Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 8 de 8
Filter
1.
An Sist Sanit Navar ; 40(1): 43-56, 2017 Apr 30.
Article in Spanish | MEDLINE | ID: mdl-28534543

ABSTRACT

BACKGROUND: Patient safety is a challenge for health care. The aim of this study is to identify the dimensions with the greatest impact on patient safety culture of healthcare staff in a medium-stay hospital; to asses its evolution over time and to check the sensitivity of monitoring indicators. METHODS: Two cross-sectional studies (2013 to 2015) were conducted. The safety culture assessment tool used was the Spanish version of the "Hospital Survey on Patient Safety" (AHRQ). Outcome variable is high perception of safety (score = 75th percentile). INDEPENDENT VARIABLES: socio-demographic characteristics and perceptions of the evaluated dimensions. The association between variables was quantified by Odds Ratio. RESULTS: The mean of perceived safety was similar in both studies: (7.81 and 7.48, N2013= 66; N2015=92). The best aspects evaluated were: "Supervisor actions" and "Teamwork within unit"; the worst evaluated were: "Staffing", "Management support" and "Teamwork across units". Socio-demographic variables had little significance, while a positive perception in some of the considered dimensions was associated with high perceived safety. The most strongly associated aspects were: "Supervisor actions", "Communication openness" and "Problems in transitions". In the comparative study, indicators based on individual dimensions detected changes better than the assessment of the degree of perceived safety. CONCLUSION: The regular assessment of Patient Safety Culture makes it possible to know the status and evolution of professionals' perceptions. The choice of appropriate indicators optimises the information obtained through these surveys.


Subject(s)
Attitude of Health Personnel , Patient Safety , Safety Management/trends , Adult , Cross-Sectional Studies , Female , Health Care Surveys , Hospitals , Humans , Length of Stay , Male , Middle Aged
2.
An. sist. sanit. Navar ; 40(1): 43-56, ene.-abr. 2017. tab, graf
Article in Spanish | IBECS | ID: ibc-162982

ABSTRACT

Fundamento: La seguridad del paciente es un reto para la asistencia sanitaria. El objetivo de este estudio es identificar las dimensiones con mayor impacto sobre la cultura de seguridad en un hospital de media-larga estancia, monitorizar su evolución y comprobar la sensibilidad de los indicadores de seguimiento. Material y métodos: Se realizaron 2 estudios transversales (2013-2015), utilizando la versión española del cuestionario «Hospital Survey on Patient Safety» (AHRQ). Variable resultado: alto grado de seguridad percibida (puntuación ≥ al percentil 75). Variables predictoras: características socio-demográficas y percepciones de las dimensiones evaluadas. La asociación entre variables se cuantificó mediante OddsRatio. Resultados: El grado de seguridad percibida fue similar en ambos estudios: (7,81-7,48; N2013=66; N2015=92). Los aspectos mejor evaluados fueron: «Acciones de los supervisores» y «Trabajo en equipo en la unidad»; los peor evaluados fueron: «Dotación de personal», «Apoyo de la dirección» y «Trabajo en equipo entre unidades». Las variables socio-demográficas presentaron escasa significación, mientras que una percepción positiva de algunas dimensiones consideradas, sí que se asociaba a un alto grado de seguridad percibida. Los aspectos más fuertemente asociados fueron: «Acciones de los supervisores», «Franqueza en la comunicación» y «Problemas en los cambios de turno». En el estudio comparativo de los resultados, los indicadores basados en las dimensiones individuales detectaron mejor los cambios que el grado de seguridad percibida. Conclusiones: La evaluación periódica de la cultura de seguridad permite conocer el estado y la evolución de las percepciones de los profesionales. La elección de indicadores apropiados optimiza la información obtenida a través de estas encuestas (AU)


