Factors Associated with In-Hospital Mortality in Acute Care Hospital Settings: A Prospective Observational Study.

Background: In-hospital mortality is a key indicator of the quality of care. Studies so far have demonstrated the influence of patient and hospital-related factors on in-hospital mortality. Currently, new variables, such as nursing workload or the level of dependency, are being incorporated. We aimed to identify which individual, clinical and hospital characteristics are related to hospital mortality. Methods: A multicentre prospective observational study design was used. Sampling was conducted between February 2015 and October 2017. Patients over 16 years, admitted to medical or surgical units at 11 public hospitals in Andalusia (Spain), with a foreseeable stay of at least 48 h were included. Multivariate regression analyses were performed to analyse the data. Results: The sample consisted of 3821 assessments conducted in 1004 patients. The mean profile was that of a male (52%), mean age of 64.5 years old, admitted to a medical unit (56.5%), with an informal caregiver (60%). In-hospital mortality was 4%. The INICIARE (Inventario del Nivel de Cuidados Mediante Indicadores de Clasificación de Resultados de Enfermería) scale yielded an adjusted odds ratio [AOR] of 0.987 (95% confidence interval [CI]: 0.97-0.99) and the nurse staffing level (NSL) yielded an AOR of 1.197 (95% CI: 1.02-1.4). Conclusion: Nursing care dependency measured by INICIARE and nurse staffing level was associated with in-hospital mortality.

Intoxicaciones agudas por insecticidas anticolinesterásicos / Acute intoxications due to organic phosphorus - carbamate based insecticides, "anticoliesterasics"

El empleo cada vez más generalizado de insecticidas anticolinesterásicos (organofosforados y carbamatos) de uso agrícola ha contribuido al aumento de intoxicaciones, muy importante en zonas de alta producción agrícola y dando lugar a pacientes que precisan de una estrecha vigilancia y gran cantidad de cuidados y técnicas de enfermería, dado lo florido de su clínica y su tratamiento. Tras analizar las vías de entrada, el mecanismo de acción y la clínica, en el artículo se estudia la actuación de enfermería que debe ser precoz y dirigida principalmente a disminuir la absorción del tóxico y administración de los antídotos así como tratamiento sintomático y una estrecha vigilancia (AU)