[Perception of the safe administration of medications in primary care]. / Percepción de la administración segura de medicamentos en atención primaria.

The purpose of this study was to know the perception of nurses about safety in the preparation and administration of medications in a primary care health department of the Spanish national health system. Cross-sectional descriptive study. Carried out in the Health Department 21 (Alicante, Spain) in the months of September to November 2021. 66 nurses, with a predominance of women (88.9%). A semi-structured interview with ten questions was used. The inclusion criterion took into account nurses with more than two years of experience working in the health center. The perception of nurses about the degree of safety in the preparation and administration of medications was evaluated. 81.9% of the sample did not report adverse events. The steps for secure administration were varied. A significant association was observed in the correct time of medication (p < 0.031) and antisepsis (p < 0.026) according to the number of nurses in the basic health areas. Our results indicate the perceptions of nurses about improvements in the degree of implementation of standards or tools for the safe administration of medications, with special attention to lack of knowledge, care overload (high patient/nurse ratio) and associated dilemmas with the notification.

[Medication safety during the COVID-19 pandemic in primary care nurses]. / Seguridad de medicamentos durante la pandemia COVID-19 en las enfermeras de atención primaria.

OBJECTIVE: To know the perception of nurses about the factors that influence the safe administration of medications during the COVID-19 period, in the work context in a primary care health department of the Spanish national health system. DESIGN: This is a qualitative phenomenological study. SITE: Carried out in the Department of Health 21 (Alicante, Spain) between the months of September 2021 and November 2021. PARTICIPANTS: Fifteen nurses chosen by intentional sampling. METHODS: A semi-structured interview lasting between 30 and 60min was used, recorded and transcribed verbatim by the research team. A main category called "know" is established, which encompasses all the reflections about the nurse's performance during the medication administration process. RESULTS: The participants expressed concern about the performance of medication administration procedures, which made it possible to perceive safety as the greatest concern in the study unit. From this main category, the following subcategories are developed: work overload, insufficient training, distractions and communication and information failures. CONCLUSION: Knowing the perception of nurses about the factors that influence the safe administration of medications could facilitate the use of instruments to standardize and reduce variability in the safe administration of medications. As well as improving conditions in work environments at the community level, and not favoring social, personal and professional stigmatization due to care error.

Analysis of medication errors in Neonatal Intensive Care: A systematic review.

Medication errors, potentially causing harm and causing harm, increase significantly in newborns cared for in intensive care settings. In this sense, this work carries out a systematic review to analyze the most current evidence in relation to medication errors in neonatal intensive care, discussing the topics that refer to health technology from smart pumps, cost-effectiveness of medications, the practice of nursing professionals on the medication administration process and quality improvement models. In this way, it could be considered a useful tool to promote quality and safety in neonatal intensive care.

Development and Evaluation of a Software Designed by a Nursing and Technology Team to Assess the Health Status of Adults over 65 Years of Age.

Objective: This work sought to develop the Actuasalud platform as a useful tool for nursing that permits assessing health, in term of frailty, in population over 65 years of age. Methods: For the design and development of Actuasalud, two working groups were formed: one from nursing with different profiles, to identify the scientific content and a computer science group responsible for the software programming and development. Both teams adapted the scientific content to the technology so that the tool would allow for population screening with detection of health problems and frailty states. Results: The software was developed in three large blocks that include all the dimensions of frailty: a: sociodemographic variables, b: comorbidities, and c: assessment tools of autonomy-related needs that evaluate the dimensions of frailty. At the end of the evaluation, a detailed report is displayed through bar diagram with the diagnosis of each of the dimensions assessed. The assessment in the participating elderly showed that 44.7% (n = 38) of the population was considered not frail, and 55.3%; (n = 47) as frail. Regarding associated pathologies, high blood pressure (67.1%; n = 57), osteoarthritis and/or arthritis (55.3%; n = 47), diabetes (48.2%; n = 41) and falls during the last year (35.3%; n = 30) were highlighted. Conclusion: Actuasalud is an application that allows nursing professionals to evaluate frailty and issue a quick diagnosis with ordered sequence, which helps to provide individualized care to elderly individuals according to the problems detected during the evaluation.

[Urinary tract infections in older adults: Etiology and antimicrobial susceptibilities in a southern area of Spain]. / Infecciones del tracto urinario en personas mayores: etiología y susceptibilidades antimicrobianas en un área del sur de España.

