RESUMO
UNLABELLED: We describe the process of implementation of improvements for patient safety in the administration of medication in the operating room. OBJECTIVES: To know the weaknesses of the operating room that can contribute to an incident related to the medication and the administration of intravenous fluids in the operating room, and to place improvement strategies to reduce or prevent errors based on the experiences of the nurses. METHOD: Qualitative consensus by expert nurses group and questionnaire about the levels of risk that they attribute to each of the categories of analysis. We explore their experiences about safety in the operating room and their proposals for controlling medication errors. RESULTS: We identified as areas of greatest risk the providers, the prescription and the processing, as well as the weaknesses of the professional culture of patient safety and improvement proposals.
Assuntos
Erros de Medicação/enfermagem , Erros de Medicação/prevenção & controle , Segurança do Paciente , Procedimentos Cirúrgicos Operatórios , Humanos , Fatores de RiscoRESUMO
BACKGROUND: As marker genes for bipolar disorder (BP) and attention deficit hyperactivity disorder (ADHD) are not fully identified, we carried out a complete genome analysis to search for genes differentially expressed in ADHD and BP. MATERIALS AND METHODS: We recruited 39 patients (30 ADHD, 9 BP), aged 7 to 23 years. For evaluation of the psychiatric diagnosis, we used a semi-structured interview based on the K-SADS-PL (DSM-IV). RNA was extracted from peripheral blood and analyzed with the GeneChip® Human Genome U133-Plus 2.0 (Affymetrix). For the validation of differentially expressed genes, real-time PCR was used. RESULTS: Hybridization and subsequent statistical analysis found 502 probe-sets with significant differences in expression in ADHD and BP patients. Of these, 82 had highly significant differences. Neuregulin (NRG1), cathepsins B and D (CTSB, CTSD) and prostaglandin-D2-synthase (PTGDS) were chosen for semi-quantitative mRNA determination. The expression of PTGDS was statistically increased in ADHD relative to BP patients (p=0.01). We found no such differential expression with NRG1, CTSB and CTSD genes (p>0.05). CONCLUSIONS: The gene coding for PTGDS was found to be more expressed in patients with ADHD relative to patients with BP, indicating a possible link with the differential etiology of ADHD. The experimental approach we have used is, at least in part, validated by the detection of proteins directly concerned with brain functions, and shows a possible way forward for studies of the connection between brain function genes and psychiatric disorders. LIMITATIONS: Confirmation of our findings requires a larger sample of patients with clearly-defined phenotypes.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/genética , Transtorno Bipolar/genética , Oxirredutases Intramoleculares/genética , Lipocalinas/genética , Adolescente , Criança , Feminino , Expressão Gênica , Estudo de Associação Genômica Ampla , Humanos , Masculino , Fenótipo , Adulto JovemRESUMO
The Virgen de las Nieves University School of Nursing has adopted the methodology of Problem-Based Learning (ABP in Spanish acronym) as a supplementary method to gain specific transversal competencies. In so doing, all basic required/obligatory subjects necessary for a degree have been partially affected. With the objective of identifying and administering all the structural and cultural barriers which could impede the success or effectiveness of its adoption, a strategic analysis at the School was carried out. This technique was based on a) knowing the strong and weak points the School has for adopting the Problem-Based Learning methodology; b) describing the structural problems and necessities to carry out this teaching innovation; c) to discover the needs professors have regarding knowledge and skills related to Problem-Based Learning; d) to prepare students by informing them about the characteristics of Problem-Based Learning; e) to evaluate the results obtained by means of professor and student opinions, f) to adopt the improvements identified. The stages followed were: strategic analysis, preparation, pilot program, adoption and evaluation.
