Tracheostomy Patient Care Unit. An innovative Otorhinolaryngology solution of a transversal nature for the hospital.

BACKGROUND AND OBJECTIVE: The care of tracheostomized patients are high risk skills and low incidence. Strategies for improvement of health care in hospital wards and specialties other than otolaryngology based solely on training have not been able to offer an adequate solution. A tracheostomized patient unit is presented directed by the otolaryngology service to attend all tracheostomized hospitalised patients of all specialties. MATERIAL AND METHODS: Background: Third level public hospital with 876 hospitalisation beds and 30 ICU beds for 481,296 inhabitants. Unit model: Transversal unit for the hospital providing attention to all tracheostomized patients, adults, and children, of all specialties, with dedication of 50% of a ENT nurse of hospitalisation that moves to the hospitalisation bed of the specialty of each patient and 50% of another office ENT nurse for ambulatory patients care, with the consultancy of an ENT specialist and coordinated by the ENT supervisor. RESULTS: 572 patients between 2016 and 2021, 80% men, aged 63 ± 14 years, were attended in the Unit. 14.7 ± 2 tracheostomized patients daily and 96 ± 4 complication annual consultations were attended, rising up to 19 tracheostomized patients daily by 2020 and 141 ± 8.4 consultations by complications in 2020 and 2021, during the COVID-19 pandemic. The mean stay of the non-ENT specialties was reduced in 13 days, increasing the satisfaction of the ENT and non-ENT professionals and the satisfaction of the users. CONCLUSIONS: A Tracheostomized Patient Care Unit proactively directed from the Otorhinolaryngology Service to transversally care for all tracheostomized patients improves the quality of health care by reducing stay, complications, and emergencies. Improves the satisfaction of non-otolaryngological professionals by reducing the anxiety of facing care of patients who lack knowledge and experience and that of ENT specialists and nurses by reducing unplanned extemporaneous demands for care. Improves user satisfaction by perceiving adequate continuity of care. The Otorhinolaryngology Services provide their experience in the management of laryngectomized and tracheostomized patients and in teamwork with other specialists and professionals without the need to create new structures outside Otorhinolaryngology.

Unidad de Atención al Paciente Traqueostomizado. Una solución innovadora desde Otorrinolaringología con carácter transversal para el hospital

