ABSTRACT
Abstract Background: Healthcare-associated infections (HCAIs) are a hospital problem with a prevalence of approximately 5% in Mexico. HCAIs have been related to the patient-nurse ratio (PNR). This study aimed to analyze the association between PNR and HCAI in a tertiary-level pediatric hospital. Methods: We conducted a descriptive and prospective study at a tertiary-level pediatric hospital in Mexico. Nursing attendance and HCAIs records were documented from July 2017 to December 2018. PNR was calculated using nurse staffing records and patient census. Results: We obtained 63,114 staff attendance data from five hospital departments for the morning, evening, and night shifts. PNR > 2:1 was associated with a 54% (95% confidence interval (CI) 42-167%; p < 0.001) increased risk (odds ratio (OR)) for HCAIs, adjusted by shift staff, special conditions, and surveillance periods. The HCAIs more associated with PNR were urinary tract infections (OR 1.83; 95%CI 1.34-2.46), procedure-related pneumonia (OR 2.08; 95%CI 1.41-3.07), and varicella (OR 2.33; 95%CI 1.08-5.03). Conclusions: A high number of patients per nurse increased the probability of various types of HCAI. PNR needs to be established the HCAI guidelines and policies, as regulating the number of patients per nurse can prevent HCAIs and their complications.
Resumen Introducción: Las infecciones asociadas a la atención a la salud (IAAS) son un problema para los hospitales; en México se ha reportado una prevalencia de alrededor del 5%. Las IAAS se han relacionado con el índice paciente-enfermera (IPE). El objetivo de este estudio fue analizar la asociación entre el IPE y las IAAS en un hospital pediátrico de tercer nivel. Métodos: Se realizó un estudio descriptivo y prospectivo en un hospital pediátrico de tercer nivel en México. Los registros de asistencia de enfermeras y de IAAS se documentaron desde julio de 2017 hasta diciembre de 2018. El IPE se calculó utilizando los registros de personal de enfermería y el censo de pacientes. Resultados: Se obtuvieron 63,114 datos de asistencia del personal de cinco departamentos del hospital para los turnos de mañana, tarde y noche. El IPE > 2:1 se asoció con un aumento del 54% (IC95% 42167%; p < 0.001) de riesgo (razón de momios [RM]) para IAAS, ajustado por personal de turno, condiciones especiales y periodos de vigilancia. Las IAAS mayormente asociadas con el IPE fueron infecciones del tracto urinario (RM 1.83; IC 95% 1.34-2.46), neumonía relacionada con procedimientos (RM 2.08; IC95% 1.41-3.07) y varicela (RM 2.33; IC95% 1.08-5.03). Conclusiones: Un alto número de pacientes por enfermera aumenta las probabilidades de varios tipos de IAAS. Es fundamental que el IPE se establezca en las guías y políticas en materia de IAAS, ya que regular el número de pacientes por enfermera puede prevenir las IAAS, así como sus complicaciones.
ABSTRACT
Abstract Background: The SARS-CoV-2 pandemic has challenged blood banks. In Mexico, donors decreased 22% between April and May 2020 compared to the same months in 2019. This study analyzed the effect of the strategies to recover donors (altruistic and family) in a tertiary pediatric care center during the pandemic. Methods: The Blood Bank of the Hospital Infantil de México Federico Gómez implemented strategies to obtain blood components to ensure self-sufficiency. The effect of these strategies on donor recovery was analyzed. Results: There were 7,315 eligible donors in 2019 and 5,070 in 2020. Blood component requirements decreased from 10,037 units in 2019 to 8,619 in 2020. The strategies aimed at attracting altruistic donors managed to increase the percentage of this type of donor when comparing the months in which these strategies were applied with the same months in 2019. In addition, it was observed that the greater the number of methods used simultaneously, the higher the percentage of altruistic donors (rho = 0.846, p = 0.002). In contrast, strategies aimed at attracting family donors did not increase the number of this type of donor. Conclusions: Actions to recruit altruistic donors increased the number of this type of donor to meet the hospital's needs.
