Revista de Calidad Asistencial最新文献

{"title":"Abordaje de la evaluación económica de dispositivos de bioseguridad desde la gestión sanitaria y la perspectiva social","authors":"M. López Gobernado , J. Hernández Bartolomé , D. Villalba Gil , J.M. Eiros Bouza","doi":"10.1016/j.cali.2017.03.002","DOIUrl":"10.1016/j.cali.2017.03.002","url":null,"abstract":"","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"32 5","pages":"Pages 292-293"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2017.03.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35011153","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}

{"title":"Adecuación de las derivaciones desde atención primaria a un servicio de neumología","authors":"J.M. Figueira Gonçalves","doi":"10.1016/j.cali.2017.02.002","DOIUrl":"10.1016/j.cali.2017.02.002","url":null,"abstract":"","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"32 5","pages":"Pages 298-299"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2017.02.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34874007","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}

{"title":"Identificación de eventos centinela en atención primaria","authors":"G. Olivera Cañadas ,&nbsp;A. Cañada Dorado ,&nbsp;M. Drake Canela ,&nbsp;B. Fernández-Martínez ,&nbsp;G. Ordóñez León ,&nbsp;M. Cimas Ballesteros","doi":"10.1016/j.cali.2017.03.003","DOIUrl":"10.1016/j.cali.2017.03.003","url":null,"abstract":"<div><h3>Objective</h3><p>To identify and describe a list of sentinel events (SEs) for Primary Care (PC).</p></div><div><h3>Methododology</h3><p>A structured experts’ consensus was obtained by using two online questionnaires. The participants were selected because of their expertise in PC and patient safety. The first questionnaire assessed the suitability of the hospital SEs established in the National Quality Forum 2006 for use in PC via responses of “yes”, “no”, or “yes but with modification”. In the latter case, a re-wording of the SE was requested. Additionally, inclusion of new SEs was also allowed. The second questionnaire included those SEs with positive responses (“yes”, “yes with modification”<em>)</em>, so that the experts could choose between the original and alternative drafts, and evaluate the newly described SEs.</p></div><div><h3>Results</h3><p>The questionnaires were completed by 44 out of a total of the 47 experts asked to participate, and a total of 17 SEs were identified as suitable for PC. For the first questionnaire, 12 of the 28 hospital SEs were considered adaptable to PC, of which 11 were re-drafts. Thirty-seven experts proposed new SEs. These mainly concerned problems with medication and vaccines, delay, or lack of assistance, diagnostic delays, and problems with diagnostic tests, and were finally summarised in 5 SEs. In the second questionnaire, ≥<!--> <!-->65% of the experts chose the alternative wording against the original cases for the 11 SEs suitable for PC. The 5 newly included SEs were considered adequate with a positive response of 70-85%.</p></div><div><h3>Conclusion</h3><p>Having a list of SEs available in PC will help to improve the management of health care risks.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"32 5","pages":"Pages 269-277"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2017.03.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35014145","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}

{"title":"Análisis de 51.996 opiniones online sobre profesionales sanitarios en una web comercial","authors":"R. Ibáñez ,&nbsp;F. Lupiañez-Villanueva","doi":"10.1016/j.cali.2017.03.001","DOIUrl":"10.1016/j.cali.2017.03.001","url":null,"abstract":"","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"32 5","pages":"Pages 294-296"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2017.03.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34954769","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}

{"title":"Identificación de indicadores de resultado en salud en atención primaria. Una revisión de revisiones sistemáticas","authors":"A. Olry de Labry Lima ,&nbsp;L. García Mochón ,&nbsp;C. Bermúdez Tamayo","doi":"10.1016/j.cali.2017.08.001","DOIUrl":"10.1016/j.cali.2017.08.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Outcome measures are being widely used by health services to assess the quality of health care. It is important to have a battery of useful performance indicators with high validity and feasibility. Thus, the objective of this study is to perform a review of reviews in order to identify outcome indicators for use in Primary Care.</p></div><div><h3>Methodology</h3><p>A review of systematic reviews (umbrella review) was carried out. The following databases were consulted: MedLine, EMBASE, and CINAHL, using descriptors and free terms, limiting searches to documents published in English or Spanish. In addition, a search was made for free terms in different web pages. Those reviews that offered indicators that could be used in the Primary Care environment were included.</p></div><div><h3>Results</h3><p>This review included a total of 5 reviews on performance indicators in Primary Care, which consisted of indicators in the following areas or clinical care processes: in osteoarthritis, chronicity, childhood asthma, clinical effectiveness, and prescription safety indicators. A total of 69 performance indicators were identified, with the percentage of performance indicators ranging from 0% to 92.8%. None of the reviews identified performed an analysis of the measurement control (feasibility or sensitivity to change of indicators).</p></div><div><h3>Conclusions</h3><p>This paper offers a set of 69 performance indicators that have been identified and subsequently validated and prioritised by a panel of experts.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"32 5","pages":"Pages 278-288"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2017.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35513928","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}