INTRODUCTION: Urinary tract infection (UTI) is one of the most prevalent diseases in clinical practice and increases in patients older than 65years compared to middle-aged patients. In order to improve empirical treatment, the etiology and antibiotic sensitivity profile of the most frequent bacteria that produce UTIs in older people have been studied. MATERIAL AND METHODS: Cross-sectional, descriptive and retrospective study in which isolated micro-organisms with significant counts in urine samples from patients with UTI were included. The global etiology and according to sex were analyzed. Only one urine sample per patient and UTI episode was considered. RESULTS: Regarding the origin of the sample, the highest proportion was in primary care with 4853 urine cultures (51.6% of positive urine cultures), followed by hospital care with 3565 urine cultures (46.4% of positive urine cultures) and 94 urine cultures in nursing homes elderly (2% positive urine cultures). Escherichia coli was the most isolated micro-organism both in the population as a whole (54%) and in each of the analyzed groups. It was observed that E.coli isolated in women was significantly higher than in men (χ2, P=.044). Their sensitivity was: 80% fosfomycin and 75% amoxicillin-clavulanic acid. CONCLUSIONS: E.coli continues to be the most frequently isolated micro-organism in UTI. Empirical treatment of UTI in our environment should include fosfomycin or amoxicillin-clavulanic acid, regardless of the health care unit and gender.

[Effectiveness of the influenza vaccine in the prevention of influenza in people over 65 years of age]. / Efectividad de la vacuna antigripal en la prevención de la gripe en personas mayores de 65 años.

INTRODUCTION: Influenza is one of the diseases with the greatest epidemiological impact and of maximum relevance in the management of health services. The flu vaccine can have great variability each season, so our objective was to find out the effectiveness of the flu vaccine for the 2017/2018 season for the prevention of severe cases of flu in people over 65 years of age in a 385-bed acute general hospital. MATERIAL AND METHOD: Study of cases and controls. All hospitalized patients with laboratory-confirmed influenza older than 65 years during the 2017/2018 season were included. Those who met the criteria for a severe case of influenza were considered cases. Those who did not meet the severity criteria were considered controls. Factors associated with the development of severe influenza were calculated. RESULTS: The median age was 68 years (SD 91.87). The attack rate was 0.23 per hundred inhabitants and the vaccine effectiveness was 38%. The vaccinated and unvaccinated groups were different in terms of age (p < 0.0481). Vaccination status against severe influenza was found to be an independent protective factor (OR = 0.840; 0.746-0.913). CONCLUSIONS: The effectiveness of influenza vaccination provided greater protection against infection and reduced the severity of influenza in older hospitalized patients. These findings should be taken into account to improve vaccination strategies and achieve better vaccination coverage in the population at risk.

[Primary care pathways and locations during the pandemic in a rural area of Alicante]. / Vías y lugares de atención primaria durante la pandemia en una zona rural de Alicante.

This paper describes the means of health care used in a primary health care centre (PHCC) in a rural area to care for patients during the COVID-19 pandemic. After conducting a cross-sectional study using health questionnaire with 243 patients (100 COVID-19 and 143 other pathologies), we observed that general medical care was 100% by telephone, and little use was made of the portal for citizen information and appointment requests of the Conselleria de Sanitat de la Comunidad Valenciana. Nursing attended 100% by telephone, as did the PHCC doctors and the PHCC emergencies; in the case of taking samples, blood samples and wound care it was face-to-face (men 91%, women 88%), and at home (9% and 12%). In conclusion, different care patterns are observed according to the PHCC professionals, and the need to improve the online pathway with care management.

Nurses' Perceptions on the Implementation of a Safe Drug Administration Protocol and Its Effect on Error Notification.

Patient safety and quality of care are fundamental pillars in the health policies of various governments and international organizations. The purpose of this study is to evaluate nurses' perceptions on the degree of implementation of a protocol for the standardization of care and to measure its influence on notification of adverse events related to the administration of medications. This comparative study used data obtained from questionnaires completed by 180 nurses from medical and surgical units. Our analyses included analysis of variance and regression models. We observe that the responses changed unevenly over time in each group, finding significant differences in all comparisons. The mean response rating was increased at 6 months in the intervention group, and this level was maintained at 12 months. With the new protocol, a total of 246 adverse events and 481 incidents without harm was reported. Thus, actions such as the use of protocols and event notification systems should be implemented to improve quality of care and patient safety.

