ABSTRACT
Objective:To study the current status of critical neonatal care centers (CNCC) construction and treatment of critically-ill neonates at city- and county-level in Henan Province.Methods:A questionnaire survey was conducted in January 2022 to city- and county-level CNCC in Henan Province. The basic information of CNCC, ward settings, neonatal management in the Department of Obstetrics and the treatment of critically-ill neonates in 2019-2021 were analyzed.Results:A total of 188 questionnaires were sent and 183 (97.3%) eligible questionnaires were analyzed, including 30 from city centers and 153 from county centers. The bed occupancy rate in county centers was significantly lower than city centers (67.3%±24.1% vs. 86.1%±23.2%), and the doctor/bed ratio, doctor/rescue bed ratio and nurse/rescue bed ratio were significantly higher than city centers ( P<0.05). All city centers had set up independent Department of Neonatology and the number is 92.8% (142/153) in county center. For 80.9% (148/183) centers, neonates were managed in the Department of Obstetrics with consultations and referrals to the Department of Pediatrics and 19.1% (35/183) were managed in the Department of Pediatrics/Neonatology. The average number of deliveries and admissions to the Department of Neonatology in both city and county centers decreased year on year during 2019-2021, but the proportion of premature and low/very low birth weight infants treated in these centers increased year on year. During 2019-2021, the top three diseases treated at the city centers were neonatal respiratory distress syndrome, neonatal asphyxia and acute respiratory distress syndrome, while the top three diseases treated at the county centers were neonatal asphyxia, neonatal respiratory distress syndrome and meconium aspiration syndrome. The incidence of sudden infant death syndrome in city and county centers was (10~30)/100,000. Conclusions:The construction of CNCC in Henan Province is facing challenges such as decreased hospital admissions, increased critically-ill neonates, insufficient cooperation between Obstetrics and Pediatrics and waste of resources. Rationally allocated and optimised use of resources to improve the ability to treat critically-ill neonates is warranted.
ABSTRACT
Introducción: La educación médica responde al encargo social del logro de una práctica competente en la profesión. El desarrollo de las Unidades de Cuidados Intensivos Neonatales y sus tendencias internacionales demanda nuevas estrategias para la superación del profesional de enfermería en pos de una atención de calidad. Objetivo: Diseñar una estrategia de superación para el desarrollo de competencias profesionales específicas en la atención de enfermería al neonato crítico. Métodos: Se utilizaron como métodos teóricos: sistematización, análisis-síntesis, sistémico estructural funcional, modelación; además se efectuó un taller de socialización con expertos de la especialidad. Resultados: El diseño de la estrategia responde al desarrollo de las competencias profesionales específicas en la atención de enfermería al neonato crítico y se fundamenta desde los referentes filosóficos, epistemológicos, psicológicos y sociales. Además, garantiza el impacto instructivo para la educación de posgrado, y conlleva al desarrollo de valores y habilidades específicas para ejercer las competencias. La valoración mediante el taller de socialización corroboró la pertinencia, la factibilidad y las posibilidades para su desarrollo en las Unidades de Cuidados Intensivos Neonatales. Conclusiones: La fundamentación de la estrategia de superación para el desarrollo de competencias profesionales específicas en la atención de enfermería al neonato crítico permite establecer relaciones esenciales que aportan a la teoría en esta área del conocimiento. La estructura de la estrategia propuesta está en correspondencia con los fundamentos asumidos y contribuye al perfeccionamiento del desempeño profesional de enfermería en las Unidades de Cuidados Intensivos Neonatales(AU)
Introduction: Medical education fulfills the social task of achieving competent professional performance. The development of neonatal intensive care units and its international trends demand new strategies for nursing professional upgrading in pursuit of quality care. Objective: To design an upgrading strategy for the development of specific professional skills in nursing care for the critical newborn. Methods: We used theoretical methods: systematization, analysis-synthesis, systemic functional structure, modeling. A socialization workshop was held with the participation of experts from the specialty. Results: The strategy design responds to the development of specific professional competences in nursing care for the critical newborn and is based on philosophical, epistemological, psychological and social referents. Besides, it guarantees the instructive impact for postgraduate education, and leads to the development of specific values and skills to use competences in practice. Assessment through the socialization workshop proved the relevance, feasibility and possibilities for its development in neonatal intensive care units. Conclusions: The foundations of the upgrading strategy for the development of specific professional competences in nursing care for the critical newborn allows establishing essential relationships that contribute to theory in this area of knowledge. The structure of the proposed strategy is in correspondence with the assumed foundations and contributes to the improvement of professional nursing performance in neonatal intensive care units(AU)
Subject(s)
Humans , Specialization , Intensive Care Units, Neonatal , Health Strategies , Education, Medical , Nursing CareABSTRACT
En los neonatos en estado crítico es necesario establecer un sistema de farmacovigilancia con el cual se les proteja de posibles reacciones adversas a los medicamentos; estas reacciones pueden ser por el efecto farmacológico, la interacción con otros medicamentos, errores de dosificación y la idiosincrasia del paciente, de acuerdo con la Norma Oficial Mexicana 220. Objetivo: Conocer el estado actual de la farmacovigilancia en unidades de cuidado intensivo neonatal del estado de Jalisco. Material y métodos: Mediante un cuestionario estructurado de 12 preguntas, se practicó una encuesta de opinión en referencia a los programas de farmacovigilancia en los recién nacidos en estado crítico en instituciones del área metropolitana de Guadalajara y el interior del estado de Jalisco. Se aplicó en ocho centros hospitalarios que cuentan con terapia intensiva neonatal y en un congreso estatal de pediatría en el año 2011. A todos los participantes se les pidió que de manera voluntaria, llenaran una documento ad hoc; los resultados se procesaron en el programa Epi info 2010. Discusión y conclusiones: Los resultados demuestran que no se está cumpliendo la NOM 220. Existe un gran déficit de unidades con programas implementados de farmacovigilancia y proceso de notificación de reacciones adversas a medicamentos; la cobertura es menor al 50%. Al parecer, el problema es aún mayor en instituciones particulares. Es necesario cumplir con la NOM 220 para asegurar la calidad de atención en los recién nacidos críticos en el estado de Jalisco.
There is a need to establish medication surveillance/monitoring systemsfor newborn patients in critical condition in order to protect these patients from possible adverse reactions to prescribed drugs. In accordance with Mexican official standard NOM 220, these reactions may result from pharmacological effects, interaction with other drugs, dosage errors, and the patient's nature/idiosyncrasy. Objective: Our goal was to gain knowledge on the current situation regarding medication surveillance in neonatal intensive care units within the state of Jalisco. Material and methods: By means of a structured questionnaire involving 12 questions, an opinion poll was carried out with reference to medication surveillance programs for newborn patients in critical condition at institutions within Guadalajara's metropolitan area and the State of Jalisco. The survey was conducted in 8 hospital centers that provide neonatal intensive care and at a state congress on pediatrics that took place in 2011. All of the respondents were asked to voluntarily fill out a questionnaire Ad-hoc, and the results were processed using the Epi Info 2010 program. Discussion and conclusions: The results show that there is widespread noncompliance of NOM 220. There is a considerable deficit with respect to units implementing medication surveillance systems and methods to notify adverse reactions to medication, with implementation rates lower than 50%. It appears that the problem is even greater in private institutions. Compliance with NOM 220 is essential in order to guarantee the quality of the care provided to newborn patients in critical condition within the state of Jalisco.