Impacto de las consultas y triajes telefónicos pediátricos en el uso del servicio de urgencias hospitalario / Pediatric televisits and telephone triage: impact on use of a hospital emergency department

Objetivos: Analizar las características de las teleconsultas y triajes telefónicos pediátricos atendidos por CatSalut Respon y describir su impacto sobre la actitud y la decisión final de los padres-usuarios de acudir o no a urgencias. Método: Estudio observacional transversal. Durante la teleconsulta los pacientes se clasificaron según los niveles del sistema español de triaje. Aquellos que fueron derivados a urgencias se volvieron a clasificar en el hospital, y se compararon los niveles de triaje. Posteriormente, se realizó una llamada de verificación. Se recogieron variables sociodemográficas y clínicas. Resultados: Se analizaron 370 teleconsultas, fundamentalmente no urgentes (n = 300; 81%). Un 20,3% (n = 75) fueron derivadas a urgencias. La fiebre (p = 0,002) y las dudas de medicación (p < 0,001) fueron motivos significativos de teleconsulta no urgente. Casi un 46% de los casos con niveles de gravedad altos en el triaje de la llamada también fueron clasificados con niveles de gravedad altos en el triaje posterior realizado en el servicio de urgencias hospitalario, mostrando una concordancia moderada. Más del 50% de los padres tenían intención de acudir a urgencias antes de la teleconsulta y un 46% cambiaron de actitud tras realizar esta llamada. Conclusiones: Fiebre y dudas de medicación fueron motivos estadísticamente significativos de teleconsulta no urgente. La consulta telefónica produjo un cambio de actitud en casi la mitad de los padres

Objectives: To analyze the characteristics of remote telephone consultations (televisits) and triage of pediatric emergencies attended by the 24-hour emergency service of Catalonia (CatSalut Respon), and to describe the impact of televisits on callers' decisions about whether or not to come to the emergency department and their opinion of the call service. Methods: Observational cross-sectional study. During the call, cases were classified according the Spanish and Andorran triage system. Patients who were sent to the hospital underwent triage again, and the 2 assigned triage levels were compared. The families were later called to check data and ask their opinion of the service. Sociodemographic and clinical data related to the cases were recorded. Results: A total of 370 televisits were made. Most cases (300, 81%) were not emergencies. Seventy-five callers (20.3%) were advised to go to an emergency department. Fever (P = .002) and questions about medication (P < .001) were the problems significantly associated with nonurgent cases. Nearly 46% of the cases classified as serious during telephone triage were also considered serious when the child was brought to the emergency department. The rate of agreement between the 2 triage levels was moderate. Over half the parents stated they had intended to go to the hospital before calling the service; 46% changed their mind based on the call. Conclusions: Fever and questions about medication were significantly associated with televisits for nonurgent cases. Nearly half the parents changed their mind about going to the emergency department after a televisit

Pediatric televisits and telephone triage: impact on use of a hospital emergency department. / Impacto de las consultas y triajes telefónicos pediátricos en el uso del servicio de urgencias hospitalario.

OBJECTIVES: To analyze the characteristics of remote telephone consultations (televisits) and triage of pediatric emergencies attended by the 24-hour emergency service of Catalonia (CatSalut Respon), and to describe the impact of televisits on callers' decisions about whether or not to come to the emergency department and their opinion of the call service. MATERIAL AND METHODS: Observational cross-sectional study. During the call, cases were classified according the Spanish and Andorran triage system. Patients who were sent to the hospital underwent triage again, and the 2 assigned triage levels were compared. The families were later called to check data and ask their opinion of the service. Sociodemographic and clinical data related to the cases were recorded. RESULTS: A total of 370 televisits were made. Most cases (300, 81%) were not emergencies. Seventy-five callers (20.3%) were advised to go to an emergency department. Fever (P = .002) and questions about medication (P < .001) were the problems significantly associated with nonurgent cases. Nearly 46% of the cases classified as serious during telephone triage were also considered serious when the child was brought to the emergency department. The rate of agreement between the 2 triage levels was moderate. Over half the parents stated they had intended to go to the hospital before calling the service; 46% changed their mind based on the call. CONCLUSION: Fever and questions about medication were significantly associated with televisits for nonurgent cases. Nearly half the parents changed their mind about going to the emergency department after a televisit.

