Observational Prospective Study to Determine the Efficacy of 'Non-Slip Socks' vs. 'Adequate Footwear' Regarding the Number of Falls Observed among Admitted Patients.

BACKGROUND: Fall prevention is an important indicator of the quality of patient care. Prevention includes the use of adequate footwear. Our objective is to determine the differences in the number of falls between patients with "adequate footwear" and "non slip socks", and their associated consequences, to support their use in the prevention of falls among hospitalized patients. METHODS: This is an observational prospective study on inpatient falls. Patient characteristics, fall circumstances, and injuries were collected through Clinical Report Forms, a review of fall reports, and medical records. Admitted patients over 18 years old were recruited from Geriatric and Internal Medicine Units over a brief period of 3 months. RESULTS: A total of 158 hospitalized patients were recruited. In total, 77 patients (48.73%) were assigned to the non-slip socks group, and 81 (51.27%) were assigned to the adequate footwear group. There were 21 falls during the study period, all of which were experienced by the adequate footwear group (p < 0.0001). The mean age of the patients who fell was 83.14 (range 60-100) years old. The most frequent reasons for admission among the patients who fell were COVID-19 infection (19%) and oncological complications (19%). Overall, 61.9% of patients had a high risk of falling. Most falls (76.1%) occurred in patient rooms, and most of these occurred while wandering around. The most frequent reason for falls was slipping (14/21). For 16 of 21 patients, falls did not have immediate consequences, while 5 had contusions and 1 suffered a wound. Nobody needed to be admitted to the ER or suffered external hemorrhages or loss of consciousness. CONCLUSIONS: Non-slip socks represent an adequate alternative to well-fitting rubber-soled footwear. It seems that non-slip socks could prevent falls among hospitalized patients; nevertheless, further studies are necessary to clarify their role in preventing hospital falls and reducing injury rates.

Experiencia en la generación de estrategias de monitorización y evaluación en la implantación de Guías de Práctica Clínica en España / Experience Generating Evaluation and Monitoring Strategies in the Implementation of Clinical Practice Guidelines in Spain / Experiência na geração de estratégias de monitoramento e avaliação na implementação de manuais de prática clínica na Espanha

Introducción. La monitorización de la utilización del conocimiento y la evaluación de resultados permiten conocer la aplicación de la evidencia, cambios en los conocimientos y actitudes, el impacto en resultados de salud y la integración y el mantenimiento de las prácticas adoptadas. Existen debilidades relacionadas con la falta de sistematización, limitaciones de los registros y calidad del proceso. El objetivo de este artículo es describir la experiencia en la generación de estrategias de monitorización y evaluación de resultados de implantación de Guías de Buenas Prácticas en España. División de temas tratados. En primer lugar, se revisan los procesos de medición de resultados en la implantación de Guías, en el marco del Programa Best Practice Spotlight Organizations®, cuya herramienta para liderar el cambio incluye la monitorización y evaluación como una de las seis fases del ciclo de acción. En segundo lugar, se analizan las estrategias de monitorización y evaluación propuestas en la literatura, destacando la Asociación Profesional de Enfermeras de Ontario. Finalmente, se analizan las estrategias de monitorización y evaluación generadas por dos instituciones españolas participantes en el programa, centradas en adecuación de registros, explotación y análisis de indicadores, desarrollo de herramientas, procedimientos de evaluación y mecanismos de difusión y retroalimentación. Conclusiones. La definición de estrategias de monitorización y evaluación planificada de forma temprana contribuye a la viabilidad de la evaluación de la implantación y su sostenibilidad. Es necesario adaptarlas al contexto, con estrategias transversales que alcancen a toda la institución, facilitadas por la institución. Palabras clave: Ciencia de la Implementación; Práctica Clínica Basada en la Evidencia; Evaluación de Resultado en la Atención de Salud; Mecanismos de Evaluación de la Atención de Salud; Indicadores de Calidad de la Atención de Salud