Resumen Antecedentes y objetivo Los cuidados de los pacientes traqueostomizados son habilidades de alto riesgo y baja incidencia. Las estrategias de mejora de la atención sanitaria en plantas hospitalarias y en especialidades distintas a la Otorrinolaringología (ORL) basadas únicamente en la formación no han sido capaces de ofrecer una solución adecuada. Se presenta un modelo de Unidad de Atención al Paciente Traqueostomizado dirigida por el Servicio de Otorrinolaringología para atender a todos los pacientes traqueostomizados de un hospital en todas las especialidades. Material y métodos Ámbito: hospital universitario público de tercer nivel con 876 camas de hospitalización y 30 camas de UCI para 481.296 habitantes. Modelo de Unidad: unidad transversal para el hospital proporcionando atención a todos los pacientes traqueostomizados, adultos y niños, de todas las especialidades, con dedicación del 50% de una enfermera de ORL de hospitalización que se desplaza hasta la cama de hospitalización de la especialidad de cada paciente y el 50% de otra enfermera de ORL de consultas externas para los pacientes ambulatorios, con la consultoría de un especialista en ORL y coordinación de la supervisora de ORL. Resultados Se atendió en la unidad a 572 pacientes entre 2016 y 2021, el 80% varones, con una media de edad de 63±14 años. Se atendieron 14,7±2 pacientes traqueostomizados diarios y 96±4 consultas por complicaciones anuales, elevándose hasta 19 pacientes traqueostomizados diarios en 2020 y 141±8,4 consultas por complicaciones en los años 2020 y 2021, durante la pandemia por COVID-19. Se redujo la estancia media de las especialidades no ORL en 13 días a lo largo de los 6 años del estudio, aumentando la satisfacción de los profesionales de ORL y de no ORL, y la satisfacción de los usuarios. Conclusiones Una Unidad de Atención al Paciente Traqueostomizado dirigida proactivamente desde el Servicio de Otorrinolaringología para atender transversalmente a todos los pacientes traqueostomizados mejora la calidad de la atención sanitaria al reducir la estancia, complicaciones y urgencias. Este modelo de unidad ha resistido la pandemia COVID-19 manteniendo los estándares alcanzados de calidad y eficiencia. Se mejora la satisfacción de los profesionales no otorrinolaringológicos al reducir la incertidumbre de afrontar cuidados de pacientes sobre los que carecen de conocimientos y experiencia, y la de los especialistas y enfermeras de ORL al reducirse las demandas extemporáneas no planificadas de atención. Mejora la satisfacción de los usuarios al percibir una adecuada continuidad asistencial. Los Servicios de Otorrinolaringología aportan su experiencia en manejo de pacientes laringectomizados y traqueostomizados y en trabajo en equipo con otros especialistas y profesionales sin que el hospital tenga necesidad de crear nuevas estructuras al margen de Otorrinolaringología. Background and objective The care of tracheostomized patients are high risk skills and low incidence. Strategies for improvement of health care in hospital wards and specialties other than otolaryngology based solely on training have not been able to offer an adequate solution. A tracheostomized patient unit is presented directed by the otolaryngology service to attend all tracheostomized hospitalized patients of all specialties. Material and methods Background: Third level public hospital with 876 hospitalization beds and 30 ICU beds for 481,296 inhabitants. Unit model: Transversal unit for the hospital providing attention to all tracheostomized patients, adults, and children, of all specialties, with dedication of 50% of a ENT nurse of hospitalization that moves to the hospitalization bed of the specialty of each patient and 50% of another office ENT nurse for ambulatory patients care, with the consultancy of an ENT specialist and coordinated by the ENT supervisor. Results 572 patients between 2016 and 2021, 80% men, aged 63±14 years, were attended in the unit. 14.7±2 tracheostomized patients daily and 96±4 complication annual consultations were attended, rising up to 19 tracheostomized patients daily by 2020 and 141±8.4 consultations by complications in 2020 and 2021, during the COVID-19 pandemic. The mean stay of the non-ENT specialties was reduced in 13 days, increasing the satisfaction of the ENT and non-ENT professionals and the satisfaction of the users. Conclusions A Tracheostomized Patient Care Unit proactively directed from the Otorhinolaryngology Service to transversally care for all tracheostomized patients improves the quality of health care by reducing stay, complications, and emergencies. Improves the satisfaction of non-otolaryngological professionals by reducing the anxiety of facing care of patients who lack knowledge and experience and that of ENT specialists and nurses by reducing unplanned extemporaneous demands for care. Improves user satisfaction by perceiving adequate continuity of care. The Otorhinolaryngology Services provide their experience in the management of laryngectomized and tracheostomized patients and in teamwork with other specialists and professionals without the need to create new structures outside otorhinolaryngology.

Bronchoscopist's perception of the quality of the single-use bronchoscope (Ambu aScope4™) in selected bronchoscopies: a multicenter study in 21 Spanish pulmonology services.

BACKGROUND: The disposable bronchoscope is an excellent alternative to face the problem of SARS-CoV-2 and other cross infections, but the bronchoscopist's perception of its quality has not been evaluated. METHODS: To evaluate the quality of the Ambu-aScope4 disposable bronchoscope, we carried out a cross-sectional study in 21 Spanish pulmonology services. We use a standardized questionnaire completed by the bronchoscopists at the end of each bronchoscopy. The variables were described with absolute and relative frequencies, measures of central tendency and dispersion depending on their nature. The existence of learning curves was evaluated by CUSUM analysis. RESULTS: The most frequent indications in 300 included bronchoscopies was bronchial aspiration in 69.3% and the median duration of these was 9.1 min. The route of entry was nasal in 47.2% and oral in 34.1%. The average score for ease of use, image, and aspiration quality was 80/100. All the planned techniques were performed in 94.9% and the bronchoscopist was satisfied in 96.6% of the bronchoscopies. They highlighted the portability and immediacy of the aScope4TM to start the procedure in 99.3%, the possibility of taking and storing images in 99.3%. The CUSUM analysis showed average scores > 70/100 from the first procedure and from the 9th procedure more than 80% of the scores exceeded the 80/100 score. CONCLUSIONS: The aScope4™ scored well for ease of use, imaging, and aspiration. We found a learning curve with excellent scores from the 9th procedure. Bronchoscopists highlighted its portability, immediacy of use and the possibility of taking and storing images.

