Visita agendada do profissional de enfermagem a idosos em seu domicílio: prevenção ou tratamento?

;;OBJETIVOS:;; conocer la repercusión de la visita domiciliaria de los profesionales en enfermería a personas de 65 años o más, pluripatológicas, en morbimortalidad.;;;;MÉTODO:;; estudio retrospectivo caso-control por auditoria de historias clínicas. Muestreo aleatorio. Variables principales morbilidad, mortalidad; descriptivas: visitas de la enfermera, filiación, datos clínicos y socio sanitarios. Análisis por medidas de tendencia central, dispersión, posición, tabulación, frecuencias relativas, absolutas; no paramétricas, contrastes χ2; Wilcoxon-Mann-Whitney.;;;;RESULTADOS:;; se estudiaron a 1743 pacientes, de ellos 199 recibieron visita domiciliaria; la edad media de quien recibe visita es de 81,99 años; estos presentan mayor número de patologías de media 3,76; habitan en domicilio particular, si bien en conjunto presentan más institucionalización que los controles; el 50% no tiene identificado el Cuidador Principal; es mayor el número de visitas de las enfermeras a los pacientes que viven en residencias (p < 0,001). El 50% de casos no tiene plan de cuidados, con relación significativa (p < 0,001). No existen diferencias significativas en tiempo de vida entre los casos y los controles.;;;;CONCLUSIÓN:;; la visita domiciliaria del profesional en enfermería no repercute en la morbimortalidad; visita a los pacientes cuando ya ha aparecido el problema de salud, no hay datos de prevención.;;;;OBJETIVOS:;; conocer la repercusión de la visita domiciliaria de los profesionales en enfermería a personas de 65 años o más, pluripatológicas, en morbimortalidad.;;;;MÉTODO:;; estudio retrospectivo caso-control por auditoria de historias clínicas. Muestreo aleatorio. Variables principales morbilidad, mortalidad; descriptivas: visitas de la enfermera, filiación, datos clínicos y socio sanitarios. Análisis por medidas de tendencia central, dispersión, posición, tabulación, frecuencias relativas, absolutas; no paramétricas, contrastes χ2; Wilcoxon-Mann-Whitney.;;;;RESULTADOS:;; se estudiaron a 1743 pacientes, de ellos 199 recibieron visita domiciliaria; la edad media de quien recibe visita es de 81,99 años; estos presentan mayor número de patologías de media 3,76; habitan en domicilio particular, si bien en conjunto presentan más institucionalización que los controles; el 50% no tiene identificado el Cuidador Principal; es mayor el número de visitas de las enfermeras a los pacientes que viven en residencias (p < 0,001). El 50% de casos no tiene plan de cuidados, con relación significativa (p < 0,001). No existen diferencias significativas en tiempo de vida entre los casos y los controles.;;;;CONCLUSIÓN:;; la visita domiciliaria del profesional en enfermería no repercute en la morbimortalidad; visita a los pacientes cuando ya ha aparecido el problema de salud, no hay datos de prevención.;;;;OBJETIVOS:;; compreender o impacto da visita domiciliar dos profissionais de enfermagem a pessoas com 65 anos ou mais, com diversas doenças, em morbimortalidade.;;;;MÉTODO:;; estudo retrospectivo, caso-controle, por levantamento de registros médicos. Amostragem aleatória. Como variáveis principais, morbidade e mortalidade; descritivo: visita do enfermeiro, filiação, dados clínicos e saúde social. Análise por medidas de tendência central, dispersão, posição, catalogação, frequências relativas e absolutas; não paramétricas, contraste χ2; Wilcoxon-Mann-Whitney.;;;;RESULTADOS:;; foram incluídos no estudo 1743, destes, 199 receberam visitas domiciliares; a média de idade de quem recebeu a visita é 81,99 anos; estes apresentam maior número de doenças, com média de 3,76; vivem em casa, embora juntos tenham mais institucionalização que os controles; 50% não tem um cuidador principal; o maior o número de visitas de enfermeiros são aos pacientes que vivem em casa (p &lt; 0,001); 50% não tem nenhum plano de saúde, com relação significativa (p &lt; 0,001). Não existem diferenças significativas na vida entre casos e controles.;;;;CONCLUSÃO:;; a visita domiciliar do profissional de enfermagem não tem impacto na morbimortalidade; a visita ocorre quando os pacientes já têm problemas de saúde, sem dados de prevenção.;

Hard-to-Heal Wound Healing: Superiority of Hydrogel EHO-85 (Containing Olea europaea Leaf Extract) vs. a Standard Hydrogel. A Randomized Controlled Trial