Eficacia y seguridad de la vacunación antigripal pediátrica: una revisión sistemática / Efficacy and safety of pediatric flu vaccination: a systematic review

Introducción. Los a corren un mayor riesgo de infección por influenza en comparación con la población general. La Organización Mundial la Salud y las recomendaciones del Comité Asesor de Vacunas de la Asociación Española de Pediatría contemplan la vacunación anual como la forma más eficaz de prevenir la enfermedad. Por lo tanto, el propósito de esta revisión fue actualizar la información sobre eficacia y seguridad en la vacuna antigripal en niños y adolescentes. Material y métodos. Una búsqueda en cuatro bases de datos electrónicas (Scopus, Cumulative Index to Nursing and Allied Health Literature, MedLine / PubMed, Google Scholar y Cochrane), así como una búsqueda manual para identificar investigaciones originales publicadas entre 2012 y 2022. Se adoptaron las directrices de análisis (PRISMAcR) como elemento de informe preferido para revisiones sistemáticas. Resultados. Se incluyeron siete artículos de investigación originales donde se identificaron dos temas de la vacunación antigripal en niños/adolescentes sanos y con patologías. La eficacia (entre un 30% y un 80% aproximadamente) varió en función de la vacuna utilizada y los subtipos circulantes. La mayoría de las reacciones adversas fueron de intensidad leve y el evento adverso local más común informado fue dolor en el sitio de la inyección. Conclusiones. Destacamos positivamente la seguridad de la vacunación antigripal pediátrica en los estudios analizados, por el contrario, con respecto a la eficacia de la vacunación antigripal, observamos una amplia variabilidad de resultados. Existe una clara necesidad de seguir realizando estudios de eficacia y seguridad en el niño. (AU)

Introduction. Children are at a higher risk of influenza infection compared to the general population. The World Organization Health and recommendations of the Vaccine Advisory Committee of the Spanish Association of Pediatrics contemplate annual vaccination as the most effective way to prevent the disease. Therefore, the purpose of this review was to update information on efficacy and safety in the anti -shed vaccine in children and adolescents. Material and methods. A search in four electronic databases (Scopus, Cumulative Index to Nursing and Allied Health Literature, Medline / Pubmed, Google Scholar and Cochrane), as well as a manual search to identify original research published between 2012 and 2022. The guidelines of ANALYSIS (PRISMACR) as a preferred report element for systematic reviews. Results. Seven original research articles were included where two issues of antigripal vaccination were identified in healthy children/adolescents and with pathologies. The efficacy (between approximately 30% and 80%) varied depending on the vaccine used and circulating subtypes. Most adverse reactions were mild intensity, and the most common local adverse event was pain in the injection site. Conclusions. We positively highlight the safety of pediatric flu vaccination in analyzed studies, on the contrary, with respect to the efficacy of flu vaccination, we observe a wide variability of results. There is a clear need to continue conducting efficacy and safety studies in the child. (AU)

Development and Evaluation of a Software Designed by a Nursing and Technology Team to Assess the Health Status of Adults over 65 Years of Age / Desarrollo y evaluación de un software diseñado por un equipo de enfermería y tecnología para la valoración del estado de salud de los adultos mayores de 65 año / Desenvolvimento e avaliação de um software desenvolvido por uma equipe de enfermagem e tecnologia para avaliação do estado de saúde de adultos com mais de 65 anos

Objective. This work sought to develop the Actuasalud platformas a useful tool for nursing that permits assessing health, in term of frailty, in population over 65 years of age. Methods. For the design and development of Actuasalud, two working groups were formed: one from nursing with different profiles, to identify the scientific content and a computer science group responsible for the software programming and development. Both teams adapted the scientific content to the technology so that the tool would allow for population screening with detection of health problems and frailty states. Results. The software was developed in three large blocks that include all the dimensions of frailty: a) sociodemographic variables, b) comorbidities, and c) assessment tools of autonomy-related needs that evaluate the dimensions of frailty. At the end of the evaluation, a detailed report is displayed through bar diagram with the diagnosis of each of the dimensions assessed. The assessment in the participating elderly showed that 44.7% (n = 38) of the population was considered not frail, and 55.3%; (n = 47) as frail. Regarding associated pathologies, high blood pressure (67.1%; n = 57), osteoarthritis and/or arthritis (55.3%; n = 47), diabetes (48.2%; n = 41) and falls during the last year (35.3%; n = 30) were highlighted. Conclusion.Actuasalud is an application that allows nursing professionals to evaluate frailty and issue a quick diagnosis with ordered sequence,which helps to provide individualized care to elderly individuals according to the problems detected during the evaluation.

