ABSTRACT
Introducción y objetivos: la prevención de las deficiencias infantiles resulta más eficiente cuando coordinamos recursos, implicamos a los profesionales e incorporamos herramientas para la detección e intervención temprana en las deficiencias infantiles y en situaciones de riesgo biológico, psicológico y/o social. Material y métodos: presentamos los primeros resultados de la implantación del Proceso de atención integrada en niños con necesidades especiales (PAINNE), de la Organización Sanitaria Integrada Bilbao-Basurto (Bilbao, España), siguiendo el modelo de atención temprana del País Vasco, en una población de 20 655 menores de seis años. Aplicando metodología cualitativa, incorporamos nuevos datos básicos del paciente sobre desarrollo infantil en la historia clínica electrónica, junto con los indicadores del proceso, recogidos en la guía PAINNE 2013. Resultados: el 75% de los pediatras y el 56% de los profesionales de enfermería participaron previamente en actividades de formación en atención temprana. Las propuestas desde los equipos de Pediatría se validaron por el equipo técnico de valoración en atención temprana de la Diputación Foral de Bizkaia (EVAT), en el 93,27% de los casos. La edad media de derivación a salud mental infantil descendió en ocho meses, hasta los tres años, en casos de enfermedad mental grave, mejorando el diagnóstico precoz y el inicio de los programas de intervención. Conclusiones: los resultados obtenidos en el primer año indican que los equipos de Pediatría se consolidan como gestores válidos de 516 niños con necesidades especiales de salud en programas de atención temprana entre 0 y 6 años (AU)
Introduction and objectives: the prevention of childhood deficits is more efficient when resources are coordinated amongst the professionals responsible for the child's care and screening tools are utilized to detect and provide early intervention to address situations of biological, psychological, and/or social risk. Material and methods: we present the initial results of the implementation of the process for integrated care for children with special needs, PAINNE, in the integrated health organization Bilbao-Basurto, following the model of early intervention in the Basque Country, with a population of 20 655 children under the age of 6 years old. Applying the qualitative methodology, we have incorporated developmental screening tools in the electronic medical record, along with the other process indicators, as described in the guide PAINNE 2013. Results: 75% of the pediatricians and 56% of the nurses participated in continuing educational activities regarding early intervention. The referrals for early intervention were accepted in 93.27% of the cases by the Basque Early Intervention Team (EVAT). The median age for referral to mental health services for children with severe mental health problems decreased by 8 months to 3 years old, showing improvement in the early detection and implementation of services. Conclusions: the results obtained in the first year indicated that the Pediatric Primary Care teams have reliably identified and referred 516 children with special needs, ages 0-6 years, to early intervention programs (AU)
Subject(s)
Child , Child, Preschool , Humans , Infant , Health Services for Persons with Disabilities/organization & administration , /organization & administration , Intellectual Disability/prevention & control , Disabled Children/statistics & numerical data , Early Diagnosis , Primary Health Care/organization & administrationABSTRACT
En este capítulo describimos brevemente la práctica diaria en las Unidades de Desarrollo Infantil, Neuropediatría, Genética clínica, y Dismorfología. Enumeramos las situaciones de riesgo y patologías más frecuentemente atendidas, y hacemos especial hincapié en la creación de equipos multidisciplinares. Estos equipos son imprescindibles para el diagnóstico preconcepcional y prenatal. Un aspecto clave de nuestra actividad es la detección precoz y prevención de las discapacidades en la infancia. Se requiere para ello una atención coordinada entre los servicios y recursos para una intervención temprana, lo que ofrecemos a través de un proceso de atención integrada centrado en las necesidades de los niños y sus familias. Este proceso incluye en este momento también niños y niñas y sus familias con enfermedades poco frecuentes (AU)
In this chapter we describe briefly the daily practice in Units of Child Development, Pediatric Neurology, Clinical Genetics and Dysmorphology. We list the situations of risk and pathologies most often served, and we make special emphasis on the creation of multidisciplinary teams. These teams are essential for preconception and prenatal diagnosis. A key aspect of our activity is the early detection and prevention of disabilities in children. Resources and services coordination tasks are required for early intervention, what we offer through a process of integrated care centered on the needs of children and their families. This process also includes children and their families with rare diseases at this time (AU)
Subject(s)
Humans , Male , Female , Child , Neurology/organization & administration , Child Development , Genetics, Medical/organization & administration , Body Dysmorphic Disorders , Rare Diseases , Hospitals, University/organization & administration , Comprehensive Health Care/organization & administration , Delivery of Health Care, Integrated/organization & administrationABSTRACT
OBJECTIVES: To describe epidemiological characteristics, types of injury, prognosis and medical management of bicycle-related Paediatric Emergency Department (ED) visits and to identify potential preventive measures. PATIENTS AND METHODS: This multicentred, observational prospective study included all children between 3 and 16 years of age treated for bicycle-related injuries in the Emergency Departments of 15 Spanish Hospitals belonging to the «Unintentional Paediatric Injury Workshop¼ of the Spanish Paediatric Emergency Society between the 1(st) of June 2011 and the 31(st) of May 2012. Characteristics of all ED visits, as well as epidemiological data and accident-related information, were collected. RESULTS: A total of 846 patients were included in the study, with a male predominance (72.9%) and a median age of 9.6 ± 3.6 years. Head injury was the third most common injury (22.3%) and the main cause of admission to the Pediatric Intensive Care Unit (PICU) (68.4%). More than three-quarters (77.9%) of the patients did not wear a helmet, which was significantly associated to a higher incidence of head injury and admission to PICU. Older children (OR 1.063) and bicycle injuries involving motor vehicles (OR 2.431) were identified as independent risk factors for worse outcomes. CONCLUSIONS: Since helmet use reduces up to 88% of central nervous system lesions secondary to head injury, promotion of its use should be the main preventive measure, followed by restriction of bike-riding to cycling areas.
