Soporte social a personas en situación de enfermedad crónica renal

La metodología utilizada en esta investigación fue un estudio de casos descriptivo de abordaje cualitativo, con el propósito de describir el soporte social que tienen las personas en situación de enfermedad renal crónica. La muestra la conforman 26 pacientes con edades que oscilan entre 18 y 68 años, con diagnóstico de Enfermedad Renal Crónica que se encontraban en fase 3 y 4 de la enfermedad, que estaban inscritos en el Programa de Hemodiálisis de la Clínica de la Costa de la ciudad de Barranquilla. Esta investigación se basó en el modelo teórico determinado por Hilbert (1990)1, quien define el soporte social en cinco categorías: interacción personal, guía, retroalimentación, ayuda tangible e interacción social. Para la recolección de los datos se realizó a los participantes entrevistas semi-estructuradas, que permitió el análisis del soporte social con que cuentan las personas en situación de Enfermedad Crónica Renal, se evidencia en la población de estudio que el soporte es aportado en su mayoría por familiares, seguido por los amigos, Entidad Prestadora de Salud, y profesionales de la salud (enfermera-médico), que laboran en la unidad de hemodiálisis. Los datos que se analizaron describen el soporte social en cuatro categorías: AYUDA, RECURSOS, SATISFACCIÓN Y SENTIMIENTO DE AFECTO.Abstract. The methodology used in this research was a descriptive case study of qualitative approach in order to describe the social support with people suffering from chronic kidney disease. The sample is composed of 26 patients with ages ranging between 18 and 68 years, diagnosed with chronic kidney disease who were in stage 3 and 4 disease who were enrolled in the Hemodialysis Clinic of the Coast Barranquilla. This research was based on the theoretical model given by Hilbert (1990), who defines social support in five categories: personal interaction, guidance, feedback, tangible support and social interaction. For data collection the participants was semi-structured interviews, which allowed the analysis of social support available to people in a situation of chronic kidney disease, is evident in the study population that support is provided for the most by family, followed by friends, entity providing health and health professionals (nurse-doctor), working in the hemodialysis unit. The data were analyzed social support described in four categories: HELP, RESOURCES, AND SATISFACTION feeling of affection.Maestrí

TELEENFERMERIA, HERRAMIENTA DE INNOVACIÓN TECNOLÓGICA AL SEGUIMIENTO CONTÍNUO DEL CUIDADO

La implementación de las nuevas tecnologías de la información y comunicación, se han convertido hoy en día en una herramienta fundamental para el cuidado del paciente. La teleenfermería como herramienta tecnológica ofrece múltiples alternativas de cuidado al paciente desde la asistencia a distancia, siendo una innovación en los cuidados enfermeros. El objetivo de esta investigación es realizar una revisión integrativa de literatura sobre la teleenfermeria como herramienta de innovación tecnológica al seguimiento continuo del cuidado del paciente en su domicilio por enfermería. Se realizó una revisión bibliográfica mediante búsqueda de artículos en bases de datos de ciencias de la salud, como Medline, Scielo, Redalic, Bireme, Elsevier, utilizando descriptores como teleenfermeria, cuidado de enfermería y tecnología. Este estudio permite concluir que la teleenfermeria como estrategia tecnológica en el ámbito sanitario, se considera un gran avance para el cuidado enfermero, ofreciendo en los pacientes un acceso oportuno al cuidado e información por parte del personal de enfermería. Para ello, es necesario que se generen investigaciones en este campo debido a que la bibliografía referente al tema es escasa a pesar de su utilización

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Lipohipertrofia: conocimiento y educación al tratamiento con insulina en la diabetes mellitus

