Propuesta de un modelo de gestión de seguridad y salud en el trabajo para la empresa Social del Estado Salud de Aquitania

El sistema de gestión en cada una de las compañías es obligatorio así con el cumplimiento de cada uno de los estándares de la norma OHSAS 18001 es por eso que el grupo colaborativo del curso de diplomado en gerencia del talento humano decide diseñar e implementar un sistema de seguridad en el trabajo a la empresa social del estado salud de Aquitania ubicada en el municipio de Aquitania Boyacá la cual cuenta con 70 empleados; (15 administrativos y 55 asistenciales.) Este sistema busca el bienestar físico mental y social sin tener en cuenta el tipo de trabajo de cada uno de los colaboradores, tiene como objetivo la evaluación de los riesgos para cada una de las áreas, anticiparnos a los riesgos y controlarlos mejorándolos de manera continua, se tiene en cuenta que para la implementación de este sistema de salud y seguridad en el trabajo hay una planificación, aplicación verificación y actuar, donde se identifica el planteamiento del sistema, los conceptos y teorías y junto con ellos se utiliza como método de evaluación la investigación mixta donde se nos permite recolectar información acertada y asertiva para la toma de decisiones al momento de la implementación del programa, y con esto tener claro que se quiere mantener una mejora continua de cada una de las herramientas utilizadas para contribuir con el buen clima laboral y además con la integridad de cada uno de los colaboradores, ya que es de completa responsabilidad del empleador ofrecer ambientes sanos y seguros, pero también el trabajador tiene el compromiso de ayudar a que el sistema de gestión sea exitoso mediante el autocuidado.The management system and the achievement of regulatory compliance of the OHSAS 18001 standard is mandatory in each company. Therefore, the collaborative group of the human talent management degree course has decided to design and implement an occupational safety system in the social state company Salud Aquitania; which is located in Aquitania Boyacá, and is made up of seventy employees, including 15 administrative workers and 55 care workers. This system aims to the physical, mental and social well-being of employees, not taking into consideration the kind of job they perform. The Project aims to assess, foresee and control continuously the risks in each department. It is necessary to take into account that to implement this occupational health and safety system there is a process of preparation, application, verification and assessment. It means, to identify the system planning, to set concepts and theories, to establish the use of the mixed research as the assessment approach, in which it is possible to collect accurate and assertive data, in order to take decisions when implementing the program. And in this way, keeping in mind the idea of a continuous improvement of the tools used to contribute to good work environment and personal and moral integrity of the employees, taking into account that the employer is in charge of providing safe and healthful spaces and the workers are committed to help to the success of the management system through self-care

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease