[Prevalence of dermatological diseases in Primary Care]. / Prevalencia de enfermedades dermatológicas en atención primaria.

OBJECTIVE: To guide the training of Primary Care physicians in the most prevalent and relevant skin pathologies, it is necessary to study their prevalence in the Primary Care consultation and describe their characteristics. MATERIALS AND METHODS: Observational cross-sectional study. It took place at the Porriño Health Center (Pontevedra, Spain). A total of 305 patients of the same quota participated, recruited in consultation during 41days between September 2018 and February 2019, selected by systematic sampling coinciding with those mentioned at the hour between 9 and 13hours and, failing that, we selected the next of those mentioned. The variables were analyzed: age, sex, educational and economic level, diagnostic means, previous diagnosis of dermatological disease, treatment, follow-up and relationship with systemic diseases. The statistical analysis performed was descriptive and bivariate by sex with chi-square and Fisher's exact tests. RESULTS: 161 women and 144 men participated, age and number of consultations being non-parametric. Median age was 59years (IQR: 42-69), with no significant differences between sexes. 69.83% (95%CI: 64.46-74.71) present between 1 and 5 types of skin lesions grouped in 33 different diagnoses. The 15 most frequent pathologies account for 77.35% (95%CI: 75.80-84.48) of diagnoses. As the most relevant pathologies, we observed two basal cell carcinomas and one squamous cell carcinoma (0.98%; 95%CI: 0.34-2.85). CONCLUSIONS: Dermatological diseases have a high prevalence in Primary Care.

Evaluación mediante grupos focales de las expectativas y percepciones de las mujeres durante el proceso del parto / Evaluation by focus groups on women's expectations and perceptions during the birth process

Objetivos. Actualmente el proceso de atención al parto es objeto de un excesivo intervencionismo, no siempre avalado por la evidencia científica, y descuidándose aspectos organizativos y de humanización. Pretendemos analizar la percepción y expectativas de las madres en la atención a su parto, puerperio y lactancia en los hospitales públicos del Servicio Gallego de Salud, para informar y facilitar la mejora de de este servicio en ellos. Material y métodos. Se realizaron 14 grupos focales (uno por cada hospital público de Galicia), compuestos de mujeres que dieron a luz en el año 2008 mediante parto vaginal o cesárea no programada. Resultados. Se analiza el proceso del parto, identificando secuencialmente los elementos importantes para las madres, positivos y negativos, y las propuestas de mejora. Sus vivencias y opiniones, especialmente en aspectos como su participación en la toma de decisiones, la tecnificación del parto y la lactancia han permitido llevar a cabo una evaluación del funcionamiento del área de maternidad. Al investigar las expectativas y demandas de las usuarias se ha obtenido información de la calidad percibida, y se ha respondido a la necesidad de las madres de compartir su experiencia de parto. Conclusiones. Las madres demandan un trato más humano, empatía, más información y participación. Los procesos clave en los que se debe realizar un mayor esfuerzo en la aplicación de estos elementos son la dilatación y la estancia en la planta (AU)

Objectives: Delivery care giving is undergoing excessive interventionism today, not supported by scientific evidence, neglecting organisational aspects and individualisation. This study analyses the perception of mothers during their delivery, postpartum and breastfeeding periods in the Galician Health Service, in order to inform and help to improve this service. Material and methods: A total of 14 focus group meetings were held (one in each Galician public hospital), consisting of women who, in 2008, delivered by vaginal delivery or those who were not scheduled for a caesarean section. Results: The process of birth analysis can identify a sequence of important elements both positive and negative, for mothers, and may lead to suggestions for improvement. Their experiences and opinions, especially in aspects such as participation in decision-making, mechanisation of labour and lactation, may help to conduct an assessment of the maternity ward operating. When investigating expectations and demands from users, information from perceived quality is received, and also mothers’ experience is shared. Conclusions: Mothers call for humanity, empathy, information and participation. Facing the implementation of these elements, the key processes for working harder are the dilation stage and hospital staying (AU)

[Evaluation by focus groups on women's expectations and perceptions during the birth process]. / Evaluación mediante grupos focales de las expectativas y percepciones de las mujeres durante el proceso del parto.

OBJECTIVES: Delivery care giving is undergoing excessive interventionism today, not supported by scientific evidence, neglecting organisational aspects and individualisation. This study analyses the perception of mothers during their delivery, postpartum and breastfeeding periods in the Galician Health Service, in order to inform and help to improve this service. MATERIAL AND METHODS: A total of 14 focus group meetings were held (one in each Galician public hospital), consisting of women who, in 2008, delivered by vaginal delivery or those who were not scheduled for a caesarean section. RESULTS: The process of birth analysis can identify a sequence of important elements both positive and negative, for mothers, and may lead to suggestions for improvement. Their experiences and opinions, especially in aspects such as participation in decision-making, mechanisation of labour and lactation, may help to conduct an assessment of the maternity ward operating. When investigating expectations and demands from users, information from perceived quality is received, and also mothers' experience is shared. CONCLUSIONS: Mothers call for humanity, empathy, information and participation. Facing the implementation of these elements, the key processes for working harder are the dilation stage and hospital staying.

Las unidades funcionales para la gestión de riesgos sanitarios (seguridad del paciente / Operational units for health risk management (patient safety)

En 1995, el INSALUD comenzó a desarrollar actuaciones de asesoría en gestión de riesgos que después de las transferencias culminaron en el desarrollo de estructuras funcionales en los centros sanitarios. Estas unidades están compuestas por un conjunto de profesionales, incluidos directivos, y tienen como objetivo identificar, evaluar, analizar y tratar los riesgos sanitarios para mejorar la seguridad de los pacientes. Su estructura organizativa puede variar en función de necesidades, recursos y filosofía de cada organización. En este artículo se presenta la experiencia de las unidades de gestión de riesgo desarrolladas en las comunidades autónomas de Madrid, País Vasco, INGESA (Ceuta y Melilla) y Galicia. Asimismo, se plantea una reflexión sobre la evaluación de su impacto y sus futuras funciones para mejorar la seguridad de los servicios sanitarios (AU)

In 1995 INSALUD began to develop performance measures in the field of risk management, and following transfer of powers to the regions, these led to the development of operational units in individual healthcare centres. These units, which consist of a group of health professionals, including managers, aim to identify, evaluate, analyse and deal with health risks, to enhance patient safety. Their organisational structure can vary in accordance with the needs, resources and philosophy of each individual organisation. This paper presents the experience of the risk management units developed in four Spanish regions: Madrid, the Basque Country, Galicia and INGESA (Ceuta and Melilla). It also includes reflections on assessment of their impact and on their future role in improving safety in healthcare services (AU)

[Operational units for health risk management (patient safety)]. / Las unidades funcionales para la gestión de riesgos sanitarios (seguridad del paciente).

In 1995 INSALUD began to develop performance measures in the field of risk management, and following transfer of powers to the regions, these led to the development of operational units in individual healthcare centres. These units, which consist of a group of health professionals, including managers, aim to identify, evaluate, analyse and deal with health risks, to enhance patient safety. Their organisational structure can vary in accordance with the needs, resources and philosophy of each individual organisation. This paper presents the experience of the risk management units developed in four Spanish regions: Madrid, the Basque Country, Galicia and INGESA (Ceuta and Melilla). It also includes reflections on assessment of their impact and on their future role in improving safety in healthcare services.