Revista de Calidad Asistencial最新文献_第10页

Opinión de los profesionales de una unidad de cuidados intensivos sobre la limitación del esfuerzo terapéutico 重症监护病房专业人员对治疗努力限制的意见

Revista de Calidad Asistencial Pub Date : 2016-09-01 DOI: 10.1016/j.cali.2015.12.007

A. González-Castro, O. Azcune, Y. Peñasco, J.C. Rodríguez, M.J. Domínguez, R. Rojas

{"title":"Opinión de los profesionales de una unidad de cuidados intensivos sobre la limitación del esfuerzo terapéutico","authors":"A. González-Castro, O. Azcune, Y. Peñasco, J.C. Rodríguez, M.J. Domínguez, R. Rojas","doi":"10.1016/j.cali.2015.12.007","DOIUrl":"10.1016/j.cali.2015.12.007","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the opinion held by professionals in an intensive care unit on the limitation of therapeutic effort process at the end-of-life (LTE). To collect this information, and then use it to improve the basic aspects that the LTE have on the quality of care by intensive care unit staff.</p></div><div><h3>Material and methods</h3><p>A prospective descriptive study was carried out in the Intensive Care Unit of a third level public university hospital. A questionnaire was prepared that included questions on their demographic profile and others to provide an ethical valuation profile, as well as to find out the knowledge and information that the professional had on the LTE. Descriptive study of the sample and comparative statistics were performed using the chi-squared statistical test.</p></div><div><h3>Results</h3><p>A total of 65 valid questionnaires were obtained from a convenience sample of 70 professionals. Almost all of them (98%) were in favour of the limitation of therapeutic effort. The LTE was considered as some kind of euthanasia (active or passive) in up to 28% of the replies, valuations by professional categories is shown in. More than three-quarters (77%) had the belief that not to start treatment was not the same as withdrawing an already established treatment. Just over half (52%) of the respondents believe the value that should have more weight when considering LET would be the prognosis of the current illness of the patient, and 46% the future quality of life of the patient. The economic cost of treatment to be applied was not considered in any case.</p></div><div><h3>Conclusions</h3><p>The LTE is approved by the majority of professionals in our Intensive Care Unit. Although a non-negligible percentage understood it as a form of euthanasia.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 5","pages":"Pages 262-266"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2015.12.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75499981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Características sociodemográficas y variabilidad geográfica relacionada con la satisfacción del paciente en Atención Primaria 与初级保健患者满意度相关的社会人口学特征和地理变异性

Revista de Calidad Asistencial Pub Date : 2016-09-01 DOI: 10.1016/j.cali.2016.01.004

S. Pérez-Romero , J.J. Gascón-Cánovas , D. Salmerón-Martínez , P. Parra-Hidalgo , O. Monteagudo-Piqueras

{"title":"Características sociodemográficas y variabilidad geográfica relacionada con la satisfacción del paciente en Atención Primaria","authors":"S. Pérez-Romero , J.J. Gascón-Cánovas , D. Salmerón-Martínez , P. Parra-Hidalgo , O. Monteagudo-Piqueras","doi":"10.1016/j.cali.2016.01.004","DOIUrl":"10.1016/j.cali.2016.01.004","url":null,"abstract":"<div><h3>Background</h3><p>Patient satisfaction with health services plays an important role in programs to improve the quality of care from the point of view of users. The objectives of this study were: To identify sociodemographic characteristics associated with patient satisfaction in the care provided by family doctors in Primary Health Care (PHC) centres, and describe the geographical variability of this phenomenon in the Spanish National Health Service.</p></div><div><h3>Material and methods</h3><p>The data come from the European Health Survey (2009). Prevalence ratios (crude and adjusted) of the characteristics associated with both excellent satisfaction and dissatisfaction using Poisson regression, and their geographical variability are discussed.</p></div><div><h3>Results</h3><p>About one in every 3 users of the PHC believes that the care provided was excellent, while 6.7% were dissatisfied. There is a wide variability in the perception of satisfaction among the various regional health services, with prevalence ranging between 10.9% and 55.2%. Moreover, this assessment is closely related to age, level of self-perceived health, mental health, previous hospitalisation, chronic disease status, and limitations in daily activities.</p></div><div><h3>Conclusions</h3><p>Satisfaction with the care provided by the PHC physician is relatively high. However, the distribution between regions and socio-demographic characteristics and health status of the user is heterogeneous.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 5","pages":"Pages 300-308"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2016.01.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34408405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 10

Innovando en procesos asistenciales y seguridad del paciente mediante simulación clínica 通过临床模拟创新护理流程和患者安全

Revista de Calidad Asistencial Pub Date : 2016-09-01 DOI: 10.1016/j.cali.2015.12.008