Background: Patient safety is a challenge for health care. The aim of this study is to identify the dimensions with the greatest impact on patient safety culture of healthcare staff in a medium-stay hospital; to asses its evolution over time and to check the sensitivity of monitoring indicators. Methods: Two cross-sectional studies (2013 to 2015) were conducted. The safety culture assessment tool used was the Spanish version of the «Hospital Survey on Patient Safety» (AHRQ). Outcome variable is high perception of safety (score ≥ 75th percentile). Independent variables: socio-demographic characteristics and perceptions of the evaluated dimensions. The association between variables was quantified by Odds Ratio. Results: The mean of perceived safety was similar in both studies: (7.81 and 7.48, N2013= 66; N2015=92). The best aspects evaluated were: «Supervisor actions» and «Teamwork within unit»; the worst evaluated were: «Staffing», «Management support» and «Teamwork across units». Socio-demographic variables had little significance, while a positive perception in some of the considered dimensions was associated with high perceived safety. The most strongly associated aspects were: «Supervisor actions», «Communication openness» and «Problems in transitions». In the comparative study, indicators based on individual dimensions detected changes better than the assessment of the degree of perceived safety. Conclusion: The regular assessment of Patient Safety Culture makes it possible to know the status and evolution of professionals' perceptions. The choice of appropriate indicators optimises the information obtained through these surveys (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Patient Safety/standards , Organizational Culture , Health Organizations , Quality Assurance, Health Care/organization & administration , Quality of Health Care/organization & administration , Quality of Health Care/standards , Follow-Up Studies , Surveys and Questionnaires , Length of Stay
3.
Ars pharm ; 52(4): 29-38, oct.-dic. 2011. ilus
Article in English | IBECS | ID: ibc-92364

ABSTRACT

Objective: To assess the effect of a protocol-based pharmacist intervention on blood pressure control and medication adherence among treated hypertensive patients who are users of community pharmacies.Methods: A quasi experimental study design with control group has been designed to compare the effect of pharmaceutical intervention (intervention group) versus the standard healthcare procedure (control group) on blood pressure and medication adherence among hypertensive patients receiving drug therapy in community pharmacies. The patients will be allocated evenly between the two groups (ncontrol = nintervention), with a 6-month follow-up. The pharmaceutical intervention program will comprise three main parts: 1) patient education / information on issues relating to hypertension and medication adherence; 2) self-monitoring of blood pressure; and 3) interaction with the physician through personalized reports when the mean blood pressure values recorded at home exceed the treatment goal according to the clinical condition of the patient. In order to evaluate the effect of the pharmaceutical intervention upon medication adherence and blood pressure, blood pressure recordings will be made in the pharmacy, while percent medication adherence will be established based on pill count in both groups at the start and end of the study.Discussion: To our knowledge, this is the first study in the community pharmacy setting in Spain to evaluate the effectiveness of pharmaceutical intervention in combination with home blood pressure monitoring on blood pressure control. In addition, the pharmaceutical intervention has been designed for inclusion as standard practice in the context of Pharmaceutical Care(AU)


Objetivo: Evaluar el efecto de una intervención farmacéutica protocolizada sobre el control de la presión arterial y la adherencia al tratamiento farmacológico en pacientes usuarios de farmacias comunitarias.Material y métodos: Estudio cuasi-experimental con grupo control en el que se comparará el efecto de una intervención farmacéutica (grupo intervención) con el proceso de atención habitual (grupo control), sobre la presión arterial y la adherencia al tratamiento de pacientes hipertensos tratados farmacológicamente en farmacias comunitarias. Los pacientes serán distribuidos de forma equitativa en ambos grupos (n control = n intervención) y serán seguido durante 6 meses. El programa de la intervención farmacéutica constará de tres partes fundamentales: 1) educación/información al paciente sobre aspectos relacionados con la hipertensión y adherencia al tratamiento farmacológico, 2) automonitorización de la presión arterial y, 3) interacción con el médico mediante informes personalizados cuando la media de las cifras de presión arterial realizadas en el domicilio superen el objetivo terapéutico acorde con la situación clínica del paciente. Para evaluar el efecto de la intervención farmacéutica sobre la adherencia terapéutica y la presión arterial se obtendrán medidas de presión arterial en la farmacia y porcentaje de cumplimiento terapéutico mediante recuento de comprimidos en ambos grupos al principio y al final del estudio.Discusión: Según nuestros conocimientos, éste es el primer estudio que se realiza en farmacia comunitaria en España para probar la efectividad de una intervención farmacéutica conjuntamente con la automedida de la presión arterial sobre el control de la presión arterial. Además, la intervención farmacéutica se ha diseñado de forma que pueda integrase como práctica habitual enmarcada dentro de la Atención Farmacéutica(AU)


