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Copyright of Pedagogía Social is the property of Pedagogia Social and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Central Line-Associated Bloodstream Infections (CLABSI) are preventable and potential fatal events, frequent in critical patient care. By mid-2018 an increase was noted in the incidence rate of CLABSI at a high complexity institution in Colombia, demanding immediate interventions to lower those numbers. Objective: To assess the effectiveness of the continuous quality improvement methodology (CQI) to lower the incidence rate of CLABSI at a university hospital in Bogotá, Colombia. Methods: Longitudinal, prospective study implementing a multifaceted intervention in accordance with the CQI methodology. The project was developed at a high complexity university hospital in Bogotá, Colombia, between July 2018 and December 2019. A root cause analysis was consecutively conducted prioritizing contributing factors, gathering ideas for improvement, building a strategy and prioritizing the implementation plan. Results: The CQI methodology enabled the identification of areas susceptible of catheter insertion and management errors at the institution; additionally, it allowed for the prioritization of the areas requiring intervention through consecutive test cycles for improvement ideas. The reduction and sustainability of insertion-related CLABSI was accomplished three months after the start of the interventions, achieving a zero value. The implementation of improvement ideas aimed at reducing the events associated with catheter maintenance was also able to reduce the incidence to zero, until the end of the period of observation of the study. Conclusions: It is feasible to implement CQI in settings similar to the one herein described, in order to efficiently reduce CLABSIs. [ABSTRACT FROM AUTHOR]

Background: Central line-associated bloodstream infections (CLABSIs) are among the most epidemiologically relevant health care-associated infections. The aseptic non-touch technique (ANTT) is a standardized practice used to prevent CLABSIs. In a pediatric hospital, the overall CLABSI rate was 1.92/1000 catheter days (CD). However, in one unit, the rate was 5.7/1000 CD. Methods: Nurses were trained in ANTT. For the implementation, plan-do-study-act (PDSA) cycles were completed. Adherence monitoring of the ANTT and epidemiological surveillance were performed. Results: ANTT adherence of 95% was achieved after 6 PDSA cycles. Hand hygiene and general cleaning reached 100% adherence. Port disinfection and material collection had the lowest adherence rates, with 76.2% and 84.7%, respectively. The CLABSI rate decreased from 5.7 to 1.26/1000 CD. Conclusion: The implementation of ANTT helped reduce the CLABSI rate. Training and continuous monitoring are key to maintaining ANTT adherence. [ABSTRACT FROM AUTHOR]

Aim. This research work aims to identify the characteristic features of the development and implementation of quality standards for patient monitoring and safety services in medical institutions, in order to improve quality based on the developed digital model, and describe the requirements for the implementation of quality control according to ISO 9001:2015 and ISO 15189:2022 Standards. Methods. The work uses a digital model of the Traumatology Center, built using the AnyLogic programming environment. This model is designed to identify and analyze effective solutions for implementation, such as patient registration processes, staffing, scheduling of specialized departments, identification of clinical characteristics and early symptoms of diseases to prevent complications during the incubation period. Results. It was discovered that modern wireless technologies and data analytics can be used to develop a remote health monitoring system, enabling early detection of chronic diseases to prevent complications. The scientific novelty of the study consists in the development of a sequence for the implementation of documentation on standardization and quality of service in medical institutions to prevent harm to patients, and improve their safety with the help of a complex of measuring devices and technologies. of the information. [ABSTRACT FROM AUTHOR]

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: Analizar la evidencia científica sobre cómo la autoevaluación contribuye a la mejora de la calidad educativa en la educación superior en enfermería. Métodos: Revisión sistemática de la literatura; entre los meses de agosto y setiembre de 2023, se realizó una revisión sistemática en las bases de datos Medline-PubMed, Scielo y Repositorios, usando descriptores en Ciencias de la Salud (DeCS/MeSH) y operadores booleanos OR y AND. Tras aplicar criterios de inclusión y exclusión, se seleccionaron 4 artículos, empleando el diagrama de flujo PRISMA. Resultados: Se identificaron 15 manuscritos en Scielo, 5 en Medline-PubMed y 10 en Repositorios, sumando 30 registros en total. A través de un análisis de títulos y resúmenes, se escogieron 4 manuscritos, eran textos completos, (2 de Scielo, 1 de PubMed y 1 de Repositorio) se incluyeron en el estudio. Los estudios evidencian mejoras en la calidad educativa a través de la autoevaluación, con avances en soporte institucional y gestión estratégica, pero con retos en el impacto de los exámenes. Conclusión: La autoevaluación desempeña un papel crucial en el incremento de la calidad educativa en la educación de enfermería, mostrando un efecto beneficioso en la enseñanza y el aprendizaje. No obstante, se requieren investigaciones adicionales para evaluar con mayor precisión la efectividad de la mejora continua en los programas de enfermería.

