Nurses' Perception of Patient Safety Culture in a Referral Hospital: A Cross-Sectional Study.

Healthcare systems are becoming increasingly complex which is helping to promote a 'culture of safety' within them based on the best scientific evidence available. Indeed, creating a positive institutional culture of patient safety is reflected in health outcomes. The aim of this present study was to describe the perception of culture of safety by nurses in adult inpatient units in a tertiary hospital and to analyze adverse events reporting. It was a cross-sectional study in which 202 nurses from adult hospitalization units of the Hospital Universitario y Politécnico La Fe in Valencia (Spain) participated. The perception of safety culture was measured using the Hospital Survey on Patient Safety questionnaire version 1.0, which consists of 42 items distributed in 12 dimensions that are considered strengths or weaknesses. In addition, adverse events related to nursing care during the study period and those reported in the official hospital registry were collected. Finally, the association between safety culture and sociodemographic and labor variables was explored. A total of 148 responses to the questionnaire were analyzed (Cronbach's alpha = 0.94), where seven dimensions and 25 items were identified as weaknesses. Two hundred and fourteen events were identified and none were reported in the official registry. Years of experience were significantly (p < 0.05) associated with safety culture. It is necessary to establish strategies to improve the perception of the safety culture of nurses, as well as to make nurses aware of the importance of notifying adverse events derived from health care.

[Serological survey of measles, rubella and mumps immunity among pediatric and resident physicians, Valencia, Spain]. / Seroprevalencia frente a sarampión, rubeola y parotiditis en personal facultativo del servicio de pediatría del Hospital Universitario y Politécnico La Fe de Valencia.

BACKGROUND: Health workers are exposed to vaccine-preventable diseases. Therefore, vaccination programs are essential for preventing sanitary environment-acquired infections and avoiding additional damage to patients. The objectives were to estimate the prevalence of antibodies against measles, rubella and mumps among physicians of the Clinical Area of Children Diseases of the La Fe University Hospital (Valencia) and to study its relationship with history of disease, vaccination and professional status. METHODS: Observational, cross-sectional and analytical study. All subjects underwent a serological test for detection of specific antibodies against measles, rubella and mumps. Some of them also completed a questionnaire about the history of disease and vaccination. A descriptive and relation analysis was performed to each disease. RESULTS: 97 physicians participated in the study. 75 participants (77,3%) had positive serology to measles, 85 (87,6%) to rubella and 68 (70,1%) to mumps. The logistic regression model showed a significant effect of age (OR 1,22) in the prevalence of antibodies against measles and a significant effect of sex (OR 5,16) in the prevalence of antibodies against rubella. CONCLUSION: Given the high prevalence of seronegative young physicians and taking into account their professional activity, vaccination in this group would be recommended. Therefore it would be desirable to design strategies to achieve the accession of physicians to the vaccination program.

[Incidence and variability of temporary disability due to anxiety disorders during 2009 in the Valencia Community, Spain].

BACKGROUND: Anxiety, dissociative and somatoform disorders (WHO-e 300) are the second cause of Temporary Disability (TD) in Spain. This is the main reason that justifies the analysis of the variability among primary health care centers (PHC) of the Valencian Community in the prescription processes of Temporary Disability for these disorders. METHODS: Epidemiological cross-sectional descriptive study of variability of TD processes initiated in 2009 corresponding to diagnosis e 300 in 739 PHC from 23 health districts in the Valencian Community, where 25,859 TD processes for the diagnosis e 300 were prescribed. Traditional indicators of variation developed for the analysis of small areas were used to determine variability in the incidence rate of TD processes. The analysis of variance was used to determine the percentage of explanation of the factors studied. RESULTS: The average incidence rate obtained was of 1.08 for 100 individuals. The variation range was between 0.01 and 1.97 for percentiles P(5) to P(95). In the variance components analysis, the factor of health district explains the highest percentage of variability (22.12), followed by the factor province (20.21%), coastal areas (4.65%), teaching accreditation (2.44%) and the size of population assigned to each PHC (2.40%). CONCLUSIONS: Significant differences were observed in the incidence rate of TD processes for the diagnosis e 300. The PHCs with greater population pressure and those that are accredited had the highest rates of incidence.

