ABSTRACT
OBJECTIVE: Develop a performance improvement project to introduce safety needle tube holder for venous blood collection after evaluation of the professionals. METHODS: Reach: Costa Ponent Primary Care Direction and the Hospital Viladecans Hospital from Institute Català de la Salut. METHOD: Create interdisciplinary group. Design in two phases. First, material selection and assessment of safety devices. Second, implementation and evaluation of the proposed performance improvements. The material was selected using standardized criteria on safety devices, suitability to clinical practice and technical compatibility The assessment was qualitative questionnaire by adapting the Centers for Disease Control and Prevention. RESULT: We evaluated three types of needles, two of them were evaluated by 54 primary care professionals and one for 12 professionals from the hospital. Good acceptance regarding their interaction with technology and patient safety. It was considered effective safety device. The overall rating was satisfactory. Underutilized the material by hospital professionals. There were no differences regarding sex, the hand size, experience, training you received, and type of needle. It prepared a proposal to come in progressively safety needle tube holder in primary care. The evaluation performed in the hospital it was considered insufficient. CONCLUSIONS: Interdisciplinary participation is essential to implement measures to safe care. The safety needle evaluated were effective with respect to security professionals and the patient. The involvement of different levels of the organization have developed a proposal for performance improvement adapted to the needs of our environment.
Subject(s)
Protective Devices/standards , Quality Improvement , Humans , Interdisciplinary CommunicationABSTRACT
Objective: To identify the characteristics of chronic patients and their environment in order to predictthe nursing workload required 1 year after their inclusion in a home care program.Methods: A longitudinal study was carried out in 72 primary health care teams in Catalonia (Spain)with a 1-year follow-up of 1,068 home care patients over 64 years old. The variables collected fromeach patient included data on health and social status (Charlson and Barthel indexes and the Pfeiffer,Braden and Gijon scales), carer overburden (Zarit scale), hospital admissions, use of emergency services,self-perceived health (SF-12) and the number of health worker visits.Results: Patients received 7.2 (SD 10.4) visits per year from their nurse-in-charge, out of a total of 8.7 (SD13.1) nursing visits per year. Risk factors for receiving more nursing visits at home were male gender(IRR = 1.42, 95%CI: 1.20-1.67), dependency for daily activities (IRR = 1.65, 95%CI: 1.29-2.13), decubitusulcers (IRR = 4.03, 95%CI: 2.27-7.14) and receiving emergency medical care at home (IRR = 1.65, 95%CI:1.31-2.07). In contrast, patients with major cognitive impairment (IRR = 0.78, 95%CI: 0.63-0.98) had alower probability of receiving nursing visits at home.Conclusions: Workload can be predicted by patients clinical characteristics. The positive correlation ofworkload with variables related to disease severity and the negative correlation with variables relatedto cognitive impairment show that home care nursing in Catalonia is basically demand-oriented (AU)
Objetivo: Identificar las características basales de los pacientes crónicos y su entorno que predicen la cargade trabajo de enfermería durante el ano siguiente a su inclusión en un programa de atención domiciliaria(ATDOM).Métodos: Estudio longitudinal realizado en 72 equipos de atención primaria de salud en Cataluna.Seguimiento durante un ano de 1068 pacientes de ATDOM mayores de 64 anos de edad. Variables recogidas:nivel de salud y situación social (test de Charlson, Barthel, Pfeiffer, Braden y Gijón); sobrecarga delcuidador (Test de Zarit); ingresos hospitalarios y visitas a urgencias; estado subjetivo de salud (SF-12);visitas de los profesionales de salud.Resultados: Los pacientes recibieron 7,2 (DE: 10,4) visitas anuales de su enfermera habitual. Observamosque tienen más riesgo de recibir visitas de enfermería los pacientes varones (IRR = 1,42, IC95%: 1,20-1,67), con dependencia para las actividades de la vida diaria (IRR = 1,65, IC95%: 1,29-2,13), afectados porúlceras por decúbito (IRR = 4,03, IC95%: 2,27-7,14) y que precisaron servicios de atención de urgencia adomicilio (IRR = 1,65, IC95%: 1,31-2,07). Por otro lado, los pacientes con deterioro cognitivo importantetienen menos probabilidad de recibir visitas de su enfermera (IRR = 0,78, IC95%: 0,63-0,98).Conclusiones: Las características clínicas de los pacientes permiten predecir la carga de trabajo de enfermería.Esta relación positiva de la carga de trabajo con las variables relacionadas con la gravedad de laenfermedad y la relación negativa con el deterioro cognitivo muestra que la enfermería domiciliaria enCataluña está básicamente orientada a la demanda(AU)
