Implementación de un programa de educación maternal en medio acuático / Implementation of a maternal education program in an aquatic environment

Objetivo: evaluar la efectividad de una intervención de educación maternal en medio acuático guiado por matronas en mujeres gestantes en seguimiento en Atención Primaria.Método: estudio cuasi-experimental, longitudinal y prospectivo. Participarán las mujeres gestantes pertenecientes a los centros de salud adscritos al programa de educación maternal que hayan realizado el seguimiento completo del embarazo en los centros de salud ubicados en el distrito de Usera (Madrid), y cuyo parto haya tenido lugar en el hospital de referencia. El programa de educación maternal consta de seis sesiones de 50 minutos de duración, que incluye ejercicios acuáticos dirigidos por las matronas del centro de salud. La variable principal será el porcentaje de partos eutócicos. Entre las variables secundarias se analizará el control del dolor y el traumatismo perineal. Se llevará a cabo análisis descriptivo. Para la comparación entre grupos se usarán los test estadísticos adecuados al tipo de variables.Conclusión: con la implementación del programa se pretende disminuir la tasa de cesáreas.(AU)

Objective: to evaluate the effectiveness of a maternal education intervention in an aquatic environment and guided by midwives for pregnant women under follow-up by Primary Care.Method: a quasi-experimental, longitudinal and prospective study, which will include pregnant women from the Primary Care centres affiliated with the Maternal Education Program, who have received complete follow-up for their pregnancy in the health centres at the Usera district (Madrid), and with delivery taking place in their hospital of reference. The Maternal Education program consists of six 50-minute sessions, and includes aquatic exercises guided by the Primary Care centre midwives. The primary endpoint will be the proportion of normal deliveries. The secondary endpoints will include the analysis of pain management and perineal trauma. Descriptive analysis will be conducted. The statistical tests adequate for this type of endpoints will be used for comparison between arms.Conclusion: the implementation of the program intends to reduce the rate of Caesarean deliveries.(AU)

Health care professionals' preference for a fully liquid, ready-to-use hexavalent vaccine in Spain.

Vaccination is an effective health intervention for the prevention of infectious diseases. This study aims to evaluate the response provided by nurses toward the use of ready-to-use (RTU) formulations of hexavalent vaccines and measures to prevent errors during the vaccination process. This observational, descriptive, cross-sectional study took place from March to May 2018. It included 201 interviews with nurses from health centers in Madrid (70), Murcia (59), and Andalusia (72), who had administered RTU vaccines in the last 12 months. Approximately 91.6% of nurses provided a positive feedback for the use of RTU vaccines. The most significant concerns experienced by nurses were during the preparation and administration of vaccines; 84.1% versus 18.9% of nurses felt that the risk of making mistakes was lower while using RTU vaccines compared with non-reconstituted (lyophilized) vaccines, and 74.1% versus 22.4% of nurses felt ease at preparing RTU vaccines compared with lyophilized vaccines. A total of 66.7% of nurses believed that there were risks associated with the preparation of lyophilized vaccines (administration risk [42.8%] and risk of needle injury [42.3%]). Risk percentages reduced to 4% and 9.5%, respectively, with the use of the RTU vaccines. Therefore, nurses adopted an average of seven steps to reduce the risk of errors. The average time saved during the administration of the vaccines was 1.1 min. In summary, nurses highlighted the need for administering vaccines using RTU formulations for ensuring the safety of the recipients, preventing errors, and saving time during the vaccination process.

Establishing Technical Values for Nursing Diagnoses in Primary Healthcare.

PURPOSE: To establish technical values for nursing diagnoses in primary healthcare with which to weight the delivery of care based on criteria of complexity and relevance. METHODS: A three-phase cross-sectional descriptive study: (1) establishing and weighting of the assessment criteria of technical values, (2) scoring of the assessment criteria per diagnosis, and (3) assigning technical values. FINDINGS: Diagnoses were ordered on the scoring scale obtained and a technical value of 1 to 4 was assigned according to their quartile. CONCLUSIONS: Having a technical value for each nursing diagnosis helps to measure the diversity and complexity of care. IMPLICATIONS FOR NURSING PRACTICE: Technical values may contribute to improving nursing management indicators, as they incorporate a quantitative view into the assessment process.