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To design a risk map (RM) as a tool for identifying and managing risks in the paediatric emergency department and to assess the impact of the improvement actions developed based on the identified risks in terms of the level of risk to patient safety. Methodology: A multidisciplinary working group reviewed the entire care process by applying the Failure Mode and Effects Analysis (FMEA) tool. Project phases: (1) RM 2017 and planning of improvement actions; (2) Development and implementation of improvement actions; (3) RM 2019; (4) Analysis: evolution of the RM and impact of improvement actions. Results: A total of 106 failure modes (FMs) were identified in the 2017 RM (54.7% high- or very high risk). We applied prioritization criteria to select the improvement actions to plan. Nineteen improvement actions were planned, with assigned responsible parties and deadlines, to address 46 priority FMs. One hundred percent were implemented. In the 2019 RM, we identified 110 FMs (48.2% high risk) and found an overall reduction of the risk level of 20%. Analysing the 46 priority FMs that had been addressed by the 19 planned improvement actions, we found that 60% had changed from high to medium risk level and that the risk level had decreased, both overall (–27.8%) and by process. Conclusion: The FMEA is a useful tool to identify risks, analyse the impact of improvement strategies and monitor the risk level of a complex clinical care department. The improvement actions developed succeeded in reducing the level of risk in the processes in our unit, improving patient safety. Resumen: Objetivo: Diseñar un Mapa de Riesgos (MR) como herramienta para identificar y gestionar los riesgos en Urgencias Pediátricas y analizar el impacto de las acciones de mejora desarrolladas a partir de los riesgos identificados, en el nivel de riesgo para la Seguridad del Paciente (SP). Metodología: Un grupo de trabajo multidisciplinar revisó todo el proceso asistencial aplicando la herramienta AMFE (“Análisis Modal Fallos y Efectos”). Fases del proyecto: 1ª) MR 2017 y planificación acciones de mejora; 2ª) Desarrollo e implantación de acciones de mejora; 3ª) MR 2019; 4ª) Análisis: evolución del MR e impacto de las acciones de mejora. Resultados: En el MR 2017 se identificaron 106 modos de fallo (MF) (54,7% riesgo alto o muy alto). Se aplicaron criterios de priorización para seleccionar las acciones de mejora que debían planificarse. Se planificaron 19 acciones de mejora, con responsables y plazos, que permitían abordar 46 MF prioritarios. Se implantaron el 100%. En el MR 2019 se identificaron 110 MF (48.2% riesgo alto) y se objetivó una reducción global del nivel de riesgo del 20%. Analizando los 46 MF prioritarios que se habían abordado mediante las 19 acciones de mejora planificadas, se comprobó que el 60% habían pasado de nivel de riesgo alto a medio y que se había reducido el nivel de riesgo tanto a nivel global (−27.8%) como desglosado por procesos. Conclusión: El AMFE es una herramienta útil para identificar riesgos, analizar el impacto de las estrategias de mejora y monitorizar el nivel de riesgo de un servicio clínico complejo. Las acciones de mejora desarrolladas han logrado reducir el nivel de riesgo de nuestros procesos, mejorando la SP.

Copyright of Revista Espacios is the property of Talleres de Impresos Oma and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista EntreLínguas is the property of Revista EntreLinguas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gaceta Médica de Caracas is the property of Academia Nacional de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Uno de los problemas constantes en la mejora de la evaluación de los sistemas de gestión de calidad, está relacionado con minimizar la subjetividad e incrementar los criterios de valoración. La presente investigación tuvo como objetivo proponer un procedimiento de cálculo y análisis para la evaluación del desempeño de los sistemas de gestión de calidad, orientado a reducir la subjetividad en la valoración del nivel de eficacia del sistema, según norma ISO 9000, a través del análisis de la literatura. Con este propósito, se correlacionaron los principios básicos de la gestión de calidad con indicadores de la entidad, utilizando el método de expertos para conformar una base de cálculo. El resultado obtenido fue un indicador del desempeño del sistema de gestión de calidad (EDsgc) de la organización; que, de acuerdo a los resultados del sistema, identifica la organización como: Principiante, Proactiva, Flexible, Innovadora o Sostenible. El procedimiento minimiza la subjetividad del resultado con el uso de escalas numéricas en cada indicador.