Valoración del cuestionario de Boston como screening en patología laboral por síndrome del tunel carpiano / Boston questionnaire assessment as work for screening in pathology carpal tunnel syndrome

Objetivos: el cuestionario de Boston incluye referidas al dolor, molestias, pérdida de sensibilidad, debilidad, hormigueo y funcionalidad de la mano y muñeca que debe responder el paciente. El objetivo del trabajo es evaluar el cuestionario de Boston como técnica de screening para síndrome del túnel carpiano laboral. Material y métodos: estudio de casos y controles. La población del estudio pertenecen al sector de distribución Se han utilizado las siguientes técnicas estadísticas: Chi cuadrado, T de Student, curvas ROC y regresión logística. Resultados: muestran diferencias significativas en todos sus ítems entre casos y controles, siendo la diferencia global de puntuación entre ambos grupos de 11 puntos. El riesgo de padecer STC es seis veces superior si se puntúa entre 15 y 25 y treinta y siete veces superior si se puntúa por encima de 25 que si se puntúa por debajo de 15. Conclusiones: el Cuestionario de Boston se constituye como una herramienta muy útil en el screening de STC (AU)

Objectives: Boston questionnaire includes referring to pain, discomfort, numbness, weakness, tingling and functionality of the hand and wrist that the patient should respond. The aim of the study is to evaluate the Boston questionnaire as a screening technique for labour carpal tunnel syndrome. Material and methods: a case-control study in workers of distribution sector. We used the following statistical techniques: Chi square, T-test, ROC curves and logistic regression. Results: it showssignificant differences in all items between cases and controls, the overall difference between the two groups scoring 11 points. The risk 2016of STC is six times higher if rate between 15 and 25 and thirty-seven times if you scored above 25 if it is scored below 15. Conclusions: the questionnaire Boston is established as a very useful tool in the screening of STC (AU)

Análisis de factores de riesgo laborales y no laborales en Síndrome de Túnel Carpiano (STC) mediante análisis bivariante y multivariante / Analysis of occupational risk factors and unoccupational in Carpal Tunnel Syndrome (CTS) by bivariate and multivariate analysis

El Síndrome del Túnel Carpiano (STC) está incluido en la lista de la Unión Europea de enfermedades profesionales, pese a ello, se ha pretendido estudiar tanto los factores de riesgo laborales como los no laborales que influyen en su desarrollo, as. como describir las características demográficas y clínicas, mediante un estudio de casos y controles en 545 trabajadores del sector distribución, analizándose 61 variables. Los resultados evidencian que la edad y sexo femenino son factores de riesgo, as. como también la comorbilidad, número de hijos, coexistencia de varios factores, tipo de trabajo y determinados movimientos y posturas. De entre los factores de riesgo laborales, solamente se han evidenciado los movimientos de hiperflexión e hiperextensión de la muñeca. La prevalencia de STC en la población trabajadora del sector distribución es similar a la de la población general, evidenciándose factores laborales y no laborales como de riesgo para el desarrollo del síndrome (AU)

The Carpal Tunnel Syndrome (CTS) is included in the list of the European Union occupational diseases, nevertheless, it has tried to study both occupational risk factors as no occupational that influence their development and describe the characteristics demographic and clinical characteristics, using a case-control study of 545 workers in the distribution sector, analyzing 61 variables. The results show that age and female sex are risk factors, as well as comorbidity, number of children, coexistence of various factors, type of work and certain movements and postures. Among the occupational risk factors, only hyperflexion and hyperextension movements of the wrist have been shown. The prevalence of STC in the working population distribution sector is similar to that of the general population, showing labour and non labour as risk for developing the syndrome factors (AU)

La importancia de las palabras: ¿medicamentos peligrosos o medicamentos biopeligrosos? Propuesta de un nuevo término / The relevance of words: dangerous drugs or hazardous drugs? A proposal of a new term

No disponible

Alérgenos en la dermatitis de contacto alérgica de origen laboral / Allergens in occupational allergic contact dermatitis

Introducción: Las dermatosis profesionales tienen una alta incidencia, lo que conlleva considerables consecuencias médicas y laborales. Objetivos: Describir las características de la población afectada por dermatitis de contacto alérgica de origen laboral y los alérgenos responsables. Material y Métodos: Durante cinco años se incluyó a todos los pacientes diagnosticados de Dermatitis de Contacto Alérgica en una consulta de Dermatología en un hospital de referencia, con positividad a al menos un alérgeno presente en su puesto de trabajo. Resultados: En sector de cosmética el 93,7% fue causada por acrilatos, en peluquería un 72,7% fue causada por PPDA, en alimentación un 63,3% de los alérgenos fueron productos alimentarios, en construcción el 60% fueron causadas por cemento y en industria PPDA causó un 30%. Las manos fueron la principal área corporal afectada en todos los grupos laborales. Conclusión: parece recomendable mejorar la coordinación entre los facultativos de Medicina del Trabajo y de atención primaria con los facultativos dermatólogos, estableciéndose protocolos de actuación conjuntos que permitan disponer de un diagnóstico definitivo en el menor tiempo posible (AU)

