Health System of Andalusia (SSPA) has developed, in recent decades, different nursing roles that include new competences, with the aim of responding to the needs of citizens. The objective of this article is to present how the competences development framework of nurses has been configured in the SSPA, which also integrates advanced skills in care and advanced practice profiles (Clinical Nurse Specialists and Advanced practice nurses)


Assuntos
Humanos , Prática Avançada de Enfermagem , Papel do Profissional de Enfermagem , Competência Profissional , Setor Público , Espanha
6.
Enferm Clin ; 29(2): 74-82, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30837191

RESUMO

AIM: To determine the impact of advanced practice nurses in chronic wound care in the adequacy of treatments for patients with chronic wounds and the consumption of dressings in the districts where they have been implemented. METHOD: A quasi-experimental pre-poststudy without a control group with 3measurements: pre-implementation in 2015, one year after implementation in 2016, and 2years post-implementation in 2017, in the health districts (HD) where the role of the advanced practice nurse in chronic wound care was piloted in Andalusia. The main variables were trained professionals, consultancies, prevalence of chronic wounds, adequacy of treatments and economic cost in materials for the participating HD. RESULTS: The training of a total of 2,717 health teams with a total of 95,095 teaching hours was achieved. In addition, a total of 3,871 consultancies were performed. The prevalence of patients with injuries in the home care (HC) programme and in care homes diminished significantly, to almost half. The adequacy of the treatments increased to 90% and savings of more than 250,000€ in dressings were achieved in just 2years. CONCLUSION: The prevalence of chronic wounds during the 2years of implementation decreased by almost half. Adequacy of training and consultancy was achieved, rationalising health expenditure and ensuring efficient care for patients with chronic wounds.


Assuntos
Prática Avançada de Enfermagem , Bandagens/estatística & dados numéricos , Ferimentos e Lesões/enfermagem , Doença Crônica , Humanos , Projetos Piloto , Espanha
7.
Enferm Clin ; 29(2): 83-89, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30799095

RESUMO

The socio-demographic and epidemiological changes of our environment are characterized by an increase in aging, chronic illness, comorbidities and with it, a progressive escalation of the demand for care. These new demands and expectations of citizenship are accompanied by an evolution of health systems (technological advances, complexity of the healthcare network, limited resources), the need to develop new roles and competence in care, together with the opportunity that full academic development implies: Nursing undergraduate and posgraduate degrees. This is why, at present, it is necessary to reorient care models in order to achieve health care for more agile, efficient and better quality care processes, adapted to the needs and expectations of citizens and to the sustainability of health systems. The Public Health System of Andalusia (SSPA) has developed, in recent decades, different nursing roles that include new competences, with the aim of responding to the needs of citizens. The objective of this article is to present how the competences development framework of nurses has been configured in the SSPA, which also integrates advanced skills in care and advanced practice profiles (Clinical Nurse Specialists and Advanced practice nurses).


Assuntos
Competência Clínica , Assistência à Saúde , Educação em Enfermagem , Saúde Pública , Prática Avançada de Enfermagem , Humanos , Espanha
11.
Recurso na Internet em Espanhol | LIS - Localizador de Informação em Saúde, LIS-ES-PROF | ID: lis-LISBR1.1-42112

RESUMO

Documento que pretende ser una guía ágil donde las enfermeras encuentren respuestas ajustadas a cada situación, con el objetivo de adaptar su práctica clínica de manera individualizada a cada paciente y sus familias. Contiene: diagnósticos más prevalentes en personas con diabetes, diagnóstico y clasificación de la diabetes, la alimentación, ejercicio físico, tratamiento farmacológico, autoanálisis, hipoglucemia, hiperglucemia, complicaciones crónicas, cuidados de los pies, educación diabetológica, etc.


Assuntos
Diabetes Mellitus , Dieta para Diabéticos , Complicações do Diabetes , Enfermagem
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