ABSTRACT
INTRODUCCIÓN: Los cuidados proporcionados a las personas ostomizadas son cruciales para su evolución y rehabilitación. Las Guías de práctica clínica de la Registered Nurses' Association of Ontario recogen las intervenciones enfermeras con mayor evidencia en el cuidado del paciente ostomizado. El objetivo del estudio es analizar el impacto en los cuidados y los resultados de salud de los pacientes tras la implantación de la guía Cuidado y manejo de la ostomía. MÉTODO: Estudio cuasiexperimental pre-post test en todos los pacientes a los que se les realizó una ostomía digestiva o urológica en 8 Centros Comprometidos con la Excelencia en Cuidados® donde se implanta la guía para el cuidado y manejo de la ostomía, desde 2012 hasta 2018. Se analizaron y compararon variables clínicas de proceso y de resultados en salud en 3 períodos de tiempo. Se realizó un análisis descriptivo y se compararon las proporciones entre períodos, mediante Chi cuadrado, aplicando la corrección de Yates, considerando un nivel de confianza del 95%. RESULTADOS: La educación preoperatoria pasó del 36,7 al 47,3% (p < 0,05); el marcaje de la ostomía, del 25,2 al 33,8% (p < 0,05); la evaluación postoperatoria, del 94,8 al 59% (p < 0,05); la educación postoperatoria, del 75,5 al 91,9% (p < 0,05); las complicaciones en la piel periestomal, del 16,6 al 10,9% (p < 0,05), y las complicaciones en la ostomía, del 21,8 al 27,9% (p < 0,05). CONCLUSIONES: La implantación de la guía para el cuidado y manejo de la ostomía produjo mejoras en los cuidados preoperatorios, el marcaje del estoma y en las complicaciones de la piel periestomal
INTRODUCTION: Care provided to ostomized people is crucial in their progress and rehabilitation. The Registered Nurses' Association of Ontario clinical practice guidelines include greatest evidence nursing interventions for ostomized patient care. The aim of the study is to analyze the impact on patients' care and health outcomes after Care and management of ostomy guideline implementation. METHOD: Pre-post quasi-experimental study, carried out in all patients who underwent a digestive or urological ostomy in 8 centres of Best Practices Spotlight Organization® where the ostomy care and management guideline was implanted from 2012 to 2018. Clinical, process and health outcome variables were analyzed and compared in 3 periods of time. Descriptive analysis and comparison of proportions between the periods was performed, using Chi square, applying Yates correction, considering a 95% confidence interval. RESULTS: Preoperative education went from 36.7 to 47.3% (P<.05); stoma site marking from 25.2 to 33.8% (P<.05); postoperative evaluation from 94.8 to 59% (P<.05); postoperative education from 75.5 to 91.9% (P<.05); peristomal skin complications from 16.6 to 10.9% (P<.05), and ostomy complications from 21.8 to 27.9% (P<.05). CONCLUSIONS: The implementation of the ostomy care and management improved preoperative care, stoma site marking and peristomal skin complications
Subject(s)
Humans , Office Nursing/standards , Health Plan Implementation/standards , Ostomy/nursing , Ostomy/standards , Practice Guidelines as Topic/standards , Treatment Outcome , Nursing Care/standards , Confidence Intervals , Preoperative Care/standards , Postoperative Care/standards , Ostomy/statistics & numerical dataABSTRACT
INTRODUCTION: Care provided to ostomized people is crucial in their progress and rehabilitation. The Registered Nurses' Association of Ontario clinical practice guidelines include greatest evidence nursing interventions for ostomized patient care. The aim of the study is to analyze the impact on patients' care and health outcomes after Care and management of ostomy guideline implementation. METHOD: Pre-post quasi-experimental study, carried out in all patients who underwent a digestive or urological ostomy in 8 centres of Best Practices Spotlight Organization® where the ostomy care and management guideline was implanted from 2012 to 2018. Clinical, process and health outcome variables were analyzed and compared in 3 periods of time. Descriptive analysis and comparison of proportions between the periods was performed, using Chi square, applying Yates correction, considering a 95% confidence interval. RESULTS: Preoperative education went from 36.7 to 47.3% (P<.05); stoma site marking from 25.2 to 33.8% (P<.05); postoperative evaluation from 94.8 to 59% (P<.05); postoperative education from 75.5 to 91.9% (P<.05); peristomal skin complications from 16.6 to 10.9% (P<.05), and ostomy complications from 21.8 to 27.9% (P<.05). CONCLUSIONS: The implementation of the ostomy care and management improved preoperative care, stoma site marking and peristomal skin complications.
