Jimeno San Martín L, López Alfaro P, Sarasa Monreal Mdel M
… +5 more, Nicolás Olmedo A, Munárriz Ariz L, Azcona Martínez MA, Aguirre Santano R, Regaira Martínez E
Rev Enferm
· 2016 Apr · PMID 27349064
UNLABELLED: Patients admitted to the ICU are at risk of immobility and an early and important physical deconditioning. OBJECTIVE: To develop and to implement an early and safe protocol for ICU patients' mobilization. MET...UNLABELLED: Patients admitted to the ICU are at risk of immobility and an early and important physical deconditioning. OBJECTIVE: To develop and to implement an early and safe protocol for ICU patients' mobilization. METHODOLOGY: The Evidence Based Practice Model for Staff Nurses was used. It encompasses Assessment, Problem Identification, Planning, Implementation and Evaluation, Integration and Maintenance in Practice. RESULTS: The research team (Advanced Practice Nurse and expert clinical nurses), along with the medical team and rehabilitation service, identified the need to develop the protocol. For its elaboration, a literature search on the data bases PubMed, CINA-HL and Cochrane Library was performed; a questionnaire was administered and structured observations were conducted. For the implementation training sessions were offered to nurses, posters were placed in the unit and protocol was included in the computer program. Finally, an assessment of the knowledge, perceptions and practices of nurses in the unit and a recording of adverse events related to the mobilization will take place. CONCLUSIONS: The development and implementation of a protocol for early mobilization of ICU patients has facilitated the integration of this care in daily practice. This model of evidence-based practice allows nurses an active part in changing the culture in terms of the integration of research into practice.
Ramos Frausto VM, De La Roca Chiapas JM, Días García NY
… +2 more, Luna Camargo JG, García Rocha M
Rev Enferm
· 2016 Apr · PMID 27349063
INTRODUCTION: The Pressure Ulcer Scale for Healing (PUSH) represent a serious problem around the world since they have important consequences, personal and economic, this making it a public problem health. The PUSH are a...INTRODUCTION: The Pressure Ulcer Scale for Healing (PUSH) represent a serious problem around the world since they have important consequences, personal and economic, this making it a public problem health. The PUSH are a challenge for professionals nursing at all levels of care. OBJECTVE: Identify the frequency of Pressure Ulcer Scale for Healing in patients hospitalized in coronary and intensive unit care of a high specialty hospital. MATERIAL AND METHODS: A descriptive, observational, prospective, and cross-sectional study. The population was composed of 139 patients who were admitted in June and July period of 2015 in the Coronary and Intensive Unit Care. RESULTS: The total of patients valued (139) show a mean age of 50 years old, the 51.8% male, of these the 61.4% developed a skin lesion related to prostration. The 84.17% are not mobilized as recommended, of these the (45.3%) belonged to Neurosurgery, with a range hospital stay from 1 to 36-day. The 79.8% (111 patients) were under sedation drug. Directly related to the emergence of PUSH, obtaining 41% of patients ulcerated lesions the 8.2 average days. CONCLUSIONS: The PUSH as problem are present in a Coronary and General Intensive Care Unit frequently (41%) in June and July of 2015. The care and treatment of people with PUSH must be dynamic and interdisciplinary.
Aparicio Julián MA, Mayorga Baca MS, Morató García C
… +2 more, Masa Font R, Sánchez Schmidt JM
Rev Enferm
· 2016 Apr · PMID 27349062
INTRODUCTION: Hydroxyurea (HU) is an antineoplastic drug used in chronic myeloproliferative disorders. In this article we will go into detail about the rare but serious appearance of lower limb ulcers in relation to HU t...INTRODUCTION: Hydroxyurea (HU) is an antineoplastic drug used in chronic myeloproliferative disorders. In this article we will go into detail about the rare but serious appearance of lower limb ulcers in relation to HU treatment. METHODOLOGY: Two simultaneous cases are presented, both from patients with lower limb torpid lesions unresponsive to conventional treatments. After dismissing other aetiologies, HU was found to be the causal agent in both cases. DISCUSSION: In spite of HU's known correlation to lower limb ulcers, pathogenesis isn't clearly defined. In this article we add two more cases to the existing bibliography, with the goal of both insisting on the importance of integral valuation of patients with ulcers and contemplating dermatologic screening on patients treated with HU. CONCLUSION: HU laden ulcers are usually underdiagnosed. Integral valuation and dermatologic screening on patients are critical.
