Blood cultures ... What they tell you and what you do

Objetivo: Objetivo principal: Conocer la variabilidad práctica de los enfermeros/as (DUE´s) del Hospital General Nuestra Señora del Prado, sobre la técnica para la extracción de hemocultivo. Objetivos específicos: Determinar las condiciones de asepsia/ esterilidad de la técnica. Establecer la utilización (desinfección, orden de llenado, volumen, cambio de aguja) de los frascos de hemocultivos. Método: Estudio descriptivo transversal realizado en el Hospital General Nuestra Señora del Prado. Ha consistido en la entrega de un cuestionario para autocumplimentación a los profesionales de enfermería, donde se han incluido variantes tanto cuantitativas como cualitativas. Resultados: Se han recogido 52,9% encuestas de los 363 DUE´s del centro hospitalario, con una experiencia profesional media de 12,9 años [DE±7,9]. El 57,8% cree que no es necesario técnica estéril para el procedimiento. 94,7% utiliza un único antiséptico. 78,6% afirman que en la extracción de acceso venoso central desecha los primeros 10cc que extrae. Conclusiones: Consideramos un alto índice de respuesta, ya que es superior al 40% para cuestionarios autocumplimentados. Hemos observado que la mayoría de DUE´s utilizan técnica aséptica y en los protocolos estudiados no existe un consenso entre la utilización de técnica estéril y aséptica. Este estudio nos revela que la mayoría de los Enfermería Global Nº 26 Abril 2012 Página 147 DUE´s utilizan un único antiséptico, sin embargo la mayoría de los protocolos recomiendan la utilización primero de alcohol y luego povidona yodada para la desinfección de la piel.ABSTRACT Aims: Main aim: To ascertain differences in nurses at the Hospital General Nuestra Señora del Prado, in blood extraction and blood culture techniques. Specific aims: To determine the asepsis/sterility conditions of the technique; to establish the use (disinfection, filling order, volume, needle change) of the blood culture vials. Method: Transversal descriptive study made at the Hospital General Nuestra Señora del Prado. A self-completion questionnaire including quantitative and qualitative variants was delivered to nursing professionals. Results: 52.9% of the questionnaires were collected from the 363 DUE´s at the hospital. Mena working experience was 12.9 years [DE±7,9]. 57,8% believe sterile technique for the procedure was not necessary. 94.7% use a single antiseptic. 78.6% stated that they discard the first 10 cc extracted from the central vein. Conclusions: We consider that the response is high, with over 40% of the questionnaires being completed. We observed that most DUE´s use aseptic techniques and in the protocols studied there was no consensus about the use of sterilization and septic techniques. The study reveals that the majority of the DUE´s use a single antiseptic, even though most protocols recommend the use of alcohol, followed by povidone.iodine to disinfect the skin

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease