General care patients with noninvasive mechanical ventilation

Objetivos: Homogeneizar los criterios de actuación de Enfermería para mejorar la calidad asistencial. Proporcionar una herramienta de trabajo para los trabajadores de nueva incorporación fomentando el trabajo en equipo y mejorando la organización y planificación de los cuidados hacia el paciente. Método: Estudio descriptivo elaborado tras una revisión bibliográfica como apoyo a la experiencia profesional. Resultados: La descripción del procedimiento que se emplea, nos sirve de guía para el buen funcionamiento del proceso. Conclusiones: La implicación de la enfermería es de suma importancia en el proceso del paciente que precisa de Ventilación Mecánica no Invasiva (VMNI). La comparación de los artículos con el resultado obtenido y la puesta en común, nos ha llevado a la conclusión de la importancia de establecer unas bases que sirvan de motivación a los profesionales sanitarios para conseguir el mayor éxito posible en los objetivos planteados. Una adecuada secuencia de técnicas aplicadas correctamente, condicionan el éxito de la VMNI. Es imprescindible que enfermería tenga los conocimientos y las habilidades necesarios para un correcto inicio de la VMNI.Objectives: Mix the performance criteria to improve nursing care quality. Provide a working tool for fostering new workers teamwork and improving the organization and planning of care to the patient. Method: A descriptive study was developed following a literature review to support the experience. Results: The description of the procedure used, serves as a guide for the proper functioning of the process. Conclusions: The involvement of nursing is of utmost importance in the process of patients who need Noninvasive Mechanical Ventilation (NIV). The comparison of items with the result and sharing has led us to conclude the importance of establishing a foundation that will serve as motivation to healthcare professionals to achieve the greatest possible success in the objectives. A proper sequence of techniques properly applied, determine the success of NIV. It is imperative that nurses have the knowledge and skills necessary for proper initiation of NIV

Efficacy of naloxegol on symptoms and quality of life related to opioid-induced constipation in patients with cancer: a 3-month follow-up analysis

Objectives: Opioid-induced constipation (OIC) can affect up to 63% of all patients with cancer. The objectives of this study were to assess quality of life as well as efficacy and safety of naloxegol, in patients with cancer with OIC. Methods: An observational study was made of a cohort of patients with cancer and with OIC exhibiting an inadequate response to laxatives and treated with naloxegol. The sample consisted of adult outpatients with a Karnofsky performance status score ≥50. The Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) and the Patient Assessment of Constipation Symptoms (PAC-SYM) were applied for 3 months. Results: A total of 126 patients (58.2% males) with a mean age of 61.3 years (range 34-89) were included. Clinically relevant improvements (>0.5 points) were recorded in the PAC-QOL and PAC-SYM questionnaires (p<0.0001) from 15 days of treatment. The number of days a week with complete spontaneous bowel movements increased significantly (p<0.0001) from 2.4 to 4.6 on day 15, 4.7 after 1 month and 5 after 3 months. Pain control significantly improved (p<0.0001) during follow-up. A total of 13.5% of the patients (17/126) presented some gastrointestinal adverse reaction, mostly of mild (62.5%) or moderate intensity (25%). Conclusions: Clinically relevant improvements in OIC-related quality of life, number of bowel movements and constipation-related symptoms were recorded as early as after 15 days of treatment with naloxegol in patients with cancer and OIC, with a good safety profile