Subject(s)
Humans , Male , Female , Aged , Home Care Services, Hospital-Based/statistics & numerical data , Nursing Care/statistics & numerical data , Workload/statistics & numerical data , Primary Health Care/statistics & numerical data , Health Services for the Aged/statistics & numerical dataABSTRACT
No disponible
Subject(s)
Humans , Community Health Nursing/trends , Primary Health Care , Home Care Services , SpainSubject(s)
Home Care Services , Nursing Care , Primary Health Care , Social Work , Adult , Female , Health Planning , Humans , Male , Middle Aged , SpainABSTRACT
No disponible
Subject(s)
Middle Aged , Adult , Male , Female , Humans , Social Work , Nursing Care , Primary Health Care , Home Care Services , Spain , Health PlanningABSTRACT
BACKGROUND: Primary care teams are facing an increased need to develop quality programmes at local level. GPs must lead this process and promote a positive organizational culture if they want to achieve and maintain a continuous improvement of the service. OBJECTIVE: The aim of the present study was to test the applicability and reliability of the European Foundation for Quality Management (EFQM) excellence model self-assessment questionnaire in a primary health care organization. METHOD: A cross-sectional study was carried out of the EFQM questionnaire to compare the scores achieved by a primary health care team in Spain caring for 42 000 inhabitants using internal self-assessment with the scores achieved by professional management auditors through an external audit. RESULTS: The scores of each criterion achieved by self-evaluation are similar to or lower than those assessed by the external evaluation. There is agreement in the areas suitable for improvement. CONCLUSIONS: The experience proves the applicability of the EFQM excellence model for primary health care teams and its reliability, at least when the team undergoing self-assessment know they are going to be re-evaluated. There is high concordance in the identification of areas for improvement.
Subject(s)
Benchmarking , Models, Organizational , Primary Health Care/standards , Quality of Health Care , Cross-Sectional Studies , Humans , Organizational Culture , Patient Care Team/standards , Reproducibility of Results , Spain , Surveys and QuestionnairesABSTRACT
No disponible
Subject(s)
Humans , Organizational Culture , Home Care Services , Spain , Regression Analysis , Referral and Consultation , Professional Practice , Drug Utilization , Cross-Sectional Studies , Analysis of Variance , Health ResourcesABSTRACT
Existen factores en nuestro entorno que nos hacen pensar que la atención a domicilio constituye un nuevo escenario de interés por parte de todas las organizaciones sanitarias y sociales. El escaso interés por parte de la Administración a la contratación integrada de servicios está propiciando la creación de nuevos servicios de atención domiciliaria con configuraciones y objetivos muy diversos. Algunas organizaciones ven en este nuevo escenario la posibilidad de ofrecer un nuevo servicio que demandan los ciudadanos y otras, como es el caso de los hospitales, una forma de hacer más eficiente su propia organización sustituyendo estancias hospitalarias por domiciliarias. La contratación integrada de servicios podría ser una condición necesaria, pero no suficiente, para desarrollar un modelo de atención domiciliaria en un marco de atención compartida. La gestión de proyectos, el desarrollo de organizaciones en red, la implementación de nueva metodología en la construcción colectiva de decisiones y la implicación de directivos que sepan ver más allá de su propia organización podría facilitar la configuración de esta nueva realidad de atención compartida (AU)