Objetivo. Desarrollar la plataforma Actuasalud como una herramienta útil para enfermería que permita evaluar la salud, en términos de fragilidad, en población mayor de 65 años. Métodos. Para el diseño y desarrollo de Actuasalud,se constituyeron dos grupos de trabajo: uno de enfermería con diferentes perfiles para identificar el contenido científico y uno informático que se responsabilizó de la programación y desarrollo del software. Ambos equipos adaptaron el contenido científico a la tecnología de manera que la herramienta permitiese hacer un cribado poblacional con detección de problemas de salud y estados de fragilidad. Resultados. Se desarrolló el software en tres grandes bloques que incluyen todas las dimensiones de fragilidad: a) variables sociodemográficas, b) comorbilidades y c) herramientas de evaluación de necesidades relacionadas con la autonomía que evalúan las dimensiones de fragilidad. Al finalizar la evaluación, se visualiza un informe detallado mediante diagrama de barras con el diagnóstico de cada una de las dimensiones evaluadas. La evaluación en los mayores participantes mostró que el 44.7% (n = 38) de la población se consideró como no frágil, y un 55.3%; (n = 47) como frágiles. En cuanto a las patologías asociadas, destacaron hipertensión arterial (67,1 %; n = 57), artrosis y/o artritis (55.3%; n = 47), diabetes (48.2 %; n = 41) y caídas en el último año (35,3 %; n = 30). Conclusión.Actuasalud es una aplicación que permite a los profesionales de enfermería evaluar fragilidad y emitir un diagnóstico de forma ágil con secuencia ordenada que ayuda a brindar cuidados individualizados a personas mayores de acuerdo los problemas detectados en la evaluación.

Objetivo. Desenvolver a plataforma Actuasalud como uma ferramenta útil para a enfermagem que permite avaliar a saúde, em termos de fragilidade, numa população com mais de 65 anos. Métodos. Para a concepção e desenvolvimento do Actuasalud foram formados dois grupos de trabalho: um grupo de enfermagem com perfis diferentes, para identificar o conteúdo científico, e um grupo de informática que foi responsável pela programação e desenvolvimento do software. Ambas as equipas adaptaram o conteúdo científico à tecnologia para que a ferramenta permitisse o rastreio da população para detectar problemas de saúde e estados de fragilidade. Resultados. O software foi desenvolvido em três grandes blocos que incluem todas as dimensões da fragilidade: a) variáveis sociodemográficas, b) comorbidades ec) instrumentos de avaliação de necessidades relacionadas à autonomia que avaliam as dimensões da fragilidade. Ao final da avaliação é apresentado um relatório detalhado através de um diagrama de barras com o diagnóstico de cada uma das dimensões avaliadas. A avaliação nos idosos mostrou que 44.7% (n=38) da população foi considerada não frágil e 55.3%; (n=47) como frágil. Quanto às patologias associadas, destacaram-se a hipertensão arterial (67.1%; n=57), a osteoartrite e/ou artrite (55.3%; n=47), a diabetes (48.2%; n=41) e as quedas no último ano (35.3%; n=30). Conclusão. Actuasalud é um aplicativo que permite ao profissional de enfermagem avaliar a fragilidade e emitir um diagnóstico de forma ágil e com sequência ordenada que auxilia no atendimento individualizado ao idoso de acordo com os problemas detectados na avaliação.

Percepción de los estudiantes de enfermería con las prácticas clínicas durante la pandemia covid-19

Objetivo: Conocer la percepción de los estudiantes de tercer grado de enfermería del ambiente de aprendizaje de prácticas clínicas durante el periodo de pandemia Covid-19. Material y Método: Estudio cualitativo fenomenológico que se llevó a cabo en un curso académico 2021-2022, de una universidad en Alicante, España. Participaron 15 estudiantes de tercer curso del grado de enfermería en el ambiente de aprendizaje de prácticas clínicas (5 módulos de prácticas, de 17 días cada uno) durante el periodo Covid-19 y en ámbitos de atención primaria y especializada. Se empleó un tipo de muestreo intencionado y se aplicaron las preguntas guía en entrevistas semiestructuradas hasta la saturación del objeto de estudio. Los datos fueron sometidos a análisis de contenido según Bardin. Resultados: Los participantes manifestaron preocupación ante la percepción con las prácticas clínicas durante la pandemia Covid-19, lo que permitió establecer una categoría principal denominada "Conocer". A partir de esta categoría principal se desarrollan las siguientes subcategorías: 1) Relación con los tutores, 2) Ambiente pedagógico en la sala de hospitalizados, 3) Rol de la enfermera docente, 4) Relación con la supervisora y el equipo clínico y 5) Documentación de enfermería. Conclusiones: Las percepciones de los estudiantes sobre el entorno de aprendizaje en las prácticas clínicas pueden considerarse aceptables, lo que refuerza la idea de que la práctica clínica en un entorno de apoyo podría motivar a los estudiantes y ayudarlos a adquirir conocimientos incluso en periodo de pandemia de Covid-19.