Resumen Introducción: La pandemia por SARS-CoV-2 ha representado un reto en los bancos de sangre. En México, los donadores disminuyeron el 22% entre abril y mayo del 2020 en comparación con los mismos meses del 2019. Este estudio analizó el efecto de las estrategias realizadas para recuperar donantes, altruistas y familiares, en un centro de atención pediátrica de tercer nivel durante la pandemia. Métodos: El Banco de Sangre del Hospital Infantil de México Federico Gómez implementó estrategias encaminadas a la obtención de componentes sanguíneos para asegurar la autosuficiencia. Se analizó el efecto de dichas estrategias en la recuperación de donantes. Resultados: Se registraron 7,315 donadores aptos en el año 2019 y 5,070 en el 2020. Los requerimientos de componentes sanguíneos disminuyeron de 10,037 unidades en 2019 a 8,619 en 2020. Las estrategias que estaban destinadas a captar donadores altruistas lograron aumentar el porcentaje de este tipo de donadores al comparar los meses en que se aplicaron dichas estrategias con los mismos meses en el 2019. Además, se observó que, a mayor número de estrategias aplicadas de manera simultánea, mayor porcentaje de donadores altruistas (rho = 0.846, p = 0.002). Por el contrario, las estrategias con la finalidad de atraer donadores familiares no lograron aumentar la cantidad de este tipo de donadores. Conclusiones: Las acciones para recabar donadores altruistas aumentaron la cantidad de este tipo de donadores para satisfacer las necesidades del hospital.
ABSTRACT
The species of the genus Drepanotrema, most of them endemic to the Neotropical region, belong to the Planorbidae. Of the nine species of this genus, six are found in Argentina. The present investigation analysed the individual growth of Drepanotrema cimex in Arenalcito pond (34°11 S, 58°15 W), Martín García Island Natural Reserve of Multiple Uses, Buenos Aires Province, Argentina. A total of 14 samples were collected (n = 1931) from February 2006 to June 2007. Five environmental variables were measured: water temperature, dissolved oxygen (mg L1), electrical conductivity (µS cm1), total dissolved solids, and pH. The individual growth of the species was analysed mathematically by means of the von Bertalanffy equation, where: Lt = 5,6(1-e2,0592 (t0,293)). The parameter L was estimated by the Ford-Walford Method. The population of D. cimex was characterised by a complex and dynamic size structure throughout the annual cycle. The analysis of the curves revealed unimodal (2006) and polymodal (April to June 2007) distributions, which pattern served to identify the existence of cohorts within the population studied.
As espécies do gênero Drepanotrema, a maioria delas endêmicas da região Neotropical, pertencem ao Planorbidae. Das nove espécies desta família, seis são encontradas na Argentina. Este artigo analisa o crescimento individual de Drepanotrema cimex na lagoa de Arenalcito, Reserva Natural de Usos Múltiples Ilha Martín García, Buenos Aires, Argentina (34°11 S - 58°15 W). A amostragem foi realizada entre fevereiro de 2006 e junho de 2007. Durante o curso das campanhas foram obtidas 14 amostras (n = 1931). Cinco variáveis ambientais foram medidas: temperatura da água, oxigênio dissolvido (mg L1), condutividade elétrica (uS cm1), sólidos dissolvidos e pH. O crescimento individual das espécies foi analisada matematicamente por meio da equação de von Bertalanffy em que: Lt = 5,6 (1-e2, 0592 (t0, 293)). O paràmetro L foi estimada pe lo método de Ford-Walford. A população de D.cimex foi caracterizada por uma estrutura complexa e dinâmica de tamanho ao longo do ciclo anual. A análise das curvas mostrou distribuições unimodais (2006) e polimodais (abril-junho 2007), identificando a existência de coortes na população estudada.