Introduction: Diabetes mellitus type 1 is a chronic disease that, once diagnosed, generates changes in the patient's lifestyle. In order to achieve optimal treatment and avoid subsequent complications, such as lipohypertrophy caused by the increase in the use of insulin, it is vital that patients and medical personnel receive adequate education, so that they acquire knowledge and skills related to the application of the insulin injection. Lipohypertrophy occurs due to the accumulation of subcutaneous fat at the site where insulin is repeatedly injected. Objective: To describe lipohy subject. Methodology: A review of the literature in the databases SciELO, Ovid, Medline, PubMed, ScienceDirect, and Elsevier was carried out, from which 71 articles we identified, and of which 50 met the criteria and were relevant to the search. Results: The most complete and pertinent information was selected from the databases regarding lipohypertrophy, knowledge, education, and insulin treatment in diabetes mellitus. Conclusion: This research allowed us to determine that lipohypertrophy, a secondary complication of insulin treatment in diabetes mellitus, is caused by factors such as an inadequate application technique and inadequate rotation of the injection sites, as well as the lack of knowledge that patients have regarding the treatment, and the lack of education of health personnel when it comes to the use of insulin application techniques.Introdução. A diabetes mellitus tipo 1 é uma doença crônica que, uma vez diagnosticada, gera mudanças no estilo de vida do paciente. Para obter um tratamento ótimo e evitar complicações posteriores, como lipohipertrofia pelo aumento no uso da insulina, é de vital importância proporcionar aos pacientes e o pessoal médico uma adequada educação, para que adquiram conhecimentos e habilidades na aplicação da injeção de insulina. A lipohipertrofia se apresenta por acumulação de gordura subcutânea no lugar onde se injeta constantemente a insulina. Objetivo: descrever a lipohipertrofia em pacientes com diabetes mellitus, os conhecimentos e educação que deve adquirir com respeito ao tema. Metodologia: se realizou una revisão de literatura nas bases de dados SciELO, Ovid, Medline, PubMed, ScienceDirect, Elsevier, que permitiu identificar 71 artigos, dos quais 50 cumpriam com os critérios e pertinência da busca. Resultados: selecionou-se a informação mais completa e pertinente das bases de dados, com relação à lipohipertrofia, conhecimento, educação e tratamento com insulina na diabetes Mellitus. Conclusão: esta revisão permitiu determinar que a lipohipertrofia, uma complicação secundária do tratamento com insulina na diabetes Mellitus, origina-se em fatores tais como a técnica de aplicação e rotação inadequadas dos pontos de injeção, o escasso conhecimento dos pacientes sobre o tratamento e a falta de educação do pessoal sanitário com relação ao uso das técnicas de aplicação da insulina.Introducción: la diabetes mellitus tipo 1 es una enfermedad crónica que, una vez diagnósticada, genera cambios en el estilo de vida del paciente. Para lograr un tratamiento óptimo y evitar complicaciones posteriores, como lipohipertrofia por el aumento en el uso de la insulina, es de vital importancia que se brinde a los pacientes y el personal médico una adecuada educación, para que adquieran conocimientos y habilidades en la aplicación de la inyección de insulina. La lipohipertrofia se presenta por acumulación de grasa subcutánea en el sitio donde se inyecta constantemente la insulina. Objetivo: describir la lipohipertrofia en pacientes con diabetes mellitus, los conocimientos y educación que debe adquirir con respecto al tema. Metodología: se realizó una revisión de literatura en las bases de datos SciELO, Ovid, Medline, PubMed, ScienceDirect y Elsevier, que permitió identificar 71 artículos, de los cuales 50 cumplían con los criterios y pertinencia de la búsqueda. Resultados: se seleccionó la información más completa y pertinente de las bases de datos, respecto a la lipohipertrofia, conocimiento, educación y tratamiento con insulina en la diabetes Mellitus. Conclusión: esta revisión permitió determinar que la lipohipertrofia, una complicación secundaria del tratamiento con insulina en la diabetes Mellitus; se origina en factores tales como la técnica de aplicación y rotación inadecuadas de los puntos de inyección, el escaso conocimiento de los pacientes acerca del tratamiento y la falta de educación del personal sanitario con respecto al uso de las técnicas de aplicación de la insulina

