Estudio de las condiciones sociosanitarias de una población de personas mayores usuarias de un servicio de teleasistencia

[Resumen] El envejecimiento poblacional es una realidad y Galicia acusa este fenómeno demográfico, que previsiblemente se acentuará todavía más en los próximos años. La Ley de Promoción de la Autonomía Personal y Atención a las personas en situación de dependencia implica incremento de prestaciones sociales, como la Teleasistencia domiciliaria (TAD), de baja cobertura en Galicia, a pesar de su crecimiento en los últimos años. La TAD es un servicio de apoyo social y sanitario, que según su grado de desarrollo tecnológico puede presentar diferentes funcionalidades, generalmente dirigidas a personas mayores. Se realiza estudio transversal sobre muestra de 746 usuarios de TAD, con una media de edad de 82 años, mayoría de sexo femenino (85,8%) y con características sociales y demográficas particulares, muy influenciadas por el lugar de residencia. Poseen baja comorbilidad y dependencia, pero alta discapacidad. Están polimedicados, consumiendo una media de 5,6 medicamentos al día. Las enfermedades con mayor prevalencia son aquellas proclives a tener situaciones donde la asistencia de urgencia es básica (infartos, diabetes). A efectos de mejorar la eficiencia de la TAD, es necesario implementar nuevas tecnologías de apoyo, que adaptadas a las necesidades reales del usuario, pueden significarse como eficaces herramientas para la prevención de la salud.[Resumo] O avellentamento poboacional é unha realidade e Galicia acusa este fenómeno demográfico, que previsiblemente se acentuará aínda máis nos próximos anos. A Lei de Promoción da Autonomía Persoal e Atención ás persoas en situación de dependencia implica incremento de prestacións sociais, como a Teleasistencia domiciliaria (TAD), de baixa cobertura en Galicia, malia o seu crecemento nos últimos anos. A TAD é un servizo de apoio social e sanitario, que segundo o seu grado de desenvolvemento tecnolóxico pode presentar diferentes funcionalidades, xeralmente dirixidas ás persoas maiores. Realízase estudo transversal sobre mostra de 746 usuarios de TAD, cunha media de idade de 82 anos, maioría de sexo feminino (85,8%) e con características sociais e demográficas particulares, moi influenciadas polo lugar de residencia. Posúen baixa comorbilidade e dependencia, pero alta discapacidade. Están polimedicados, consumindo unha media de 5,6 medicamentos ao día. As enfermidades con maior prevalencia son aquelas proclives a ter situacións onde a asistencia de urxencia é básica (infartos, diabetes). A efectos de mellorar a eficencia da TAD, é preciso implementar novas tecnoloxías de apoio, que adaptadas ás necesidades reais do usuario, poden significarse como eficaces ferramentas para a prevención da saúde.[Abstract] The aging of the population is a real fact and Galicia is not immune to this demographic phenomenon which will become more accentuated in the coming years. The Law for the Promotion of Personal Autonomy and Long-Term Care for people in situations of dependency imply an increase in social benefits, such as home Telecare (TAD), which still has a low coverage in Galicia despite its growth in the recent years. TAD is a service of health and social support with different functionalities according to its level of technological development, which are mainly addressed to the elderly. A cross-sectional study was performed on a sample of 746 users of TAD, mean age of 82 years old, mostly female (85.8%) and with certain social and demographic characteristics strongly influenced by the place of residence. All have low comorbidity and dependence, but high disability. They are polymedicated, with a daily consumption average of 5.6 medications. The most prevalent illnesses are likely to be those in which the emergency assistance is basic (stroke, diabetes). The health characteristics of TAD users are specific and their knowledge ensures that the technological developments are in line with the needs identified

Diseño de un proyecto para implementar la simulación como metodología didáctica en el Grado de Enfermería

[Resumen] La simulación se ha ido introduciendo en los procesos educativos en el ámbito sanitario, siendo un pilar en la metodología docente en nuestros días. La simulación se define como las actividades que imitan la realidad del entorno clínico, diseñado para entrenar procedimientos, toma de decisiones y aplicar el pensamiento crítico. Mediante la simulación se trabajan habilidades técnicas y habilidades no técnicas basadas en el CRM (Crew Resource Management) y en la cultura de seguridad y hacen referencia, entre otras, al trabajo en equipo, el liderazgo y a la comunicación eficaz. El objetivo principal del proyecto es introducir la simulación clínica en el Grado de Enfermería. El proyecto consta de 3 fases diferenciadas. La primera fase es la creación de un grupo de trabajo de profesorado voluntario en el cual se trabajarán varios puntos: estructura, dotación económica y objetivos; la segunda fase se realizará la propuesta del proyecto; la tercera fase será la formación del profesorado. La implementación de la simulación en el Grado de Enfermería será secuencial y se realizarán una evaluación anual y final, por alumnos y docentes del Grado de Enfermería.[Abstract] Simulation has been introduced into educational processes in healthcare, being a pillar in the teaching methodology in nowdays. Simulation is described as the activities that mimic the reality of the clinical setting, designed to train procedures, decision making and applying critical thinking. Simulation assist technical and non-technical skills based on the CRM (Crew Resource Management) and safety culture and which make reference to teamwork, leadership and effective communication. The main objective of the project is to introduce clinical simulation in the Nursing Degree. The project consists of 3 stages. The first stage will be the creation of a working group of voluntary teachers in which several points will work on: structure, financial resources and objectives; the second stage will be present the project proposal; the third stage will be teacher training. The implementation of the simulation in the Nursing Degree will be sequential and there will be an annual and final evaluation by students and teachers of the Nursing Degree