Cuidados generales a pacientes con ventilación mecánica no invasiva

Objectives: Mix the performance criteria to improve nursing care quality. Provide a working tool for fostering new workers teamwork and improving the organization and planning of care to the patient. Method: A descriptive study was developed following a literature review to support the experience. Results: The description of the procedure used, serves as a guide for the proper functioning of the process. Conclusions: The involvement of nursing is of utmost importance in the process of patients who need Noninvasive Mechanical Ventilation (NIV). The comparison of items with the result and sharing has led us to conclude the importance of establishing a foundation that will serve as motivation to healthcare professionals to achieve the greatest possible success in the objectives. A proper sequence of techniques properly applied, determine the success of NIV. It is imperative that nurses have the knowledge and skills necessary for proper initiation of NIV.Objetivos: Homogeneizar los criterios de actuación de Enfermería para mejorar la calidad asistencial. Proporcionar una herramienta de trabajo para los trabajadores de nueva incorporación fomentando el trabajo en equipo y mejorando la organización y planificación de los cuidados hacia el paciente. Método: Estudio descriptivo elaborado tras una revisión bibliográfica como apoyo a la experiencia profesional. Resultados: La descripción del procedimiento que se emplea, nos sirve de guía para el buen funcionamiento del proceso. Conclusiones: La implicación de la enfermería es de suma importancia en el proceso del paciente que precisa de Ventilación Mecánica no Invasiva (VMNI). La comparación de los artículos con el resultado obtenido y la puesta en común, nos ha llevado a la conclusión de la importancia de establecer unas bases que sirvan de motivación a los profesionales sanitarios para conseguir el mayor éxito posible en los objetivos planteados. Una adecuada secuencia de técnicas aplicadas correctamente, condicionan el éxito de la VMNI. Es imprescindible que enfermería tenga los conocimientos y las habilidades necesarios para un correcto inicio de la VMNI

Nursing students faced with organ donation: Multicenter stratified national study

Aim: To analyze the attitude of university nursing students at Spanish universities toward organ donation and transplantation and the factors affecting to their attitude. Background: The opinion of future nurses toward organ transplant donation could have an important influence on the population. Knowing that opinion and what factors influence it is important to improve the attitude towards organ donation and transplantation. Design: A multicenter, sociological, interdisciplinary and observational study including university nursing diploma students in a complete academic year. Methods: Selected and randomized sample was taken of students from 52 of the 111 faculties and nursing schools and faculties in Spain with teaching activity Participants: A sample of 10,566 students was selected stratified by geographical area and year. Measurement instrument: The instrument used was a validated questionnaire of attitude toward organ donation and transplantation, self-administered and completed anonymously. Results: Completion rate: 85 % (n = 9001). Of the students surveyed, 78 % (n = 7040) would donate their organs after dying. Variables related to a favourable attitude: (1) Interest in listening to a talk about organ donation and transplantation [Odds ratio 1.66, 95 % confidence interval 2.05–1.35]; (2) Family discussion [Odds ratio 2.30, 95 % confidence interval 2.79–1.90] or discussion with friends about organ donation and transplantation [Odds ratio 1.56, 95 % confidence interval 1.86–1.31]; (3) Knowing that one’s father [Odds ratio 1.54, 95 % confidence interval 1.94–1.22], mother’s [Odds ratio 1.44, 95 % confidence interval 1.82–1.13] or partner [Odds ratio 1.28, 95 % confidence interval 1.60–1.03] has a favourable opinion; (4) Having a good self-assessment of information about organ donation and transplantation [Odds ratio 2.94, 95 % confidence interval 4.90–1.78]; (5) Not being worried about possible mutilation of the body after donation [Odds ratio 2.73, 95 % confidence interval 3.36–1.72]. Conclusions: Nursing students in Spain tend to have a favourable attitude toward organ donation and trans- plantation although more than 20 % of those surveyed are not in favour. Tweetable Abstract: To maintain a high rate of organ donation for organ transplantation, it is necessary to improve the social awareness of future generations of nurses towards organ donation

A nomogram for predicting complications in patients with solid tumours and seemingly stable febrile neutropenia.