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction and Objectives: The Scarborough Health Network joined the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) in fiscal year 2017-2018 with interest in tracking surgical outcomes in General and Vascular Surgery patients. Results of the ACS NSQIP program revealed poor outcomes in 30-day urinary tract infection (UTI) rates in this population group. Results were in the lowest quartile compared to peer hospitals. To improve patient care, SHN initiated a multi-pronged quality improvement plan (QIP)., Methods: The QIP focused on several improvements: (1) clarify the current state and conduct a root cause analysis, (2) determine a plan to encourage early removal of catheters in post-surgical patients, (3) enhance team communication in the pre-operative, operative and post-operative care environments, and (4) improve education around UTI prevention and treatment., Results: This study demonstrates the success of the quality improvement plan to improve a peri-operative complication in surgical patients. By 2019, SHN saw a significant decrease in UTI rates, and became a top decile performer in ACS NSQIP., Conclusions: This study demonstrates the feasibility and success of implementing a quality improvement project, and its methods can be adapted at other hospital sites to improve patient care., (Copyright © 2024. Publicado por Elsevier España, S.L.U.)

Artificial intelligence (AI) will power many of the tools in the armamentarium of digital surgeons. AI methods and surgical proof-of-concept flourish, but we have yet to witness clinical translation and value. Here we exemplify the potential of AI in the care pathway of colorectal cancer patients and discuss clinical, technical, and governance considerations of major importance for the safe translation of surgical AI for the benefit of our patients and practices., (Copyright © 2024 AEC. Published by Elsevier España, S.L.U. All rights reserved.)

Resumen Las industrias pesqueras forman parte de cadenas de suministros complejas, por el limitado ciclo de vida del pescado, la alta variabilidad en la disponibilidad, calidad y cantidad de las materias primas; además, por los cambios que experimenta la calidad del producto en los diferentes procesos. El trabajo muestra los principales resultados de la aplicación de un procedimiento para el diagnóstico de la logística de aprovisionamiento a la industria pesquera, mediante un caso de estudio en una empresa de la provincia de Sancti Spíritus en Cuba. Para ello, se emplearon herramientas como el diagrama de influencias:análisis modal de fallos y efectos,análisis modal de variaciones y efecto y la matriz de escenarios. Se identificaron las perturbaciones e impacto de vulnerabilidades en la cadena de suministro, para robustecer su desempeño. Con el diseño de indicadores, se propusieron atributos para evaluar la calidad de la materia primar, a partir del método de índice de calidad. Abstract Fishing industries are part of complex supply chains, due to the limited life cycle of fish, high variability in the availability, quality and quantity of raw materials; also for the changes experienced by the quality of the product in the different processes. The research shows the main results of the application of a procedure for the diagnosis of supply logistics to the fishing industry, through a case study in an enterprise of the Cuban province of Sancti Spíritus. For this, tools such as the influences diagram were used; failure mode and effects analysis; variant mode and effect analysis and the scenario matrix. Disturbances were identified, as well as the impact of vulnerabilities in the supply chain to strengthen its performance. With the design of indicators, attributes were proposed to evaluate the quality of the raw material, based on the quality index method. https://doi.org/10.22209/rt.v44n1a03

Minimizing the subjectivity and increasing the criteria of valuation, have been a constant problem in order to improve the evaluation of the quality management systems. The objective of the present investigation was to develop a proposal of calculation procedure and analysis for the performance assessment of the quality management systems, guided to reduce the subjectivity in the valuation of the level of effectiveness of the system, according to norm ISO 9000, through the analysis of the literature. For this purpose, it was correlated the basic principles of the quality management with indicators of the entity, using the method of experts to conform a calculation base. The obtained result was an indicator of the performance of the quality management system (EDsgc) of the organization; that according to the results of the system, it identifies the organization as: Beginner, Proactive, Flexible, Innovative or Sustainable. The procedure minimizes the subjectivity of the result with the use of numeric scales in each indicator. [ABSTRACT FROM AUTHOR]