Morbidity and medication consumption among users of home telecare services

[Abstract] Telecare is a healthcare resource based on new technologies that, through the services offered, attempt to help elderly people to continue living in their homes. In this sense, first-generation telecare services have quickly developed in Europe. The aim of this work was to define the profile, pattern of medication consumption and disease frequencies of elderly users of a telecare service. The cross-sectional study involved 742 Spanish community-dwelling elders (85.3% of the total users aged 65 years and over who used a telecare service before the end of the data collection period). Data were collected between March and September 2012. Subjects’ mean age was 83.3 (SD 6.6) years, and the majority lived alone (78.3%) and were female (85.8%). The mean Charlson comorbidity index score was 1.13 (SD 1.1), and the mean number of prescribed medications per day was 5.6 (SD 3.0). The most frequent diseases were hypertension (51.1%) and rheumatic disorders (44%); and the most consumed medications were those for the cardiovascular (75%) and nervous (65.2%) systems. For the total sample, the three main determinants of polymedication (five or more medications) were hypertension, anxiety-depressive symptoms and coronary heart disease. Regardless of the social elements contributing to the implementation of telecare services, specific health characteristics of potential users, such as morbidity and polypharmacy, should be carefully considered when implementing telecare services in the coming years

Proyecto de Innovación Docente en la materia de Estancias Clínicas I del Grado en Enfermería a través de la metodología “Flip Teaching”

[Resumen] Contextualización: La asignatura Estancias Clínicas I es el primer paso práctico para la inmersión de los alumnos en las técnicas de Enfermería. Actualmente se organiza con presentaciones orales en aula (parte teórica) y posteriormente, con gran carga práctica, en laboratorios, con simulación para cada técnica de 2 h, en grupos pequeños de 10 alumnos. Limitaciones: transmisión de la información teórica y su relación con la parte práctica (distanciadas en tiempo y forma), desmotivación del alumnado, falta de horas prácticas para las técnicas. Objetivos: mejorar la motivación y el aprendizaje de las competencias marcadas dentro y fuera del aula (previo a la simulación) a través de la metodología Flipped Classroom. Metodología: Cuasiexperimental. Se formarán dos grupos de alumnos (experimental implantando el Flip Teaching y control) de 30 alumnos cada uno, seleccionados aleatoriamente. Se distribuirán en grupos de 10 para la simulación en laboratorio. Grupo control: seguirá la metodología tradicional. Grupo experimental: recibirá para cada técnica, presentaciones locutadas de 20 min y videos educativos elaborados por los docentes; realizarán obligatoriamente un resumen y un foro de participación y un documento de dudas (no obligatorio); finalmente, tendrán que acertar 7 preguntas de 10 aleatorias (pull de 100), con 3 intentos posibles en un autotest. Todo ello trabajado con Moodle antes de la simulación. ¿Qué esperamos?: Mejorar el proceso de enseñanza-aprendizaje y la motivación. Flexibilizar del aprendizaje previo a la sesión de simulación en laboratorio de las técnicas de enfermería. Ganar horas de simulación práctica al eliminar las clases teóricas presenciale

Cytotoxicity and concentration of silver ions released from dressings in the treatment of infected wounds: a systematic review

IntroductionSilver-releasing dressings are used in the treatment of infected wounds. Despite their widespread use, neither the amount of silver released nor the potential in vivo toxicity is known. The aim of this study was to evaluate the cytotoxic effects and the amount of silver released from commercially available dressings with infected wounds.MethodsThe review was conducted according to the PRISMA statement. The Web of Science, PubMed, Embase, Scopus, and CINAHL databases were searched for studies from 2002 through December 2022. The criteria were as follows: population (human patients with infected wounds); intervention (commercial dressings with clinical silver authorized for use in humans); and outcomes (concentrations of silver ions released into tissues and plasma). Any study based on silver-free dressings, experimental dressings, or dressings not for clinical use in humans should be excluded. According to the type of study, systematic reviews, experimental, quasi-experimental, and observational studies in English, Spanish, or Portuguese were considered. The quality of the selected studies was assessed using the JBI critical appraisal tools. Studies that assessed at least 65% of the included items were included. Data were extracted independently by two reviewers.Results740 articles were found and five were finally selected (all of them quasi-experimental). Heterogeneity was found in terms of study design, application of silver dressings, and methods of assessment, which limited the comparability between studies.ConclusionIn vivo comparative studies of clinical dressings for control of infection lack a standardized methodology that allows observation of all the variables of silver performance at local and systemic levels, as well as evaluation of its cytotoxicity. It cannot be concluded whether the assessed concentrations of released silver in commercial dressings for the topical treatment of infected wounds are cytotoxic to skin cells.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022351041, PROSPERO [CRD42022351041]