E. Rojo , J.M. Maestre , A.R. Díaz-Mendi , L. Ansorena , I. del Moral

{"title":"Innovando en procesos asistenciales y seguridad del paciente mediante simulación clínica","authors":"E. Rojo , J.M. Maestre , A.R. Díaz-Mendi , L. Ansorena , I. del Moral","doi":"10.1016/j.cali.2015.12.008","DOIUrl":"10.1016/j.cali.2015.12.008","url":null,"abstract":"<div><h3>Objective</h3><p>Many excellent ideas are never implemented or generalised by healthcare organisations. There are two related paradigms: thinking that individuals primarily change through accumulating knowledge, and believing that the dissemination of that knowledge within the organisation is the key element to facilitate change. As an alternative, a description and evaluation of a simulation-based inter-professional team training program conducted in a Regional Health Service to promote and facilitate change is presented.</p></div><div><h3>Material and methods</h3><p>The Department of Continuing Education completed the needs assessment using the proposals presented by clinical units and management. Skills and behaviors that could be learned using simulation were selected, and all personnel from the units participating were included. Experiential learning principles based on clinical simulation and debriefing, were used for the instructional design. The Kirkpatrick model was used to evaluate the program.</p></div><div><h3>Results</h3><p>Objectives included: a) decision-making and teamwork skills training in high prevalence diseases with a high rate of preventable complications; b) care processes reorganisation to improve efficiency, while maintaining patient safety; and, c) implementation of new complex techniques with a long learning curve, and high preventable complications rate. Thirty clinical units organised 39 training programs in the 3 public hospitals, and primary care of the Regional Health Service during 2013-2014. Over 1,559 healthcare professionals participated, including nursing assistants, nurses and physicians.</p></div><div><h3>Conclusion</h3><p>Simulation in healthcare to train inter-professional teams can promote and facilitate change in patient care, and organisational re-engineering.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 5","pages":"Pages 267-278"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2015.12.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75217615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Análisis y modelado de la cultura de seguridad de un hospital mexicano mediante cadenas de Markov 利用马尔可夫链分析和建模墨西哥医院的安全文化

Revista de Calidad Asistencial Pub Date : 2016-09-01 DOI: 10.1016/j.cali.2016.03.001

J.D. Velázquez-Martínez , H. Cruz-Suárez , J. Santos-Reyes

{"title":"Análisis y modelado de la cultura de seguridad de un hospital mexicano mediante cadenas de Markov","authors":"J.D. Velázquez-Martínez , H. Cruz-Suárez , J. Santos-Reyes","doi":"10.1016/j.cali.2016.03.001","DOIUrl":"10.1016/j.cali.2016.03.001","url":null,"abstract":"<div><h3>Introduction</h3><p>The objective of this study was to analyse and model the safety culture with Markov chains, as well as predicting and/or prioritizing over time the evolutionary behaviour of the safety culture of the health's staff in one Mexican hospital.</p></div><div><h3>Method</h3><p>The Markov chain theory has been employed in the analysis, and the input data has been obtained from a previous study based on the Safety Attitude Questionnaire (CAS-MX-II), by considering the following 6 dimensions: safety climate, teamwork, job satisfaction, recognition of stress, perception of management, and work environment.</p></div><div><h3>Results</h3><p>The results highlighted the predictions and/or prioritisation of the approximate time for the possible integration into the evolutionary behaviour of the safety culture as regards the “slightly agree” (Likert scale) for: safety climate (in 12 years; 24.13%); teamwork (8 years; 34.61%); job satisfaction (11 years; 52.41%); recognition of the level of stress (8 years; 19.35%); and perception of the direction (22 years; 27.87%). The work environment dimension was unable to determine the behaviour of staff information, i.e. no information cultural roots were obtained.</p></div><div><h3>Conclusion</h3><p>In general, it has been shown that there are weaknesses in the safety culture of the hospital, which is an opportunity to suggest changes to the mandatory policies in order to strengthen it.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 5","pages":"Pages 309-314"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2016.03.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34408404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Estudio Regional de Incidentes Derivados de la Atención (ERIDA) en Urgencias 紧急护理事件区域研究(ERIDA)

Revista de Calidad Asistencial Pub Date : 2016-09-01 DOI: 10.1016/j.cali.2015.12.011

J. Alcaraz-Martínez , J.M. Aranaz-Andrés , C. Martínez-Ros , S. Moreno-Reina , L. Escobar-Álvaro , J.V. Ortega-Liarte , grupo de trabajo ERIDA

