Revista de Calidad Asistencial最新文献

{"title":"De la cabina al quirófano","authors":"P. Fernández-Salmerón , M. Ruiz-Marín , V. Soria-Aledo","doi":"10.1016/j.cali.2016.07.001","DOIUrl":"10.1016/j.cali.2016.07.001","url":null,"abstract":"","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 6","pages":"Pages 319-321"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2016.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73857421","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":"Implantación de una guía de buenas prácticas para la prevención de caídas: percepción de los pacientes hospitalizados y sus cuidadores","authors":"M.D. Saiz-Vinuesa,&nbsp;E. Muñoz-Mansilla,&nbsp;T. Muñoz-Serrano,&nbsp;M.P. Córcoles-Jiménez,&nbsp;M.V. Ruiz-García,&nbsp;P. Fernández-Pallarés,&nbsp;L. Herreros-Sáez,&nbsp;F. Calero-Yáñez","doi":"10.1016/j.cali.2016.04.009","DOIUrl":"10.1016/j.cali.2016.04.009","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze the influence that the implementation of a fall prevention Best Practice Guideline (BPG) could have on the perception of patients and their caregivers about the utility of the activities implemented, about the care provided during admission and the adherence (the level of follow-up) to the recommendations received at discharge.</p></div><div><h3>Material and method</h3><p><em>Design</em>. Quasi-experimental study. Patients <!--> <!-->&gt;<!--> <!-->65 years admitted<!--> <!-->≥<!--> <!-->48<!--> <!-->h to the Medical Area of the General Hospital of Albacete. <em>Sample</em>. 104 subjects (consecutive sampling January-March 2013). Experimental group (EG). Patients admitted to BPG implementation units. Control group (CG). Usual care units. <em>Variables</em>. Sociodemographic characteristics; previous and during admission falls, cognitive status (Pfeiffer); independence in daily life activities (ADLs); satisfaction with care and information provided, utility perceived, adherence to recommendations at discharge. <em>Data sources</em>. Interview and clinical history. <em>Statistical analysis</em> (SPSS 15.0). Descriptive and bivariant. Relative Risk. CI95%.</p></div><div><h3>Results</h3><p>104 patients, EG 46.2% (48) and CG 53.8% (56). Women 51.9%, average age 79.9 years (s.d.<!--> <!-->=<!--> <!-->7.8). Pfeiffer 4,3 (s.d.<!--> <!-->=<!--> <!-->3.7). Previous falls 31.1%. In process, 1 fall in each group. There were statistically significant differences between EG/CG: age, cognitive status and independence in ADLs. In the EG was higher the percentage of perception about the usefulness of the recommendations to prevent falls (<em>P</em> <!-->&lt;<!--> <!-->.001), greater adherence to them (<em>P</em> <!-->=<!--> <!-->0.0002), and to be very or quite satisfied with the information (<em>P</em> <!-->&lt;<!--> <!-->.00004) and care received (<em>P</em> <!-->=<!--> <!-->.002).</p></div><div><h3>Conclusion</h3><p>To implement recommendations according to an Evidence-based BPG to prevent falls in older people has shown, in users and caregivers, greater satisfaction, better perception of its usefulness and greater adherence to the recommendations.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 6","pages":"Pages 329-337"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2016.04.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34534753","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":"Los documentos de voluntades anticipadas. La opinión de los representantes","authors":"J.M. Busquets i Font ,&nbsp;P. Hernando Robles ,&nbsp;R. Font i Canals ,&nbsp;G. Diestre Ortin ,&nbsp;S. Quintana","doi":"10.1016/j.cali.2016.02.006","DOIUrl":"10.1016/j.cali.2016.02.006","url":null,"abstract":"<div><h3>Introduction</h3><p>The use and usefulness of Advance Directives has led to a lot of controversy about their validity and effectiveness. Those areas are unexplored in our country from the perspective of representatives.</p></div><div><h3>Objective</h3><p>To determine the opinion of the representatives appointed in a registered Statement of Advance Directives (SAD) on the use of this document.</p></div><div><h3>Methods</h3><p>Telephone survey of representatives of 146 already dead people and who, since February 2012, had registered a SAD document.</p></div><div><h3>Results</h3><p>More the two-thirds (98) of respondents recalled that the SAD was consulted, with 86 (58.9%) saying that their opinion as representative was consulted, and 120 (82.1%) believe that the patient's will was respected. Of those interviewed, 102 (69.9%) believe that patients who had previously planned their care using a SAD had a good death, with 33 (22.4%) saying it could have been better, and 10 (6.9%) believe they suffered greatly.