Objective: To know the perception of third year students of the nursing program in the learning environment of clinical practice during the period of the Covid-19 pandemic. Material and Methods: A qualitative phenomenological study was conducted in the academic year 2021-2022, from a university of Alicante, Spain. 15 third-year nursing students participated in the clinical practice-learning environment (5 practice modules of 17 days each) during the Covid-19 period and in primary and specialized care settings. An intentional sampling technique was used and the guiding questions were applied in semi-structured interviews until reaching saturation. The data were subjected to Bardin's content analysis. Results: Participants expressed concerns about the perception of clinical practices during the Covid-19 pandemic, which allowed the establishment of a main category called "to know". From this main category, the following subcategories were developed: 1) Relationship with instructors, 2) Educational environment in the inpatient treatment room, 3) Role of the nurse educator, 4) Relationship with the supervisor and the clinical team, and 5) Nursing documentation. Conclusions: Students' perceptions of the learning environment in the clinical practice can be considered acceptable, which reinforces the idea that clinical practice in a supportive environment can motivate students and help them acquire knowledge even in the period of the Covid-19 pandemic.

Objetivo: Conhecer a percepção dos estudantes do terceiro ano do programa de enfermagem sobre o ambiente de aprendizagem da prática clínica durante o período da pandemia da Covid-19. Material e Método: Estudo fenomenológico qualitativo realizado no ano académico 2021-2022 na uma universidade de Alicante, Espanha. 15 estudantes de enfermagem do terceiro ano participaram do ambiente de aprendizagem de prática clínica (5 módulos de prática de 17 dias cada) durante o período da Covid-19 em ambientes de atendimento primário e especializado. Utilizou-se uma técnica de amostragem intencional e as perguntas orientadoras foram aplicadas em entrevistas semiestruturadas até atingir a saturação. Os dados foram submetidos à análise de conteúdo de Bardin. Resultados: Os participantes manifestaram preocupação com a percepção das práticas clínicas durante a pandemia de Covid-19, o que permitiu estabelecer uma categoria principal denominada "conhecer". A partir desta categoria principal desenvolvem-se as seguintes subcategorias: 1) Relacionamento com os tutores, 2) Ambiente pedagógico na enfermaria do hospital, 3) Papel do enfermeiro docente, 4) Relacionamento com o supervisor e a equipe clínica e 5) Documentação de enfermagem. Conclusões: As percepções dos estudantes sobre o ambiente de aprendizagem nas práticas clínicas podem ser consideradas aceitáveis, o que reforça a ideia de que a prática clínica num ambiente de apoio pode motivar os estudantes e ajudá-los a adquirir conhecimento, mesmo no período de pandemia da Covid-19.

Percepción de la salud en los pacientes durante la pandemia COVID-19 / Perception of health in patients during the COVID-19 pandemic

Objetivo: Analizar la percepción de la salud en los pacientes de atención primaria del departamento de salud 21 durante el período epidémico de la COVID-19. Material y Métodos: Estudio observacional transversal. Realizado en el Departamento de Salud 21 (Alicante-España) en los meses del 23 de febrero de 2021 al 15 de mayo de 2021. Participaron un total de 243 usuarios. Se utilizó una entrevista semiestructurada, tomando como referencia la información del Cuestionario de Salud de la Comunidad Valenciana Adaptado. Se consideró la variable resultado la percepción de la salud en los pacientes. Los criterios de inclusión tomaron en cuenta a personas mayores de 18 años que fueran atendidas durante la pandemia de COVID-19 y que quisieran participar en el estudio. Resultados: Las edades estuvieron comprendidas entre los 20 y 94, años con una media de 64,55 años (DE 19,97). En la percepción de la salud, destacamos el grupo de las mujeres donde refieren tener una peor salud (69%) durante los últimos 12 meses y mayores problemas para caminar (59,2%). Nuestros resultados indican asociación significativa en los recursos sociales utilizados para las actividades de la vida cotidiana (p<0,001) y la teleasistencia (p<0,043). Conclusión: A nivel práctico, si tenemos en cuenta la esperanza de vida en la población, las comorbilidades asociadas y la asistencia sanitaria en el periodo pandémico, podemos decir que la percepción de la salud es peor en las mujeres. A pesar de todos estos factores, la satisfacción con los servicios sanitarios en periodo pandémico es satisfactoria. (AU)

Objective: To analyze the perception of health in primary care patients of the health department 21 during the COVID-19 epidemic period. Material and Methods: Cross-sectional observational study. Held in the Department of Health 21 (Alicante-Spain) from February 23, 2021, to May 15, 2021. A total of 243 users participated. A semi- structured interview was used, taking as a reference the information from the Valencian Community Health Survey Adapted. The variable result of the perception of health in patients was considered. The inclusion criteria considered 18-year-olds who were served during the COVID-19 pandemic and who wanted to participate in the study. Results: The ages were comprised between 20 and 94, years with an average of 64.55 years (SD 19.97). In the perception of health, we highlight the group of women who reported having a worse health (69%) during the last 12 months and major problems to walk (59.2%). Our results indicate a significant association in the social resources used for the activities of daily life (p<0.001) and teleassistance (p<0.043). Conclusion: On a practical level, if we have an account of life expectancy in the population, associated comorbidities and health care in the pandemic period, we can decide that the perception of health is worse in women. Despite all these factors, satisfaction with health services during the pandemic is satisfactory. (AU)

La salud y sus determinantes en adultos mayores durante la pandemia de COVID-19 / Health and its determinants in older adults during the COVID-19 pandemic

Introducción: La epidemia de COVID-19 ha sobrecargado los servicios de salud, por lo que los grupos de mayor edad pueden ser más vulnerables a los determinantes de la salud asociados con la pandemia de COVID-19. Objetivo: Analizar la salud y sus determinantes en adultos mayores durante el período de pandemia de COVID-19 en un área mediterránea. Metodología: Estudio observacional transversal realizado en un área mediterránea, España. Participantes:En total fueron 158 pacientes, de los que 40 tenían COVID-19, y 118 con otras patologías no COVID-19. Criterios de inclusión:Personas mayores de 60 años que acudieron al área básica de salud de estudio durante la pandemia de COVID-19 del 23 de febrero de 2021 al 15 de mayo de 2021. Se utilizó entrevista semiestructurada validada. Resultados: Las edades oscilaron entre 60 y 94 años con una media de edad (DE 77,297). Se observó una mayor comorbilidad en ambos grupos en hombres, así como un mayor hábito tabáquico. Con respecto a la variable vivir en pareja, se observó una asociación significativa en ambos grupos y por sexo (p < 0,009). En cuanto al uso de nuevas tecnologías, no se observó significación y los valores obtenidos fueron muy bajos, tanto en pacientes con COVID-19 como sin COVID-19. Conclusión: Parece necesario sensibilizar a las instituciones y animar a las familias, organizaciones de voluntariado y proyectos comunitarios a apoyar y comunicarse con las personas de esta franja etaria en contextos de pandemia. A su vez, se debe implementar e incentivar el uso de los recursos sociales para mejorar la asistencia y atención a las personas mayores para prevenir los efectos negativos de la pandemia relacionados con el aislamiento social (AU)

Introduction: The COVID-19 epidemic has overburdened health services, so older age groups may be more vulnerable to the determinants of health associated with the COVID-19 pandemic. Objective: To analyse health and its determinants in older adults during the COVID-19 pandemic period in a Mediterranean area. Methodology: Observational cross-sectional study carried out in in a Mediterranean area, Spain. Participants: 158, COVID-19 patients (n = 40) and patients with other non-COVID-19 pathologies (n = 118). Inclusion criteria: People over 60 years of age who were seen in the basic health area of study during the COVID-19 pandemic from 23 February 2021 to 15 May 2021. A validated semi-structured interview was used. Results: Ages ranged from 60 to 94 years with a mean age (SD 77.297). A greater comorbidity was observed in both groups in men, as well as a greater smoking habit. With respect to the variable of living with a partner, a significant association was observed in both groups and by sex (p < 0.009). With regard to the use of new technologies, no significance was observed and the values obtained were very low in both COVID-19 and non-COVID-19 patients. Conclusion:It seems necessary to raise awareness among institutions and to encourage families, voluntary organizations and community projects to support and communicate with people in this age group in pandemic contexts. In turn, the use of social resources should be implemented and encouraged to improve assistance and care for the elderly to prevent the negative effects of the pandemic related to social isolation (AU)

Vías y lugares de atención primaria durante la pandemia en una zona rural de Alicante / Primary care pathways and locations during the pandemic in a rural area of Alicante

Este trabajo describe las vías de asistencia sanitaria utilizadas en un centro de atención primaria de salud (CAPS) de una zona rural para la atención a sus pacientes durante la pandemia de COVID-19. Tras realizar un estudio transversal mediante un cuestionario de salud a 243 pacientes (100 con COVID-19 y 143 con otras patologías), observamos que la atención de medicina general fue el 100% telefónica y hubo escaso uso del portal de información a la ciudadanía y solicitud de cita previa de la Conselleria de Sanitat de la Comunidad Valenciana. En urgencias médicas, la atención a pacientes de COVID-19 fue también telefónica, pero presencial para otras patologías (63%). Enfermería atendió el 100% por vía telefónica, al igual que los/las médicos/as de CAPS y de urgencias de CAPS; en toma de muestras, constantes y cuidados de heridas fue presencial (hombres 91%, mujeres 88%) y en domicilio (9% y 12%). En conclusión, se observan distintos patrones asistenciales según los/las profesionales del CAPS y una necesidad de mejorar la vía online en la gestión asistencial. (AU)

This paper describes the means of health care used in a primary health care centre (PHCC) in a rural area to care for patients during the COVID-19 pandemic. After conducting a cross-sectional study using health questionnaire with 243 patients (100 COVID-19 and 143 other pathologies), we observed that general medical care was 100% by telephone, and little use was made of the portal for citizen information and appointment requests of the Conselleria de Sanitat de la Comunidad Valenciana. Nursing attended 100% by telephone, as did the PHCC doctors and the PHCC emergencies; in the case of taking samples, blood samples and wound care it was face-to-face (men 91%, women 88%), and at home (9% and 12%). In conclusion, different care patterns are observed according to the PHCC professionals, and the need to improve the online pathway with care management. (AU)

Percepciones de los estudiantes de enfermería sobre la administración segura de medicamentos / The perceptions of nursing students regarding the safe administration of medications

Objetivo: El propósito de esta revisión fue identificar las percepciones de los estudiantes de enfermería sobre la administración segura de medicamentos. Método: Investigación empírica original que describe un método para incorporar conceptos de seguridad en la administración de medicamentos en la educación de enfermería y examinar las percepciones de los estudiantes de enfermería para su revisión. Una búsqueda en cuatro bases de datos electrónicas (Scopus, Cumulative Index to Nursing and Allied Health Literature, MedLine / PubMed y Google Scholar), así como una búsqueda manual para identificar investigaciones originales publicadas entre 2017 y 2021. Se adoptaron las directrices de análisis (PRISMA) como elemento de informe preferido para revisiones sistemáticas y metaanálisis. Resultados: Se incluyeron doce artículos de investigación originales para su revisión. Se identificaron dos métodos para incorporar la seguridad en la administración de medicamentos en la educación de enfermería: factores de proceso o sistemas en el entorno clínico y factores de educación en el entorno académico. El uso de intervenciones varió, pero todas se enfocaron en analizar las experiencias de los estudiantes para promover habilidades y conocimientos en los diferentes entornos (académico y clínico). Conclusión: Los educadores de enfermería deben promover la teoría y las experiencias clínicas de manera integral para que el alumno aprenda e interiorice las actitudes, comportamientos y valores de la profesión con un enfoque de responsabilidad en todos los aspectos. La percepción y formación de los estudiantes podría generar cambios en la forma en que se administran los medicamentos, así como disminuir la tasa de eventos adversos en el futuro. (AU)

Objective: The purpose of this review was to identify the perceptions of nursing students about the safe administration of medications. Method: Original empirical research that describes a method to incorporate concepts of safety in the administration of medicines in nursing education and examine the perceptions of nursing students for review. A search of four electronic databases (Scopus, Cumulative Index to Nursing and Allied Health Literature, MedLine / PubMed and Google Scholar), as well as a manual search to identify original research published between 2017 and 2021. Analysis guidelines were adopted (PRISMA) as the preferred reporting element for systematic reviews and meta-analyzes. Results: Twelve original research articles were included for review. Two methods were identified for incorporating safety in the administration of medications in nursing education: process factors or systems in the clinical setting and educational factors in the academic setting. The use of interventions varied, but all focused on analyzing students' experiences to promote skills and knowledge in different settings (academic and clinical). Conclusion: Nursing educators must promote theory and clinical experiences in a comprehensive way so that the student learns and internalizes the attitudes, behaviors and values of the profession with a focus of responsibility in all aspects. The perception and training of students could lead to changes in the way drugs are administered, as well as decrease the rate of adverse events in the future. (AU)

Infecciones del tracto urinario: etiología y susceptibilidades antimicrobianas / Urinary tract infections: etiology and antimicrobial susceptibilities