{"title":"Estudio Regional de Incidentes Derivados de la Atención (ERIDA) en Urgencias","authors":"J. Alcaraz-Martínez , J.M. Aranaz-Andrés , C. Martínez-Ros , S. Moreno-Reina , L. Escobar-Álvaro , J.V. Ortega-Liarte , grupo de trabajo ERIDA","doi":"10.1016/j.cali.2015.12.011","DOIUrl":"10.1016/j.cali.2015.12.011","url":null,"abstract":"<div><h3>Objective</h3><p>Evaluate the patient safety incidents that occur in the emergency departments of our region.</p></div><div><h3>Material and method</h3><p>Observational study conducted in all the hospital emergency departments in the Regional Health Service of Murcia. After systematic random sampling, data were collected during care and a week later by telephone survey. Health professionals of each service were trained and collected the information, following the methodology of the National Study of Adverse Events Related to Hospitalization –ENEAS– and the Adverse Events Related to Spanish Hospital Emergency Department Care –EVADUR–.</p></div><div><h3>Results</h3><p>A total of 393 samples were collected, proportional to the cases treated in each hospital. In 10 cases (3.1%) the complaint was a previous safety incident. At least one incident was detected in 47 patients (11.95%; 8.7 to 15.1%). In 3 cases there were 2 incidents, bringing the number of incidents to 50. Regarding the impact, the 51% of incidents caused harm to the patients. The effects more frequent in patients were the need for repeat visits (9 cases), and mismanagement of pain (8 cases). In 24 cases (51.1%) health care was not affected, although 3 cases required an additional test, 11 cases required further consultation, and led to hospitalisation in 2 cases. The most frequent causal factors of these incidents were medication (14) and care (12). The incidents were considered preventable in 60% of cases.</p></div><div><h3>Conclusions</h3><p>A rate of incidents in the emergency departments, representative of the region, has been obtained. The implications of the results for the population means that 12 out of every 100 patients treated in emergency departments have an adverse event, and 7 of these are avoidable.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 5","pages":"Pages 285-292"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2015.12.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34452099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Ensayos clínicos, ciencia y economía 临床试验，科学和经济学

Revista de Calidad Asistencial Pub Date : 2016-09-01 DOI: 10.1016/j.cali.2016.04.006

M. Velasco , P. Sanmartin , J.C. Alonso , C. Guijarro

引用次数: 0

El reclutamiento en los estudios clínicos, clave para mejorar los ingresos económicos en investigación biomédica 临床试验招募是提高生物医学研究经济收入的关键

Revista de Calidad Asistencial Pub Date : 2016-09-01 DOI: 10.1016/j.cali.2016.01.007

F. Ojeda , D. Navarro-Llobet

引用次数: 1

Satisfacción del paciente como indicador de calidad en salud mental 患者满意度作为心理健康质量的指标

Revista de Calidad Asistencial Pub Date : 2016-09-01 DOI: 10.1016/j.cali.2015.12.006

L.C. Fernández-Martín , H. Iglesias-de-Sena , C. Fombellida-Velasco , I. Vicente-Torres , M. Alonso-Sardón , J.A. Mirón Canelo

{"title":"Satisfacción del paciente como indicador de calidad en salud mental","authors":"L.C. Fernández-Martín , H. Iglesias-de-Sena , C. Fombellida-Velasco , I. Vicente-Torres , M. Alonso-Sardón , J.A. Mirón Canelo","doi":"10.1016/j.cali.2015.12.006","DOIUrl":"10.1016/j.cali.2015.12.006","url":null,"abstract":"<div><h3>Objective</h3><p>To improve the quality of care in a Mental Health Hospital and identify the level of patient satisfaction.</p></div><div><h3>Material and method</h3><p>A descriptive, longitudinal, and retrospective study was conducted on 666 patients who completed treatment in the Mental Health Day Hospital of Salamanca, during the period 1994-2012, using the Hospital Management Annual Reports. A questionnaire designed for this purpose was used as the measurement tool.</p></div><div><h3>Results</h3><p>Most of the patients satisfactorily valued aspects, such as the general impression of the treatment (90% said «good/fairly good») and perception of being helped (94% perceived «very/fairly helped»); with 83% believing that the hospital is accessible. As regards empathy-understanding, it was noted that 14% feel discontent. While 18% of patients expected to be completely cured, the 83% of patients that finished their treatment have said that, in their opinion, the symptoms have subsided «very or somewhat». As regards the knowledge that they have about their disease, 30% believe it has advanced «a lot.»</p></div><div><h3>Conclusions</h3><p>Based on the perceptions reported by patients, it may be said that in general, the level of user satisfaction in the Mental Health Day Hospital is high. Assessing quality through the user opinions helps control the quality, considering that patient satisfaction is a good indicator of result of the care received during their hospitalisation.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 5","pages":"Pages 254-261"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2015.12.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79935369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

RECAS RECAS

Revista de Calidad Asistencial Pub Date : 2016-09-01 DOI: 10.1016/S1134-282X(16)30120-8

引用次数: 0

Management by missions in the healthcare sector 医疗保健部门的特派团管理

Revista de Calidad Asistencial Pub Date : 2016-07-01 DOI: 10.1016/j.cali.2016.03.003

J. Fonseca Pires , C. Rey , M. Más-Machuca , M. Bastons

引用次数: 1