Actitud y comportamiento de la mujer frente a la prevención de la enfermedad cardiovascular / ttitude and behaviour of women to prevention of cardiovascular disease

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Procedimiento de colocación del catéter de bomba de insulina / Procedure for placing an insulin pump catheter

La terapia con Infusión Subcutánea Continua de Insulina (ISCI) o bomba de insulina puede ser una buena alternativa terapéutica para las personas con diabetes tipo 1 en situaciones concretas. El aprendizaje de esta técnica ha de realizarse mediante un programa de educación sanitaria impartido por un equipo multidisciplinar, con el que se capacita al paciente en el manejo del dispostivo y en cuidado de la zona de la inserción de la cánula. Cumpliendo estas condiciones básicas, la persona puede obtener beneficios, tanto en el control glucémico como en la reducción de la incidencia de hipoglucemias y, por lo tanto, una mejoría en su calidad de vida.El objetivo de este artículo consiste en explicar las indicaciones, el equipo necesario y el procedimiento de autoaplicacion de la bomba de insulina,así como las posibles complicaciones asociadas, con el fin de garantizarlas máximas condiciones de seguridad y las mínimas incomodidades para la persona que sigue este tipo de tratamiento (AU)

Continuous subcutaneous insulin infusion (CSII) therapy or an insulinpump can be a good therapeutic alternative for people with type 1 diabetes in specific situations.The learning of this technique must be performed by means of a health education programme taught by a multidisciplinary team, in which thepatient is taught to manage the device and to care for the cannula’s insertion area. If the patient adheres to these basic conditions, he/she can reap the benefits, both in glycemic control and in the reduction of the incidence of hypoglycaemias, which in turn improves his or her quality of life.The objective of this article is to explain the indications, the equipment that is needed and the self-application procedure for the insulin pump, as well as possible complications, in order to guarantee the best safety conditions and to decrease the discomfort experienced by the patient who undergoes this type of treatment (AU)

Primer contacto con una bomba de insulina. Caso clínico / First contact with an insulin pump. Clinical case

Las bombas de insulina son unos dispositivos que infunden la insulina de forma similar a la secreción pancreática, continuamente y con infinidad de posibilidades para adaptarse a horarios, comidas y actividad física, otorgando a los diabéticos la posibilidad de llevar una vida con muchas menos ataduras debido a su enfermedad. Además de la libertad que les proporciona, esta terapia permite un control más exacto de las glucemias, mejorando notablemente el autocontrol general y con ello la calidad de vida de estas personas, reduciendo la aparición de complicaciones a largo plazo. Aunque todos los diabéticos reciben a lo largo de su enfermedad infinidad de pautas y recomendaciones para un óptimo control, los pacientes incluidos en este protocolo tienen que estar especialmente concienciados e implicados en su autocontrol, ya que el tratamiento les exige una gran implicación, tanto para aprender a utilizar el dispositivo como para tomar decisiones una vez se está utilizando. Se presenta el caso clínico de una paciente diabética tipo 1 de 21 años de evolución, durante un día de ingreso en el hospital para llevar a cabo la implantación de un infusor continuo de insulina subcutánea (bomba de insulina). Para ello, elaboramos el plan de cuidados de la paciente siguiendo los pasos del método científico y apoyándonos en la taxonomía NANDA, así como en la NOC y NIC para delimitar objetivos e intervenciones enfermeras, respectivamente (AU)

Insulin pumps are devices that inject insulin continuously into the body in a similarway to the pancreatic secretion, and with endless possibilities to adjust schedules, meals and physical activities, giving diabetics the chance to lead a life with many less restraints due totheir illness. Besides giving them this freedom, the therapy allows more precise control of blood glucose, significantly improving the overall self-control and thus the quality of life of the diabetics, reducing the appearance of long-term complications. Although all diabetics receive many guidelinesand recommendations for optimal control throughout their illness patients included in this protocolmust be especially aware and involved in self-control, since the treatment demands more involvement both when learning to use the device as well as making decisions once they are using it. We present the case of a type 1 diabetic patient, twenty-one years of onset, who while admitted to hospital for a day, had a continuous subcutaneous insulin infusion pump implanted (insulin pump). To this end, we developed a patient care plan of patient following the steps of scientific method and relying on the NANDA taxonomy and on the NOC and NIC to design goals and nursing interventions, respectively (AU)

[First contact with an insulin pump. Clinical case]. / Primer contacto con una bomba de insulina. Caso clínico.

