Implantación de la Guía de buenas prácticas para el cuidado y manejo de la ostomía: resultados en cuidados / Implementation of best practice guidelines for ostomy care and management: Care outcomes

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

Implementation of best practice guidelines for ostomy care and management: Care outcomes. / Implantación de la Guía de buenas prácticas para el cuidado y manejo de la ostomía: resultados en cuidados.

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.

Modified calibration procedures for a Yankee Environmental System UVB-1 biometer based on spectral measurements with a brewer spectrophotometer.

The calibration of the erythemal irradiance measured by a Yankee Environmental System (YES) UVB-1 biometer is presented using two methods of calibration with a wide range of experimental solar zenith angles (SZAs) and ozone values. The calibration is performed through simultaneous spectral measurements by a calibrated double-monochromator Brewer MK-III spectrophotometer at "El Arenosillo" station, located in southwestern Spain. Because the range of spectral measurements of the Brewer spectrophotometer is 290-363 nm, a previously validated radiative transfer model was used to account for the erythemal contribution between 363 and 400 nm. Both methods are recommended by the World Meteorological Organization and we present and discuss here a wide range of results and features given by modified procedures applied to these two general methods. As is well established, the calibration factor for this type of radiometric system is dependent on atmospheric conditions, the most important of which are the ozone content and the SZA. Although the first method is insensitive to these two factors, we analyze this behavior in terms of the range used for the SZA and the use of two different mathematical approaches for its determination. The second method shows the dependence on SZA and ozone content and, thus, a polynomial as a function of SZA or a matrix including SZA and ozone content were determined as general calibration factors for the UV radiometric system. We must note that the angular responses of the YES radiometer and Brewer spectroradiometer have not been considered, because of the difficulty in correcting them. The results show in detail the advantages and drawbacks (and the corresponding associated error) given by the different approaches used for the determination of these calibration coefficients.

UV index experimental values during the years 2000 and 2001 from the Spanish broadband UV-B radiometric network.

An analysis is made of experimental ultraviolet erythemal solar radiation data measured during the years 2000 and 2001 by the Spanish UV-B radiation evaluation and prediction network. This network consists of 16 Robertson-Berger type pyranometers for evaluating solar erythemal radiation and five Brewer spectroradiometers for evaluating the stratospheric ozone. On the basis of these data the Ultraviolet Index (UVI) was evaluated for the measuring stations that are located either in coastal regions or in the more densely populated regions inland on the Iberian Peninsula. It has been checked that in most cases the maximum irradiance values corresponded to solar noon, although there were exceptions that could be explained by cloudiness. The maximum experimental values of the UVI were around 9 during the summer, though frequently passing this value at the inland measurement stations. The annual accumulated dose of irradiation on a horizontal plane has also been studied, as well as the evolution through the year in units of energy, standard erythemal doses and minimum erythemal doses, according to different phototypes.