Diseño e implementación de un sistema de gestión ambiental en un departamento de Hemodiálisis / Design and implementation of an environmental management system in a department of hemodialysis

La ocurrencia de infecciones con hepatitis B, C y VIH/SIDA, entre otras enfermedades contagiosas, en el Departamento de Hemodiálisis de los servicios de Nefrología, es un problema grave de salud en el país. El Hospital de Morón no era la excepción a esta problemática debido a diferentes causas que iban desde su ineficiente y antiguo diseño constructivo, hasta violaciones en la disciplina de trabajo, el desconocimiento por el personal de las buenas prácticas en bioseguridad e higiene ambiental y el manejo incorrecto de los desechos hospitalarios. Con el fin de superar estas deficiencias se planteó como objetivo diseñar e implementar un sistema de gestión ambiental, a partir de una revisión ambiental inicial, como solución a la ocurrencia de enfermedades infecciosas. El diseño e implementación de dicho sistema permitió realizar una serie de inversiones y medidas que dieron como resultado final la mejoría de la calidad de vida de los pacientes y trabajadores. Desde la implementación del sistema no se reportan casos incidentes de hepatitis B y C.

The occurrence of infections with hepatitis B, C and HIV / AIDS, among other infectious diseases in the Hemodialysis Department of Nephrology services is a serious health problem in the country. Morón Hospital was no exception to this problem due to various reasons ranging from their inefficient and old construction design, to violations of work discipline, lack of knowledge by staff of best practices in biosafety and environmental hygiene and mishandling of medical waste.To overcome these deficiencies the aim raised was to design and implement an environmental management system, from an initial environmental review as a solution to the occurrence of infectious diseases. The design and implementation of this system allowed a series of investments and actions that finally resulted the improved quality of patients life and workers. Since the system implementation are not reported incident cases of hepatitis B and C.

[Determining the adequacy of hemodialysis in hemodialysis units of Kohgilouyeh and Boyerahmad hospitals in 2009]

Cardiovascular disease and hemodialysis incompetence are the main factors determining the disability and mortality in dialysis patients. Increasing in adequacy of hemodialysis is quite effective in patients' prognosis. There are several methods for evaluating the adequacy and need of hemodialysis. One of these methods is the assessment of KT/V in patients. This study aimed to determine the adequacy of hemodialysis patients in hemodialysis units in Kohgilouyeh and Boyerahmad hospitals. This was a cross-sectional descriptive study which was conducted at Yasuj University of Medical Sciences in 2009. The study population included all patients under hemodialysis. In this study, 41 patients were eligible for study in hemodialysis units. From all patients, before and after hemodialysis, blood samples were taken and blood urea nitrogen and creatinine were measured. KT/V and URR were used for the evaluation of dialysis adequacy. Collected data were analyzed by descriptive statistics [mean, standard deviation] and inferential [one way ANOVA test and t-test] using the SPSS software. Results of this study showed that the mean BUN of patients before dialysis was 69.9 +/- 23/6 and after that was 32/63 +/- 11/96. Minimum KT/V, 0.45 and a maximum of 1.77 with average was 0.94 +/- 0.4. Considering the standard KT/V, 17 patients [41.5 percent] with optimal dialysis adequacy, 3 patients [7.3 percent] near-optimal rate and 21 people [51.2 percent] were less than optimal. The minimum URR was 28% and the maximum was 75% with an average of 50% +/- 0.69 respectively. Considering the URR criteria, 11 patients [26.8 percent] with optimal dialysis adequacy, 10 patients [24.4 percent] near to the optimum level and 20 patients [48.8 percent] were less than optimal. In view of the standard KT/V and URR, much of the patients had inadequate hemodialysis at these hemodialysis centers. Because of the direct connection between the clinical status and adequacy of hemodialysis and mortality, evaluation of the related causes is necessary

Metodologia de assistência de enfermagem na unidade de tratamento dialítico / Methodology of assistence of nursing in the units of dialytic treatment

O trabalho descreve a implantação da metodologia de assistência de enfermagem em uma unidade de tratamento dialítico de um hospital universitário e apresenta os impressos desenvolvidos para esse processo de trabalho. Utilizou-se como referencial metodológico as teorias de enfermagem de Dorothea Orem e Wanda de Aguiar Horta, adaptando-as às necessidades do paciente renal crônico. A utilização dos impressos na prática do processo de enfermagem favoreceu a uma assistência individual e humanizada, proporcionou a geração de dados para pesquisa, informações e controles efetivos do tratamento dialítico facilitando as discussões entre o profissional da enfermagem e os demais membros da equipe multidisciplinar(40)

Estudio microbiológico del agua para hemodiálisis / Microbiological study of water used for hemodialysis

Se llevó a cabo un monitoreo para estudiar la contaminación bacteriológica del agua en una unidad de hemodiálisis, por el riesgo que representa para la salud de los enfermos. Se investigó la presencia de bacterias heterotróficas de acuerdo con los lineamientos de la Asociación Americana para el Progreso de los Instrumentos Médicos, y la de Pseudomonas aeruginosa según métodos normalizados. Se informan las densidades de bacterias obtenidas, cuyos valores no transgreden las normas establecidas en el agua para diálisis y en los fluidos de diálisis. Se reportan las características piocinogénicas de las cepas de Pseudomonas aeruginosa aisladas, los piocinotipos 10 y 6 fueron los más frecuentes

Historia de la hemodialisis en Cochabamba / Hemodialysis history in Cochabamba

La historia de la hemodialisis en Cochabamba, es una descripcion de los acontecimientos relacionados con el desarrollo de la hemodialisis en nuestro departamento, sus dificultades, personajes involucrados, manejo de los primeros pacientes, centros en los que se hizo por primera vez este tipo de tratamiento. Relata asi mismo los motivos por los que dichos servicios fueron discontinuados con la llegada de los primeros nefrologos.

new concept in the design of an intensive care unit for haemodialysis

The intensive care units are extensively used in Egypt for haemodialysis. The paper discussed the development of the basis utilized for the design of renal intensive care units. The design should fulfill, maximum utilization of resources, area and time. The paper suggested an integrated concept for the planning of such units. The suggested design presented in the paper suits developing countries