Interrupción de la cadena de frío vacunal en un centro de atención primaria y su valoración económica / Vaccine cold chain interruption in a primary care center and economic evaluation

OBJETIVOS: El control de la cadena de frío constituye uno de los eslabones más importantes para garantizar la efectividad de las vacunas, por lo que es necesario disponer de recursos materiales y humanos específicos para su gestión. El objetivo principal es valorar las interrupciones de la cadena de frío de los últimos 6 años y el posible ahorro económico que supondrían nuevas mejoras. MÉTODO: Estudio retrospectivo, descriptivo, basado en la revisión de todas las interrupciones de la cadena de frío en los últimos 6 años, en el Centro de Salud Valdefierro. RESULTADOS: Cinco interrupciones, con temperatura máxima de 23,1±3,4°C y 25,2±20,7 h de interrupción; 1.611 vacunas fueron afectadas y 165 desechadas. La pérdida económica total fue 2.098,10 € y el ahorro 33.611,64 €. El fallo de suministro eléctrico fue la causa de interrupción en los 5 casos. CONCLUSIONES: El equipamiento y el personal son esenciales. Se tomaron medidas como minimizar los periodos entre controles sobre la nevera, control de stocks mínimos y, valorar cambios en la población, y se ha solicitado un sistema de suministro eléctrico

OBJECTIVES: Cold chain control is one of the most important facts to ensure the effectiveness of vaccines links, which requires specific material and human resources for management. The principal objective is to evaluate the interruptions in cold chain of the last 6 years and the possible cost savings that would result in further improvements. Method: A retrospective and descriptive study based on a review of all cold chain interruptions during the last 6 years, at Valdefierro Primary Health Center. RESULTS: We had 5 interruptions, the maximum temperature reached was 23.1±3.4°C and the longest interruption lasted 25.2±20.7 hours.1611 vaccines were affected and 165 discarded. Total economic loss was 2.098,10 € and 33.611,64 € were savings. The electrical failure was the disruption cause in 5 cases. CONCLUSIONS: Equipment and staff are essential. The center did some corrective actions, such as minimizing refrigerator time control, minimum stock control, considering population changes, and the center has requested a electrical supply system

[Vaccine cold chain interruption in a primary care center and economic evaluation]. / Interrupción de la cadena de frío vacunal en un centro de atención primaria y su valoración económica.

OBJECTIVES: Cold chain control is one of the most important facts to ensure the effectiveness of vaccines links, which requires specific material and human resources for management. The principal objective is to evaluate the interruptions in cold chain of the last 6 years and the possible cost savings that would result in further improvements. METHOD: A retrospective and descriptive study based on a review of all cold chain interruptions during the last 6 years, at Valdefierro Primary Health Center. RESULTS: We had 5 interruptions, the maximum temperature reached was 23.1±3.4°C and the longest interruption lasted 25.2±20.7hours. 1611 vaccines were affected and 165 discarded. Total economic loss was 2.098,10 € and 33.611,64 € were savings. The electrical failure was the disruption cause in 5 cases. CONCLUSIONS: Equipment and staff are essential. The center did some corrective actions, such as minimizing refrigerator time control, minimum stock control, considering population changes, and the center has requested a electrical supply system.

Estudio de los efectos de la implantación de un banco de leche donada en los recién nacidos pretérmino en Aragón / Study of the effects of the implementation of a human milk donor bank in preterm newborns in Aragon

