Impacto de una intervención para mejorar el uso del sondaje uretral y reducir las infecciones del tracto urinario / Impact of an intervention to improve indwelling urinary catheter use and reduce urinary tract infections

Objetivo. Evaluar el impacto de una intervención en la adecuación del uso y en la mejora del cuidado del sondaje uretral (SU), así como en la frecuencia de infección del tracto urinario asociada al SU (ITU-SU) en pacientes hospitalizados. Material y métodos. Estudio cuasi-experimental. En el periodo preintervención se midieron indicadores basales de uso del SU. La intervención consistió en educación sobre el SU y en la implementación de recordatorios para su retirada. En el periodo postintervención se evaluaron las mismas variables. Resultados. Se incluyeron 197 pacientes durante el periodo preintervención y 194 durante el periodo postintervención. La prevalencia (17,3% versus 15,3%) y los días de SU (4,8 ± 5,8 versus 4,3 ± 4,2) experimentaron un descenso no significativo. Se incrementaron las sondas correctamente prescritas (41,1% versus 61,9%; p < 0,001) y fijadas (0% versus 38,1%; p < 0,001) y descendieron las bolsas de diuresis en el suelo (26,4% versus 6,2%; p < 0,001). El incremento en la adecuación de la indicación del SU (86,8% versus 92,3%) y el descenso en la densidad de incidencia de ITU-SU (2,1 versus 1,2 episodios/1.000 días de SU) no fueron significativos, aunque superaron los estándares. Conclusiones. Tras la intervención se incrementó de forma significativa el número de SU correctamente prescritas y fijadas, y disminuyó las bolsas de diuresis en el suelo. La mejora en la indicación del SU y en la frecuencia de ITU-SU alcanzaron los estándares de calidad. Las actividades formativas y el uso de recordatorios mejoran la seguridad del paciente ingresado con SU (AU)

Objective. To evaluate the impact of an intervention regarding the adequate use and improvement in the care of indwelling urinary catheters (IUC) and the frequency of catheter-associated urinary tract infections (CAUTI) in hospitalised patients. Material and methods. A quasi-experimental study was performed. Basic data on the use of IUC were recorded before and after the intervention, which consisted of training on IUC use and the implementation of reminders for their removal. Results. There were 197 patients in the pre-intervention period and 194 in the post-intervention period. There was a non-significant decrease in the prevalence (17.3% versus 15.3%) and days with IUC (4.8 ± 5.8 versus 4.3 ± 4.2). There was an increase in adequately prescribed (41.1% versus 61.9%; P < .001) and attached IUC (0% vs 38.1%; P < .001), and a decrease in the urine collection bags on the floor (26.4% vs 6,2%; P < .001). The increase in the appropriate indications for IUC (86.8% vs 92.3%) and the decrease in CAUTI incidence density (2.1 vs 1.2 episodes/1,000 catheter days) were not significant, although above the standards. Conclusions. After the intervention there was a significant increase in the number of adequately prescribed and attached IUC, and a decrease in the number of urine collection bags on the floor. Improvement in IUC indication and frequency of CAUTI reached the quality standards. Educational activities and the use of reminders improve safety of hospitalised patients with IUC (AU)

[Impact of an intervention to improve indwelling urinary catheter use and reduce urinary tract infections]. / Impacto de una intervención para mejorar el uso del sondaje uretral y reducir las infecciones del tracto urinario.

OBJECTIVE: To evaluate the impact of an intervention regarding the adequate use and improvement in the care of indwelling urinary catheters (IUC) and the frequency of catheter-associated urinary tract infections (CAUTI) in hospitalised patients. MATERIAL AND METHODS: A quasi-experimental study was performed. Basic data on the use of IUC were recorded before and after the intervention, which consisted of training on IUC use and the implementation of reminders for their removal. RESULTS: There were 197 patients in the pre-intervention period and 194 in the post-intervention period. There was a non-significant decrease in the prevalence (17.3% versus 15.3%) and days with IUC (4.8±5.8 versus 4.3±4.2). There was an increase in adequately prescribed (41.1% versus 61.9%; P<.001) and attached IUC (0% vs 38.1%; P<.001), and a decrease in the urine collection bags on the floor (26.4% vs 6,2%; P<.001). The increase in the appropriate indications for IUC (86.8% vs 92.3%) and the decrease in CAUTI incidence density (2.1 vs 1.2 episodes/1,000 catheter days) were not significant, although above the standards. CONCLUSIONS: After the intervention there was a significant increase in the number of adequately prescribed and attached IUC, and a decrease in the number of urine collection bags on the floor. Improvement in IUC indication and frequency of CAUTI reached the quality standards. Educational activities and the use of reminders improve safety of hospitalised patients with IUC.