Chronic wounds, especially those that are hard-to-heal, constitute a serious public-health problem. Although progress has been made in the development of wound dressings for healing, there is little high-quality evidence of their efficacy, with no evidence of superiority in the use of one hydrogel over another. To evaluate the superiority of a hydrogel (EHO-85), containing Olea europaea leaf extract (OELE), over a standard hydrogel (SH), the promotion and/or improvement of healing of difficult-to-heal wounds was compared in a prospective, parallel-group multicenter, randomized, observer-blinded, controlled trial (“MACAON”). Non-hospitalized patients with pressure, venous or diabetic foot-ulcers difficult-to-heal were recruited and treated with standard care, and EHO-85 (n = 35) or VariHesive (n = 34) as SH. Wound-area reduction (WAR; percentage) and healing rate (HR; mm2/day) were measured. EHO-85 showed a statistically significant superior effect over VariHesive. At the end of the follow-up period, the relative WAR decreased by 51.6% vs. 18.9% (p < 0.001), with a HR mean of 10.5 ± 5.7 vs. 1.0 ± 7.5 mm2/day (p = 0.036). EHO-85 superiority is probably based on its optimal ability to balance the ulcer bed, by modulating pH and oxidative stress. That complements the wetting and barrier functions, characteristics of conventional hydrogels. These results support the use of EHO-85 dressing, for treatment of hard-to-heal ulcers. Trial Registration AEMPS:PS/CR623/17/CE.This research was developed by QUESPER R&D, and partially funded by INNCORPO-RA-TU-2011-1886 subprogram (Ministry of Economy and Competitiveness, Spain) and the programme for the Reinforcement of Research Activity in the Clinical Management Units of the Andalusian Health Service (Department of Health, Regional Government of Andalusia, Spain)

Superiority of a Novel Multifunctional Amorphous Hydrogel Containing Olea europaea Leaf Extract (EHO-85) for the Treatment of Skin Ulcers: A Randomized, Active-Controlled Clinical Trial

This 8-week, multicenter, randomized, active-controlled, observer-blinded clinical trial was designed to demonstrate the accelerating effect on wound healing of the novel Olea europaea leaf extract hydrogel (EHO-85) by comparing it to a widely used amorphous hydrogel. Results showed that EHO-85 significantly accelerated wound healing, regardless of ulcer etiology (pressure, venous leg or diabetic foot) and prognosis, doubling the median wound area reduction compared with a reference amorphous hydrogel (79.4% vs. 39.7%; difference: −39.7%, 95% CI: −71.1 to −21.3%; p < 0.001). The intention-to-treat analysis was conducted on 195 patients from 23 Spanish health centers/nursing homes. This novel treatment balances the ulcer microenvironment by modulating reactive oxygen species and pH. These actions complement the moistening and barrier functions inherent to amorphous hydrogels, whilst also conferring EHO-85 its documented granulation formation and pain relief properties. Furthermore, efficacy was achieved safely and in a cost-efficient manner due to its multi-dose format, which reduced the amount of product needed by 85.8% over 8 weeks compared to single-use hydrogel. The present randomized controlled trial is a relevant milestone in evidence-based practice for being the first to demonstrate (i) the effectiveness of an amorphous hydrogel in accelerating wound healing and (ii) the superiority of a specific hydrogel over another.This research was funded by QUESPER R&D (Córdoba, Spain) and partially by the programme for the Reinforcement of Research Activity in the Clinical Management Units of the Andalusian Health Service (Department of Health. Regional Government of Andalusia, Spain)

Study of the effect or primary health nurses scheduled and protocolized hombe visit over and morbidity on multipathological patients of 65 or older

