Actualización del Sistema de Gestión de Seguridad y Salud en el Trabajo de la empresa Básico Proyecto S.A.S.

La organización Básico Proyectos S.A.S., para el año 2016, inicio con el diseño e implementación del Sistema de Gestión de Seguridad y Salud en el Trabajo (SG-SST), bajo la norma establecida en el Decreto 1072 de 2015 y la Resolución 1111 de 2017, la cual está derogada por la Resolución 0312 de 2019. En la actualidad la empresa cuenta con un SG-SST desactualizado desde el año 2019. Durante la investigación se procuró el mejoramiento del SGSST a través de la evaluación inicial de la situación actual del SGSST y de la actualización de la matriz de riesgos donde se identificaron nuevos peligros y se valoraron los riesgos debido a los cambios organizacionales, de tal manera que se establecieron directrices para la prevención de los posibles incidentes y accidentes de trabajo a partir de probables controles de ingeniería y/o administrativos.The organization Básico Proyectos SAS, for the year 2016, began with the design and implementation of the Occupational Health and Safety Management System (SG-SST), under the norm established in Decree 1072 of 2015 and Resolution 1111 of 2017, which is repealed by Resolution 0312 of 2019. Currently, the company has an outdated SG-SST since 2019. During the investigation, the improvement of the SGSST was sought through the initial evaluation of the current situation of the SGSST and updating the risk matrix where new hazards were identified and risks due to organizational changes were assessed, in such a way that guidelines were established for the prevention of possible incidents and accidents at work based on probable engineering controls. and / or administrative.Introducción 1. Título 2. Planteamiento del Problema 2.1. Descripción del Problema 2.2. Pregunta de Investigación 2.3. Sistematización 3. Objetivos 3.1. Objetivo General 3.2. Objetivos Específicos 4. Justificación y Delimitación 4.1. Justificación 4.2. Delimitación 4.3. Limitación 5. Marcos de Referencias 5.1. Estado del Arte en Materia de Seguridad y Salud en el Trabajo 5.2. Marco Teórico 5.2.1. La tendencia de la telemedicina va en aumento 5.3. Marco Legal 6. Marco metodológico 6.1. Tipo de investigación 6.2. Paradigma 6.3. Método 6.4. Fuentes de información 6.4.1 Fuente primaria 6.4.2 Fuentes secundarias 6.5. Población 6.6. Muestra 6.7. Criterios de Inclusión 6.8. Criterios de Exclusión 6.9. Instrumentos de recolección de datos 6.10. Fases 6.10.1. Fase 1: Realizar un diagnóstico inicial de la situación actual del Sistema de Gestión de Seguridad y Salud en el Trabajo en la empresa Básico Proyectos S.A.S. 6.10.2. Fase 2: Identificar peligros y valorar los riesgos por medio de la actualización de la matriz de riesgos de la empresa Básico Proyectos S.A.S. 6.10.3. Fase 3. Diseñar estrategias acordes a las necesidades de la empresa Básico Proyectos S.A.S. 6.11. Consentimiento Informado. Ver anexo 1 6.12. Cronograma 7. Resultados 8. Análisis Financiero 8.1. Costos del proyecto 8.2. Costos y beneficios 9. Conclusiones 10. Recomendaciones 11. BibliografíaEspecializaciónEspecialista en Gerencia de la Seguridad y Salud en el TrabajoEspecialización en Gerencia de la Seguridad y Salud en el Trabaj

¡Atención Poli, con la vista en el riesgo! cuentos para seguritos

El contar historias o el storytelling, aparece como una herramienta para autores que no solo buscan el conectar de forma más auténtica con sus lectores; sino que buscan ir más allá al comprender cómo el cerebro procesa esta poderosa forma de comunicación. (Suzuki, W., Feliú-Mójer, M., Hasson, U., Yehuda, R., & Zarate, J. 2018). Esta nueva forma de contar algo, es presentada aquí, en la primera compilación de cuentos como resultado de trabajos de módulos que tratan sobre el cuerpo humano, donde el estudio y la comprensión de la forma cómo funciona nuestro organismo, es uno de los principales objetivos. Además, surge como estrategia pedagógica, que precisamente busca incentivar el desarrollo de la creatividad de los estudiantes dentro de módulos que contienen un importante abordaje de temas y conceptos como base para su desarrollo, módulos que, al incluir un alto contenido teórico, se presentan como retos para que sus temas sean interiorizados por los estudiantes. De este modo, cuando se acude a el uso de la creatividad a través del storytelling, donde se expresan ideas relacionadas con el cuerpo humano, los cuentos realizados por estudiantes aquí presentes logran mostrar cómo emplean dichos conocimientos adquiridos, organizan ideas y crean cuentos que permiten al lector recrease, conociendo diferentes aspectos sobre nuestro cuerpo y a su vez dejándose llevar por la imaginación de los autores

Libro de Proyectos Finales 2021 primer semestre

PregradoIngeniero CivilIngeniero de SistemasIngeniero ElectricistaIngeniero ElectrónicoIngeniero IndustrialIngeniero Mecánic

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care

Risk of COVID-19 after natural infection or vaccinationResearch in context

Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health

Risk of COVID-19 after natural infection or vaccinationResearch in context

Summary: Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London