Copyright of Cogitare Enfermagem is the property of Cogitare Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Skin burns are associated with the presence of metallic components in transdermal drug delivery systems during Magnetic Resonance Imaging, cardioversion, or defibrillation procedures. The aim of the study was to review the presence of metallic components in marketed products of transdermal drug delivery systems in Spain., Method: For each pharmaceutical form, the summary of product characteristics was reviewed. If the information was not provided, manufacturers were contacted., Results: We identified 59 marketed products of transdermal drug delivery systems of 12 different active substances. 59.3% of patches contained metallic components or their presence could not be ruled out. Information regarding the need to remove the patch was only included in 8 summaries of product characteristics (13.6%) A table was elaborated and included the following aspects: product, active substance, manufacturer, need to remove the patch before the exposure to magnetic or electric fields, and references., Conclusion: More than a half of the patches at the time of the study contained metals or their absence could not be confirmed by the manufacturer. However, this information was only included in 13.6% of summaries of product characteristics., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

University Radiology training has been carried out for years out of the Radiology Departments, where radiologists play their professional role. However, the educational needs and the leadership of the Scientific Societies make the Radiology Departments to be involved more and more in that training, though it has to be done in overloaded professional environments where medical students can be seen as a drawback. Nevertheless, radiologists must play an important role in the Radiology training of the future doctors for optimising the use of diagnostic imaging techniques and enhance the future of the specialty by bringing to our Departments those medical students who had demonstrated the most adequate personal profiles. The Radiology Department is that place to succeed by increasing the healthcare outcomes, the research results and the visibility of Radiology through a fruitful interaction between radiologists and medical students., (Copyright © 2023 SERAM. Published by Elsevier España, S.L.U. All rights reserved.)

A knowledge management procedure was proposed for the improvement of perishable food supply chains. A documentary review, detailed observation and interview to the workers was carried out. Techniques such as: expert method, cause-effect diagram and statistical analysis were performed. The knowledge gaps of the fishermen in the fishing company were identified and the fisherman's knowledge map was constructed. It was detected that the chain under study has an: incipient maturity, which is an organization in the internalization stage, with a low probability of success. Measures are proposed to increase the degree of maturity of the most deteriorated knowledge dimensions. [ABSTRACT FROM AUTHOR]

Objetivo. Describir el marco conceptual, metodología de implementación y análisis de la Encuesta de Satisfacción de Usuarios del Sistema de Protección Social en Salud de México. Material y métodos. Se analizan los elemen­tos metodológicos de los estudios de 2013, 2014 y 2015, incluyendo el instrumento utilizado, muestreo y diseño del estudio, modelo conceptual y características e indicadores del análisis. Resultados. La encuesta captura información sobre calidad percibida y satisfacción. El muestreo tiene representación nacional y estatal. Se construyen y describen indicadores simples y compuestos (índice de satisfacción y porcentaje de problemas de calidad reportados). El análisis se completa mediante diagramas de Pareto, correlación entre indicadores y asociación con la satisfacción mediante modelos multivariados. Conclusiones. La medición de satisfacción y calidad percibida es un proceso complejo pero necesario para cumplir con la normativa y para identificar estrategias de mejora. La encuesta descrita presenta diseño y análisis rigurosos enfocados en su utilidad para mejorar.

Introduction: Quality management in healthcare is essential for safe, effective, and patient-centered services. Quality management systems (QMS) monitor and improve healthcare quality. Integrating QMS is crucial for optimal quality of care, but previous studies show gaps in integration. This study aims to assess program adherence to a QMS in cross-sectoral psycho-oncological care and to develop strategies for better integration, ultimately improving healthcare quality., Materials and Methods: The study used a utility analysis to assess the program adherence of a cross-sectoral psycho-oncology care program using a 5-point scale. The evaluation process involved breaking down the program into distinct areas, and used key figures and developed indicators to assess adherence. Descriptive statistics were used., Results: The study conducted a comprehensive assessment of program adherence in a complex care program, analysing 4460 evaluation cases based on 128 quality indicators. The results showed a score of 4.2 out of 5 points (84%), indicating a highly effective implementation of the QMS. Notably, the study observed successful implementation of top-down elements, while encountering more challenges in integrating bottom-up aspects., Conclusion: The study demonstrates effective implementation of a comprehensive QMS. Successful integration was observed in areas such as care concept, care management, quality assurance, and IT-based documentation, while challenges remain in quality development and indicators. Active leadership involvement, staff training, data collection, and a learning culture are essential for successful implementation. Future research should assess the impact and cost-effectiveness of QMSs and develop tailored approaches to sustain healthcare professionals' motivation in quality improvement efforts., (Copyright © 2023 FECA. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objetivo: Evaluar el impacto de una intervención de enfermería en la prevención y tratamiento de úlceras por presión (UPP). Metodología: Diseño cuasi experimental pre- y postintervención. Resultados: La prevalencia global de UPP no varía tras la intervención (χ² = 1,059, p = 0,589). No obstante, descienden hasta 0 las UPP de grado III y IV, la prevalencia en la Unidad de Onco-Hematología, los pacientes con riesgo bajo que desarrollaron UPP y mejora el registro del riesgo de UPP al ingreso. Conclusiones: A pesar de estas mejoras, se continuará haciendo estudios de prevalencia para conocer la situación y poder implementar mejoras que disminuyan la tasa de prevalencia.

