Role of Different Blood Purification Nursing Models in Uremic Patients: A Preliminary Report.

BACKGROUND Accumulation of uremic toxins is closely associated with chronic kidney disease (CKD)-related complications such as cerebrovascular accidents and cardiovascular diseases. Clinical nursing is accepted as a critical clinical prognosis factor for hospitalized patients. The present study was designed to compare the effects of different blood purification nursing models on clinical outcomes in patients with uremia. MATERIAL AND METHODS A total of 68 patients with uremia were selected and divided to control and intervention groups. The patients in the control group received traditional nursing model care, while the patients in intervention group received comprehensive high-quality nursing care for 6 months. RESULTS After 6 months of treatment, the quality of life, anxiety, and depression were obviously ameliorated in both groups. The levels of blood urea nitrogen (BUN), parathyroid hormone (PTH), creatinine, ß2-microglobulin (ß2-MG), total cholesterol (TC), albumin (ALB), interleukin-1ß (IL-1ß), IL-6, tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), 8-isoprostane, and malondialdehyde (MDA), as well as superoxide dismutase (SOD) and catalase (CAT) activities were all significantly improved in both groups of patients, but the intervention group exhibited better results than the control group. CONCLUSIONS Our results demonstrated that comprehensive high-quality nursing care rectified the metabolic disorders and inhibited systematic inflammatory factors, and oxidative stress, which may be responsible for better amelioration of quality of life in patients with uremia.

Estimación del error intrínsico del instrumento de medida del laboratorio para las determinaciones analíticas del paciente crítico / Estimate of the intrinsic error of the measuring instrument of the laboratory for analytical determinations of the critical patient

Disminuir las pérdidas sanguíneas asociadas a las analíticas de laboratorio constituye un determinante de seguridad y calidad en la fase preanalítica, para llegar a alcanzar un óptimo nivel asistencial donde las enfermeras poseen gran protagonismo, al ser responsables del cuidado del paciente críticamente enfermo (AU)

Decrease blood loss associated with the analytical laboratory is a determinant of safety and quality in the preanalytical phase, in order to achieve an optimal level of care, where nurses have leading role to be responsible for the care of the critically ill patient (AU)

Fuentes de error en la toma de muestras sanguíneas. Recomendaciones para la fase preanalítica / Sources of errors when taking blood samples. Recommendations for the pre-analysis phase

Se puede definir la fase preanalítica como aquella parte del proceso analíticoque abarca desde la elaboración del petitorio hasta la entrega de la muestra enel laboratorio. Es una parte vital de este proceso, ya que en este período esdonde mayor número de profesionales de diferentes disciplinas van a intervenir.Se considera de gran trascendencia la detección de errores y la identificaciónde las causas que puedan ocasionarlos. Un aspecto importante debe ser conoceradecuadamente las interferencias que pueden alterar la preanalítica, con elobjetivo de controlar y tratar de evitar su presencia. Se incluyen una serie defactores (fisiológicos, endógenos y relacionados con la toma de muestras)cuyo conocimiento puede ayudar a prevenir estos errores. Se plantea la necesidadde establecer estrategias que ayuden a mejorar el conocimiento de estosaspectos en los profesionales enfermeros, ya que su implicación en la preanalíticaes de gran importancia y está fuera de toda duda

A pre-analysis phase is that part of the analysis process encompassing thetime from when the request is passed on to the laboratory to the time the sampleis delivered to the laboratory. It is a vital part of this process, as it is in thisperiod where the largest number of professionals from different disciplines intervenes.This pre-analysis phase is of vital importance to detect errors and toidentify the causes that might lead to these errors. An important aspect mustbe to be aware of interferences that might alter the pre-analytical phase so thatthese interferences are recognised, controlled and avoided. A series of factorsare included (physiological, endogenous and in relation to the taking of samples),the recognition and understanding of which may help prevent errors. Aneed to establish strategies that help improve the knowledge of these aspectsin nursing professionals is emphasised, as their application in the pre-analyticalphase of the process is clearly of outmost importance

Educational intervention together with an on-line quality control program achieve recommended analytical goals for bedside blood glucose monitoring in a 1200-bed university hospital.

Portable meters for blood glucose concentrations are used at the patients bedside, as well as by patients for self-monitoring of blood glucose. Even though most devices have important technological advances that decrease operator error, the analytical goals proposed for the performance of glucose meters have been recently changed by the American Diabetes Association (ADA) to reach <5% analytical error and <7.9% total error. We studied 80 meters throughout the Virgen Macarena Hospital and we found most devices with performance error higher than 10%. The aim of the present study was to establish a new system to control portable glucose meters together with an educational program for nurses in a 1200-bed University Hospital to achieve recommended analytical goals, so that we could improve the quality of diabetes care. We used portable glucose meters connected on-line to the laboratory after an educational program for nurses with responsibilities in point-of-care testing. We evaluated the system by assessing total error of the glucometers using high- and low-level glucose control solutions. In a period of 6 months, we collected data from 5642 control samples obtained by 14 devices (Precision PCx) directly from the control program (QC manager). The average total error for the low-level glucose control (2.77 mmol/l) was 6.3% (range 5.5-7.6%), and even lower for the high-level glucose control (16.66 mmol/l), at 4.8% (range 4.1-6.5%). In conclusion, the performance of glucose meters used in our University Hospital with more than 1000 beds not only improved after the intervention, but the meters achieved the analytical goals of the suggested ADA/National Academy of Clinical Biochemistry criteria for total error (<7.9% in the range 2.77-16.66 mmol/l glucose) and optimal total error for high glucose concentrations of <5%, which will improve the quality of care of our patients.

Enfermedad de Chagas Congenita y titulos de IgG e IgM / Titles od IgG and IgM of congenital chags disease

La enfermedad de Chagas es una entidad importante en nuestro medio, yaque Cochabamba es una zona endemica para este mal con porcentajes elevados, tantro de infestacion domiciliaria por Triatominos, como de serologia positiva para Tripanosoma Cruzi. Se realizo un estudio para probar la posibilidad de transmision congenita de este mal en 50 mujeres que fueron internadas en la Maternidad German Urqidi con trabajo de parto, a las mismas se les tomo una muestra de sangre endovenosa y de cordon umbilical las cuales fueron procesadas por medio de la tecnica de inmunofluorescencia indirecta (IFI) y gota gruesa. Una mayoria de estos pacientes procedian de areas perifericas de la ciudad y zonas rurales.