[Not Available]. / Sistemas de identificación de pacientes en hospitales de Cataluña.

OBJECTIVE: To know the current situation on the implementation of the patient identification systems in hospital centres in Catalonia. METHODS: Interviews carried out with nurse managers of Catalonian hospitals on patient identification systems, implementation in the different hospital services and data used in the system. RESULTS: Of the 75 centres studied, 90.7% used some kind of patient identification system. Only 26.7% of the interviewed centers had patient identification systems in all its hospital services. The most used identity data were patient name and surname (100%), clinical history number (79.4%), birth date (67.6%) and bed number (66.2%). 77.3% of the centres used only one patient identification system, and the most used was the wristband (85.3%). A wristband identification protocol was used in only 67.2% of the centres and 50% of all the centres had some problem with its use. CONCLUSIONS: There is good level of implementation of patient identification systems in Catalonia, nevertheless greater use of these systems and their standardisation needs to be promoted in all hospital services, as well as continuously monitoring compliance.

Prevention of VAP: is zero rate possible?

Infection prevention measures, specifically targeting ventilator-associated pneumonia (VAP), have been purposed as quality-of-care indicators for patients in intensive care units. The authors discuss some of the recent evidence of the prevention of nosocomial infections, with a particular emphasis on VAP. Moreover, there are several pitfalls in considering VAP rates as a safety indicator. Because of these limitations, the authors recommend the use of specific process measures, designed to reduce VAP, as the basis for interinstitutional benchmarking.

Lung transplantation for emphysema. Lung hyperinflation: incidence and outcome.

Lung transplantation, single or bilateral sequential, is the final option for patients with emphysema. This study analyzed the outcome of lung transplants for emphysema (single or double), and evaluates the incidence, predictive factors and prognosis of lung hyperinflation (LHI) in unilateral transplants. We prospectively studied patients undergoing lung transplantation for emphysema. On admission to the Intensive Care Unit (ICU) and at 12, 24, 48 and 72 h we tested the patients' respiratory function, oxygen arterial pressure (PaO2) and mean pulmonary arterial pressure (MPAP) before transplantation. LHI incidence, duration of mechanical ventilation and hypoxemia, ICU stay and mortality was also analyzed. We studied 34 consecutive patients undergoing lung transplantation for emphysema, 14 single and 20 bilateral. Single-lung transplantation had a higher mortality (50%) than double-lung transplantation (11%), with an odds ratio of 9.0 (1.3-48.7). Of the 14 patients who received a single graft, 9 patients (64%) developed LHI. No predictive factors for LHI could be established. Duration of mechanical ventilation (22 vs 3 days) and ICU stay (36 vs 6 days) was much longer in patients with LHI; however, only ICU stay reached statistical significance (P = 0.011). Mortality in patients with LHI was higher, 67% vs 20% (NS). We conclude that single-lung transplant in emphysema patients has a worse prognosis than bilateral transplant, with a 9-fold higher mortality rate. LHI is a common event in single-lung transplant for emphysema and is associated in our patients with a longer stay at the ICU.