ABSTRACT
Las lesiones vasculares de las extremidades inferiores constituyen un problema de salud con importantes consecuencias socioeconómicas y sanitarias. Su prevalencia se sitúa en el 3% de la población adulta. Es fundamental establecer un diagnóstico diferencial entre los distintos tipos de lesiones, ya que el tratamiento difiere en función de su etiología. No existe un tratamiento único y efectivo para las úlceras de extremidad inferior,por lo que el equipo clínico ha de llegar a un acuerdo sobre el tratamiento a utilizar.La necesidad de tener un criterio común de actuación surgió en nuestro hospital a causa de la manifiesta diversidad en el tratamiento de las lesiones vasculares dependiendo del lugar donde estaba ubicado el paciente y la escasez de registro de las mismas, incluso en la unidad especializada. Además, las curas eran modificadas con demasiada frecuencia, no dejando tiempo a que se pudiera comprobar su eficacia. Esta situación de variablidad en el abordaje de las curas se agudizaba en los períodos de mayor concentración de personal suplente.El propósito de este artículo es presentar una experiencia de consenso sobre una guía para el tratamiento de lesiones vasculares, útil en diferentes niveles asistenciales y algunos documentos que forman parte de la guía,como son la guía rápida, el algoritmo de decisión de tratamiento y la hoja de registros de las curas, que pueden servir para agilizar el trabajo enfermero (AU)
Vascular lesions of the lower limbs represent a health problem with significant socioeconomic and healthcare consequences. The prevalence of this condition is around 3% in the adult population. It is of outmost importance to establish a differential diagnosis between the different types of lesions as the treatment varies depending on their aetiology.There is no single and effective treatment for ulcers of the lower limb and therefore the clinical team must be in agreement regarding the most appropriate treatment to follow.The need to have a common criteria for the course of action emerged in our hospital as a result of the various different treatments for vascular lesions depending there the patient was and a lack of a registry of the lesions, including at the specialist unit. In addition, wound care wasmodified way too frequently, leaving no time to verify their efficacy, This situation of variability in wound care approach exacerbated during the periods in which there were more nursing substitutes in attendance.The aim of this article is to present a consensus experience on a clinical practice guide for the treatment of vascular lesions that is useful at the different levels of health care and some documents that are part of such guide, such as the quick reference guide, the decision-making algorithm for treatment and the wound care log, which might help to expedite nursing work (AU)
Subject(s)
Humans , Varicose Ulcer/nursing , Wound Closure Techniques/nursing , Surgical Tape , Wound Healing/physiology , /methods , Anti-Infective Agents, Local/therapeutic useABSTRACT
La unidad de atención continuada y hospital de día permite el manejo ambulatorio de los pacientes con una enfermedad digestiva. Objetivo: Disminuir los ingresos hospitalarios y el número de pacientes con una enfermedad digestiva que acude a urgencias. Material y métodos: Los pacientes se atienden según dos niveles asistenciales: a) atención continuada, en que se visitan de forma urgente los pacientes con una descompensación aguda de su enfermedad digestiva, y b) atención programada, en que se realizan procedimientos que por su complejidad requieren personal de enfermería, sin ser necesario el ingreso hospitalario. Resultados: En el período comprendido entre 1995 y 2005 se ha pasado de realizar 118 visitas en atención continuada en 1995 a 784 en 2005. En atención programada las paracentesis han aumentado de 237 en 1995 a 687 en 2006 y las infusiones de hierro intravenoso de 111 en 2004 a 519 en 2006. El número de ingresos hospitalarios pasó inicialmente de 605 en 1995 a 430 en 2000, para posteriormente aumentar. El número de pacientes con una enfermedad digestiva que acudió a urgencias disminuyó un 75% estos años. Conclusiones: La unidad de atención continuada y hospital de día permite una disminución inicial del número de ingresos en el área de hospitalización convencional y en el porcentaje de pacientes con patología digestiva que acuden a urgencias
The continuing care unit and day hospital allows ambulatory care of patients with digestive diseases. Aim: Reducing hospital admissions and the number of patients with digestive diseases that attend the emergency department. Material and methods: Two types of care are provided: a) continuing care; patients are urgently visited when they show acute decompensation of their digestive disease, and b) scheduled care: procedures that, due to their complexity, require nursing care but not necessarily hospital admission. Results: In the period 1995-2005, visits to the continuing care unit increased from 118 in 1995 to 784 in 2005. In scheduled care, the number of paracentesis increased from 237 in 1995 to 687 in 2006. Intravenous iron infusions increased from 111 in 2004 to 519 in 2006. The number of hospital admissions initially decreased from 605 in 1995 to 430 in 2000, and then increased. The number of patients with digestive diseases attending the emergency department decreased by 75% throughout the period studied. Conclusions: The continuing care unit and day hospital allowed an initial reduction in the number of conventional hospitalizations and in the percentage of patients with digestive diseases attending the emergency department
Subject(s)
Humans , Day Care, Medical/methods , Continuity of Patient Care/organization & administration , Gastrointestinal Diseases/therapy , Day Care, Medical/methods , Paracentesis/nursing , Nursing Care/methods , Patient Education as Topic/methods , Interferons/administration & dosage , Ribavirin/administration & dosageABSTRACT
UNLABELLED: The continuing care unit and day hospital allows ambulatory care of patients with digestive diseases. AIM: Reducing hospital admissions and the number of patients with digestive diseases that attend the emergency department. MATERIAL AND METHODS: Two types of care are provided: a) continuing care; patients are urgently visited when they show acute decompensation of their digestive disease, and b) scheduled care: procedures that, due to their complexity, require nursing care but not necessarily hospital admission. RESULTS: In the period 1995-2005, visits to the continuing care unit increased from 118 in 1995 to 784 in 2005. In scheduled care, the number of paracentesis increased from 237 in 1995 to 687 in 2006. Intravenous iron infusions increased from 111 in 2004 to 519 in 2006. The number of hospital admissions initially decreased from 605 in 1995 to 430 in 2000, and then increased. The number of patients with digestive diseases attending the emergency department decreased by 75% throughout the period studied. CONCLUSIONS: The continuing care unit and day hospital allowed an initial reduction in the number of conventional hospitalizations and in the percentage of patients with digestive diseases attending the emergency department.
