Plan de intervención primaria para el manejo de riesgo cardiovascular producido por cardiopatía isquémica dirigido a los habitantes del departamento del Choco

RESUMEN El presente trabajo de grado, está basado en el análisis de la problemática de salud más prevalentes encabezada principalmente por la Enfermedad isquémica del corazón, que viven las personas en el departamento del Chocó presentando estrategias y actividades organizacionales, que logren dar efectividad en la atención primaria en Salud , la finalidad de esta propuesta es dar pautas para que se logre intervenir la enfermedad isquémica del corazón, con el fin de minimizar su impacto en salud de la población teniendo en cuenta que en Colombia, las causas de mortalidad están encabezadas por las enfermedades cardiovasculares por lo que se estima que, para el año 2020, las muertes a causa de las enfermedades cardiovasculares aumentarán en 15 a 20 % y, en el año 2030, las enfermedades crónicas no transmisibles serán responsables del 75 % de las muertes en el mundo, hemos realizado investigación de la problemática de salud que enfrenta este departamento donde se revisaron Las tasas de mortalidad en el Chocó por enfermedades del sistema circulatorio tanto en hombres como mujeres, logrando observar las falencias que existen de manera notoria en las políticas de salud adoptadas de este departamento , en cuanto se refiere a el manejo de esta enfermedad podemos decir que este comportamiento se compara con la realidad del territorio en relación a los aspectos culturales, en especial con el consumo de alimentos, la raza y otros factores predominantes que permiten y favorecen la presencia de enfermedades, no podemos dejar de lado que los Determinantes Sociales de Salud contribuyen a la aparición de enfermedades éntrelos que encontramos la pobreza, condiciones sanitas, falta de afiliación a los sistemas de salud ,Condiciones de trabajo, Necesidades Básicas Insatisfechas. Recopilamos información por medio de las diferentes fuentes como es el plan decenal y el ASIS lo que nos permitió tener una visión del atención en salud que tiene este departamento, por lo anterior se plantearon tres estrategias • Actividades que deben desarrollar las entidades territoriales de salud, como son programas de promoción y prevención al igual que Desarrollo e implementación de las acciones de vigilancia en salud. • Fomentar y capacitar campañas de prevención con folletos, carteleras y charlas al no consumo de tabaco y bebidas alcohólicas. • Se garantiza enseñar los problemas Control del estrés, con charlas educativas para el manejo controlar la presión arterial, mejoran la salud en general y la del corazón. Esta propuesta tiene como finalidad que se apliquen los El objetivo del Desarrollo sostenible que para este caso es el número 3 Salud y Bienestar que responda a las inequidades en salud existentes en el departamento la cual se registra en la alta tasa de mortalidad por enfermedad cardiopatía isquémica, para lo cual se deben construir más hospitales y vías alternas que a su vez tengan conexión con el resto del país donde se deben adoptar medidas que garanticen el derecho fundamental de la salud asegurando sus servicios públicos, lo anterior con el fin buscar el mayor beneficio para la población objeto mediante la intervención de diferentes actores (Estado-privados-población en general). Se necesita mejorar los servicios de salud para toda la población, identificar las posibles causas por las que las tasas de mortalidad por cardiopatía isquémica han aumentado, y así realizar un adecuado seguimiento a estas personas que padecen esta enfermedad, realizar programas de prevención y promoción, capacitaciones para llevar adecuados hábitos de vida saludables, actividad física Con este trabajo se lograron una serie de conclusiones y planteamientos en Salud encaminadas a la solución y mejoramiento del atención en salud del departamento del Choco.SUMMARY This degree work is based on the analysis of the most prevalent health problems led mainly by ischemic heart disease, experienced by people in the department of Chocó, presenting organizational strategies and activities that achieve effectiveness in primary care In Health, the purpose of this proposal is to provide guidelines so that ischemic heart disease can be intervened, in order to minimize its impact on the health of the population, taking into account that in Colombia, the causes of mortality are led by diseases cardiovascular diseases, so it is estimated that, by 2020, deaths from cardiovascular diseases will increase by 15 to 20% and, in 2030, chronic non-communicable diseases will be responsible for 75% of deaths in the world , we have carried out research on the health problems faced by this department where the death rates were reviewed in Chocó due to diseases of the circulatory system in both men and women, managing to observe the shortcomings that exist in a notorious way in the health policies adopted by this department, as regards the management of this disease, we can say that this behavior is compared with the reality of the territory in relation to cultural aspects, especially with food consumption, race and other predominant factors that allow and favor the presence of diseases, we cannot ignore that the Social Determinants of Health contribute to the emergence of diseases among them we find poverty, healthy conditions, lack of affiliation to health systems, working conditions, unsatisfied basic needs. We collected information through different sources such as the ten-year plan and the ASIS, which allowed us to have a vision of the health care that this department has, therefore, three strategies were proposed • Activities to be developed by the territorial health entities, such as promotion and prevention programs as well as Development and implementation of health surveillance actions. • Promote and train prevention campaigns with brochures, billboards, and talks on the non-consumption of tobacco and alcoholic beverages. • It is guaranteed to teach the problems. Stress control, with educational talks on how to manage blood pressure, improve general health and that of the heart. The purpose of this proposal is to apply the Sustainable Development objective, which for this case is number 3 Health and Well-being that responds to the existing health inequities in the department, which is recorded in the high mortality rate from ischemic heart disease , for which more hospitals and alternative roads must be built that in turn have a connection with the rest of the country where measures must be adopted that guarantee the fundamental right to health by ensuring its public services, the above in order to seek the greatest benefit for the target population through the intervention of different actors (State-private-population in general). It is necessary to improve health services for the entire population, identify the possible causes why mortality rates due to ischemic heart disease have increased, and thus carry out adequate monitoring of these people who suffer from this disease, carry out prevention and promotion programs, training to lead adequate healthy lifestyle habits, physical activity With this work, a series of conclusions and approaches in Health were achieved aimed at solving and improving health care in the department of Choco

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)