Syndromic surveillance of Influenza-like illness in primary care: A complement to the sentinel surveillance network for periods of increased incidence of Influenza [Vigilancia sindrómica de la gripe en atención primaria, un instrumento complementario a las redes centinelas para períodos de elevada incidencia de gripe]
Carandell Jager E.,Gabinete Tecnico |
Pujol Buades A.,Sistemas de Informacion |
Mendez Castell M.C.,Direccion de Enfermeria |
Salva Fiol A.,Sistemas de Informacion
Atencion Primaria | Year: 2012
Objective: Epidemiological data on influenza is essential for resource management when the incidence of the disease in the population is very high, but not easily available in real-time. The objective of this study was to evaluate the use of a syndromic surveillance system for influenza-like illness in Primary Care (ILIsPC) and assess its level of agreement with the epidemiological data from the Influenza Sentinel Network. Localization: Health centres and deputising medical services in the Balearic Islands. Participants: Data from 122 epidemiological weeks for each system were included. Main measures: Data from January 1, 2007 to January 31, 2010 were compared. ILIsPC rates were obtained from the diagnoses registered in electronic health records of Primary Care clinics and deputising medical services. Data from Sentinel Network were obtained from weekly epidemiological reports. Intraclass correlation coefficient was calculated and Bland - Altman plot constructed. Results: There was good agreement between both measures, with an intraclass correlation coefficient of 0.88 (95% CI: 0.83-0.91). After constructing a Bland-Altman plot, the precision between both rates was greater during the periods of the highest influenza incidence. Conclusions: We believe that the syndromic surveillance system ILIsPC, provides access to very useful data in real-time, especially during periods of high influenza incidence, such as during epidemics or the recent pandemic. © 2010 Elsevier España, S.L. All rights reserved.
Salinero-Fort M.A.,Hospital Carlos III |
Gomez-Campelo P.,Hospital Carlos III |
de Burgos-Lunar C.,Hospital Carlos III |
Abanades-Herranz J.C.,Direccion Tecnica de Formacion e Investigacion |
And 2 more authors.
PLoS ONE | Year: 2012
Background: Implementation of a standardized language in Nursing Care Plans (SNCP) allows for increased efficiency in nursing data management. However, the potential relationship with patientś health outcomes remains uncertain. The aim of this study was to evaluate the effectiveness of SNCP implementation, based on North American Nursing Diagnosis Association (NANDA) and Nursing Interventions Classification (NIC), in the improvement of metabolic, weight, and blood pressure control of Type 2 Diabetes Mellitus (T2DM) patients. Methods: A two-year prospective follow-up study, in routine clinical practice conditions. 31 primary health care centers (Spain) participated with 24,124 T2DM outpatients. Data was collected from Computerized Clinical Records; SNCP were identified using NANDA and NIC taxonomies. Descriptive and ANCOVA analyses were conducted. Results: 18,320 patients were identified in the Usual Nursing Care (UNC) group and 5,168 in the SNCP group. At the two-year follow-up, the SNCP group improved all parameters except LDL cholesterol and diastolic blood pressure. We analyzed data adjustming by the baseline value for these variables and variables with statistically significant differences between groups at baseline visit. Results indicated a lowering of all parameters except HbA1c, but a statistically significant reduction was only observed with diastolic blood pressure results. However, the adjusted reduction of diastolic blood pressure is of little clinical relevance. Greater differences of control values for diastolic blood pressure, HbA1c, LDL-cholesterol and Body Mass Index were found in the SNCP group, but only reached statistical significance for HbA1c. A greater proportion of patients with baseline HbA1c ≥7 decreased to <7% at the two-year follow-up in the SNCP group than in the UNC group (16.9% vs. 15%; respectively; p = 0.01). Conclusions: Utilization of SNCP was helpful in achieving glycemic control targets in poorly controlled patients with T2DM (HbA1c ≥7%). Diastolic blood pressure results were slightly improved in the SNCP group compared to the UNC group. Trial Registration: ClinicalTrials.gov NCT01482481. © 2012 Cárdenas-Valladolid et al.
Effects of a revision program on the control of type 2 diabetics followed at the primary care level. Diabetes First program [Efectos de un programa de revisión en el control de los diabéticos tipo 2 seguidos en atención primaria. Programa Diabetes First]
Hernandez M.L.,Medico de Familia |
Navarro A.M.,Gerencia de Atencion Primaria |
Oliver A.F.N.,Gerencia de Atencion Primaria |
Pedrola Z.L.,Gerencia de Atencion Primaria |
Ruiz M.G.,Direccion de Enfermeria
Endocrinologia y Nutricion | Year: 2010
Background and objective: To analyze the evolution of the glycosylated hemoglobin and other parameters after performing a control program and follow-up by nurses to improve the control of the patients with type 2 diabetes mellitus (Diabetes First). Patients and method: Intervention study in type 2 diabetes mellitus patients from Murcia. The inclusion criterium was to be a type 2 diabetes mellitus patient badly controlled on diabetes parameters (glycosylated haemoglobin ≥ 7%). We included 831 patients from 8 primary care centers. The program consisted of three visits (first one, after three months and after six months), where the patients received diabetic education. Results: The mean initial glycosylated haemoglobin value was 8.1% ± 1.3%, after 3 months it decreased to 7.5% ± 1.1%, and after 6 months from the first visit its value was 7.5% ± 2.6%. There was a statistically significant (p < 0.001) difference between the initial glycosylated haemoglobin and the values three months later. There was not such a difference between the second and third visit. Total and low-density liporpotein cholesterol decreased significantly after 3 months (p < 0.05). High-density lipoprotein cholesterol and triglycerides showed no difference. Systolic and diastolic blood pressure significantly decreased after three months (p < 0.0001 and p < 0.005). Conclusions: A simple nursing intervention program performed in primary care centers has a very positive impact on the control and treatment of patients with type 2 diabetes mellitus. © 2010 Sociedad Española de Endocrinología y Nutrición.
PubMed | Direccion de Enfermeria and University of Malaga
Type: Journal Article | Journal: Revista de calidad asistencial : organo de la Sociedad Espanola de Calidad Asistencial | Year: 2015
The application of screening tools to detect the risk of falls in hospitalized patients is in general use. During the development of a systematic review a serious disparity in three items of the Spanish version of the Downton index was detected, compared to the original version. The aim of this study was to determine the impact of this error and to compare the estimated risk of falls with each of these versions, its validity and internal consistency.A descriptive cross-sectional study in acute hospitalised patients was performed during 2011 in Hospital Costa del Sol, Marbella. The patients risk of falling was assessed by the Spanish version of the Downton index, and then it was re-calculated according to the items in the original version. Sensitivity, specificity and Cronbachs alpha were calculated.Application of the original version of the index reduced the number of patients classified as high risk of falling by 24.2%. With the Spanish version of the tool, the possibility of being classed as high risk of falling was considerably 3.3 times higher (OR: 3.3). Both versions of the Downton index showed low accuracy and diagnostic validity. The sensitivity of the original scale was 28% and specificity of 82%. Its internal consistency was low (Cronbachs alpha: .51).The Downton index, given its poor accuracy and diagnostic validity, low internal consistency, and the significant error observed in its Spanish translation, is not the most appropriate tool to assess the risk of falls in hospitalised acute patients.