Introducción: la infección del tracto urinario (ITU) es una de las enfermedades más prevalentes en la práctica clínica. Con el fin de mejorar el tratamiento empírico, se ha estudiado la etiología de las infecciones urinarias en Pediatría y el perfil de sensibilidad antibiótica de los microorganismos responsables. Material y métodos: estudio transversal, descriptivo y retrospectivo (2020-2021), en el que se incluyeron los microorganismos aislados con recuento significativo en muestras de orina de pacientes con ITU. Se analizó la etiología global y en función de la edad y el sexo. Se consideró únicamente una muestra de orina por paciente y episodio de ITU. Resultados: Escherichia coli fue el microorganismo más aislado tanto en el conjunto de la población (62%) como en cada uno de los grupos analizados según edad y sexo. Su aislamiento en mujeres fue significativamente superior que en hombres (χ², p = 0,043). Su sensibilidad fue: 94% a fosfomicina y 86% a amoxicilina-ácido clavulánico. Conclusiones: Escherichia coli continúa siendo el microorganismo más frecuentemente aislado en ITU. Por ello, para las ITU bajas, la amoxicilina-clavulánico y la nitrofurantoína podrían ser opciones adecuadas. Nuestro medio debería recomendar fosfomicina, ya que muestra varias ventajas para su uso, como la dosificación una vez al día, bajos efectos secundarios, resultados clínicos y microbiológicos adecuados y poco efecto sobre la microbiota intestinal (AU)

Introduction: urinary tract infection (UTI) is one of the most prevalent diseases in clinical practice. In order to improve empirical treatment, the etiology of pediatric urinary tract infections and the antibiotic sensitivity profile of the responsible microorganisms have been studied.Material and methods: cross-sectional, descriptive and retrospective study (2020-2021) in which isolated microorganisms with significant counts in urine samples from patients with UTI were included. The global etiology and according to age and sex were analyzed. Only one urine sample per patient and UTI episode was considered.Results: Escherichia coli was the most isolated microorganism both in the population as a whole (62%) and in each of the groups analyzed according to age and sex. It was isolated in women significantly higher than in men (χ², p=0.043). Their sensitivity was: 94% fosfomycin and 86% amoxicillin-clavulanic acid.Conclusions: Escherichia coli continues to be the most frequently isolated microorganism in UTI. Therefore, for lower UTIs, amoxicillin-clavulanic acid and nitrofurantoin could be suitable options. Our environment should recommend fosfomycin, since it shows several advantages for its use, such as once-daily dosing, low side effects, adequate clinical and microbiological results, and little effect on the intestinal microbiota. (AU)

Percepción de la administración segura de medicamentos en atención primaria / Perception of the safe administration of medications in primary care

Objetivo: El propósito de este estudio fue conocer la percepción de enfermeras sobre la seguridad en la preparación y administración de medicamentos en un departamento de salud de atención primaria del Sistema Nacional de Salud de España. Diseño: Estudio descriptivo transversal. Sitio: Realizado en el Departamento de Salud 21 (Alicante-España) en los meses de septiembre hasta noviembre del 2021.Participantes: Sesenta y seis enfermeras, con predominio de mujeres (88,9%).IntervencionesSe utilizó una entrevista semiestructurada con 10 preguntas. El criterio de inclusión tuvo en cuenta las enfermeras con más de dos años de experiencia trabajando en el centro de salud. Medidas principales: Se evaluó la percepción de las enfermeras sobre el grado de seguridad en la preparación y administración de medicamentos. Resultados: El 81,9% de la muestra no notifican los eventos adversos. Los pasos para la administración segura fueron variados. Se observó asociación significativa en la hora correcta de la medicación (p < 0,031) y la antisepsia (p < 0,026), según el número de enfermeras en las zonas básicas de salud. Conclusión: Nuestros resultados indican las percepciones de enfermeras sobre mejoras en el grado de implementación de estándares o herramientas para la administración segura de medicamentos, con especial atención en la falta de conocimientos, la sobrecarga asistencial (elevada ratio paciente/enfermera) y los dilemas asociados con la notificación.(AU)

The purpose of this study was to know the perception of nurses about safety in the preparation and administration of medications in a primary care health department of the Spanish national health system. Cross-sectional descriptive study. Carried out in the Health Department 21 (Alicante, Spain) in the months of September to November 2021. 66 nurses, with a predominance of women (88.9%). A semi-structured interview with ten questions was used. The inclusion criterion took into account nurses with more than two years of experience working in the health center. The perception of nurses about the degree of safety in the preparation and administration of medications was evaluated. 81.9% of the sample did not report adverse events. The steps for secure administration were varied. A significant association was observed in the correct time of medication (p < 0.031) and antisepsis (p < 0.026) according to the number of nurses in the basic health areas. Our results indicate the perceptions of nurses about improvements in the degree of implementation of standards or tools for the safe administration of medications, with special attention to lack of knowledge, care overload (high patient/nurse ratio) and associated dilemmas with the notification.(AU)