Aportaciones de la Toxicología Clínica al conjunto de la investigación toxicológica en España durante 15 años (1991-2005) / Contribution of clinical toxicology to total toxicological research in Spain (1991-2005)

Cada vez resulta más importante medir de forma objetiva la producción científica individual, de los grupos de investigación o de un área científica, para lo que se utilizan parámetros bibliométricos. En el presente estudio se analiza la actividad investigadora llevada a cabo por los toxicólogos españoles durante 15años, se compara con la de otras áreas científicas y con la de los toxicólogos de otros países y, finalmente, se investiga la aportación de la toxicología clínica al conjunto de la investigación toxicológica española. Se empleó como herramienta de búsqueda bibliométrica de documentos científicos publicados por toxicólogos españoles el programa Web of Knowledge del Institute for Science Information(ISI) y como base de datos el Science Citation Index (SCI). El periodo de tiempo analizado fue de 1991 a 2005. Los datos tabulados fueron: año de publicación, nombre de la revista y su factor de impacto, país del editor de la revista, tipo e idioma del documento, centro, provincia y comunidad del primer toxicólogo firmante, colaboración con otros servicios de toxicología y número de citas que recibió el artículo. Para el análisis estadístico, los datos se introdujeron en el programa informático SPSS versión 12.0. Durante los 15 años estudiados se han identificado 1904 documentos firmados por toxicólogos españoles y publicados en 523 revistas diferentes. Durante este periodo de tiempo, se ha observado un incremento progresivo y significativo del número de documentos firmados por toxicólogos, así como de los documentos encuadrados en el área de toxicología. Sin embargo, como la producción científica global en España ha mostrado un marcado aumento, el porcentaje que supone la toxicología respecto a la producción total española, ha experimentado un significativo descenso. En un 16% de los trabajos se estableció una colaboración internacional...(AU)

Objective measurement of scientific production by individuals, research groups or scientific areas using bibliometric parameters is increasingly important. The aims of this study were to analyze the research made by spanish toxicologists during a 15-year period, to compare it with that of other scientific areas and toxicologists from other countries and to determine the contribution of clinical toxicology to total spanish toxicological lresearch. The Web of Knowledge programme of the Institute for Science Information (ISI) and the Science Citation Index (SCI) database were used to carry out a bibliometric search for scientific documents published by spanish toxicologists from 1991 to 2005.The data tabulated were: year of publication, names of the journal and its impact factor, nationality of the journal's editor, type and language of the document, centre, province and community of the first toxicologist author, collaboration with other toxicology services and number of citations of each article. The statistical analysis was made using the SPSS version 12.0 statistical programme. During the study period, 1904 works authored by spanish toxicologists appearing in523 different journals were identified. There was a significant, progressive increase in the number of works authored by toxicologists and the number of works in the area of toxicology during the study period. However, as global scientific production in Spain increased markedly during this period, the percentage of toxicological works as a percentage of total spanish scientific production fell significantly. There was international collaboration in16% of the toxicological studies included. A total of 79 spanish toxicological centres authored scientific works, with the greatest number being produced by the autonomic communities of Catalonia, Andalusia and Madrid...(AU)

Electrocardiograma

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[Indoor air pollution in a zone of extreme poverty of La Pintana, Santiago-Chile]. / Contaminación intradomiciliaria en un sector de extrema pobreza de la comuna de la pintana.

BACKGROUND: Indoor pollution can be an important risk factor for human health, considering that people spend more than 60% of their time in their houses. AIM: To investigate indoor pollution in a zone of extreme poverty in Metropolitan Santiago. MATERIAL AND METHODS: During 24 h, carbon monoxide (CO), sulfur dioxide (SO2), respirable particulate matter (PM10), polycyclic aromatic hydrocarbons absorbed in PM5, temperature and humidity, were measured in the interior of 24 houses in a La Pintana, Santiago. RESULTS: The higher pollutant concentrations were observed during hours when heating was used, in houses that used coal (mean PM10 250 micrograms/m3, CO 42 ppm, SO2 192 pph) or firewood (mean PM10 489 micrograms/m3, CO 57 ppm, SO2 295 pph). In all houses, polycyclic aromatic hydrocarbons were detected and they came from the interior of the house and not from external filtered air. Coal, firewood and cigarette smoke were important sources of carcinogenic and kerosene and gas were sources of non carcinogenic polycyclic aromatic hydrocarbons. CONCLUSIONS: In the houses studied, the population was exposed to an accumulation of highly toxic pollutants, caused by a lack of ventilation. A high relative humidity also contributed to the growth of biological pollutants.