</p></div><div><h3>Conclusion</h3><p>The SAD were mostly respected and consulted, and possibly this is related to the fact that most of the representatives declare that the death of those they represented was perceived as comfortable. It would be desirable to conduct further studies addressed at health personnel in order to know their perceptions regarding the use of Advance Directives in the process of dying.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 6","pages":"Pages 373-379"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2016.02.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34478498","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":"Áreas de mejora en el manejo clínico de la depresión: perspectiva de pacientes, familiares y profesionales","authors":"Y. Triñanes ,&nbsp;G. Atienza ,&nbsp;A. Rial-Boubeta ,&nbsp;C. Calderón-Gómez ,&nbsp;M. Álvarez-Ariza ,&nbsp;E. de-las-Heras-Liñero ,&nbsp;M. López-García","doi":"10.1016/j.cali.2016.03.010","DOIUrl":"10.1016/j.cali.2016.03.010","url":null,"abstract":"<div><h3>Introduction</h3><p>There is currently a consensus that depression care requires understanding the experiences, expectations, and preferences of patients, and incorporating the views of the professionals involved in its management. The aim of this study was to explore and compare the perspectives of patients, families, and health professionals on the main areas for improvement in the clinical practice of depression.</p></div><div><h3>Material and methods</h3><p>Four focus groups were performed (2 with patients with major depression, one with family members, and one with professionals). Participants were recruited with the collaboration the Galician Health Service and the Federation of Associations of Relatives and Persons with Mental Disease. The content of the transcripts were analysed thematically.</p></div><div><h3>Results</h3><p>Five themes and 18 sub-themes emerged, including, diagnostic challenges, the need for a comprehensive approach, improvements in the coordination and monitoring, the establishment of an adequate relationship and therapeutic space and, finally, the impact of stigma. Patients, families and professionals provided partially overlapping and complementary information on these main themes.</p></div><div><h3>Conclusions</h3><p>The management of depression is a complex task, which requires the implementation of measures of a different nature. The incorporation of the perspectives of key stakeholders is essential and it is necessary to continue working on models of care for depression that optimise the experiences of patients, and take into account their preferences and expectations.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 6","pages":"Pages 365-372"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2016.03.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34490754","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":"¿Son las unidades de corta estancia un recurso adecuado para la hospitalización de los pacientes ancianos con infección?","authors":"Ferran Llopis ,&nbsp;Carles Ferré ,&nbsp;Eric Jorge García-Lamberechts ,&nbsp;Mikel Martínez-Ortiz-de-Zárate ,&nbsp;Javier Jacob ,&nbsp;Juan González-del-Castillo ,&nbsp;en representación del grupo de trabajo INFURG-SEMES y URG UCE SEMES","doi":"10.1016/j.cali.2016.02.007","DOIUrl":"10.1016/j.cali.2016.02.007","url":null,"abstract":"<div><h3>Objective</h3><p>To describe the clinical characteristics and outcomes of elderly patients (≥ 75 years) with suspected infection attending the emergency department (ED) and to compare patients admitted to a short-stay unit (SSU) with those admitted to a conventional hospital unit (CHU).</p></div><div><h3>Material and methods</h3><p>Prospective cohort study including, using opportunity sampling, patients ≥<!--> <!-->75 years treated for infection in the ED of 3 Spanish university hospitals (2013). Demographic variables, comorbidity, baseline performance status, presence of sepsis, infection type, destination on discharge, and mortality at 30 days were collected.</p></div><div><h3>Results</h3><p>During the study period, 330 patients ≥<!--> <!-->75 years (mean age 83.8<!--> <!-->±<!--> <!