Subject(s)
Humans , Pharmaceutical Services , Hypertension/drug therapy , Antihypertensive Agents/therapeutic use , Patient Compliance , /statistics & numerical data , Blood Pressure Monitoring, Ambulatory
4.
Pharm. care Esp ; 13(3): 123-133, mayo-jun. 2011. tab
Article in Spanish | IBECS | ID: ibc-108647

ABSTRACT

La medida de la presión arterial (PA) en la consulta médica (PAC) ha sido durante muchos años el método de referencia para realizar el diagnóstico, seguimiento y tomar las decisiones clínicas en el manejo de la hipertensión arterial (HTA). Por otra parte, la medida de la PA en la farmacia comunitaria es un método poco estudiado y su utilidad en la práctica clínica es, cuando menos, desconocida. La aparición de la automedida domiciliaria de la PA (AMPA) y de la monitorización ambulatoria de la PA (MAPA) ha permitido superar muchas de las limitaciones inherentes a la medida de la PAC, principalmente al proporcionar múltiples medidas de PA exentas del efecto de bata blanca. Además, estos métodos han demostrado relacionarse más estrechamente que la medida de la PAC con el pronóstico cardiovascular y la lesión de órganos diana. En defi nitiva, la AMPA y la MAPA proporcionan una evaluación más precisa (p. ej., del riesgo cardiovascular o del efecto de los tratamientos antihipertensivos) y un mejor manejo del paciente con HTA. El presente artículo ofrece una visión actualizada sobre el interés de los distintos métodos de medida de la PA disponibles en la farmacia para el cribado y seguimiento del paciente hipertenso(AU)


The blood pressure (BP) measurement in the physician’s office has been for many years the gold standard for diagnosis, monitoring and making clinical decisions in the management of hypertension. On the other hand, few studies analyze the usefulness of the community pharmacy BP measurement method, which remains unknown in clinical practice. Home and ambulatory BP monitoring (HBPM and ABPM, respectively) have overcome many of the inherent limitations of the BP measurement at the physician’s office, mainly providing multiple BP readings exempt from the white coat effect. Additionally, these methods have shown to be better predictors of end-organ damage and cardiovascular outcome than BP measured in the physician’s offi ce. Finally, the use of HBPM or ABPM enables a more accurate assessment and an improved management of hypertension. This article provides an overview update on the interest of the different BP measurement methods available in the community pharmacy for the screening and monitoring of hypertensive patients(AU)


Subject(s)
Humans , Male , Female , Arterial Pressure , Hypertension/drug therapy , Pharmacies/organization & administration , Antihypertensive Agents/administration & dosage , Antihypertensive Agents/therapeutic use , Pharmacies/ethics , Antihypertensive Agents/metabolism , Antihypertensive Agents/pharmacokinetics , Mass Screening/methods , Mass Screening/prevention & control
5.
Pharm. pract. (Granada, Internet) ; 7(3): 125-138, jul.-sept. 2009. tab
Article in English | IBECS | ID: ibc-73126

ABSTRACT

Aims: To describe medication adherence education, practice, research and policy efforts carried out by pharmacists in Spain in the last decade. Methods: A literature review using Medline and Embase was conducted covering the last ten years. Additional pharmaceutical bibliographic sources in Spain were consulted to retrieve articles of interest from the last decade. Articles were included if a pharmacist was involved and if medication adherence was measured or there was any direct or indirect pharmacist intervention in monitoring and/or improving adherence. Articles focusing on the development of tools for adherence assessment were collected. Pre- and post-graduate pharmacy training programs were also reviewed through the Spanish Ministry of Education and Science website. Information regarding policy issues was gathered from the Spanish and Autonomous Communities of Education and Health Ministries websites. Results: Pharmacists receive no specific training focused on adherence. There is no specific government policies for pharmacists in Spain related to medication adherence regardless of their practice setting. A total of 24 research studies met our inclusion criteria. Of these, 10 involved pharmacist intervention in monitoring and/or improving adherence and 14 assessed only adherence. Ten studies involved hospital pharmacists working in collaboration with another healthcare professional. Conclusions: At present in Spain, the investigative role of the pharmacist is not well developed in the area of medication adherence. Adherence improvement services provided to patients by pharmacists are not implemented in a systematic way. However, recent efforts to implement new initiatives in this area may provide the basis for offering new cognitive services aimed at improving patient adherence in the near future (AU)