INTRODUCCIÓN: Numerosos obstáculos pueden impedir que un prematuro o un neonato enfermo reciba leche de su madre. En estos casos las sociedades científicas pediátricas recomiendan la alimentación con leche materna donada. Explicamos qué es un banco de leche, cómo funciona, el método de selección de donantes y sus beneficios. Finalmente, describimos la situación actual en Aragón. MATERIAL Y MÉTODOS: Estudio retrospectivo de tipo descriptivo de las características perinatales de la muestra y analítico observacional, comparando 2 grupos de la muestra: prebanco y posbanco de leche. Finalmente se buscan diferencias dentro de la etapa posbanco entre los alimentados con leche materna propia y donada. RESULTADOS: Un total de 234 pacientes (104 hombres y 130 mujeres). Dos grupos: prebanco (152 pacientes) y posbanco (82 pacientes), comparables al nacimiento; longitud y perímetro cefálico significativamente mayor en grupo posbanco y menor tasa de enterocolitis necrosante. Sin diferencias estadísticamente significativas en el resto de variables, y tampoco entre los subgrupos de leche materna propia y donada. Discusión La implantación del banco supone un efecto beneficioso, con reducción de la morbilidad neonatal en el caso de la enterocolitis necrosante, y la alimentación con leche materna podría ser un factor protector frente a sepsis neonatal tardía al mejorar la inmunidad. CONCLUSIONES: La incidencia de enterocolitis necrosante es menor tras la implantación del banco de leche. Estudios con mayor número de pacientes quizás demostrasen diferencias en otras variables

INTRODUCTION: Numerous obstacles may prevent a premature or sick neonate receiving their mother's milk. In these cases, pediatric scientific societies recommend feeding with donor human milk. In this article, it is explained what a milk bank is, how it works, the donors' selection method, and the benefits. We also describe the current situation in Aragon (Spain) is also described. MATERIAL AND METHODS: A retrospective and descriptive study was conducted on the perinatal sample characteristics, as well as an analytical observational study, comparing two sample groups: pre- and post-human milk bank. Finally, differences in the post-bank stage between those patients fed with own-mother's or donor human milk were determined. RESULTS: The study included a total of 234 PATIENTS: 104 females and 130 males. Two groups: pre and post-bank, with 152 and 82 patients, respectively, which had similar characteristics at birth; length and head circumference were significantly higher in the post-bank group and a lower rate of necrotizing enterocolitis was also found. No statistically significant differences were found in other variables between subgroups fed with own-mother's milk and donor human milk. Discussion The establishment of the human milk donor bank has a beneficial effect, as it reduces neonatal morbidity in cases of necrotizing enterocolitis. Human milk feeding could be a protective factor against neonatal sepsis due to improve immunity. CONCLUSIONS: The incidence of necrotizing enterocolitis is lower after the establishment of the milk bank. Studies with more patients may demonstrate differences in other variables

[Study of the effects of the implementation of a human milk donor bank in preterm newborns in Aragon]. / Estudio de los efectos de la implantación de un banco de leche donada en los recién nacidos pretérmino en Aragón.

INTRODUCTION: Numerous obstacles may prevent a premature or sick neonate receiving their mother's milk. In these cases, pediatric scientific societies recommend feeding with donor human milk. In this article, it is explained what a milk bank is, how it works, the donors' selection method, and the benefits. We also describe the current situation in Aragon (Spain) is also described. MATERIAL AND METHODS: A retrospective and descriptive study was conducted on the perinatal sample characteristics, as well as an analytical observational study, comparing two sample groups: pre- and post-human milk bank. Finally, differences in the post-bank stage between those patients fed with own-mother's or donor human milk were determined. RESULTS: The study included a total of 234 patients: 104 females and 130 males. Two groups: pre and post-bank, with 152 and 82 patients, respectively, which had similar characteristics at birth; length and head circumference were significantly higher in the post-bank group and a lower rate of necrotizing enterocolitis was also found. No statistically significant differences were found in other variables between subgroups fed with own-mother's milk and donor human milk. DISCUSSION: The establishment of the human milk donor bank has a beneficial effect, as it reduces neonatal morbidity in cases of necrotizing enterocolitis. Human milk feeding could be a protective factor against neonatal sepsis due to improve immunity. CONCLUSIONS: The incidence of necrotizing enterocolitis is lower after the establishment of the milk bank. Studies with more patients may demonstrate differences in other variables.