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Objective The purpose of this study was to examine the predictive value of elevated cardiac troponin I (cTnI) and Score for the Targeting of Atrial Fibrillation (STAF) in the diagnosis of cardiogenic cerebral infarction. Methods Two hundred twenty-three patients with acute ischemic stroke were recruited in the study including 38 patients in cardiogenic cerebral infarction (CCI) group and 185 in non-cardiac cerebral infarction (NCCI) group. Clinical data were collected. Chemiluminescence immunoassay was used to detect serum cTnI concentrations in patients and STAF scores were calculated. The clinical baseline data of the two groups were compared. A receiver operating characteristic (ROC) curve was used to determine the boundary value of cTnI and STAF scores in diagnosing CCI and in analyzing their predictive value. Results In the CCI group, the patients were older with higher frequency in atrial fibrillation and ischemic heart disease. Moreover, the NIHSS scores, the value of cTnI and STAF scores were significantly higher in CCI group than in the NCCI group (P＜0.05). The area under the ROC curve of STAF scores was 0.954, and its 95%CI was between 0.924 and 0.985. The area under the ROC curve of the cTnI value was 0.852, and its 95% CI was between 0.788 and 0.916. The cutoff of STAF scores was 4 points, with a sensitivity of 92.1% and a specificity of 89.2%. The cutoff of cTnI value was 0.0085ng/ml, with a sensitivity of 73.7% and a specificity of 84.9%. Conclusion Serum cTnI value and STAF score have a good predictive value for CCI, and STAF score have a higher value than serum cTnI in predicting the diagnosis of CCI. Clinically, serum cTnI and STAF score may be helpful for etiology classification of acute ischemic stroke.
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Objective To explore the clinical application values of the score for the targeting of atrial fibrillation (STAF) and left atrial diameter (L),age (A),diagnosis of stroke or TIA (D),and smoking one year before onset (S) (LADS) and acute stroke atrial fibrillation score (ASAS) (including 4 indicators:age,National Institutes of Health Stroke Scale [NIHSS] score,left atrial enlargement,and vascular etiology) in the screening of patients with ischemic stroke complicated with atrial fibrillation.Methods From April 2016 to April 2017,the clinical and imaging data of 317 patients with acute ischemic stroke admitted to the Department of Neurology,the Second Affiliated Hospital of Guangzhou Medical University were analyzed retrospectively.The patients were divided into either an atrial fibrillation group (n =56) or a non-atrial fibrillation group (n =261) according to whether they had atrial fibrillation or not.The relative clinical data including gender,age,past history,NIHSS score,echocardiographic results,and cerebrovascular assessment were collected.STAF,LADS,and ASAS scores were performed in all patients,the receiver operating characteristic (ROC) curve was drawn,the area under the curve was calculated,and the sensitivity,specificity,and accuracy of the 3 methods for predicting ischemic stroke with atrial fibrillation were compared.Results Compared with the non-atrial fibrillation group,the differences were statistically significant in age (69 ± 11 years vs.62 ± 12 years),NIHSS scores (8.2 ± 1.3 vs.4.4 ± 0.3),and internal diameter of left atrium (42.3 ± 6.8 mm vs.31.7 ± 2.5 mm) in the atrial fibrillation group (t =2.99,3.38,and 6.32,respectively,all P ＜ 0.01).The area under the curve of STAF score for the diagnosis of ischemic stroke complicated with atrial fibrillation was 0.801.The optimal cut-off point was STAF ≥5,the sensitivity was 58.9％,specificity was 81.2％,and accuracy was 77.3％.The area under the curve of LADS score for diagnosis of atrial fibrillation was 0.846,the optimal cut-off point was LADS ≥ 4,the sensitivity was 66.1％,specificity 83.5 ％,and accuracy was 80.4％.The area under the curve of pr (ASAS) score for diagnosis of ischemic stroke complicated with atrial fibrillation was 0.835,the optimal cut-off point was pr (ASAS) ≥0.09,the sensitivity was 85.7％,specificity 56.7％,and accuracy was 61.8％.The sensitivity,specificity and accuracy of the three scoring methods were statistically significant (x2 =10.308,59.685,and 32.054,respectively,all P ＜ 0.01).Conclusion The accuracy of LADS ≥ 4 is the highest in screening of acute ischemic stroke complicated with atrial fibrillation
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Resumen:
Introducción: la seguridad del paciente se ha convertido en un objeto esencial de los sistemas de salud desde la perspectiva de calidad asistencial, puesto que se identifica con los procesos de mejora de los servicios sanitarios para elevar la calidad de la atención. La Comisión Internacional de Enfermería propone el trato digno como un indicador de calidad. La enfermera es el personaje que tiene más interacción con el paciente. Objetivo: conocer la percepción del familiar y del paciente sobre el trato digno otorgado por el personal de enfermería. Metodología: se realizó una encuesta a 114 sujetos en el Hospital de Especialidades Ignacio García Téllez de Mérida, Yucatán. Se utilizó el cuestionario sobre trato digno; los datos se sometieron a análisis descriptivo y los resultados se presentaron en cuadros y figuras. Resultados: el promedio de edad fue de 40.62 ± 7.77 años. El 55.3 % de los pacientes perteneció al género femenino. El 31.6 % era del servicio de Hematología y el 28.1 % de Oncología. El nivel de escolaridad predominante fue la secundaria. El 82.5 % de los pacientes respondió que siempre recibe trato digno. Conclusiones: el personal de enfermería cumplió con los criterios de trato digno al paciente hospitalizado; sin embargo, no alcanza el indicador del sistema INDICAS, por lo que es necesario plantear p royectos de mejora para elevar la calidad de la atención.