Introduction: The occupational dermatosis have a high incidence, leading to considerable medical and occupational consequences. Objectives: Describe the characteristics of the population affected by allergic contact dermatitis of labor origin and allergens responsible. Methods: During 5 years, all Allergic Contact Dermatitis were includedat the time of diagnosis, on a Dermatology outpatient department in a tertiary hospital, with positivity for at least 1 allergen present in their workplace. Results: In Cosmetics a 93.7% was caused by acrylates, in Hairdressing a 72.7% was caused by PPDA in Food Workers 63.3% of allergens were food products, in Construction a 60% were caused by cement and in Industry PPDA caused a 30%. The hands were the main body area affected in all labor groups. Conclusions: it seems to need an improvement about the communication and protocols between Occupational Medicine, Family Medicine and Dermatology to short the time of the diagnosis of these occupational diseases (AU)

La protección del embarazo en el Departamento de Salud Valencia La Fe de 2010 a 2013 / Protection of pregnancy in the Department of Health La Fe, Valencia, 2010 to 2013

No disponible

Seroprevalencia frente a Sarampión, Rubeola y Parotiditis en personal facultativo del Servicio de Pediatría del Hospital Universitario y Politécnico de La Fe de Valencia / Serological survey of measles, Rubella and mumps immunity among pediatric and residents physicians. Valencia, Spain

Fundamentos: El personal sanitario está expuesto a enfermedades prevenibles por vacunación y por tanto, asegurar una adhesión a programas de vacunación es un elemento clave en la prevención de las infecciones adquiridas en el trabajo y evitar causar daño a los pacientes. Los objetivos fueron estimar la prevalencia de anticuerpos frente a sarampión, rubeola y parotiditis entre los facultativos del Área Clínica de Enfermedades del Niño del Hospital Universitario y Politécnico la Fe de Valencia y estudiar su relación con antecedentes de la enfermedad, vacunación y categoría y experiencia profesional. Métodos: Estudio observacional transversal analítico. A todos los participantes se les realizó un análisis serológico para la detección de anticuerpos específicos frente a sarampión, rubeola y parotiditis y se les ofreció la posibilidad de cumplimentar un cuestionario sobre antecedentes de enfermedad y/o vacunación. Se realizó un análisis descriptivo y de relación para cada una de las enfermedades. Resultados: Participaron 97 facultativos, de ellos presentaban serología positiva para sarampión 75 (77,3%), para rubeola 85 (87,6%) y 68 (70,1%) frente a parotiditis. El modelo de regresión logística mostró diferencias significativas en la prevalencia de anticuerpos frente a sarampión en función de la edad (OR 1,22) y frente a rubeola en función del sexo (OR 5,16). Conclusiones: Considerando la alta prevalencia de facultativos jóvenes seronegativos y teniendo en cuenta la actividad profesional que desarrollan, la vacunación en este colectivo estaría recomendada por lo que sería conveniente diseñar estrategias para conseguir la adhesión de los profesionales al programa de vacunación (AU)

Background: Health workers are exposed to vaccine-preventable diseases. Therefore, vaccination programs are essential for preventing sanitary environment-acquired infections and avoiding additional damage to patients. The objectives were to estimate the prevalence of antibodies against measles, rubella and mumps among physicians of the Clinical Area of Children Diseases of the La Fe University Hospital (Valencia) and to study its relationship with history of disease, vaccination and professional status. Methods: Observational, cross-sectional and analytical study. All subjects underwent a serological test for detection of specific antibodies against measles, rubella andmumps. Some of themalso completed a questionnaire about the history of disease and vaccination. A descriptive and relation analysis was performed to each disease. Results: 97 physicians participated in the study. 75 participants (77,3%) had positive serology to measles, 85 (87,6%) to rubella and 68 (70,1%) to mumps. The logistic regression model showed a significant effect of age (OR 1,22) in the prevalence of antibodies againstmeasles and a significant effect of sex (OR 5,16) in the prevalence of antibodies against rubella. Conclusion: Given the high prevalence of seronegative young physicians and taking into account their professional activity, vaccination in this group would be recommended. Therefore it would be desirable to design strategies to achieve the accession of physicians to the vaccination program (AU)

El área de conocimiento de Medicina del Trabajo en el grado de Medicina de las Universidades Españolas / Knowledge área of occupational medicine in the grade of spanish universities