Aguilar Vega FA, Sánchez Hernández Mdel M, López Pérez MS
Rev Enferm
· 2016 Apr · PMID 27349061
Epidermolysis bullosa is a genetic disease characterized by an alteration in the proteins involved in the binding of the dermis to the epidermis. It can also affect the mucous, causing inner injuries. It is classified in...Epidermolysis bullosa is a genetic disease characterized by an alteration in the proteins involved in the binding of the dermis to the epidermis. It can also affect the mucous, causing inner injuries. It is classified into three main types: simple, junctional and dystrophic, and, depending on its inheritance, can be dominant and recessive. There is no specific treatment and its evolution is chronic, significantly affecting the quality of life of patients. The caretaking required by people with this disease is a real challenge for the nursing professional and it is very important to have the support of his family. In our case we explain how we got to modify the healthcare that this patient received for years, who was averse to changes, both himself and his family. Counseled by DEBRA nurses, the association of those affected by this disease and their families, and also by a cures-specialist nurse that DEBRA introduced to us, they helped us convincing thepatient and his family of the need of changing the hydrophilic cotton gauze dipped in antibiotic ointment with different concentrations depending on the zone, to more advanced cures, with dressings for wound healing in a moist environment, gaining time and comfort, given that previous cures were slow and painful. The pain, odor and time needed for healing has decreased. The patient has gained comfort by reducing the time spent on cures. Nursing has achieved its goal to improve the quality of the patient's life.
Cano Cerro MM, Jiménez Fornés EM, Fabrich Lloret MJ
… +3 more, Gans Cuenca O, Redón Martínez M, Sales Molió E
Rev Enferm
· 2016 Apr · PMID 27349060
The dermatosis known since reactive perforating collagenosis (RPC) is an injury that is characterized by the transepidermal elimination of the collagen. Two forms of presentation exist: the inherited one and the acquired...The dermatosis known since reactive perforating collagenosis (RPC) is an injury that is characterized by the transepidermal elimination of the collagen. Two forms of presentation exist: the inherited one and the acquired one. The acquired form appears in the adult age, principally in diabetics with renal chronic insufficiency. The hyaluronic acid is a glycosaminoglycan of high place molecular weight that is synthesized in the system vacuolar of the fibroblasts and other cells, since they are the keratinocytes, with help of the factors of growth and in other cytokines. The argentic sulphadiazine is a hackneyed medicament of antiinfectious action that is in use for anticipating and treating the infections in wounds and burns of degree the II and IIIrd. His action realizes it on bacteria and fungi.
Martínez Faura MD, Franco Romero M, Ordoño Martínez C
… +1 more, García Mallo ME
Rev Enferm
· 2016 Apr · PMID 27349059
INTRODUCTION: Maggot therapy is a wound bed preparation method of ancestral use. Its use was relegated with the emergence of antibiotics, until today, where is reemerging as an option in the treatment of chronic wounds....INTRODUCTION: Maggot therapy is a wound bed preparation method of ancestral use. Its use was relegated with the emergence of antibiotics, until today, where is reemerging as an option in the treatment of chronic wounds. METHODOLOGY: We report a case study where a six months wound in diabetic foot with torpid evolution and with several changes of ineffective treatment, improved in 3-4 days after the use of maggot therapy at home; leaving the wound bed prepared for the process of granulation. RESULTS: As could see, after four days from the application of maggot therapy, the wound bed was free of slough, also decreasing exudation and edema. Leaving the optimal conditions for wound healing. It was assessed by the VAS scale decreased pain after dressing changes. It was demonstrated that maggot therapy can be used in home or community care without inconvenience. CONCLUSION: The maggot therapy is a method of debridement fast, effective and safe, this method can be used in home care.
Burn injuries are tissue injuries originated as a result of a physical or chemical trauma. They can cause from a mild skin affectation to the total destruction of the affected tissues, depending on various levels of seve...Burn injuries are tissue injuries originated as a result of a physical or chemical trauma. They can cause from a mild skin affectation to the total destruction of the affected tissues, depending on various levels of severity. Moreover, if the affected body surface is very large, patient life can seriously be compromised. In this chapter, the intention is to clarify the nursing care for the affected area, once patient's life risk is stabilized and controlled. This care should be based on an adequate approach to local handling of burn injuries, after their severity and prognosis have been stated. To do this, it will be used the standardized nursing language NNN, referring to Nursing Diagnosis NANDA (North American Nursing Diagnosis Association), Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC). This taxonomy is very useful to describe the Nursing clinical practice of burns care because it can easily be used by nurses participating in the care of this type of patients. Nursing plans using the NNN taxonomy can be designed using existing software applications.