Insulin pumps are devices that inject insulin continuously into the body in a similar way to the pancreatic secretion, and with endless possibilities to adjust schedules, meals and physical activities, giving diabetics the chance to lead a life with many less restraints due to their illness. Besides giving them this freedom, the therapy allows more precise control of blood glucose, significantly improving the overall self-control and thus the quality of life of the diabetics, reducing the appearance of long-term complications. Although all diabetics receive many guidelines and recommendations for optimal control throughout their illness patients included in this protocol must be especially aware and involved in self-control, since the treatment demands more involvement both when learning to use the device as well as making decisions once they are using it. We present the case of a type 1 diabetic patient, twenty-one years of onset, who while admitted to hospital for a day, had a continuous subcutaneous insulin infusion pump implanted (insulin pump). To this end, we developed a patient care plan of patient following the steps of scientific method and relying on the NANDA taxonomy and on the NOC and NIC to design goals and nursing interventions, respectively.

Conocimiento y cumplimiento de las medidas de bioseguridad y accidentes biológicos de los estudiantes de enfermería en las prácticas clínicas / Knowledge and adherence to bio-safety measures and biological accidents by nursing students during their clinical practice

Objetivo. Identificar el grado de conocimiento y aplicación de las medidas de bioseguridad en los estudiantes de Enfermería, así como conocer los tipos de accidentes biológicos durante sus prácticas clínicas. Método. Estudio descriptivo y transversal, realizado en los estudiantes de los tres cursos de Enfermería durante el mes de mayo de 2008. La información se recogió mediante un cuestionario anónimo de autocumplimentación, obteniendo una participación del 54%. Resultados. El 97% de los estudiantes manifiesta conocer las precauciones estándares y el 100% afirma que deben ser aplicadas a todos los pacientes. Sin embargo, en la práctica clínica, las medidas de bioseguridad son aplicadas parcialmente: como media, un 60,2% manifiesta realizar las normas de higiene personal, un 66,1% manifiesta el uso de elementos de protección de barrera y un 44% manifiesta el manejo de objetos cortantes o punzantes. El 32,25% de los estudiantes ha sufrido un accidente biológico, con mayor incidencia en el segundo curso, administrando una inyección (24%), extrayendo sangre con agujas tipo venojet® (18%) y reencapsulando la aguja (17%). Conclusiones. El alto grado de conocimiento que manifiestan tener los estudiantes sobre las precauciones estándares no se demuestra en la práctica clínica. Se observan importantes deficiencias en las prácticas de seguridad de los estudiantes ya que el reencapsulado de la aguja sigue siendo una de las prácticas de riesgo más frecuente(AU)

Objective. To identify the degree of knowledge and performance of bio-safety measures by nursing students and knowing the type of biological accidents suffered during their clinical practice. Method. A cross-sectional study was conducted on the students of three Nursing courses held in May of 2008. Data was collected by an anonymous self-administered questionnaire, with a return of 54%. Results. A total of 97% of students seemed to know the standard biosafety measures, and all of them (100%) stated that those measures must be applied to every patient. However, the reality of clinical practice shows that biosafety measures are only partially applied. An average of 60.2% implement the personal hygiene measures, 66.1% use physical barriers, and 44% use sharp materials safely. Results. Around 32.25% of the students have suffered some biological accident, with a greater incidence in the second year: administering injections (24%), drawing blood samples with Venojet® needles (18%) and recapping used needles (17%). Conclusions. The high level of knowledge shown by the students on standard precautions is not always shown in clinical practice. There are significant deficiencies in student safety practices: recapping of used needles continues to be one of the most common risk practices carried out(AU)

Fibrinólisis en infarto agudo de miocardio en el Servicio de Urgencias de un hospital comarcal / Fibrinolysis in acute myocardial infarction in the emergency department of a general hospital

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[Knowledge and adherence to bio-safety measures and biological accidents by nursing students during their clinical practice]. / Conocimiento y cumplimiento de las medidas de bioseguridad y accidentes biológicos de los estudiantes de enfermería en las prácticas clínicas.

OBJECTIVE: To identify the degree of knowledge and performance of bio-safety measures by nursing students and knowing the type of biological accidents suffered during their clinical practice. METHOD: A cross-sectional study was conducted on the students of three Nursing courses held in May of 2008. Data was collected by an anonymous self-administered questionnaire, with a return of 54%. RESULTS: A total of 97% of students seemed to know the standard biosafety measures, and all of them (100%) stated that those measures must be applied to every patient. However, the reality of clinical practice shows that biosafety measures are only partially applied. An average of 60.2% implement the personal hygiene measures, 66.1% use physical barriers, and 44% use sharp materials safely. Around 32.25% of the students have suffered some biological accident, with a greater incidence in the second year: administering injections (24%), drawing blood samples with Venojet needles (18%) and recapping used needles (17%). CONCLUSIONS: The high level of knowledge shown by the students on standard precautions is not always shown in clinical practice. There are significant deficiencies in student safety practices: recapping of used needles continues to be one of the most common risk practices carried out.