Objetivos: Conocer la repercusión en morbilidad de la Visita Domiciliaria de la Enfermera a personas de 65 años o más, pluripatológicas (2 ó más enfermedades crónicas). Método: Estudio retrospectivo caso (con visita)-control (sin visita); auditoria de historias clínicas de 2013. Cálculo muestral asumiendo un 14% de mortalidad en casos, nivel de confianza 95%, precisión relativa 80%, posteriormente secuencias aleatorias. Variables principales morbilidad y mortalidad; descriptivas: visitas domiciliarias, filiación, datos clínicos y sociosanitarios. SPSS 15, medidas de tendencia central, dispersión, posición y tabulación, frecuencias relativas y absolutas; técnicas no paramétricas, contrastes c2; contrastes de Wilcoxon y U de Mann-Whitney; nivel de confianza 95%. Resultados: 1743 pacientes, 1546 no recibieron visita de la enfermera en domicilio y 199 sí; predominan mujeres (60,2%), edad media de quien recibe visita 81,99 (ET 0,539), presentan mayor número de patologías de media 3,76 (ET 0,107), habitan domicilio particular, más del 50% no tiene identificado el Cuidador Principal; la media de visitas de la enfermera es de 2,44 (DT 12,479); tanto en la zona rural como en la zona urbana existe un mayor número de visitas de las enfermeras a los pacientes en residencias que a los que viven en su domicilio (p,000). Menos del 50% de los casos tiene plan de cuidados, con relación significativa (p 0,000). No existen diferencias significativas en cuanto al tiempo de vida entre los casos y los controles. Conclusión: La visita domiciliaria de la enfermera no repercute en la morbilidad; se interviene cuando ya ha aparecido el problema de salud. No se han encontrado registros con datos de prevención y se intuye una discriminación involuntaria en la atención que afecta a la mujer mayor.Objectives: To determine the impact on morbidity of Home Visit Nurse for people 65 years or older, pluripathologicals (2 or more chronic diseases). Method: Retrospective case (visit)-control (no visit); medical records of 2013 audit. Sample calculation assuming a 14% mortality in cases, 95% confidence level, 80% relative accuracy, subsequently random sequences. Main variables: morbidity and mortality; Descriptive: home visits, filiation, and socio-clinical data. SPSS 15, central tendency measures, dispersion, position and tabulation, absolute and relative frequencies; nonparametric techniques, c2 contrast; contrasts Wilcoxon and Mann- Whitney U; 95% confidence level. Results: 1743 patients, 1546 did not receive nurse visit at home and 199 did; predominantly women (60.2%), average age of visited patient 81.99 (0.539 ET), presents the highest number of pathologies, average 3.76 (0.107 ET), live in private home, over 50% have no identified Primary Caregiver; the average number of nurse visits is 2.44 (SD 12,479); both in rural and in urban areas there is a greater number of nursing visits to patients in nursing homes than those living at home (p, 000). Less than 50% of cases have care plan, with significant relationship (p 0.000). No significant differences in lifetime between cases and controls. Conclusion: Nurse home visit has no impact on morbidity; intervention takes place once the health problem has appeared. No records with prevention data and involuntary discrimination on attention affecting older women

Evaluation of user satisfaction of nursing consultation in health centers based on quality and technical communication indicators

Objetivos: Medir la satisfacción relacionada con aspectos técnicos y comunicativos de los usuarios de consulta de Enfermería en Atención Primaria. Métodos: Estudio descriptivo realizado con pacientes usuarios del Servicio de Enfermería de los Centros de Salud (CCSS) de Córdoba y provincia. Los pacientes fueron entrevistados utilizando dos tipos de preguntas, cerradas y abiertas que recogían sus opiniones y satisfacción en dominios comunicacionales como la relación enfermera-paciente, la información recibida o el tiempo empleado; así como los procedimientos utilizados. Análisis descriptivo e inferencial (Test de Ji-cuadrado; p<0,05). Las preguntas abiertas se agruparon en categorías en un proceso de análisis cualitativo que implicó a dos investigadoras independientes. Resultados: Participaron 335 pacientes. Se obtuvo un 76,5% de satisfacción en las respuestas cerradas respecto a los procedimientos utilizados en la sala de curas, sin embargo el 26,1% de los pacientes planteo alguna sugerencia o propuesta de cambio en las respuestas abiertas. Al 89,1% de satisfacción en información recibida en respuestas cerradas, el 16,1% hizo sugerencias de cambio en las respuestas abiertas. En cuanto a la relación enfermera paciente, los resultados fueron: un 94,2% mostraba satisfacción frente a un 7,5% que planteó sugerencias en preguntas abiertas; en referencia al tiempo empleado la satisfacción oscilo del 88,5% al 16,8%. Conclusiones: La mayoría de los pacientes que consultaron con Enfermería en los Centros de Salud mostraron satisfacción con la atención recibida, si bien les gustaría participar más en la toma de decisiones.ABSTRACT: Objectives: To measure the satisfaction related to communication and technical aspects of the users of nursing consultation in Primary Care. Material and methods: Descriptive study conducted with patients using the nursing service Health Centers. After consultation with the staff, the patients were interviewed using two types of open and closed questions that assessed their views and satisfaction with some communication domains. Frequency distributions and exploring the differences between the two measures were explored using descriptive and inferential analysis (chi-square test, P <0.05). Open-ended questions were grouped into categories in a process of qualitative analysis involving two researchers independently. Results: 335 patients participated, 76.5% was obtained of the closed-ended satisfaction regarding the procedures used in the treatment room, and however, 26.1% of patients won’t have any suggestions or proposed changes in the open responses. To 89.1% of satisfaction with information received in closed responses, 16.1% made suggestions for change in the open answers. As the nurse patient, the results were 94.2% showed satisfaction, compared to 7.5% which raised suggestions on open questions, and time used the ratio was 88.5% vs. 16.8%. Discussion and Conclusions: Most patients who consult with nurses in health centers showed satisfaction with care received, however they would like to participate more in decision making

Programmed home visits by nursing professionals to older adults: prevention or treatment?

