Efficiency of Diagnostic Test for SARS-CoV-2 in a Nursing Home.

BACKGROUND: there is no consensus on how to optimally use diagnostic tests in each stage of COVID-19 pandemic. The objective of this research is to determine the efficiency of sorting positive antibody test quarterly. METHODS: this research uses a retrospective, observational study. COVID-19 diagnostic tests performed and avoided refer to a Spanish nursing home. POPULATION: 261 employees and 107 residents. A quarterly antibody test was performed on subjects who had tested positive during the first wave of coronavirus, and a antibody rapid test on the remaining subjects. RESULTS: during the first wave, 24.0% of the employees and 51.4% of the residents had a positive antibody test. Seronegativization was observed in 7.6% of employees and 1.6% of residents. An employee was infected with COVID-19 in September 2020, followed by a nursing home outbreak in October: 118 Polymerase Chain Reactions tests were avoided in residents and 18 in employees, which in turn prevented 15 workers from going on sick leave and the quarantine of 59 residents. This represents savings of about $15,000. CONCLUSIONS: our study supports the need to know and apply the strategies for early detection, surveillance and control of COVID-19 for future outbreaks. We conclude that surveillance for positive COVID-19 serology among long-term care staff and residents may be a cost-effective strategy during a pandemic.

Influencia de los modelos de gestión en la calidad de vida profesional del personal cuidador en residencias de mayores de Albacete / Influence of management models on the quality of professional life of the personal carer in old people's homes in albacete (Spain)

Objetivo. Determinar la relación entre los tipos de gestión en residencias de mayores (público, privado, mixto e inglés) y la calidad de vida profesional (CVP) del personal de enfermería. Método. Estudio transversal descriptivo entre el personal de enfermería (n=389) de las 7 residencias sociosanitarias de Albacete ciudad. Se emplea un cuestionario autoadministrado con variables sociodemográficas y una escala validada (CVP-35) que mide la CVP a través de 35 preguntas (escala de 1 a 10, del nivel más bajo al más alto), que se agrupan en tres dimensiones. Resultados. La tasa de respuesta fue del 66,32% (n=258). Se obtiene una CVP de 4,98 (desviación estándar [DE]=2,32). La percepción de “cargas de trabajo” fue de 5,89 (DE=1,59), “motivación intrínseca” de 8,07 (DE=1,46) y “apoyo directivo” de 4,55 (DE=1,70). La CVP se correlaciona positivamente con “apoyo directivo” y “motivación intrínseca” y negativamente con “carga de trabajo”. No existen diferencias estadísticamente significativas con las variables sociolaborales. Por modelos de gestión, las cargas de trabajo son mayores en el modelo mixto que en el privado (6,15/5,49), la motivación intrínseca presenta puntuaciones menores en el modelo privado que en el mixto (6,95/8,37) y el inglés (6,95/8,56) y el apoyo directivo es menor en el mixto que en el inglés (4,20/5,03) y en el privado (4,20/5,11). Conclusiones. La CVP de los profesionales es media-baja. Esto podría indicar la necesidad de un cambio cultural organizativo basado en la participación y la motivación más allá de las dimensiones estructurales, aumentando el apoyo directivo y reforzando la motivación intrínseca como favorecedora en la resolución de conflictos(AU)

Objective. Determine if there is any relationship between different management models (public, private, mixed and English) and the quality of professional life (QPL) of the nursing staff. Method. A cross-sectional descriptive among the geriatric nursing staff (n=389) from the 7 geriatric homes in the city of Albacete. Using a questionnaire which included sociodemographic variables, along with a validated scale (QPL −35.), which measures quality of professional life using 35 questions (1 to 10 scale, from lower to higher degree). Results. With a response rate of 66.33%, the QPL average value was 4.98 (standard deviation [SD]=2.32). Perception of “workload” achieved 5.89 (SD=1.59), “intrinsic motivation” 8.07 (SD=1.46) and “management support” 4.55 (SD=1.70.). The QPL is positively related to variables such as “management support” and “intrinsic motivation” and negatively with “workload”. There are no statistically significant differences, with the work and social variables. Comparing management models, there were slightly significant differences between workload in private models than mixed ones (6.95/8.37), intrinsic motivation has lower results in private than mixed (6.95/8.37) and English (6.95/8.56). Management support is lower in mixed than English (4,20/5,03) and private (4,20/5,11). Conclusions. The QPL of our professionals is low-medium. Our data could show the need of a cultural management change based on participation and motivation, being necessary to increase the level of management support to reinforce intrinsic motivation, in order to help resolve conflicts(AU)

[Influence of management models on the quality of professional life of the personal carer in old people's homes in Albacete (Spain)]. / Influencia de los modelos de gestión en la calidad de vida profesional del personal cuidador en residencias de mayores de Albacete.

