Access to Cancer Care Resources in a Federally Qualified Health Center: a Mixed Methods Study to Increase the Understanding of Met and Unmet Needs of Cancer Survivors.

Assessing the met and unmet needs of cancer survivors is critical in optimizing access to cancer services especially in underserved populations. The purpose of this study is to expand our understanding of the priority needs for cancer survivorship within racial/ethnic and underserved populations that speak either English or Spanish and seek health care in a federally qualified health center (FQHC). A convergent mixed methods design integrating survey and focus group data was utilized for this study. A total of 17 participants were enrolled in the study. The meta-inferences were drawn by looking across the top ten matched survey and focus group met and unmet needs including psychological, informational, and health system as well as patient care and support. The preferred languages of participants were Spanish 53% (n = 9) and English 47% (n = 8), and the survival breakdown was 65% (n = 11) within 0-5 years with 17.5% (n = 3), 6-10 years and 17.5% (n = 3), and 17.5% (n = 3) > 11 years. The most frequently met needs included health care providers and hospital staff being attentive to their physical and emotional needs and feeling they were treated with respect. Unmet needs were often related to physical and daily living needs such as pain, fatigue, sadness, depression, and not being able to work. Providing a needs-based approach of cancer health services in a FQHC or similar community-based health center is critical to meet the needs of cancer survivors to improve health outcomes and quality of life.

Implementación del registro código ictus en el servicio de urgencias de un hospital comarcal / Implementation of the stroke code registry in the emergency department of a regional hospital

El ictus es una enfermedad cerebrovascular ocasionada por una disminución u obstrucción brusca del flujo sanguíneo cerebral. Las células nerviosas no reciben oxígeno y se produce una alteración transitoria o permanente de las funciones del encéfalo, que provoca una elevada morbimortalidad ocasionando discapacidades con un gran coste económico para la sociedad. El código ictus (CI) se instauró en el Hospital de Mollet en el año 2015 y contó con la creación de un protocolo específico, una guía de actuación y una hoja de registro. El hospital no dispone de unidad de ictus por lo que las personas tributarias de revascularización son trasladadas al centro de referencia. La hoja de registro CI se estructura en varias partes: datos demográficos y clínicos, valoración A-B-C-D, escala National Institute of Health Stroke (NIHSS) y escala de Rankin, procedimientos y diagnósticos enfermeros: deterioro de la comunicación verbal, deterioro de la movilidad física, dolor agudo, ansiedad y riesgo de aspiración. Este trabajo tiene como objetivo describir la implementación del registro CI y evaluar el nivel de cumplimentación en el servicio de urgencias del Hospital de Mollet. También permite conocer los tiempos de atención y traslado a otro centro, el grado de cumplimentación de las escalas NIHSS y de Rankin, y evaluar la activación de los diagnósticos enfermeros. El análisis del registro CI ofrece una visión global sobre la atención sanitaria e identifica los puntos débiles para instaurar nuevos planes de actuación, estandarizar la atención, favorecer la continuidad asistencial y evitar posibles errores

Stroke is a cerebrovascular disease caused by a decrease or abrupt obstruction of blood flow to the brain. Nerve cells do not receive oxygen and there is a transient or permanent alteration of the function of a certain region of the brain. It causes high morbidity and mortality resulting in disabilities with a large economic cost to society. The Stroke Code was established at the Mollet Hospital in 2015. A protocol, action guideline and registry were created. The Mollet Hospital does not have a specialist unit so people who suffer thrombolysis and / or who require specific care are transferred to the referral centre. This registry is organized in several parts: demographic and clinical data, A-B-C-D assessment, procedures, National Institute of Health Stroke Scale (NIHSS) and Rankin scale, and nursing diagnoses: Impaired verbal communication, Impaired physical mobility, Acute pain, Anxiety and Risk for aspiration. This paper aims to describe the implementation of the Stroke Code registry and the level of completion in the emergency department of the Mollet hospital, revealing care times and transfers to other centres; NIHSS and Ranking scales completion and the activation of nursing diagnoses. An analysis of the Stroke Code registry provides data about healthcare services and detects weak points to improve to establish new action plans, standardise and promote continuity of care and avoid possible errors

Implementation of the stroke code registry in the emergency department of a regional hospital. / Implementación del registro código ictus en el servicio de urgencias de un hospital comarcal.

Stroke is a cerebrovascular disease caused by a decrease or abrupt obstruction of blood flow to the brain. Nerve cells do not receive oxygen and there is a transient or permanent alteration of the function of a certain region of the brain. It causes high morbidity and mortality resulting in disabilities with a large economic cost to society. The Stroke Code was established at the Mollet Hospital in 2015. A protocol, action guideline and registry were created. The Mollet Hospital does not have a specialist unit so people who suffer thrombolysis and / or who require specific care are transferred to the referral centre. This registry is organized in several parts: demographic and clinical data, A-B-C-D assessment, procedures, National Institute of Health Stroke Scale (NIHSS) and Rankin scale, and nursing diagnoses: Impaired verbal communication, Impaired physical mobility, Acute pain, Anxiety and Risk for aspiration. This paper aims to describe the implementation of the Stroke Code registry and the level of completion in the emergency department of the Mollet hospital, revealing care times and transfers to other centres; NIHSS and Ranking scales completion and the activation of nursing diagnoses. An analysis of the Stroke Code registry provides data about healthcare services and detects weak points to improve to establish new action plans, standardise and promote continuity of care and avoid possible errors.

Evaluating the linguistic appropriateness and cultural sensitivity of a self-report system for spanish-speaking patients with cancer.

Spanish speakers in the United States encounter numerous communication barriers during cancer treatment. Communication-focused interventions may help Spanish speakers communicate better with healthcare providers and manage symptoms and quality of life issues (SQOL). For this study, we developed a Spanish version of the electronic self-report assessment for cancer (ESRA-C), a web-based program that helps people with cancer report, track, and manage cancer-related SQOL. Four methods were used to evaluate the Spanish version. Focus groups and cognitive interviews were conducted with 51 Spanish-speaking individuals to elicit feedback. Readability was assessed using the Fry readability formula. The cultural sensitivity assessment tool was applied by three bilingual, bicultural reviewers. Revisions were made to personalize the introduction using a patient story and photos and to simplify language. Focus group participants endorsed changes to the program in a second round of focus groups. Cultural sensitivity of the program was scored unacceptable ([Formula: see text]) for audiovisual material and acceptable ([Formula: see text]) for written material. Fry reading levels ranged from 4th to 10th grade. Findings from this study provide several next steps to refine ESRA-C for Spanish speakers with cancer.

Evaluación del uso de sangre total y concentrado globular en el Hospital Universitario de Caracas / Evaluation of the use of total blood and red cells in the University Hospital of Caracas

Se realizó un estudio retrospectivo sobre el uso de Sangre Total (ST) y Concentrado de Glóbulos Rojos (CGR) en el Hospital Universitario de Caracas durante el período enero-diciembre 1990. El valor medio de Hb pre-transfusional en los Servicios Quirúrgicos fue igual o mayor de 10g/dl y en los Servicios Médicos entre 7 y 8 g/dl. Existe un alto número de indicaciones de transfusiones urgentes y un elevado porcentaje de sangre compatibilizada para transfusiones electivas (74 por ciento) y urgentes (35 por ciento) que no se reclama. Se proponen instituir programas educacionales y la creación de un Comite de Transfusion.