Percepción de los usuarios de la farmacia comunitaria sobre la COVID-19

OBJETIVOS: evaluar la percepción de los usuarios de las farmacias sobre la repercusión de la pandemia COVID-19 en su salud, el conocimiento sobre su posible inclusión en grupos de riesgo y su actitud ante una posible vacuna. MATERIAL Y MÉTODOS: estudio observacional transversal aleatorizado, en farmacias de Pontevedra y Ourense, desde marzo a junio de 2020 al comienzo y después de la restricción de movimientos. Sujetos: usuarios ≥18 años que acuden a las farmacias participantes en demanda de medicamentos y/o material de higiene y protección. Procedimiento: el usuario cumplimentaba un cuestionario anónimo, depositándolo hasta la noche en una bandeja de plástico desinfectada diariamente. El procedimiento se repetirá tras cesar el confinamiento. Resultados de la primera fase: se realizaron 706 encuestas. 415 (58,8 %) mujeres, edad media 48,9 (DE=16,9) años. 100 participantes (14,2 %) viven solos.637 (90,2 %) creen que la COVID-19 es más peligrosa que la gripe, 189 (26,8 %) desconocen estar en algún grupo de riesgo. 107 (15,1 %) dicen sentirse mal o muy mal con el aislamiento. Los aspectos más afectados son: familiar 350 (49,6 %) y emocional 338 (47,9 %). En 2019/20 se vacunaron de la gripe 172 (24,4 %) y en 2020/21 piensan vacunarse 243 (34,4 %). 448 (63,5 %) se vacunarán frente a la COVID-19 cuando exista vacuna, esté o no financiada por el Sistema Nacional de Salud, 183 (25,9 %) se lo pensarán. CONCLUSIONES: los encuestados consideran la COVID-19 más peligrosa que la gripe estacional. En esta primera fase la afectación sobre bienestar y salud no parece elevada. Un alto porcentaje se vacunará frente a la COVID-19 AIMS: to assess the pharmacy users'perception on the impact of the COVID-19 pandemic on their health, the knowledge of their possible inclusion in risk groups and their attitude towards a potential vaccine. MATERIAL AND METHODS: Randomized, cross-sectional, observational study in pharmacies of Pontevedra and Ourense, from March to June 2020 at the beginning and after movement restrictions. Subjects: users ≥18 years old who go to the participating pharmacies to purchase medicines and/or hygiene and protection material. Procedure: the user completed an anonymous questionnaire, which was then placed until night in a plastic tray that was disinfected daily. The procedure will be repeated after the confinement has been terminated. Results of the first phase: 706 surveys were conducted. 415 (58.8%) women, aged 48.9 9 years on average (SD=16.9). 100 participants (14.2%) live alone. 637 (90.2%) believe that COVID-19 is more dangerous than influenza, 189 (26.8%) don't know if they belong to any risk group. 107 (15.1%) say they feel bad or very bad about isolation. The most affected aspects are: familiar 350 (49.6%) and emotional 338 (47.9%). In 2019/20, 172 (24.4%) were vaccinated against influenza and in 2020/21 243 (34.4%) are planning to get vaccinated. 448 (63.5%) will be vaccinated against COVID-19 when the vaccine is available, whether or not it is financed by the National Health System, and 183 (25.9%) will think about it. CONCLUSIONS: respondents consider COVID-19 more dangerous than seasonal influenza. In this first phase, the impact on well-being and health does not seem to be high. A high percentage of people will be vaccinated against COVID-19