-->7.3) were evaluated for a suspected infection in the ED, and 306 (93%) were admitted to the hospital, 175 (53%) to the CHU and 87 (26%) to the SSU. Medical history included hypertension (74.5%), arrhythmia (30%), chronic obstructive pulmonary disease (28%), and diabetes mellitus (26%), and risk factors for multidrug resistance, such as antibiotic treatment in 3 months prior to admission (48%), and institutionalisation (26%). A classic sepsis syndrome was found to be the source of infection in 53%, and was respiratory in half of patients. When comparing patients admitted to SSU and CHU, statistically significant differences (<em>p</em> <!-->&lt;<!--> <!-->.05) were found in the Charlson index (1.95 vs. 2.51), Glasgow coma scale (14.6 vs. 14.3), classic sepsis syndrome (67% vs. 53%), severe sepsis (2.3% vs. 18%), length of stay (4.2 vs. 10.4 days), and mortality within 30 days (3.4% vs. 18%), respectively.</p></div><div><h3>Conclusions</h3><p>SSU may be an adequate alternative to CHU for elderly patients requiring admission with suspected infection.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 6","pages":"Pages 322-328"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2016.02.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34507803","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":"Autopercepción de las personas responsables en los equipos sanitarios de Andalucía. Estudio cuantitativo y cualitativo","authors":"I. García-Romera ,&nbsp;A. Danet ,&nbsp;J.C. March-Cerdà","doi":"10.1016/j.cali.2016.03.011","DOIUrl":"10.1016/j.cali.2016.03.011","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the perception and self-assessment on leadership among health care team leaders in Andalusia.</p></div><div><h3>Material and methods</h3><p>Design: Exploratory descriptive study using quantitative and qualitative methodology, developed between 2013 and 2015, using a questionnaire and semi-structured interviews. Place: Andalusia. Participants: All health managers from the Primary Care Management Units and Health Management Areas of the Departments of Paediatrics, Emergency and Internal Medicine, for the quantitative study. A purposive sample of 24 health managers was used for the qualitative study. Methods: Descriptive statistical study and bivariate analysis of comparison of means. Content analysis of the semi-structured interviews: Codification, category tree, and triangulation of results.</p></div><div><h3>Results</h3><p>The best self-assessment dimension relates to support, and the worst to considering oneself as a ‘good leader’. The definition of a ‘good leader’ includes: Honesty, trust, and attitudes of good communication, closeness, appreciation, and reinforcement of the health team members. Different leadership styles were perceived. Main difficulties for leadership are related to the economic crisis and the management of personal conflicts.</p></div><div><h3>Conclusions</h3><p>Health managers describe an adaptive leadership style, based on personal and professional support, and using communication as the main cohesive element for the team project. More studies on leaders’ perspectives are important, in order to better understand their experiences, needs and expectations.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 6","pages":"Pages 356-364"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2016.03.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34548839","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":"Disponibilidad de opioides en las unidades de cuidados paliativos de media estancia de la Comunidad de Madrid","authors":"M.A. Sancho Zamora","doi":"10.1016/j.cali.2015.11.001","DOIUrl":"10.1016/j.cali.2015.11.001","url":null,"abstract":"","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 6","pages":"Pages 380-382"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2015.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74576548","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":"Cumplimiento de las precauciones de aislamiento de contacto por microorganismos multirresistentes en un hospital de tercer nivel","authors":"A. González-Estrada ,&nbsp;M. Fernández-Prada ,&nbsp;C. Martínez Ortega ,&nbsp;A. Lana Pérez ,&nbsp;M.L. López González","doi":"10.1016/j.cali.2016.01.003","DOIUrl":"10.1016/j.cali.2016.01.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Preventive isolation of patients with multidrug-resistant microorganisms is considered an effective measure to prevent outbreaks in hospitals. The objective of this study is to assess compliance by healthcare workers and family of contact isolation precautions in colonised/infected patients with multidrug-resistant microorganisms.