{"title":"Utilidad del límite inferior de normalidad de la espirometría en pacientes diagnosticados de EPOC","authors":"J.C. Naveiro-Rilo ,&nbsp;S. García García ,&nbsp;L. Flores-Zurutuza ,&nbsp;L. Carazo Fernández ,&nbsp;C. Domínguez Fernández ,&nbsp;J.L. Palomo García","doi":"10.1016/j.cali.2017.05.001","DOIUrl":"10.1016/j.cali.2017.05.001","url":null,"abstract":"<div><h3>Aim</h3><p>To evaluate the differences in COPD patients below the lower limit of normal (LLN) of the fixed ratio FEV1/FVC &lt; 0.70 and those above this limit.</p></div><div><h3>Patients and methods</h3><p>Cross-sectional study. COPD patients between 40 and 85 years old included in primary care clinical record database were randomly selected. Baseline and postbronchodilator spirometries were performed. Two groups of patients were established: FEV1/FVC<!--> <!-->&lt;<!--> <!-->0.70 and ≤LIN (group1) and FEV/FVC<!--> <!-->&lt;<!--> <!-->0.70 and &gt;LIN (group 2). Sociodemographic, clinical, pulmonary obstruction, quality of life and attendance to health services variables were measured. The results of both groups were compared.</p></div><div><h3>Results</h3><p>22.3% of the subjects were misdiagnosed FEV1/FVC &lt; 0,70. Patients in group 2 (FEV1/FVC<!--> <!-->&lt;<!--> <!-->0.70 y &gt; LLN) are diagnosed at an older age, they have a lower exposure to tobacco and better pulmonary function (FEV1: 74.9% vs 54.6%). 35.5% of those patients belong to stage <span>i</span> of GOLD, vs 8.5%, this patients have an increased comorbidity. Patients in group 1 have more COPD exacerbations, worse quality of life, a higher BODEx index 2,3 (1.8) vs 1.1 (1.5); 55.1% of those patients were high risk patients (Gold<!--> <!-->C or Gold D). Diagnose before being 56 years old, an increased exposure to tobacco, the FEV<!--> <!-->&gt;<!--> <!-->50%, and a lower comorbidity are associated with a greater chance of suffering COPD with LLN criteria.</p></div><div><h3>Conclusion</h3><p>We obtain two groups of patients with differentiated clinical characteristics if we use LLN. Subjects with FEV1/FVC<!--> <!-->&lt;<!--> <!-->0.7 and &gt;LLN have less obstruction, less severity and more comorbidity, suggesting the possibility of overdiagnosis or misdiagnosis. On the other hand, younger age at the time of diagnosis, higher tobacco consumption and more severe obstruction are related with FEV1/FVC &gt;0.70 and<!--> <!-->&lt;<!--> <!-->LLN (group 1).</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"32 5","pages":"Pages 262-268"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2017.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35367179","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}

{"title":"Desabastecimientos de medicamentos en un hospital de tercer nivel en España","authors":"C. González-Martín ,&nbsp;V. Saavedra-Quirós ,&nbsp;J. Ruiz-Gutiérrez ,&nbsp;E. García-Sanz ,&nbsp;A. Sánchez-Guerrero","doi":"10.1016/j.cali.2017.07.005","DOIUrl":"10.1016/j.cali.2017.07.005","url":null,"abstract":"","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"32 5","pages":"Pages 289-291"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2017.07.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35499358","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}

