RESUMO
OBJECTIVE: The aim of this study was to describe 2 process indicators related to taking blood cultures (BC) in an Adult Emergency Department of a tertiary university hospital in Buenos Aires,and to describe the changes after a series of educational activities for health professionals was implemented during May 2016 as regards the appropriate indication of BC and the proper collection technique. MATERIALS AND METHODS: A retrospective cohort study was designed to assess its effectiveness, which consecutively included all patients admitted during 2015-2016. The BC request rate was used as a process indicator, and the percentage of contaminated BCs and the true positives rate were used as quality indicators. Both were measured monthly and prospectively during the period of study. RESULTS: The annual adjusted rate of BC requests was 4.9% (95% CI 4.8-5) in 2015 and 2.9% (95% CI 2.8-2.9) in 2016. The rate of false positive (contaminated) BCs was 4.5% in 2015 and 4.3% after the educational intervention. The true positive BCs were 8.3% in 2015 and 12% post-intervention. CONCLUSIONS: These findings prove how important and effective the educational interventions are.
Assuntos
Hemocultura/métodos , Coleta de Amostras Sanguíneas/métodos , Uso Excessivo dos Serviços de Saúde/prevenção & controle , Corpo Clínico Hospitalar/educação , Adulto , Idoso , Argentina , Hemocultura/normas , Hemocultura/estatística & dados numéricos , Coleta de Amostras Sanguíneas/normas , Coleta de Amostras Sanguíneas/estatística & dados numéricos , Coleta de Dados/métodos , Serviço Hospitalar de Emergência , Reações Falso-Positivas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Admissão do Paciente/estatística & dados numéricos , Controle de Qualidade , Estudos RetrospectivosRESUMO
Studies in multiple sclerosis (MS) suggest a trend of increasing disease prevalence and incidence, and especially, a disproportional increase in the incidence of multiple sclerosis in women. The objective of this study was to evaluate the incidence of MS over 22 years and to determine the ratio in incidence of men to women in a health maintenance organization from Buenos Aires, Argentina. The population was made up of all members of a hospital-based HMO affiliated between January 1992 and December 2013. Each person was followed contributing time at risk. Cases with definite diagnosis of MS were included. Incidence density was calculated with 95 % confidence intervals and compared between women and men. 165,456 subjects were followed for a total of 1,488,575 person-years, of whom 42 developed MS. Incidence density was 3/100,000 person-years (95 % CI 2.1-3.5/100,000 person-years). During this period (1992-2013), the incidence rate in women increased from 1/100,000 (95 % CI 0.8-1.6) to 4.9/100,000 (95 % CI 4.1-5.4) (p < 0.001), while in men the incidence ranged from 1.4/100,000 (95 % CI 1-1.7) to 1.8 (1.3-2.1) (p = 0.16). Incidence density during the study period increased significantly in women but not in men. This is the first report of this phenomenon in Latin America region.
Assuntos
Sistemas Pré-Pagos de Saúde/estatística & dados numéricos , Esclerose Múltipla/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Argentina/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Estudos Longitudinais , Pessoa de Meia-Idade , Adulto JovemRESUMO
Fundamentos. Anafilaxia es una reacción alérgica seria y que puede causar la muerte. Existen pocos datos sobre la incidencia y las características de anafilaxia en Argentina. Objetivos. Estimar la incidencia de anafilaxia en un sistema de salud prepago de la Ciudad de Buenos Aires. Describir el conocimiento de los pacientes con diagnóstico de anafilaxia sobre medidas de prevención y tratamiento. Marco de referencia. Hospital Italiano de la Ciudad de Buenos Aires, Argentina. Diseño. Cohorte retrospectiva Población. Padrón del Hospital Italiano de Buenos Aires con diagnóstico de anafilaxia desde enero de 2006 a abril de 2014. Método. Se revisaron las historias clínicas electrónicas de 211 pacientes. La evaluación comprendió tanto el ámbito ambulatorio como internación y central de emergencias. Se realizó una encuesta telefónica para conocer el comportamiento y conocimiento de los pacientes que presentaron un episodio de anafilaxia. Se utilizó el software estadístico SPSS 19.0. Resultados. La densidad de incidencia calculada por cada 100.000 personasaño fue de 9,03 (IC95%: 7,53-10,84) para todas las causas de anafilaxia. Las causas más comunes reportadas fueron medicamentos 49,5% y alimentos 19,79%. El 63,4% no recibió prescripción de adrenalina autoinyectable, sólo el 30,9% tienen un plan de acción ante un nuevo evento. Conclusión. La anafilaxia es un problema de salud importante y común. Este estudio demuestra posibles deficiencias en la atención de los episodios de anafilaxia, no sólo en el tratamiento de episodios pasados, sino también por la falta de preparación adecuada para futuros episodios. (AU)
Background. Anaphylaxis is a serious allergic reaction that can cause death. There are few data of the incidence and characteristics of anaphylaxis in the population of Argentina. Objectives. estimate the incidence of anaphylaxis in medical care program of Buenos Aires city. Describe the knowledge of patients with diagnosis of anaphylaxis about prevention and treatment. Setting. Italian Hospital of Buenos Aires, Argentina. Design. Retrospective cohort. Population. Census of the Italian Hospital of Buenos Aires with a diagnosis of anaphylaxis in electronic health records from January 2006 to April 2014. Method. Electronic medical records of 211 patients were reviewed, the evaluation included both inpatient and outpatient setting and emergency center. A telephone survey was conducted to understand the behavior and knowledge of the patients who had an episode of anaphylaxis. SPSS 19.0 statistical software was used. Results. The density of incidence calculated per 100,000 person-years was 9.03 (95% CI: 7.53-10.84) for all causes of anaphylaxis. The most commonly reported causes were drugs 49.5% and food 19.79%. The 63.4% of patients had never received the prescription of self-injectable epinephrine; only 30.9% have a plan of action before a new event. Conclusion. Anaphylaxis is an important and common health problem. This study demonstrates the potential gaps in care episodes of anaphylaxis, not only in the treatment of past episodes, also by the lack of adequate preparation for future episodes(AU)