</p></div><div><h3>Methods</h3><p>An observational study was conducted from October 2014 to March 2015. A checklist with a structure was designed (equipment trolley), including knowledge of the situation and compliance by the patients, families, and healthcare workers. Univariate and bivariate analyses were performed. Non-parametric tests Mann-Whitney and Kruskal-Wallis were used.</p></div><div><h3>Results</h3><p>Out of the 467 observations made, the equipment trolley was correctly situated in 97% (453) of cases, the sphygmomanometer in 90% (421), the stethoscope 43.9% (205), and thermometer 16.5% (77). A dustbin and the alcoholic solution were observed in over 98.7% (461) of cases. The antiseptic soap for patient hygiene was observed to be correctly placed in 348 (74%) of occasions. The situation was known by 84.9% (305) of patients and 91.4% (234) of families. As regards compliance by professionals with the placement/removal of disposable gowns and gloves was about 50% for entering the room (49.5%, 56 gown and 53.09%, 60 gloves), and 40% (28) for leaving the room by professionals. Hand hygiene compliance was 26.5% (30) for entering and 35.2% (25) when leaving.</p></div><div><h3>Conclusions</h3><p>There is significant room for improvement in the compliance with isolation precautions. Non-compliance to isolation procedures is not due to a deficit of materials, but to individual behaviours. It is important to implement and evaluate programs based on psychosocial intervention models that can change attitudes and behaviours related to contact isolation precautions for multidrug-resistant microorganisms.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 5","pages":"Pages 293-299"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2016.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34314925","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":"El profesional de la salud ante el mundo del Big Data","authors":"I. Hernández-Medrano ,&nbsp;G. Carrasco","doi":"10.1016/j.cali.2016.06.003","DOIUrl":"10.1016/j.cali.2016.06.003","url":null,"abstract":"","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 5","pages":"Pages 250-253"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2016.06.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34688337","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":"Prevalencia de prescripción potencialmente inapropiada de medicamentos en adultos mayores","authors":"A. Fajreldines ,&nbsp;J. Insua ,&nbsp;E. Schnitzler","doi":"10.1016/j.cali.2015.12.009","DOIUrl":"10.1016/j.cali.2015.12.009","url":null,"abstract":"<div><h3>Introduction</h3><p>One of the causes of preventable adverse drug events (ADES) in older patients constitutes inappropriate prescription of drugs (PIM). The PIM is where risks exceed the clinical benefit. Several instruments can be use to measure this problem, the most used are: a) Beers criteria; b) Screening tool to Older People Potentially inappropriate Prescription (STOPP); c) Screening tool to Alert Doctors to Right Appropriate indicated Treatments (START); d) The Medication Appropriateness Index (MAI).</p><p>This study aims to assess the prevalence of PIM, in a population of older adults in three clinical scopes of university hospital.</p></div><div><h3>Material and methods</h3><p>cross sectional study of 300 cases from a random sample of fields: hospitalization (n<!--> <!-->=<!--> <!-->100), ambulatory (n<!--> <!-->=<!--> <!-->100) and emergency (n<!--> <!-->=<!--> <!-->100), all patients over 65 years old or more who where treated at our hospital.</p></div><div><h3>Results</h3><p>1355 prescription drugs were analized, finding patients hospitalized (PIM) of 57.7%, 55%, 26%, and 80% according to Beers, in ambulatory 36%, 36.5%, 5% and 52% with the same tools and in emergency 35%, 35%, 6% y 52% with the same tools. Was found significant association the PIM with polipharmacy with Beers, STOPP and MAI.</p></div><div><h3>Conclusions</h3><p>results can be compare to world literature (26-80% vs 11-73.1%). The STOPP-START used in an integrated manner would be best estimating the problem of PIM.</p></div>","PeriodicalId":101101,"journal":{"name":"Revista de Calidad Asistencial","volume":"31 5","pages":"Pages 279-284"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cali.2015.12.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73128167","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}