OBJETIVO: Analizar las características de las teleconsultas y triajes telefónicos pediátricos atendidos por CatSalut Respon y describir su impacto sobre la actitud y la decisión final de los padres-usuarios de acudir o no a urgencias. METODO: Estudio observacional transversal. Durante la teleconsulta los pacientes se clasificaron según los niveles del sistema español de triaje. Aquellos que fueron derivados a urgencias se volvieron a clasificar en el hospital, y se compararon los niveles de triaje. Posteriormente, se realizó una llamada de verificación. Se recogieron variables sociodemográficas y clínicas. RESULTADOS: Se analizaron 370 teleconsultas, fundamentalmente no urgentes (n = 300; 81%). Un 20,3% (n = 75) fueron derivadas a urgencias. La fiebre (p = 0,002) y las dudas de medicación (p < 0,001) fueron motivos significativos de teleconsulta no urgente. Casi un 46% de los casos con niveles de gravedad altos en el triaje de la llamada también fueron clasificados con niveles de gravedad altos en el triaje posterior realizado en el servicio de urgencias hospitalario, mostrando una concordancia moderada. Más del 50% de los padres tenían intención de acudir a urgencias antes de la teleconsulta y un 46% cambiaron de actitud tras realizar esta llamada. CONCLUSIONES: Fiebre y dudas de medicación fueron motivos estadísticamente significativos de teleconsulta no urgente. La consulta telefónica produjo un cambio de actitud en casi la mitad de los padres.

Farmacoterapia en la Enfermedad Renal / Pharmacotherapy in Renal Disease

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Implantación de la telemedicina, eSalud y atención telefónica de enfermería en España / Implementing telemedicine, ehealth and telephonic nursing assistance in Spain

Introducción. Los términos «telesalud» o «eSalud» definen los servicios sanitarios diversificados prestados a distancia por un equipo de profesionales usando las TIC para mejorar la salud de un usuario o una población. Desarrollo. El desarrollo de las TIC en las décadas del 2000 y del 2010 hizo posible una mayor aplicabilidad. Aparecieron técnicas de telerradiología y telepatología. Mediante las teleconsultas se empezó a practicar la teleenfermería. Los inicios prácticos de la teleenfermería, surgieron a partir de consultorías enfermeras telefónicas en Reino Unido y Canadá. La OMS estableció, en 2005, el Observatorio Mundial de eSalud para revisar los beneficios de las TIC. Actualmente, en España, 061 Cat Salut Respon, gestionado por enfermeras, da cobertura a Cataluña a través de su página web, teléfono, correo electrónico o chat. En Andalucía, Salud Responde es un centro de información y servicios para dar atención sanitaria a la ciudadanía. Conclusiones. Los sistemas de salud ofrecen servicios a través de sistemas multicanal y aplicaciones específicas (apps) que permiten mejorar la accesibilidad, en cualquier momento, desde cualquier punto con conexión a Internet. La implicación de las enfermeras en programas de eSalud, como las tele-nurses, está cada vez más extendida en España, tal y como ocurre a nivel internacional (AU)

Introduction. Tele-Health or eHealth are defined as diversified health services provided remotely by a team of professionals using ICT (Information and Communication Technology) to improve the health of a user or population. Development. The development of ICT during the 2000 and 2010 decades allowed for a wider applicability of these services. Techniques like teleradiology and telepathology appeared. Tele-nursing began to be practiced through teleconsultations. Tele-nursing emerged from consulting telephone nurses in the United Kingdom and Canada. In 2005, the WHO established the Global eHealth Observatory to review the benefits of ICT. Currently in Spain, 061 Cat Salut Respon, managed by nurses, gives coverage to Catalonia through its website, telephone, email or chat. In Andalusia, Salud Responde is a service and information center providing citizens with remote healthcare. Conclusions. Health systems offer services through multichannel schemes and specific applications (apps) improving accessibility anytime, anywhere, provided with internet connection. The involvement of nurses in eHealth programs, such as telenurses, is increasingly spreading in Spain, mirroring the trend at an international level (AU)

[Implementing Telemedicine, EHealth and Telephonic Nursing Assistance in Spain]. / Implantación de la telemedicina, eSalud y atención telefónica de enfermería en España.

Introduction: Tele-Health or eHealth are defined as diversified health services provided remotely by a team of professionals using ICT (Information and Communication Technology) to improve the health of a user or population. Development: The development of ICT during the 2000 and 2010 decades allowed for a wider applicability of these services. Techniques like teleradiology and telepathology appeared. Tele-nursing began to be practiced through teleconsultations. Tele-nursing emerged from consulting telephone nurses in the United Kingdom and Canada. In 2005, the WHO established the Global eHealth Observatory to review the benefits of ICT. Currently in Spain, 061 Cat Salut Respon, managed by nurses, gives coverage to Catalonia through its website, telephone, email or chat. In Andalusia, Salud Responde is a service and information center providing citizens with remote healthcare. Conclusions: Health systems offer services through multichannel schemes and specific applications (apps) improving accessibility anytime, anywhere, provided with internet connection. The involvement of nurses in eHealth programs, such as telenurses, is increasingly spreading in Spain, mirroring the trend at an international level.