Introducción: El contacto inicial entre paciente y médico es clave para plantear un diagnóstico diferencial. Este proceso está basado en la experiencia y en la recuperación de patrones almacenados en el cerebro. Un problema importante es la limitación de la memoria, por lo que un sistema electrónico de sugerencia de posibilidades podría ser de utilidad. Objetivos: Conocer la precisión diagnóstica de un grupo de internistas interaccionando con un sistema informático de apoyo al diagnóstico (SIAD). Conocer el grado de acuerdo entre los clínicos y el SIAD en su capacidad para enumerar un correcto diagnóstico inicial. Pacientes y método: estudio prospectivo realizado en un hospital general en Málaga, en el que se mide la precisión diagnóstica para clínicos y SIAD en una muestra de 50 pacientes. Resultados: La precisión diagnóstica de los clínicos fue del 60% y la del SIAD, del 72%(diferencia no significativa). La concordancia entre ambos fue baja (kappa = 0,33). Conclusión: Los clínicos y el SIAD tienen similar precisión diagnóstica inicial, pero una baja concordancia, lo que puede evidenciar un comportamiento operativo diferente.

Copyright of Electronic Journal of Research in Educational Psychology is the property of Editorial of the University of Almeria (Spain) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

El objetivo del trabajo es contribuir a la discusión teórico-práctica acerca de la evaluación institucional como instrumento de mejora de la calidad educativa en las instituciones de educación brasileñas y de otros países, principalmente de Latinoamérica, en aras de lograr la consolidación de una cultura de la evaluación orientada a la mejora de los procesos educativos y, consecuentemente, a la ampliación de la responsabilidad social de esas instituciones.

En este trabajo se describe el proceso de creación de una herramienta para evaluar la satisfacción con la calidad de la docencia recibida en las rotaciones de la especialidad de Medicina Preventiva y Salud Pública. Para ello se adaptó la Encuesta de Satisfacción de la Formación Especializada por parte de un panel de expertos formado por 23 residentes de nueve comunidades autónomas, que valoraron y adaptaron la encuesta a las rotaciones de la especialidad mediante una escala de Likert de 5 puntos y la inclusión de nuevas dimensiones e ítems. Las dimensiones mejor valoradas fueron la planificación y la consecución de objetivos específicos, la supervisión, la delegación de responsabilidades, los recursos y el ambiente laboral del dispositivo, la valoración personal, el estímulo, el apoyo recibido y la productividad de la rotación. El desarrollo y la utilización de esta herramienta permitirán la elección informada del itinerario formativo de los residentes de Medicina Preventiva y Salud Pública.

Copyright of Revista Iberoamericana de Evaluación Educativa is the property of Red Iberoamericana de Investigacion sobre Cambio y Eficacia Escolar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Integration of mental health care into primary care is a strategic priority of Rwanda's national mental health care programme and a central tenet of global mental health. In 2009, the international health care delivery organisation, Partners In Health, established a community based mental health programme to support national planning goals. In 2012, the organisation collaborated with the Rwanda Ministry of Health to implement a structured mentorship programme enabling government employed, primary care nurses to care for patients with severe mental disorders at primary care health care centres in one rural district. The implementation strategy included decentralised training and consistent supervision for four priority neuropsychiatric disorders. Lessons learned were applied through the transition of supervisory responsibilities to district hospital based government nurses. The programme's focus on structured mentorship for generalist nurses, systems based improvements and use of an existing public health care strengthening efforts highlight its potential as a model for integrating mental health care into primary care in resource limited settings. [ABSTRACT FROM AUTHOR]