Hinojosa Caballero D, Torres Subires A, Álvarez Rodríguez LR
… +9 more, Garrigós Sancristóbal X, Pol Reyes MA, Espejo Arenas E, Viturtia González M, Delgado Ballesteros S, Sans Masip C, Pascual-Malo I, Zaguirre Medina M, Cuenda Macías M
Rev Enferm
· 2016 Apr · PMID 27349057
INTRODUCTION: This study presents clinical cases collecting etiologies that are more frequent in the field of complex wounds. All require a specific approach, as well as the interdisciplinary participation of different m...INTRODUCTION: This study presents clinical cases collecting etiologies that are more frequent in the field of complex wounds. All require a specific approach, as well as the interdisciplinary participation of different members of the team. But in general, established local cure plans may be quite similar. Applies them technology lipid colloidal (TLC) which consists of the combination of particles of hydrocolloid (carboxymethylcellulose) with lipid components. Products with a technology designed for every moment of healing. OBJECTIVE: Show our experience in the use of products with TLC in patients with ulcers of different etiologies. METHOD: The following products depending on the case have been used to treat: UrgoTul Absorb Border, Urgoclean (rope or plate), UrgoStart, UrgoK2 and UrgoK2 LITE. These products were applied in patients presenting four different etiologies of ulcer: hypertensive, traumatic, venous and ischemic ulcer. The use of Urgoclean rope favored cleaning the bed ulceral and applied Urgoclean plate with reinforced alginate to control the abundant exudates, with coverage of UrgoTul ABsorb Border. Once clean beds pass UrgoStart and at all times UrgoK2 bandage, cases that required compressive therapy. Intolerance to that kind of compression applied to patients presenting bandage UrgoK2 LITE (which tolerated without problem) which significantly reduced edema, favoring the control of exudate. Patients with ulcer of long evolution, at the start were reluctant to the application of new technologies, but after the first cures and sensing a good evolution, we get their confidence and commitment to the resolution. RESULTS: Are displayed clinical cases of different etiologic and personal contexts that an integral and interdisciplinary approach together with the application of products with TLC, managed to solve the problem. CONCLUSION: The materials used have been satisfactory in all cases, with a direct involvement in the resolution of lesions which carries a long unresolved, and in any of them, even with a diagnosis of poor prognosis. In the clinical practice of the wound care knowledge and research of new materials that improve the quality of life of patients, reducing the time evolution of the lesions is very important. Not to mention that education for the prevention of their health should be one of the objectives to prevent recurrences.
Normally, family plays an invaluable role concerning the dependent people care, to the extent that the concept of informal care is part of the common speech among the healthcare professionals. However, the participation...Normally, family plays an invaluable role concerning the dependent people care, to the extent that the concept of informal care is part of the common speech among the healthcare professionals. However, the participation of relatives in the health care of those hospitalized is still very low. The objective of this paper was to review the available evidence regarding the advantages of promoting the family participation in the hospitalized patient's healthcare, as well as the recommendations that several scientific societies and professional organizations have made in this sense. It has been also studied what is established in the Spanish current law in relation to the presence of the family during the professional process of healthcare. For this, diverse databases and official health organizations' recommendations about the family and the patient were revised, as well as the national, autonomic and local legislation. The evidence provided shows that the accompaniment of the family and its active participation in the healthcare of the patient is very useful to promote its recovering and well-being durina its hospitalization.
CPAP (continuous positive airway pressure) is to establish a supraatmosferica pressure throughout the respiratory cycle on which the patient vent spontaneously. Its use improves the clinical and gasometrics parameters wh...CPAP (continuous positive airway pressure) is to establish a supraatmosferica pressure throughout the respiratory cycle on which the patient vent spontaneously. Its use improves the clinical and gasometrics parameters when applied with appropriate selection criteria in the context of respiratory failure acute (IRA) hypoxemic. It has been demonstrated that applying CPAP early, decreases the need for intubation and associated complications, as well as survival, reducing health care costs and hospital stay. The use of valve Boussignac for applying a CPAP is spreading especially in the delivered environment and emergencies as a device not mechanical, simple, easy to use and transport, which can manage enough pressures to manage the patient hypoxemia. Its application is so simple that it does not need a comprehensive training and general care does not differ from other methods of mechanical ventilation noninvasive (adapted). In fact, already exist in Spain ambulances equipped with this device that can be applied and managed only by the nurse.
Although it seems that the issue of law and bioethics has been much debated today, still raising doubts and conflicts among the nursing staff on what their regulation must relationship between law and bioethics, or that...Although it seems that the issue of law and bioethics has been much debated today, still raising doubts and conflicts among the nursing staff on what their regulation must relationship between law and bioethics, or that we should know about informed consent and advance directive, if the Jehovah's Witnesses can refuse the treatments, and how these decisions affect the person and how it relates to the principle of autonomy, which are covered by a legal framework that gives greater freedom and autonomy to the patient's decision. The Jehovah's Witnesses are a Christian community descended from a group of scholars, who base their beliefs on a particular interpretation of the Bible and that, in Spain, like other denominations, are registered in the Registry of Religious Entities of the Directorate General of Religious Affairs of the Ministry of Justice. Therefore, this paper intends to analyze through a literature review the ethical and legal concepts within the existing legal framework, and how the decisions made by people, even still risking their life, must be accepted andprotected by a legalremedy, without prejudice to the exceptions provided by law.
The study was performed in order to obtain specific data confirming the influence in the diagnosis of many cardiac pathologies detected by Holter heart rate. Holter heart rate of 24 hours is an electronic device, of smal...The study was performed in order to obtain specific data confirming the influence in the diagnosis of many cardiac pathologies detected by Holter heart rate. Holter heart rate of 24 hours is an electronic device, of small size, which records and stores an electrocardiographic tracing two or three leads, while the patient activities of daily life. It leads us to conduct this study increased requests we've had in our hospital and the numerous reports that have helped in the diagnosis of our patients. We base the study with statistical data, therefore, produce two databases, one that reflects the total of studies conducted in 2013 and another with patients diagnosed with cardiac stimulation and need to refer to it. Crossing these two databases get third with patients referred for cardiac stimulation Holter heart rate realized. With these data we can say that, when this test is requested, it has a great influence on the final diagnosis (87%) and there is a high probability of finding significant findings, without forgetting the clinical and personal aspects of each patient.
Under the paradigm of complex thought, Edgar Morin and the pedagogy of the oppressed by Paulo Freire we describe and explain briefly the reasons of the squalid conditions in which develops the work of caring, which is no...Under the paradigm of complex thought, Edgar Morin and the pedagogy of the oppressed by Paulo Freire we describe and explain briefly the reasons of the squalid conditions in which develops the work of caring, which is not only an art and a science. The review of scientific literature, as well as the stories of life, support the need for a pedagogical reference change in vocational training programs.
Santacatalina Mas R, Peix Sagues MT, Miranda Salmerón J
… +3 more, Claramunt Jofre M, López López A, Salas Marco E
Rev Enferm
· 2016 Feb · PMID 27101645
The importance of protocols for preoperative antisepsis of the hands is given by the risk of transferring bacteria from the hands of the surgical team to the patient during surgery and it is relationship with infection o...The importance of protocols for preoperative antisepsis of the hands is given by the risk of transferring bacteria from the hands of the surgical team to the patient during surgery and it is relationship with infection of surgical wound site (SSI). Careful surgical scrub reduces the number of bacteria on the skin, but does not eliminate them completely, remaining transient microorganisms on hands after the surgical scrub. There fore if micropuncture in surgical gloves occurs, the correct preoperative preparation of hands and double gloving will be essential to reduce the risk of bacterial transmission to patients. The protocols for surgical hand antisepsis are two: Surgical scrub with antiseptic soap (hand scrubbing). Surgical scrub by rubbing alcohol (handrubbing). The hand antisepsis by rubbing with an alcohol solution has proved to be significantly more effective compared to soap solutions. We must also see that in surgical hand antisepsis with soap, you must rinse them with water. And often hospitals' taps and keys are contaminated by Pseudomonas spp., including P. aeuinosa.