Objetivo: Evidenciar la necesidad de un área de conocimiento específica en Medicina del Trabajo en el Grado de Medicina en las universidades españolas. Material y método: Revisión y descripción del área de conocimientos de la Medicina del Trabajo en el contenido de los planes de estudio y guías docentes de los grados de Medicina que se imparte en las universidades españolas. Resultados: Se han encontrado diferencias en el contenido de los planes de estudios en relación al área de conocimiento de Medicina del Trabajo. Conclusiones. En la mayoría de las guías docentes del Grado de Medicina los temas relaciones con la Medicina del trabajo no aparecen como asignatura específica y en general se incluyen en asignaturas como Medicina Legal, Medicina Preventiva o Salud Pública evidenciando las carencias formativas en esa materia y la necesidad de un área específica (AU)

Objective: To demonstrate the need for a specific knowledge area in Occupational Medicine Degree in Spanish universities. Methods: Review and description of the area of knowledge of Occupational Medicine Degree in Spanish universities. Methods: Review and description of the area of knowledge of Occupational Medicine in the content of curricula and teaching guides for grades of Medicine taught in Spanish universities. Results: We have found differences in the content of the curriculum in relation to the area of knowledge of Occupational Medicine. Conclusions: In most of the teaching guides Medical Grade issues Occupational Medicine either are or are not included in subjects such as Forensic Medicine, Preventive Medicine and Public Health showing the lack of training in this area and the need of a specific area (AU)

Incidencia y variabilidad de la incapacidad temporal por trastornos de ansiedad en la Comunidad Valenciana durante el 2009 / Incidence and variability of temporary disability due to anxiety disorders during 2009 in the Valencia Community, Spain

Fundamentos: Los trastornos de ansiedad, disociativos y somatomorfos (Cod300) constituyen la segunda causa de incapacidad temporal (IT) en España. Esta razón justifica que el presente trabajo se centre en analizar la variabilidad en la prescripción de procesos de IT por estas patologías en los centros de salud y consultorios (CS) de la Comunidad Valenciana (CV). Métodos: Se realizó un estudio epidemiológico poblacional transversal de variabilidad de los procesos de IT iniciados en 2009 correspondientes al Cod300 en los 739 CS, de los 23 departamentos de salud de la CV, donde se prescribieron un total de 25.859 procesos de IT por Cod300. Se utilizaron los estadísticos de variabilidad habituales en el análisis de áreas pequeñas para determinar la variabilidad observada en la tasa de incidencia (TI) de los procesos de IT. El análisis de la varianza se utilizó para determinar el porcentaje de explicación de cada factor estudiado. Resultados: La TI media por 100 individuos es de 1,08 con un rango de variación de 0,01 a 1,97 entre los percentiles P5 a P95. En el análisis de componentes de la varianza, el factor departamento de salud es el que explica mayor porcentaje de variabilidad (22,12%) seguido del factor provincia (20,21%), litoralidad (4,65%), acreditación para la docencia (2,44%) y tamaño poblacional asignado al CS (2,40%). Conclusiones: Se observa una variabilidad notable en las TI de las prescripciones de IT por Cod300. Los factores departamento y provincia son los que más explican esta variabilidad. Los CS con mayor presión poblacional y los acreditados tienen mayores tasas de incidencia(AU)

Background: Anxiety, dissociative and somatoform disorders (WHO-Code 300) are the second cause of Temporary Disability (TD) in Spain. This is the main reason that justifies the analysis of the variability among primary health care centers (PHC) of the Valencian Community in the prescription processes of Temporary Disability for these disorders. Methods: Epidemiological cross-sectional descriptive study of variability of TD processes initiated in 2009 corresponding to diagnosis code 300 in 739 PHC from 23 health districts in the Valencian Community, where 25,859 TD processes for the diagnosis code 300 were prescribed. Traditional indicators of variation developed for the analysis of small areas were used to determine variability in the incidence rate ofTD processes. The analysis of variance was used to determine the percentage of explanation of the factors studied. Results: The average incidence rate obtained was of 1.08 for 100 individuals. The variation range was between 0.01 and 1.97 for percentiles P5 to P95. In the variance components analysis, the factor of health district explains the highest percentage of variability (22.12), followed by the factor province (20.21%), coastal areas (4.65%), teaching accreditation (2.44%) and the size of population assigned to each PHC (2.40%). Conclusions: Significant differences were observed in the incidence rate of TD processes for the diagnosis code 300. The PHCs with greater population pressure and those that are accredited had the highest rates of incidence(AU)

Criterios para la acreditación sanitaria en atención primaria

Publicación en la que se establecen los criterios de calidad que deben regir la organización y funcionamiento de la atención primaria. Incluye tanto aspectos estructurales como funcionales o procedimentales y también los referentes al resultado de la actividad de la mencionada organización.