OBJECTIVE: Determine if there is any relationship between different management models (public, private, mixed and English) and the quality of professional life (QPL) of the nursing staff. METHOD: A cross-sectional descriptive among the geriatric nursing staff (n=389) from the 7 geriatric homes in the city of Albacete. Using a questionnaire which included sociodemographic variables, along with a validated scale (QPL -35.), which measures quality of professional life using 35 questions (1 to 10 scale, from lower to higher degree). RESULTS: With a response rate of 66.33%, the QPL average value was 4.98 (standard deviation [SD]=2.32). Perception of "workload" achieved 5.89 (SD=1.59), "intrinsic motivation" 8.07 (SD=1.46) and "management support" 4.55 (SD=1.70.). The QPL is positively related to variables such as "management support" and "intrinsic motivation" and negatively with "workload". There are no statistically significant differences, with the work and social variables. Comparing management models, there were slightly significant differences between workload in private models than mixed ones (6.95/8.37), intrinsic motivation has lower results in private than mixed (6.95/8.37) and English (6.95/8.56). Management support is lower in mixed than English (4,20/5,03) and private (4,20/5,11). CONCLUSIONS: The QPL of our professionals is low-medium. Our data could show the need of a cultural management change based on participation and motivation, being necessary to increase the level of management support to reinforce intrinsic motivation, in order to help resolve conflicts.

Eficacia de los ácidos grasos hiperoxigenados en la prevención de las úlceras por presión / Hyperoxygenated fatty acid effectiveness in the prevention of the pressure ulcers

Objetivos: Conocer la eficacia de los ácidos grasos hiperoxigenados enla prevención de las úlceras por presión. Determinar el nivel de evidenciadel uso de los ácidos grasos hiperoxigenados en la prevención de lasúlceras por presión. Material y método: Se realizó una búsqueda bibliográficaen Cochrane library, The Joanna Briggs Institute, Pubmedmedliney Cuiden, siendo solamente seleccionados ensayos clínicos. Parasu evaluación se han seguido las recomendaciones del Critical AppraisalSkills Programme (CASPe) junto al sistema GRADE para la valoraciónde la calidad de la evidencia y la fuerza de las recomendaciones.Resultados: En the Cochrane Library no aparece ningún documento,mientras que en The Joanna Briggs Institute aparece un bestpracticedonde no se hace ninguna referencia a los AGHO. En el resto de basesencontramos 2 ensayos clínicos aleatorizados, que cumplían los criteriosCASPe. En el estudio de Gallart, et al. sobre una muestra de 192pacientes se observó una incidencia de UPP del 19% en el grupo intervenciónfrente al 35% del grupo placebo (p < 0,007), siendo la RAR de16 (3,9-28,1), la RRR de 45,7 (11,8-66,6) y el NNT fue de 7 (4-26),con un intervalo de confianza del 95%. Por su parte, Torra i Bou, et al.,sobre una muestra de 331 pacientes, observaron una incidencia de UPPdel 7,32% en el grupo intervención frente a 17,37% en el grupo placebo(p < 0,001), siendo la RAR de 10 (3,1-17,0), la RRR de 57,9 (20,3-77,7) y el NNT fue de 10 (6-33), con un intervalo de confianza del95%. Conclusiones: De acuerdo a la clasificación GRADE, ambos estudiosnos arrojan una calidad de evidencia alta. Por lo tanto, según labibliografía consultada, los AGHO pueden constituir una medida preventivaefectiva en las UPP y, en el caso de no evitarlas, retarda el tiempo de su aparición. Aunque, dado el escaso número de estudios experimentalesllevados a cabo, estimamos necesario la realización de nuevosensayos clínicos que lo confirmen

Objectives: To know the scientific evidence about hyperoxygenated fatty acid effectivenessin the prevention of the pressure ulcers and to evaluate, through the bibliographyconsulted, their clinical effectiveness. Material and method: There was made a compilationof information in the Cochrane library, The Joanna Briggs Institute,Pubmed-medline and Cuiden.There were only selected clinical trials, for which evaluationit has been followed the recommendations of Critical Apraisal Skill Program togetherwith GRADE system in order to value the quality of the evidence and thestrength of the recommendation. Results: No documents have been found in theCochrane library, whereas in The Joanna Briggs Institute has been found a bestpracticewhere there is no reference to the hyperoxygenated fatty acid. In the rest of the databasesjust two randomised clinical trials that followed CASP criteria were found.Inthe Gallart et al study over a sample of 192 patients an UPP incidence of 19% wasfound in the intervention group it was found a pressure ulcer rate of 19% against the35% in the placebo group (p < 0,007) being the RAR of 16 (3,9-28,1) the RRR of45,7 (11,8 -66,6) and the NNT was of 7(4-26) with a confidence interval of95%.In the Torra i Bou, et al. study over a sample of 331 patients an UPP incidenceof 7,32% in the intervention group against the 17,37% in the placebo group(p < 0,001) being the RAR OF 10 (3,1-17,0) the RR of 57,9 (20,3-77,7) and theNNT was of 10 (6-33) with a confidence interval of 95%. Conclusions: Accordingto GRADE classification both studies show us a high quality evidence.So according toinformation found, the hydrogenated fatty acids could be an effective preventive measurein pressure ulcers, and when they are not able to avoid them, they could delay their occurrence.Although there are no many clinical studies we thought necessary to carry outnew clinical trials to confirm it (AU)