Introduction. Monitoring the usage of knowledge and evaluating results permits one to know the application of the evidence, knowledge, and attitude changes, the impact on health results, integration, and maintenance of the adopted practices. There exist weaknesses related to lack of systematization, limitation of the records, and quality of the process. This article's objective is to describe the experience generating monitoring strategies and evaluation of the results regarding the implementation of good practice guides in Spain. Topics for Reflection. In the first place, the measurement process of the results regarding the implementation of guides are reviewed, in the Best Practice Spotlight Organizations® program frame, whose tool to lead the change includes monitoring and evaluation as one of the sixth phases of the action cycle. In the second place, monitoring and evaluation strategies proposed in the literature are analyzed, highlighting the Professional Nurses Association of Ontario. Finally, the monitoring and evaluation strategies are analyzed by two Spanish institutions participating in the program, focused on the adequation of records, exploitation and indicator analysis, tools development, evaluation procedures, dissemination, and feedback mechanisms. Conclusions: The definition of monitoring and evaluation strategies planned in advance contributes to the viability of the evaluation regarding the implementation and its sustainability. Is necessary to adapt them to the context, with transversal strategies that reach the whole institution, facilitated by the institution. Keywords: Implementation Science; Evidence-Based Practice; Outcome Assessment, Health Care; Health Care Evaluation Mechanisms; Quality Indicators, Health Care

Introdução. Monitorizar a utilização do conhecimento e avaliar os resultados permite-nos conhecer a aplicação das evidências, as mudanças nos conhecimentos e atitudes, o impacto nos resultados de saúde e a integração e manutenção das práticas adotadas. Existem fragilidades relacionadas à falta de sistematização, limitações de registros e qualidade do processo. O objetivo deste artigo é descrever a experiência na geração de estratégias de monitoramento e avaliação dos resultados da implementação de Manuais de Boas Práticas na Espanha. Divisão dos temas abordados. Em primeiro lugar, são revistos os processos de medição de resultados na implementação dos Manuais, no âmbito do Programa Best Practice Spotlight Organizations®, cuja ferramenta para liderar a mudança inclui a monitorização e avaliação como uma das seis fases do ciclo de ação. Em segundo lugar, são analisadas as estratégias de monitoramento e avaliação propostas na literatura, com destaque para a Associação Profissional de Enfermeiros de Ontário. Por fim, são analisadas as estratégias de monitoramento e avaliação geradas por duas instituições espanholas participantes do programa, focadas na adaptação de registros, exploração e análise de indicadores, desenvolvimento de ferramentas, procedimentos de avaliação e mecanismos de divulgação e feedback. Conclusões. A definição de estratégias de monitoramento e avaliação planeadas antecipadamente contribui para a viabilidade da avaliação da implementação e para a sua sustentabilidade. É necessário adaptá-los ao contexto, com estratégias transversais que alcancem toda a instituição, facilitadas pela instituição. Palavras-chave: Ciência da Implementação; Prática Clínica Baseada em Evidências; Avaliação de Resultados em Cuidados de Saúde; Mecanismos de Avaliação da Assistência à Saúde; Indicadores de Qualidade em Assistência à Saúde

Grupo de Investigación en Cuidados. Instituto de Investigación Sanitaria San Carlos (IdISSC) / Healthcare Research Group. Institute of Health Research San Carlos (IdISSC)

El Grupo de Investigación en Cuidados (GIC) del Instituto de Investigación Sanitaria San Carlos (IdISSC) se creó en el año 2011, dando respuesta a la oportunidad que se dio por parte de las autoridades de investigación sanitaria de crear un grupo independiente de investigación para formar parte del instituto desde sus inicios, lo cual fue aprovechado de manera estratégica desde la Dirección de Enfermería del Hospital Clínico San Carlos (HCSC) de Madrid, creando dos grupos emergentes, uno de Investigación en Cuidados y otro de Investigación en Fisioterapia. El Grupo de Investigación en Cuidados está integrado por 41 personas del ámbito docente, gestor y asistencial del Hospital Clínico San Carlos y de la Universidad Complutense de Madrid (UCM), mayoritariamente. Sus tres líneas de investigación tienen interés en el entorno asistencial de hospitalización, quirúrgico y ambulatorio, denominándose "Seguridad del paciente y profesional", cuyo objetivo es "identificar mejores prácticas, optimizar y/o mejorar el cuidado que permitan minimizar riesgos, tanto en el paciente como en el profesional"; línea de "Educación terapéutica", cuyo fin es "investigar cuáles son las mejores prácticas que aseguren adherencia a tratamientos y resultados en salud" y la línea de "Evaluación y desarrollo de producto sanitario", que tiene el propósito de "optimizar y/o mejorar el uso y diseño de productos sanitarios, encaminados a disminuir la morbilidad iatrogénica". Actualmente el GIC está plenamente integrado en el IdISSC como grupo independiente emergente, y está presente en los órganos de decisión del instituto, teniendo como objetivo inmediato convertirse en grupo consolidado

