Revista de enfermería (Barcelona, Spain)
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We describe the process of implementation of improvements for patient safety in the administration of medication in the operating room. ⋯ We identified as areas of greatest risk the providers, the prescription and the processing, as well as the weaknesses of the professional culture of patient safety and improvement proposals.
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Current medical practice has made great progress over the past century which permits people to live longer and better than before. But this improvement has not been transferred to the field of death. To die with dignity today is a privilege only a few have. ⋯ Their petition usually goes unheard by the medical profession. The patients' autonomous law, which regulates last will and testaments or anticipated final wishes, is a step in this direction. The objective of this article is to publicize the current legal regulations related to last wills and testaments or last wishes by means of a critical review of the existing legislation.
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The branch hospital triage aimed at, as well as exercised by nurses, has evolved to meet their needs to organize and make visible the nurses' duties. However, it is still not properly considered as independent nursing intervention. Evidencing practice triage nurse in hospital as experienced by their protagonists disclosed the possible causes of this paradoxical competence. ⋯ In its results, 65.8% of those polled thought the triaje nursing training to be deficient and even though nearly half 48.7%, was considered competent to decide the level of emergency, 46.3% disagreed to take this task part of their duty. It is conclusive that the training received in hospital triage, regulated and sustained, is deficient, that is the main reason why professionals have their doubts to take on an activity they are not familiar with. Triage systems do not record the entire outcome of the nursing work and nursing methodology does not seem to be quite indicative for this task.
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Emergency Services in Spain are suffering from a permanent increase in demand, making it difficult to fast and efficient they are required. The new situation has led to a transformation of the emergency departments with structural, organizational and functional changes, being triage system one of the key points. Triage systems are intended primarily to classify patients according to the level of urgency in order to prioritize the order of attendance, in addition to defining the most appropriate location, predict clinical outcomes and resource needs of patients, which contribute to the management of Emergency Service. ⋯ Triage has become the hallmark of the hospital Emergency department who applies. It is an objective tool used to evaluate and improve the operation of the Emergency Services.
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Nasogastric tube (NGT) placement is a frequent procedure in the paediatric population. Nasogastric and orogastric tubes are commonly used in hospitalized children, in the paediatric emergency departments and in critical care departments. They have diagnostic, therapeutic, descompression or evacuation of gastric aspirates objectives. ⋯ Non-radiologic verification methods provide an accurate alternative and contribute to decrease radiation exposure for pediatric patients. Non-radiologic methods to verify appropiate placement of tubes are many and are supported by different degrees of evidence in the literature: measurement of tube length from point of entry; auscultation; placing the tube in water to assess bubbling; aspiration of stomach or intestinal contents for visual inspection; pH testing; use of CO2 monitoring devices, or combinations of these methods. In this article we thoroughly review the reliability and safety of these non radiologic methods for the verification of nasogastric tube placement.