OBJETIVO: Definir un valor técnico para los diagnósticos enfermeros en Atención Primaria que permita ponderar la prestación de cuidados en base a criterios de complejidad y relevancia. MÉTODOS: Estudio descriptivo transversal realizado en 3 fases: 1) definición y ponderación de los criterios de valoración del valor técnico, 2) puntuación de los criterios de valoración por diagnóstico, 3) asignación del valor técnico. RESULTADOS: Se ordenaron los diagnósticos en la escala de puntuación obtenida y se asignó un valor técnico del 1 al 4 en función del cuartil. CONCLUSIONES: Disponer de un valor técnico de cada diagnóstico enfermero permite dimensionar la diversidad y la complejidad de los cuidados. IMPLICACIONES: El valor técnico puede contribuir a mejorar los indicadores de gestión de servicios enfermeros al añadir una visión cuantitativa al proceso evaluativo. PALABRAS CLAVE: diagnóstico de enfermería; terminología normalizada de enfermería; Atención Primaria de salud; indicadores de calidad de la atención de salud; indicadores de gestión.

Enfermera familiar o de pediatría: ¿qué modelo de trabajo es más efectivo en Atención Primaria? / Family or Paediatric Nurse, which model of work is more effective in Primary Care?

Objetivo: comparar la efectividad de dos modelos organizativos de atención enfermera, el de Enfermería de Familia (MEF) y el de atención diferenciada de adultos/pediatría (MEA/MEP). Método: estudio observacional transversal. Se estudió la cobertura alcanzada de indicadores procedentes de la Cartera de Servicios y del Contrato Programa de 2014, en todos los Centros de Salud de la Dirección Asistencial Centro de Madrid. Se compararon los resultados entre los centros de salud que trabajaban con cada modelo: MEF vs. MEA/MEP. Resultados: se estudiaron los 49 centros de salud que conforman la Dirección Asistencial Centro de la Comunidad de Madrid, el 43% tenía el modelo de atención MEF y el 57%, el modelo MEA/MEP. Se registraron diferencias de cobertura estadísticamente significativas en 14 de los 15 indicadores, que muestran las desigualdades en los servicios de atención según el modelo MEF o MEA/MEP. Las mayores diferencias se constataron en los indicadores «Pacientes con resultados en planes de cuidados por CIAS de Enfermería», siendo la cobertura superior en el modelo MEF con una RC= 1,68 (IC95% 1,65-1,71) y «Promoción de hábitos saludables en la adolescencia» (201), con resultados de cobertura mayores en el modelo MEA/MEP con RC= 0,63 (IC95% 0,58-0,69). Los coeficientes de variación son excesivos en la práctica totalidad de los indicadores estudiados. Conclusiones: no se puede demostrar que alguno de los dos modelos de organización del trabajo enfermero en Atención Primaria sea claramente más efectivo que el otro. Se detectó una gran variabilidad de resultados entre los centros de salud, independientemente del modelo organizativo (AU)

Objective: to compare the effectiveness of two organization models for nursing care: the Family Nurse Model (FNM) and the Model for Differentiated Care for Adults / Paediatrics (ANM / PNM). Method: an observational transversal study on the coverage reached by the indicators from the Portfolio of Services and the 2014 Contract Program, in all Health Centres from the Healthcare Management for Central Madrid. There was a comparison of the outcomes between the health centres working with each model: FNM vs. ANM/PNM. Results: the study included the 49 health centres within the Healthcare Management for Central Madrid; 43% of them had the FNM Model of Care, and 57% had the ANM/PNM Model. There were statistically significant differences of coverage in 14 of the 15 indicators, showing the disparities in healthcare services according to the FNM or the ANM/PNM model. The highest differences were found in the indicators «Patients with results in healthcare plans by Nursing CIAS (Health Area Identification Codes): coverage was superior in the FNM Model with CR= 1.68 (CI 95% 1.65-1.71) and «Promotion of Healthy Habits in Adolescence» (201), with higher coverage results in the ANM/PNM Model with CR= 0.63 (CI95% 0.58-0.69). Variation coefficients are excessive in practically all the indicators studied. Conclusions: it cannot be demonstrated that any of the two models for the organization of nursing work in Primary Care is clearly more effective than the other. A great variability of results was found between health centres, regardless of their organization model (AU)