Objetivo: Describir la educación, práctica e investigación sobre adherencia farmacológica llevadas a cabo en la última década por farmacéuticos en España. Métodos: Se hizo una revisión de la bibliografía de los últimos 10 años en Medline y Embase. Además, se consultaron otras fuentes bibliográficas farmacéuticas españolas para recuperar artículos de interés publicados en la última década. Los artículos se incluyeron si contaban con la participación de un farmacéutico y se medía la adherencia a la medicación, o si existía una intervención farmacéutica para monitorizar y/o mejorar la adherencia, de forma directa o indirecta. Se seleccionaron también los artículos que desarrollaban herramientas para la evaluación de la adherencia. También, se revisaron los programas de formación impartidos en pre y postgrado de farmacia. La evaluación de las políticas sobre este asunto se realizó analizando las páginas web de los Ministerios de Educación y de Sanidad y Política Social a nivel estatal, así como sus homólogos a nivel autonómico. Resultados: Los farmacéuticos no reciben formación ninguna enfocada específicamente a la adherencia. Tampoco existe política ni práctica sanitaria obligatoria que deban seguir los farmacéuticos independientemente del ámbito sanitario donde ejerzan su profesión. Respecto a la investigación, se encontraron 24 estudios que cumplieron con los criterios de inclusión. De ellos, 10 trataban de alguna intervención farmacéutica para monitorizar y/o mejorar la adherencia y 14 sólo pretendían evaluar la adherencia. En diez de los estudios, participaron farmacéuticos hospitalarios en colaboración con otro profesional de la salud. Conclusiones: Actualmente en España, la actividad investigadora del farmacéutico está poco desarrollada en el campo de la adherencia farmacológica. Los servicios que proporcionan los farmacéuticos a los pacientes para mejorar la adherencia no se implementan de forma generalizada. No obstante, parece ser que los esfuerzos que se están realizando últimamente para implantar nuevas iniciativas pueden constituir una base para que en un futuro cercano se comiencen a prestar servicios cognitivos encaminados a mejorar la adherencia de los pacientes (AU)


Subject(s)
Pharmacology, Clinical/education , Pharmacology, Clinical/methods , Research/methods , Research/organization & administration , Drug Industry/legislation & jurisprudence , Drug Industry/methods , Ethics, Pharmacy , Legislation, Pharmacy , Drug and Narcotic Control/methods , Drug and Narcotic Control/trends , Pharmacology/methods
6.
Pharm. care Esp ; 10(1): 8-13, ene.-mar. 2008.
Article in Spanish | IBECS | ID: ibc-147754

ABSTRACT

Objetivos: Describir los principales errores cometidos por un grupo de farmacéuticos en la evaluación según el método Dáder de tres casos clínicos propuestos y determinar la relación existente entre la evaluación de un caso clínico y el perfil del alumno, así como con otras variables consideradas. Metodología: Estudio descriptivo transversal. La población de estudio la integraron los casos clínicos resueltos por los farmacéuticos participantes en una serie de talleres presenciales de seguimiento farmacoterapéutico (SFT) sobre antidiabéticos orales, asma y disfunción tiroidea impartidos entre septiembre de 2005 y abril de 2006. Se incluyeron 499 casos clínicos resueltos que llegaron por correo postal o fax al centro de atención farmacéutica CAF STADA. Se excluyeron los casos ilegibles y aquellos que se recibieron por duplicado. Se consideró como variable resultado el error cometido por los alumnos en la detección de sospecha de resultado negativo asociado a la medicación (RNM). Resultados: Los errores más frecuentemente cometidos fueron: sospecha de inseguridad no cuantitativa de la medicación (65,6%), en vez de inseguridad cuantitativa; evaluación de la efectividad de un tratamiento que no se podía evaluar por su instauración reciente (47,7%) y por la falta de parámetros cuantificables del problema de salud (23,4%); sospecha de una inseguridad inexistente (22,3%), y no detección de una necesidad de tratamiento (32,5%). Conclusión: Cuando se trata de detectar sospechas de RNM, no todos los farmacéuticos resuelven correctamente el caso clínico en cuestión utilizando el método Dáder. Por consiguiente, en futuros cursos de formación sobre SFT sería necesario que los docentes profundizaran más en algunos de los aspectos del método, a fin de poder conseguir resultados más satisfactorios (AU)