OBJETIVOS: conocer la repercusión de la visita domiciliaria de los profesionales en enfermería a personas de 65 años o más, pluripatológicas, en morbimortalidad.MÉTODO: estudio retrospectivo caso-control por auditoria de historias clínicas. Muestreo aleatorio. Variables principales morbilidad, mortalidad; descriptivas: visitas de la enfermera, filiación, datos clínicos y socio sanitarios. Análisis por medidas de tendencia central, dispersión, posición, tabulación, frecuencias relativas, absolutas; no paramétricas, contrastes χ2; Wilcoxon-Mann-Whitney.RESULTADOS: se estudiaron a 1743 pacientes, de ellos 199 recibieron visita domiciliaria; la edad media de quien recibe visita es de 81,99 años; estos presentan mayor número de patologías de media 3,76; habitan en domicilio particular, si bien en conjunto presentan más institucionalización que los controles; el 50% no tiene identificado el Cuidador Principal; es mayor el número de visitas de las enfermeras a los pacientes que viven en residencias (p < 0,001). El 50% de casos no tiene plan de cuidados, con relación significativa (p < 0,001). No existen diferencias significativas en tiempo de vida entre los casos y los controles.CONCLUSIÓN: la visita domiciliaria del profesional en enfermería no repercute en la morbimortalidad; visita a los pacientes cuando ya ha aparecido el problema de salud, no hay datos de prevención

Hard-to-heal wound healing: superiority of hydrogel EHO-85 (Containing Olea europaea Leaf Extract) vs. a standard hydrogel. A randomized controlled trial

Chronic wounds, especially those that are hard-to-heal, constitute a serious public-health problem. Although progress has been made in the development of wound dressings for healing, there is little high-quality evidence of their efficacy, with no evidence of superiority in the use of one hydrogel over another. To evaluate the superiority of a hydrogel (EHO-85), containing Olea europaea leaf extract (OELE), over a standard hydrogel (SH), the promotion and/or improvement of healing of difficult-to-heal wounds was compared in a prospective, parallel-group multicenter, randomized, observer-blinded, controlled trial (“MACAON”). Non-hospitalized patients with pressure, venous or diabetic foot-ulcers difficult-to-heal were recruited and treated with standard care, and EHO-85 (n = 35) or VariHesive (n = 34) as SH. Wound-area reduction (WAR; percentage) and healing rate (HR; mm2/day) were measured. EHO-85 showed a statistically significant superior effect over VariHesive. At the end of the follow-up period, the relative WAR decreased by 51.6% vs. 18.9% (p < 0.001), with a HR mean of 10.5 ± 5.7 vs. 1.0 ± 7.5 mm2/day (p = 0.036). EHO-85 superiority is probably based on its optimal ability to balance the ulcer bed, by modulating pH and oxidative stress. That complements the wetting and barrier functions, characteristics of conventional hydrogels. These results support the use of EHO-85 dressing, for treatment of hard-to-heal ulcers

EHO-85, Novel Amorphous Antioxidant Hydrogel, Containing Olea europaea Leaf Extract—Rheological Properties, and Superiority over a Standard Hydrogel in Accelerating Early Wound Healing: A Randomized Controlled Trial

Many advanced wound healing dressings exist, but there is little high-quality evidence to support them. To determine the performance of a novel amorphous hydrogel (EHO-85) in relation to its application, we compared its rheological properties with those of other standard hydrogels (SH), and we assessed the induction of acceleration of the early stages of wound healing as a secondary objective of a prospective, multicenter, randomized, observer-blinded, controlled trial. The patients were recruited if they had pressure, venous, or diabetic foot ulcers and were treated with EHO-85 (n = 103) or VariHesive® (SH) (n = 92), and their response was assessed by intention-to-treat as wound area reduction (WAR (%)) and healing rate (HR mm2/day) in the second and fourth weeks of treatment. Results: EHO-85 had the highest shear thinning and G′/G″ ratio, the lowest viscous modulus, G″, and relatively low cohesive energy; EHO-85 had a significantly superior effect over SH in WAR and HR, accelerating wound healing in the second and fourth weeks of application (p: 0.002). This superiority is likely based on its optimal moisturizing capacity and excellent pH-lowering and antioxidant properties. In addition, the distinct shear thinning of EHO-85 facilitates spreading by gentle hand pressure, making it easier to apply to wounds. These rheological properties contribute to its improved performance.This research was developed by QUESPER R&D, and partially funded by INNCORPORA-TU-2011-1886 subprogram (Ministry of Economy and Competitiveness, Spain) and the programme for the Reinforcement of Research Activity in the Clinical Management Units of the Andalusian Health Service (Department of Health, Regional Government of Andalusia, Spain). The characterization of rheological properties was financed by Noventure, Ferrer company group