{"title":"Cambio de modelo asistencial en la atención al parto normal: aplicación en el paritorio de La Ribera","authors":"F. Camacho-Morell ,&nbsp;M.J. Romero-Martín","doi":"10.1016/j.cali.2017.04.002","DOIUrl":"10.1016/j.cali.2017.04.002","url":null,"abstract":"<div><h3>Objective</h3><p>To assess knowledge, wish for inclusion and implementation of normal childbirth care protocols at La Ribera University Hospital, the reason why they are not applied, and to assess the attendance at antepartum training activities.</p></div><div><h3>Material and method</h3><p>Cross-sectional descriptive study. They were carried out 186 surveys by convenience sampling to pregnant women attending fetal well-being control at hospital between 2014 and 2015. They were collected data about knowledge, wish for inclusion, compliance of protocols and reasons for non-compliance, and attendance at antepartum training activities. Percentages and confidence intervals were calculated. Chi-square test was used to compare categorical variables.</p></div><div><h3>Results</h3><p>They were collected percentages of knowledge (77%, CI95%: 75,5-78,5) and wish for inclusion (84,6%, CI_95%: 82,5-86,7). Protocol compliance ranged from 6% (nitrous oxide administration) to 91% (skin-to-skin contact). The main reasons for non-compliance were due to circumstances of childbirth process (56,3%, CI_95%: 51,1-61,5). Attendance at maternal education classes was 62%, mainly primiparous women <em>(</em>p<!--> <!-->=<!--> <!-->0,0001) with medium or high education level <em>(</em>p<!--> <!-->=<!--> <!-->0,001).</p></div><div><h3>Conclusions</h3><p>Pregnant women have a high knowledge and wish for inclusion of normal childbirth care protocols. Attendance at antepartum training activities could by improved and the main reason for non-attendance is lack of information. Compliance is good enough in most protocols; when they are not applied is due to childbirth circumstances. Remaining tasks include the introduction of additional protocols and to involve pregnant women in decision-making.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"32 5","pages":"Pages 255-261"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2017.04.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35320268","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}

{"title":"Mortalidad y atención a pacientes hospitalizados durante los fines de semana","authors":"J.L. Zambrana-García ,&nbsp;C.J. Granados ,&nbsp;J.L. Zambrana-Luque","doi":"10.1016/j.cali.2017.07.001","DOIUrl":"10.1016/j.cali.2017.07.001","url":null,"abstract":"<div><h3>Background and objectives</h3><p>It has been shown that patients admitted to hospital during the weekends tend to have less favourable outcomes, including higher mortality rates, compared with those admitted during weekdays. The main objective of this study is to evaluate the impact of on the health outcomes of patients admitted during the weekend.</p></div><div><h3>Material and methods</h3><p>A retrospective observational study was conducted on all patients admitted to Montilla Hospital (Córdoba).. All hospitalised patients were attended to daily, including weekends and holidays. An analysis was performed on the epidemiological variables and health outcomes (total mortality).</p></div><div><h3>Results</h3><p>The study included a total of 2,565 hospital admissions, of whom 653 (25.6%) were discharged during the weekend. Patients discharged during the weekend were significantly younger [53 (27) versus 56 (27) years, <em>P</em> <!-->&lt;<!--> <!-->.002], had fewer diagnoses on discharge [6.2 (3.7) versus 6.7 (3.9), <em>P</em> <!-->&lt;<!--> <!-->.003], and had fewer procedures performed [(3 (1.9) versus 3.2 (1.8), <em>P</em> <!-->&lt;<!--> <!-->.005]. The mean length of stay was shorter for weekend discharges than the weekday discharges [3 (2.6) days versus 3.7 (3.9) days, <em>P</em> <!-->&lt;<!--> <!-->.001). The total mortality was 4%, and there were no differences between weekday and weekend admissions (4.3% versus 3.7%). Home discharges on the weekend were related to a reduction in the mean length of stay by 0.3 days (from 3.6 to 3.9 days, <em>P</em> <!-->&lt;<!--> <!-->.001).</p></div><div><h3>Conclusions</h3><p>Hospitalised patient care has led to the disappearance of increased mortality during weekends.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"32 5","pages":"Pages 248-254"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2017.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35367180","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}

{"title":"Humanizar la sanidad para mejorar la calidad de sus servicios","authors":"J.C. March","doi":"10.1016/j.cali.2017.10.001","DOIUrl":"10.1016/j.cali.2017.10.001","url":null,"abstract":"","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"32 5","pages":"Pages 245-247"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2017.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35646762","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}