We sought to develop and externally validate a nomogram and web-based calculator to individually predict the development of serious complications in seemingly stable adult patients with solid tumours and episodes of febrile neutropenia (FN). The data from the FINITE study (n=1133) and University of Salamanca Hospital (USH) FN registry (n=296) were used to develop and validate this tool. The main eligibility criterion was the presence of apparent clinical stability, defined as events without acute organ dysfunction, abnormal vital signs, or major infections. Discriminatory ability was measured as the concordance index and stratification into risk groups. The rate of infection-related complications in the FINITE and USH series was 13.4% and 18.6%, respectively. The nomogram used the following covariates: Eastern Cooperative Group (ECOG) Performance Status ⩾2, chronic obstructive pulmonary disease, chronic cardiovascular disease, mucositis of grade ⩾2 (National Cancer Institute Common Toxicity Criteria), monocytes 0.1). The concordance index was 0.855 and 0.831 in each series. Risk group stratification revealed a significant distinction in the proportion of complications. With a ⩾116-point cutoff, the nomogram yielded the following prognostic indices in the USH registry validation series: 66% sensitivity, 83% specificity, 3.88 positive likelihood ratio, 48% positive predictive value, and 91% negative predictive value. We have developed and externally validated a nomogram and web calculator to predict serious complications that can potentially impact decision-making in patients with seemingly stable FN

Preliminary data from a 4-year mirror-image and multicentre study of patients initiating paliperidone palmitate 6-monthly long-acting injectable antipsychotic: the Paliperidone 2 per Year study

Background: Paliperidone palmitate 6-monthly (PP6M) is the first long-acting antipsychotic injectable (LAI) to allow for only two medication administrations per year, though there is presently limited insight into its effectiveness and potential added value in real clinical practice conditions. Objectives: To present our ongoing study and draw its preliminary data on patient characteristics initiating PP6M and adherence during the first year of treatment. Methods: The paliperidone 2 per year (P2Y) study is a 4-year, multicentre, prospective mirror-image pragmatic study taking place at over 20 different sites in Europe. The mirror period covers 2 years either side of the PP6M LAI initiation. Retrospective data for the previous 2 years are collected for each patient from the electronic health records. Prospective data are recorded at baseline, 6, 12, 18 and 24 months of drug administration and also cover information on concomitant psychiatric medication, relapses, hospital admissions, side effects, discontinuation and its reasons. Meanwhile, here we present preliminary data from the P2Y study at basal and 6-month period (first and second PP6M administration). Results: At the point of PP6M initiation, the most frequent diagnosis was schizophrenia (69%), the clinical global impression scale mean score was 3.5 (moderately markedly ill) and the rate of previous hospital admissions per patient and year was 0.21. PP6M was initiated after a median of 3–4 years on previous treatment: 146 (73%) from paliperidone palmitate 3-monthly, 37 (19%) from paliperidone palmitate 1-monthly and 17 (9%) from other antipsychotics. The mean dose of the first PP6M was 1098.9 mg. The retention rate at 6 months and 1 year of treatment on PP6M in our cohort was 94%. Conclusion: Patient and clinician preference for LAIs with longer dosing intervals was the main reason for PP6M initiation/switching resulting in high treatment persistence. Future data are needed to evaluate the full impact of PP6M in clinical practice

Exploring Health Science Students' Notions on Organ Donation and Transplantation: A Multicenter Study.

The knowledge acquired during university education about organ donation and transplantation (ODT) decisively influences the information future health professionals transmit. This is important in ODT where the participation of the general public is essential to obtain organs. To determine notions of Spanish medicine and nursing students on ODT and its relationship with attitude toward ODT. and design. We conducted a sociologic, multicenter, and observational study. The population for our study consisted of medical and nursing students in Spanish universities. Our database was the Collaborative International Donor Project, stratified by geographic area and academic course. A validated questionnaire (PCID-DTO-RIOS) was self-administered and completed anonymously. Our sample consisted of 9598 medical and 10,566 nursing students (99% confidence interval; precision of ±1%), stratified by geographic area and year of study. The completion rate for our study was 90%. Only 20% (n=3640) of students thought their notions on ODT were good; 41% (n=7531) thought their notions were normal; 36% (n=6550) thought their notions were scarce. Comparing groups, there were differences between those who believed that their notions on ODT were good (44% nursing vs 56% medical students; P  Only 20% of Spanish medical and nursing students thought their notions on ODT were good. Having good knowledge is related to a favorable attitude towards ODT. Receiving specific information on the subject could improve their knowledge about ODT during their training