Abstract:
Introduction: Patient safety has become essential object of health systems from the perspective of quality of care and the improvement health services. The International Nursing Commission proposes Fair treatment as a quality indicator. The nurse is the character with more interaction with the patient. Objective: To know the perception of family and patient on fair treatment by the nursing staff. Methodology: We conducted a survey of 114 subjects in the UMAE of Merida, Yucatan. The dignified treatment questionnaire was used; data underwent descriptive analysis and the results are presented in tables and figures. Results: The mean age was 40.62±7.77 years. The 55.3% were female and 44.7% was male. The 31.6% of subjects was from hematology and 28.1% was from oncology. The predominant academic level was highschool. 82.5% of answers was that the subjects always received fair treatment. Conclusions: The nursing staff met the criteria of fair treatment to hospitalized patient; however, it not enough to achieve the INDICAS goal, it is necessary to propose improvement projects to reach the quality of care.
Subject(s)
Humanism , Humanization of Assistance , Personhood , Nursing Staff , Health Services , Mexico , HumansABSTRACT
El Hospital General Tacuba del ISSSTE es una organización de segundo nivel de atención que se encuentra ubicado en la calle Lago Ontario No. 119 de la Colonia Tacuba. El personal de Enfermería tiene una destacada labor en la atención de los pacientes, para lo cual se cuenta con 387 Enfermeras de las cuales existen: jefes, subjefes, supervisoras, especialistas y auxiliares de Enfermería que cubren las 24 horas de atención a los pacientes. Para ello, el personal de Enfermería se organiza en turnos de trabajo, delegando funciones y actividades, en donde la comunicación tiene una destacada función para hacer posible el lenguaje verbal, corporal y gestual que todas las Enfermeras utilizan para comunicarse con los pacientes. Este estudio realizado en el 2004, tiene por objeto identificar las barreras que tiene el personal de Enfermería en la comunicación para determinar las diversas opciones de solución y así disminuir la problemática del proceso de la comunicación del personal. Esta es una investigación diagnóstica, observacional, analítica y transversal. El universo son 387 personas, la población de interés para este estudio fueron 272 personas, y la muestra la conformaron el 100% de la población es decir, las 272 profesionales de Enfermería. Las técnicas e instrumentos utilizados son: fichas de trabajo, la observación, la entrevista y los cuestionarios. En relación con la variable barreras de la comunicación que tiene el personal de Enfermería en el hospital se pudo determinar que el 92.52% no tiene ningún temor al comunicarse, el 85.78% pone atención de lo que se les dice con lo que evitan distorsionar la comunicación y el 73.79% hablan de manera pausada para no generar problemas de comunicación. En otros datos, el 79.04% dicen que siempre están buscando la manera de aclarar todo lo que dicen para que se les entienda, el 80.90% se comunica con mensajes claros que no son distorsionados , el 82.41% no usan palabras raras cuando se comunican y el 83.15% siempre son coherentes cuando se comunican. En conclusión, el personal de Enfermería del Hospital General Tacuba no tiene barreras en la comunicación.
ISSSTE's Tacuba General Hospital is a second-level attention organization located on 119 Lago Ontario Street in Tacuba Colony. The nursing staff has an outstanding job in patients attention, for which there are 387 nurses, ranging from chiefs, sub chiefs, supervisors, specialists, and nursing auxiliaries; all of them cover the 24 hour attention period for the patients. In order to do so, the nursing staff is organized in working shifts, delegating functions and activities, and where communication has an outstanding function to make it possible the verbal, body, and gesture languages that all nurses use for communicating with the patients. This study was carried out in 2004, and aims to identify barriers the nursing staff has for their communication, in order to determine diverse solution options and diminish, thus, the staff communication process problematic. This is a diagnostic, observational, analytical, and transversal research. The universe is 387 people, the interest population for the research were 272 persons, and the sample was formed by the 100% of the population; that is, the 272 nursing professionals. The instruments and techniques used were: working cards, observation, interviews, and questionnaires. Regarding the variable about nursing staff communication barriers within the hospital, it could be determined that 92.52% has no fear in communicating, 85.78% put attention on what one tells them thus avoiding distorting communication and the 73.79% speak in a paused manner in order not to generate communication problems. In another data, 79.04% say they are ever looking for way to clarify everything they say so they could be understood; 82.41% don't use unusual words when communicating and 83.15% are always coherent when the communicate. Concluding, Tacuba General Hospital nursing staff has no barriers regarding communication.