Objectives: To describe the main errors committed by the pharmacists in the evaluation of three clinical cases put forward according to the Dáder Method and to determine the relationship between the evaluation of a clinical case and the student’s profile, as well as other variables considered. Methodology: A cross-sectional descriptive study. The study population comprised the clinical cases solved by the pharmacists participating in classroom pharmacotherapy monitoring (SFT) workshops on Oral Antidiabetics, Asthma and Thyroid Dysfunction, held between September 2005 and April 2006. Of the solved clinical cases that were received by post or fax at the Pharmaceutical Care Centre, CAF STADA, 499 cases were included. Illegible cases or cases that were received in duplicate were excluded. As outcome variable the study used the error committed by the students in the detection of suspected Negative Outcomes associated with Medication (NOM). Results: The most commonly committed errors were: the suspicion of a non-quantitative safety problem of the medication (65.6%) instead of a quantitative safety problem, the evaluation of the effectiveness of a treatment that could not be evaluated because of its recent establishment (47.7%) and because of a lack of quantifiable parameters of the health problem (23.4%), the suspicion of a nonexistent safety problem (22.3%) and the failure to detect a need for treatment (32.5%). Conclusion: Not all pharmacists correctly solve a clinical case using the Dáder Method when detecting suspected NOMs. In future pharmacotherapy monitoring training courses the teachers will have to go into certain aspects of the method in more depth in order to obtain more satisfactory results (AU)


Subject(s)
Humans , Medication Therapy Management/statistics & numerical data , Drug Monitoring/statistics & numerical data , Pharmaceutical Services , Observer Variation , Education, Pharmacy, Continuing/trends
7.
Rev Mal Respir ; 9(2): 163-9, 1992.
Article in French | MEDLINE | ID: mdl-1565828

ABSTRACT

An enquiry was made to determine the prevalence of asthma in adolescents and was achieved using a questionnaire which was filled in by the pupils in secondary schools in Rabat. The sample was determined by a systematic poll of 1,616 pupils of whom 1,464 (90.6%) replied. 88 pupils (6.0%) replied in the affirmative to the question "Have you ever had whistling noises in the chest?", 78 (5.3%) to the question "Have you ever had a sensation of respiratory difficulty or suffocation with a whistling noise in the chest?", 48 (3.3%) to the question "Have you ever had asthma?" and 36 (2.5%) to all 3 questions and 114 (7.8%) to one or other of the questions. After a detailed questionnaire had been carried out on 110 of 114 pupils the diagnosis of asthma was confirmed in 50, which gives an estimation of the accumulative prevalence of 3.4% +/- 0.9%. This prevalence is higher amongst the oldest children in the family (26 out of 349, 7.4%) compared to the birth order of the other brothers and sisters (24 out of 1,112, 2.2%) (p less than 0.001). Pupils from higher social backgrounds (22 out of 256, 8.6% against 28 out of 1,208, 2.3% from more average or more poor social backgrounds, p less than 0.01). A past family history of asthma were more often noted in asthmatics (38 out of 50, 76%) than in non-asthmatics (406 out of 414, 28.7%) p less than 0.001). In the same way cough and phlegm and episodes of bronchitis occurring in autumn and winter and breathlessness on effort are more frequent in asthmatics; 20 out of 50 (40%) against 318 out of 1,414 (22.5%) for the cough (p less than 0.01), 12 out of 50 (24%) against 157 out of 1,414 (11.1%) for phlegm (p less than 0.01), 31 out of 50 (62%) against 337 out of 1,414 (23.8%) for episodes of bronchitis (p less than 0.001) and 15 out of 50 (30%) against 219 out of 1,414 (15.5%) for breathlessness on effort (p less than 0.001). Besides this we have noticed a slight predominance of asthma in boys compared to girls but the difference is not significant.


Subject(s)
Asthma/epidemiology , Adolescent , Adult , Age Factors , Animals , Animals, Domestic , Asthma/genetics , Bronchitis/epidemiology , Child , Female , Humans , Male , Morocco/epidemiology , Prevalence , Respiration Disorders/epidemiology , Respiratory Sounds , Sex Factors , Smoking/epidemiology , Social Class
SELECTION OF CITATIONS
SEARCH DETAIL
...