The Healthcare Research Group (HRG) of the Institute of Health Research San Carlos (IdISSC) was created in 2011, as an answer to the opportunity granted by health research authorities to create an independent research group as part of the institute from the start, which was taken strategically from the Nursing Management of the Hospital Clínico San Carlos (HCSC) of Madrid, creating two emergent groups, one for Healthcare Research and another for Research on Physiotherapy. The Healthcare Research Group is formed mainly by 41 persons from the teaching, management and care settings of the Hospital Clínico San Carlos and the Universidad Complutense of Madrid (UCM). Their three lines of research are of interest for the healthcare hospitalization, surgery and outpatient settings; one is called "Patient and Professional Safety", and its objective is "to identify the best practices, to optimize and/or improve care in order to minimize risks, both for patients and professionals", there is a "Therapeutic Education" line, with the aim to "research about the best practices that will ensure treatment adherence and health outcomes", and the "Healthcare Product Evaluation and Development" line, with the aim to "optimize and/or improve the use and design of healthcare products, in order to reduce iatrogenic mortality". Currently the HRG is completely integrated in the IdISSC as an emergent independent group, with presence in the decision-making boards of the institute, and with the immediate objective of becoming a consolidated group

Definition and representation of a process to engineer a multi-user information management application for continuity of care.

This article describes the procedure of definition and design of a process for the continuity care unit to improve the attention to the patient and his/her ecosystem providing a novel alternative to the conventional methods. This work was done under the framework of the MiniQ project, funded by EIT Health to improve the management of poly-medicated patients.

Actitud y motivación frente a la investigación en un nuevo marco de oportunidad para los profesionales de enfermería / Attitude and motivation in relation to research into a new stage of opportunity for nurses

Objetivo principal: conocer la motivación y la actitud de los profesionales de enfermería hacia la investigación en un hospital español de tercer nivel. Metodología: Estudio descriptivo transversal utilizando cuestionario autoadministrado y validado al 100% de los profesionales de enfermería. La escala de respuestas utilizada es de tipo Likert. Resultados principales: Se obtienen 487 cuestionarios válidos (porcentaje de respuesta: 37,1%; error de muestreo: 4,04%). El 74,1% del personal de enfermería reconoce la investigación como función propia y el 94,1% manifiesta que investigar aporta beneficios a la práctica profesional. Consideran que las publicaciones no aportan prestigio (74,2%), existe falta de tiempo (60,6%), de motivación (55,1%), conocimientos (38,5%), recursos económicos (64,3%) y bibliográficos (48,2%) para investigar. Conclusión principal: Los profesionales encuestados tienen interés y voluntad por investigar, pero es escasa la motivación y muchas las barreras percibidas para desarrollarla. Es preciso habilitar estrategias que incentiven la investigación, constituyendo actualmente los Grupos de Investigación en Cuidados de los Institutos de Investigación Sanitaria, una gran oportunidad (AU)

Objective: Knowing the motivation and attitude of nurses towards research in a tertiary spanish hospital. Methods: Cross-sectional study with a validated self-administered questionnaire to 100% of nurses. The response scale used is Likert. Results: 487 valid questionnaires were obtained (response rate: 37.1%; sampling error: 4.04%). The 74.1% of nurses recognizes research as proper function and 94.1% said that research brings benefits to professional practice. They consider publications not brings prestige (74.2%), there is lack of time (60.6%), motivation (55.1%), knowledge (38.5%), financial resources (64.3%) and bibliographic (48.2%) to investigate. Conclusions: The professionals surveyed have interest and want to investigate, but there is little motivation and many perceived barriers to develop it. It must enable strategies that promote research, now constituting Care Research Group of the Institutes of Health Research, a great opportunity (AU)