Usuarios de teleasistencia domiciliaria: enfermedades y medicación

Resume

Analysis of Arterial Blood Gas Values Based on Storage Time Since Sampling: An Observational Study

[Abstract] Aim: To evaluate the influence of time on arterial blood gas values after artery puncture is performed. Method: Prospective longitudinal observational study carried out with gasometric samples from 86 patients, taken at different time intervals (0 (T0), 15 (T15), 30 (T30) and 60 (T60) min), from 21 October 2019 to 21 October 2020. The study variables were: partial pressure of carbon dioxide, bicarbonate, hematocrit, hemoglobin, potassium, lactic acid, pH, partial pressure of oxygen, saturation of oxygen, sodium and glucose. Results: The initial sample consisted of a total of 90 patients. Out of all the participants, four were discarded as they did not understand the purpose of the study; therefore, the total number of participants was 86, 51% of whom were men aged 72.59 on average (SD: 16.23). In the intra-group analysis, differences in PCO2, HCO3, hematocrit, Hb, K+ and and lactic acid were observed between the initial time of the test and the 15, 30 and 60 min intervals. In addition, changes in pH, pO2, SO2, Na and glucose were noted 30 min after the initial sample had been taken. Conclusions: The variation in the values, despite being significant, has no clinical relevance. Consequently, the recommendation continues to be the analysis of the GSA at the earliest point to ensure the highest reliability of the data and to provide the patient with the most appropriate treatment based on those results

Are smart glasses feasible for dispatch prehospital assistance during on-boat cardiac arrest? A pilot simulation study with fishermen.

The aim of the study was to explore feasibility of basic life support (BLS) guided through smart glasses (SGs) when assisting fishermen bystanders. Twelve participants assisted a simulated out-of-hospital cardiac arrest on a fishing boat assisted by the dispatcher through the SGs. The SGs were connected to make video calls. Feasibility was assessed whether or not they needed help from the dispatcher. BLS-AED steps, time to first shock/compression, and CPR's quality (hands-only) during 2 consecutive minutes (1st minute without dispatcher feedback, 2nd with dispatcher feedback) were analyzed. Reliability was analyzed by comparing the assessment of variables performed by the dispatcher through SGs with those registered by an on-scene instructor. Assistance through SGs was needed in 72% of the BLS steps, which enabled all participants to perform the ABC approach and use AED correctly. Feasibility was proven that dispatcher's feedback through SGs helped to improve bystanders' performance, as after dispatcher gave feedback via SGs, only 3% of skills were incorrect. Comparison of on-scene instructor vs. SGs assessment by dispatcher differ in 8% of the analyzed skills: greatest difference in the "incorrect hand position during CPR" (on-scene: 33% vs. dispatcher: 0%). When comparing the 1st minute with 2nd minute, there were only significant differences in the percentage of compressions with correct depth (1st:48 ± 42%, 2nd:70 ± 31, p = 0.02). Using SGs in aquatic settings is feasible and improves BLS. CPR quality markers were similar with and without SG. These devices have great potential for communication between dispatchers and laypersons but need more development to be used in real emergencies

Basic life support training programme in schools by school nurses: how long and how often to train?

Background: Cardiopulmonary resuscitation (CPR) training in schools, despite being legislated in Spain, is not established as such within the subjects that children are taught in schools. Objective: to evaluate the acquisition of CPR skills by 11-year-old children after a brief theoretical-practical teaching programme taught by nurses at school. Methods: 62 students were assessed in a quasi-experimental study on 2 cohorts (51.4% of the sample in control group [CG]). In total, 2 sessions were given, a theoretical one, and a practical training for skill development in children, in which the CG performed the CPR in 2-minute cycles and the intervention group in 1-minute cycles. The anthropometric variables recorded were weight and height, and the variables compression quality and ventilation quality were recorded using the Laerdal ResusciAnne manikin with Personal Computer/Wireless SkillReport. Results: The assessment showed better results, in terms of BLS sequence performance and use of automated external defibrillator, in the CG and after training, except for the evaluation of the 10-second breathing assessment technique. The quality of chest compressions was better in the CG after training, as was the quality of the ventilations. There were no major differences in CPR quality after training and 4 months after the 1-minute and 2-minute training cycles. Conclusions: 11-year-old children do not perform quality chest compressions or ventilations but, considering their age, they are able to perform a BLS sequence correctly