Conocimientos y prácticas en sexualidad en gestantes y madres adolescentes de una IPS de primer nivel

INTRODUCCIÓN: Existe una preocupación relacionada con las estrategias implementadas para la educación sexual de los adolescentes, puesto que, a pesar de ser una problemática ampliamente estudiada, se continúa evidenciando un aumento en las tasas de gestantes adolescentes. OBJETIVO: Determinar conocimientos y prácticas en sexualidad de las gestantes y madres adolescentes de una institución de primer nivel de atención de Barranquilla en el periodo 2018-2019. MATERIAL Y MÉTODOS: Estudio cuantitativo, descriptivo transversal realizado en una IPS de Barranquilla. Se seleccionó una muestra de 237 gestantes y madres adolescentes, se analizaron variables como conocimientos, prácticas en salud sexual. Para el análisis estadístico se utilizó el programa SPSS versión 23 siendo tabulados, organizados, interpretados y analizados por frecuencia absoluta y porcentual. RESULTADOS: La edad predominante con un 47,3% oscilo entre 15 y 19 años. El 64,1% no relacionan el coito con el sexo, el 47,7% manifiesta que la Postday es un método anticonceptivo, y el 42,2% no sabe cómo se transmiten las infecciones de transmisión sexual. El 66,2% refieren que no utilizaron método anticonceptivo en su primera relación y un 8,9% no recuerda si lo usó. CONCLUSIONES: Los resultados obtenidos guardan una estrecha relación con las estadísticas nacionales en aspectos relacionados a la edad, la escolaridad y otros factores comunes relacionados con el embarazo a temprana edad. Lo que permite afirmar que la problemática del embarazo en adolescentes afecta a las diferentes regiones del país en proporciones similares

Multinational prospective cohort study of incidence and risk factors for central line-associated bloodstream infections in ICUs of 8 Latin American countries

Background: Our objective was to identify central line (CL)-associated bloodstream infections (CLABSI) rates and risk factors in Latin-America. Methods: From January 1, 2014 to February 10, 2022, we conducted a multinational multicenter prospective cohort study in 58 ICUs of 34 hospitals in 21 cities in 8 Latin American countries (Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama). We applied multiple-logistic regression. Outcomes are shown as adjusted-odds ratios (aOR). Results: About 29,385 patients were hospitalized during 92,956 days, acquired 400 CLABSIs, and pooled CLABSI rate was 4.30 CLABSIs per 1,000 CL-days. We analyzed following 10 variables: Gender, age, length of stay (LOS) before CLABSI acquisition, CL-days before CLABSI acquisition, CL-device utilization (DU) ratio, CL-type, tracheostomy use, hospitalization type, intensive care unit (ICU) type, and facility ownership, Following variables were independently associated with CLABSI: LOS before CLABSI acquisition, rising risk 3% daily (aOR=1.03;95%CI=1.02-1.04; P < .0001); number of CL-days before CLABSI acquisition, rising risk 4% per CL-day (aOR=1.04;95%CI=1.03-1.05; P < .0001); publicly-owned facility (aOR=2.33;95%CI=1.79-3.02; P < .0001). ICU with highest risk was medical-surgical (aOR=2.61;95%CI=1.41-4.81; P < .0001). CL with the highest risk were femoral (aOR=2.71;95%CI=1.61-4.55; P < .0001), and internal-jugular (aOR=2.62;95%CI=1.82-3.79; P < .0001). PICC (aOR=1.25;95%CI=0.63-2.51; P = .52) was not associated with CLABSI risk. Conclusions: Based on these findings it is suggested to focus on reducing LOS, CL-days, using PICC instead of femoral or internal-jugular; and implementing evidence-based CLABSI prevention recommendations.Revisión por pare

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat