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Tarragona, Spain

Jimenez Herrera M.F.,Rovira i Virgili University | Valero Mora E.,Hospital Universitario Joan
Enfermeria Clinica | Year: 2011

The care of patients with gastrointestinal bleeding from oesophageal varices during inter-hospital transfer is a complex procedure to different causes. Some of these include, the high number of parameters to take into account, the monitoring of the electro-medical equipment, the instability of the patient and their needs or the short time available to know the patient and obtain the maximum information in order to plan a safe and proper transfer.The main role of the nurse in the transfer of critically ill patients focuses on the control and monitoring of all these aspects and the maintenance of the continuity of the caring initiated in the hospital. This requires a personalized care plan to be prepared for the patient who has to be transferred to avoid putting the individual at risk due to their high vulnerability. This should minimise the risk of possible complications or accidental incidents related to the high number of instruments used for monitoring the patients during their transfer.The case presented below describes the transfer of a patient by ambulance from a level 2 hospital to a level 3 hospital of a person who had an urgent condition that reflected all this complexity. It highlights the indications and basic care that has to be taken into account in this type of transfer and the transfer of the patient once in the receiving hospital, especially in this case, where the condition of the patient is highly compromised. © 2010 Elsevier España, S.L.

Lopez-Contreras J.,Autonomous University of Barcelona | Limon E.,at Coordinating Center | Matas L.,Hospital Universitari Germans Trias i Pujol | Olona M.,Hospital Universitario Joan | And 2 more authors.
Enfermedades Infecciosas y Microbiologia Clinica | Year: 2012

The VINCat Program is a system for epidemiological surveillance of healthcare-related infections in which the majority of Catalan hospitals participate. It has a specific module for surgical site infections (SSI) surveillance. Primary hip and knee arthroplasties are basic indicators of the program due to their high frequency and the important morbidity of SSI of these sites. Results are presented for surgical site infection (SSI) surveillance of primary hip and knee arthroplasties for the first three years of the VINCat Program. The program requires SSI surveillance to be performed in a standardized, prospective and continuous manner by an infection control team from the centers. With primary arthroplasties, as with all procedures involving implants, the surveillance is maintained for 1 year after the intervention. The VINCat Program uses the SSI definitions of the Centers for Disease Control (CDC) and patients are stratified by surgical risk, following the classification of the National Healthcare Safety Network (NHSN). During the period 2007-2009, 51 Catalan hospitals participated in the SSI surveillance of prosthetic orthopedic surgery. The overall SSI rate in the interventions for total primary hip prosthesis (7,804 procedures) was 3.0% (IC 95%: 2.6-3.4) and for total primary knee prosthesis (16,781 procedures) was 3.3% (IC95%: 3.0-3.6). During the period 2007-2009, the overall SSI rates for total primary hip and knee arthroplasty were higher than those published by some surveillance systems in our environment. There were significant differences in the infection rates by procedure and in those adjusted by risk among the different hospitals. © 2012 Elsevier España S.L. All rights reserved.

Hernandez-Osma E.,Hospital Universitario Joan | Alcolea J.M.,Master en Medicina Estetica | Alcolea J.M.,Instituto Medico Vilafortuny | Trelles M.A.,Instituto Medico Vilafortuny
Cirugia Plastica Ibero-Latinoamericana | Year: 2014

Endoluminal laser treatment is a valid alternative for elimination of dynamically insufficient great saphenous veins. Treatment is carried out under local anesthesia and/or with external cold air cooling; the procedure is not traumatic and has very little complications. We present a study on 120 limbs treated for insufficiency of the great saphenous vein with endoluminal laser on a total of 110 patients. Patients suffering from secondary varicose leg veins as a consequence of the great saphenous insufficiency were treated with polidocanol microfoam immediately after the endoluminal laser treatment. Patient control and follow-up was carried out over a mean period of 5 years. Recurrence observed was 11% over this period of time, which was analyzed to determine its origin and prompt action was taken for prevention of this recurrence. The endoluminal laser technique for the treatment of the great saphenous vein insufficiency is highly successful over medium and long term period, with results that are clearly better than those of classical stripping or similar techniques such as radiofrequency.

Afonso E.,CIBERES | Afonso E.,University of Barcelona | Llaurado M.,Hospital Universitario Joan | Gallart E.,University of Barcelona | Gallart E.,Autonomous University of Barcelona
Australian Critical Care | Year: 2013

Background: Use of chlorhexidine gluconate wipes and pre-packed washcloths has been described for preventing pathogen spread in healthcare settings. Aim: To assess the impact of chlorhexidine washcloths/wipes in preventing the spread of pathogens. Methods: Extensive and structured literature search from studies in Google Academic, Cochrane Library, Web of Science, Pubmed and Cinahl from their inception until November 2012. Findings: Final analysis included 15 studies, 9 of which were randomised controlled trials. The most frequent setting was the intensive care unit. In intensive care units, a significant reduction of bloodstream infection was associated with intervention and 3 studies revealed a decrease in blood culture contamination. One study showed a decrease in staff and environmental contamination and no increase in chlorhexidine resistance with intervention. Positive blood cultures for multiple pathogens also declined with intervention. In a paediatric intensive care unit, intervention decreased bacteraemia and catheter-associated bloodstream infection. In hospital wards, intervention was associated to a 64% reduction of pathogen transmission. One study had no statistically significant results. Pre-surgical chlorhexidine use significantly decreased bacterial colonisation but had no impact on surgical site infections. Regarding maternal and perinatal setting, one study did not show reduction of early onset neonatal sepsis and pathogen transmission. Another study of vaginal and neonatal decolonisation with chlorhexidine wiping revealed significant reduction in colonisation. One study concluded that single and multiple umbilical cord cleansing reduced the likelihood for a positive swab in 25% and 29%, respectively. Neonatal wiping maintained low levels of skin colonisation for a 24. h period, for multiple pathogens. Conclusion: Current evidence supports the usefulness of chlorhexidine washcloths and wipes in an intensive care, hospital and pre-surgical setting. More studies are required to encourage its use for prevention of perinatal and neonatal transmission of pathogens. © 2013 Australian College of Critical Care Nurses Ltd.

Chamorro C.,Hospital Universitario Puerta Of Hierro | Palencia E.,Servicio de Medicina Intensiva | Bodi M.A.,Hospital Universitario Joan | Garrido G.,Organizacion Nacional de Trasplantes ONT
Medicina Intensiva | Year: 2010

The pandemic strain of H1N1 supposes a challenge to the health care system in general and for Intensive Care Units (ICU) in particular. Therefore, it will undoubtedly have repercussions on the organ and tissue donation process. In a possible scenario of bed shortage in the ICU and difficulties in maintaining the surgical activity at a normal pace, a significant effort must be made to assure the maintenance of normal transplant activity, which should not be considered as an elective surgical procedure. Another problem related with the impact of the pandemic on the organ donation process is the possibility that a donor with influenza virus could transmit the disease to recipients. This work aims to clarify this issue, reviewing existing data on the potential transmission of influenza viruses with transplanted organs or tissue, the recommendations published in other countries and those developed in Spain by an ad hoc work group that is made up by representatives from the National Transplant Organization, the Ministry of Health and Social Policy, Regional Offices of Transplant Coordination, and various scientific societies, including SEMICYUC. © 2009 Elsevier España, S.L. y SEMICYUC.

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