Subject(s)
Ostomy , Surgical Stomas , Humans , Preoperative CareABSTRACT
INTRODUCCIÓN: La utilización inapropiada de absorbentes de incontinencia en adultos puede afectar negativamente a la autoestima, calidad de vida, e independencia del paciente, así como aumentar la carga de trabajo y provocar eventos adversos. Existen pocos estudios que valoren la adecuación del uso del pañal utilizando escalas validadas para ello, ni la justificación de las enfermeras para su uso en personas mayores hospitalizadas. OBJETIVO: Determinar la frecuencia de uso de pañal en pacientes ingresados en un centro hospitalario así como identificar los criterios que determinaron su uso y el grado de adecuación. MÉTODO: Estudio observacional, transversal sobre pacientes adultos que utilizaban pañal estando ingresados en unidades de hospitalización. Para la recogida de datos se realizó un corte de un día en abril de 2013, recogiendo datos de los registros de valoración de enfermería y de los propios pacientes y familia. Se utilizaron como criterios de adecuación los ítems del Índice de Barthel referentes a movilidad y eliminación. RESULTADOS: De los 228 pacientes ingresados 83 (34,4%) llevaban pañal y de ellos 25 (30,1%) no tenían criterios para su uso. El 28,8% (21) no utilizaba pañal previamente al ingreso siendo en la mitad de ellos inadecuado su uso. Los factores asociados al uso inadecuado de pañal fueron mayor edad, sexo femenino, más comobilidad y días de ingreso. CONCLUSIÓN: Los resultados de este estudio ponen de manifiesto la excesiva frecuencia con la que se utilizan los absorbentes de incontinencia de forma inadecuada sin que su uso se base en criterios validados
BACKGROUNDS: Improper use of incontinence absorbent products in adults can negatively affect self-esteem, quality of life and independence of the patient, as well as increase the workload and cause adverse events. There are few studies evaluating the appropriateness of diapers using validated scales for it, or the justification of nurses for its use in elderly who are hospitalized. · To determine the frequency of diaper use in patients admitted to a hospital and to identify the criteria that determined their use and adequacy. · Observational, cross-sectional study of adult patients using diapers while admitted in Inpatient Units. For data collection cut day was held in April 2013, collecting data from nursing assessment records, patients themselves and their family. Barthel Index items were used as criteria of adequacy concerning mobility and disposal. Results: 228 patients admitted. 83 (34.4%) of them had diapers and 25 (30.1%) of them had no criteria for using them. 28.8% (21) had not previously used diapers, the use of diapers in half of them was inappropriate. Factors associated with inappropriate use of diapers were older age, being female, more comorbidity and days of hospitalization. · The results of this study show the often excessive use of incontinence absorbent products without proper appplication, not based on validated criteria
Subject(s)
Humans , Urinary Incontinence/epidemiology , Fecal Incontinence/epidemiology , Diapers, Adult , Hospitalization/statistics & numerical data , Self Concept , Quality of Life , Patient Satisfaction/statistics & numerical dataABSTRACT
BACKGROUNDS: Improper use of incontinence absorbent products in adults can negatively affect self-esteem, quality of life and independence of the patient, as well as increase the workload and cause adverse events. There are few studies evaluating the appropriateness of diapers using validated scales for it, or the justification of nurses for its use in elderly who are hospitalized. OBJECTIVE: To determine the frequency of diaper use in patients admitted to a hospital and to identify the criteria that determined their use and adequacy. METHOD: Observational, cross-sectional study of adult patients using diapers while admitted in Inpatient Units. For data collection cut day was held in April 2013, collecting data from nursing assessment records, patients themselves and their family. Barthel Index items were used as criteria of adequacy concerning mobility and disposal. RESULTS: 228 patients admitted. 83 (34.4%) of them had diapers and 25 (30.1%) of them had no criteria for using them. 28.8% (21) had not previously used diapers, the use of diapers in half of them was inappropriate. Factors associated with inappropriate use of diapers were older age, being female, more comorbidity and days of hospitalization. CONCLUSION: The results of this study show the often excessive use of incontinence absorbent products without proper application, not based on validated criteria.
Subject(s)
Hospitalization , Incontinence Pads/statistics & numerical data , Urinary Incontinence , Aged , Cross-Sectional Studies , Female , Humans , Male , Urinary Incontinence/therapyABSTRACT
Las úlceras por presión (UPP) constituyen un importante problema de salud, consumo de recursos e incluso de responsabilidad legal; de aquí surge la necesidad de crear un plan integral de mejora continua para abordar este problema. Las actuaciones dirigidas a la prevención, disminución de la variabilidad, y mejora en la coordinación entre todos los niveles asistenciales, son líneas estratégicas a seguir para reducir las cifras de prevalencia, con actuaciones concretas para su logro como la creación de un protocolo; la formación y concienciación de los profesionales; la actualización de material; asesoramiento a los familiares; mejora en la organización interna de los distintos servicios y un largo etcétera (AU)
(UPP) pressure ulcers, constitute a major health problem, consumption of resources and even legal liability; hence the need to create a comprehensive continuous improvement Plan to address this problem. Action aimed at prevention, reduction of variability, and improvement in coordination between all levels of care, are strategies to reduce the figures of prevalence, with specific actions for its achievement as the creation of a Protocol, the training and awareness of professionals; the updating of material, advice to relatives; improvement in the internal organizations of the various services; etc (AU)