Introduction: The chronic nature of musculoskeletal diseases requires an integrated care which involves the Primary Care and the specialities of Rheumatology, Traumatology and Rehabilitation. The aim of this study was to assess the implementation of an integrated organizational model in osteoporosis, low back pain, shoulder disease and knee disease using Deming's continuous improvement process and considering referrals and resource consumption. Material and methods: A simulation model was used in the planning to predict the evolution of musculoskeletal diseases resource consumption and to carry out a Budget Impact Analysis from 2012 to 2020 in the Goierri-Alto Urola region. In the checking stage the status of the process in 2014 was evaluated using statistical analysis to check the degree of achievement of the objectives for each speciality. Results: Simulation models showed that population with musculoskeletal disease in Goierri-Alto Urola will increase a 4.4% by 2020. Because of that, the expenses for a conventional healthcare system will have increased a 5.9%. However, if the intervention reaches its objectives the budget would decrease an 8.5%. The statistical analysis evidenced a decline in referrals to Traumatology service and a reduction of successive consultations in all specialities. Discussion: The implementation of the integrated organizational model in osteoporosis, low back pain, shoulder disease and knee disease is still at an early stage. However, the empowerment of Primary Care improved patient referrals and reduced the costs. [ABSTRACT FROM AUTHOR]

El objetivo del estudio es el conocimiento de la prevalencia de úlceras por presión en un centro hospitalario. Se realizó un estudio transversal utilizando un muestreo de conveniencia. La recogida de datos se realizó mediante un cuestionario elaborado y pilotado. En el análisis de los datos se empleó estadística descriptiva e inferencial. Este estudio nos ha permitido conocer la situación actual sobre la que partimos e implantar acciones de mejora como la difusión de los datos obtenidos, formación a los profesionales, unificación de la escala de valoración del riesgo y mejora de los registros y reevaluación de úlceras por presión.

Objetivos: Presentar el contexto, los objetivos y el proceso de elaboración de IEMAC, Instrumento de Evaluación de Modelos de Atención ante la Cronicidad, desarrollado para trasladar al terreno operativo los marcos conceptuales del Chronic Care Model (CCM), en el entorno del Sistema Nacional de Salud. Métodos: Mediante técnicas de investigación cualitativa y contando sucesivamente con expertos nacionales de diferentes perfiles, se desarrolló el IEMAC para operativizar el CCM a nuestro contexto sanitario. Se construyó una matriz considerando qué dimensiones básicas debían conformar el nuevo modelo. Se identificaron y categorizaron posibles acciones en cada dimensión, creando una taxonomía de componentes e intervenciones. Se evaluó la claridad, la pertinencia y el nivel de evidencia de cada intervención. El cuestionario resultante fue validado por otros expertos de diversas disciplinas y ámbitos. Finalmente, el instrumento IEMAC 1.0ha sido pilotado a niveles macro, meso y micro. Resultados: IEMAC es un instrumento para ser autoadministrado por organizaciones sanitarias a niveles macro, meso y micro. Consta de 6 dimensiones, 27 componentes y 80 intervenciones, cuya implantación se evalúa en una escala que combina despliegue, evaluación sistemática y orientación a la mejora. IEMAC tiene un enfoque sistémico y poblacional, integrando promoción, prevención y coordinación con servicios sociales. Conclusiones: IEMAC muestra un conjunto de intervenciones que pueden servir de hoja de ruta a decisores, gestores y clínicos interesados en construir un modelo de excelencia para la atención a pacientes crónicos, a la vez que permite que las organizaciones sanitarias conozcan su situación basal y el progreso alcanzado tras intervenciones de mejora.Objective: To present the context, aim and process of designing the Instrument for the Assessment of Chronic Care Models (Instrumento de Evaluación de Modelos de Atención ante la Cronicidad [IEMAC]), which was developed to make the conceptual framework of the chronic care model operational in the Spanish national health system. Methods: The IEMAC was developed by a series of national experts with distinct profiles of expertise using qualitative research techniques. A matrix was built with the dimensions selected as basic for the new model. In each dimension, actions were identified and categorized, creating a taxonomy of components and interventions. The clarity and appropriateness of each intervention, and the degree of evidence to support it, were assessed. The resulting questionnaire was validated by other experts from diverse disciplines and settings. Finally, the IEMAC 1.0 was piloted at macro, meso and micro levels. Results: The IEMAC is a tool to be self-administered by health organizations at macro, meso and micro levels. This instrument is composed of six dimensions, 27 components and 80 interventions, whose implementation is assessed with the aid of a scale that combines deployment, systematic evaluation, and orientation improvement. The IEMAC uses a systemic, population-based approach and integrates promotion, prevention, and coordination with social services. Conclusions: The IEMAC contains a set of interventions that can be used as a road map by decision makers, managers and clinicians interested in building a state-of-the-art chronic care model. At the same time, the IEMAC allows healthcare organizations to identify their baseline score and the progress achieved after improvement interventions.