Mitigación del riesgo biomecánico del área operativa de la empresa Dígitos y Diseños industria gráfica SAS. un aporte desde el análisis ergonómico de puestos de trabajo.

189 p.770/5000 In Colombia, according to the I and II ENCSST, they identify the musculoskeletal risk factors as the most reported by workers, analyzing the company DIGITOS Y DISEÑOS INDUSTRIA GRAFICA SAS and the health diagnosis issued by the Health Service Provider Institution (IPS) in charge From the performance of the occupational medical examinations, it was evidenced that 35% of the workers referred pain of musculoskeletal origin, based on this, an analysis of these risk factors was carried out through the OCRA, RULA and GINSTH methods for repetitive movements, load postural and manual handling of loads respectively, finding as a result the need to redesign activities and jobs in the operational area.1. Título. 2. Problema de investigación. 3. Objetivos. 4. Justificación y delimitación. 5. Marcos referenciales. 6. Diseño metodológico. 7. Resultados. 8. Análisis financiero (costo-beneficio). 9. Conclusiones. 10. Referencias bibliográficas.En Colombia, según la I y II ENCSST identifican los factores de riesgo musculoesqueléticos como los más reportados por los trabajadores, Analizando la empresa DIGITOS Y DISEÑOS INDUSTRIA GRAFICA SAS y el diagnóstico de salud emitido por la Institución Prestadora de Servicios de Salud (IPS) encargada de la realización de los exámenes médicos ocupacionales se evidencio que el 35% de los trabajadores refirieron dolor de origen músculo esquelético, partiendo de esto se realizo análisis de estos factores de riesgo por medio de los métodos OCRA, RULA y GINSTH para movimientos repetitivos, carga postural y manipulación manual de cargas respectivamente encontrando como resultado la necesidad de realizar rediseño en actividades y puestos de trabajo del área operativa

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)