NPunto

17

Authors: Fanjul Palleiro, S

Introduction: The objective of palliative care is to improve the quality of life of people in terminal situations, covering physical aspects, psychological and spiritual 1 so that they can live in the best possible way until their death. Main objective: To know the prevention and treatment measures for the proper management of pressure ulcers in palliative patients. Secondary objectives: To know the general aspects of pressure ulcers in palliative patients and to describe the characteristics of the palliative patient. Methodology: A literature review has been carried out on pressure ulcers in people in palliative treatment. The database used to search for references has been PubMed, Medline and Google Scholar. The selection criteria used were: Spanish language and English and publications from 2014 onwards. 32 articles were reviewed. Conclusions: Pressure ulcers are a worldwide public health problem that is aggravated if they are patients who are at the end of life, since they greatly decrease the quality of life. It is essential to raise awareness of both prevention and proper management of these injuries at the end of life, where patient comfort should prevail, providing the best quality of life until the last day of life.

19

Authors: Campos Campos, I

Introduction: The World Health Organization (WHO) states that "pressure ulcers are the result of ischemic necrosis at the skin level, as well as subcutaneous tissues, it is commonly created due to the pressure exerted on a bony prominence." On the other hand, it defines palliative care as an “approach that improves the quality of life of patients and families facing the problems associated with life-threatening diseases, through the prevention and relief of suffering through early identification. And impeccable evaluation and treatment of pain and other problems, physical, psychological and spiritual.” WHO also emphasizes that Palliative Care should not be limited exclusively to the last days of life but should be applied progressively as the disease progresses and depending on the needs of patients and families. Taking into account the two definitions, we can show that pressure ulcers will be an important problem in patients who need palliative care, an issue that we will develop in this work. Aims: Collect information about the appearance of pressure ulcers and their prevention in the environment of palliative care. I consider that pressure ulcers are a very important issue in the care of the sick and even more in those at the end of their life, where we find a majority of patients bedridden or who cannot express what they feel. Methodology: The work carried out is a bibliographic review for which the following databases were consulted: PubMed, Science Direct, Cuiden, SIETES, IBECS and Cochrane. Articles written in Spanish and English were reviewed. Results: Of the 62 articles consulted, they were finally used for the results of this review 48. It is objective that pressure ulcers are a very important problem in our environment, it is considered a serious disease that affects the quality of life of patients, as well as it is considered a quality criterion of the social health centers. It also increases patient care costs. A very important fact is that they can be prevented in 95% of cases, so measures must be taken to prevent them. There are cases in which they cannot be prevented, these are considered in patients receiving palliative care, where the comfort of the patient must prevail before the healing of the pressure ulcer. Deficient knowledge is shown by healthcare professionals regarding the management of pressure ulcers in palliative patients. Conclusion: Pressure ulcers are a serious entity that can be prevented in most cases. As for injuries in patients with palliative care, it should be borne in mind that patient comfort should prevail. Much remains to be done, the training of health professionals in this area is necessary.

36

Authors: Suárez García, J.M

This document aims to define the diagnosis, prevention and treatment of pressure ulcers from the nursing point of view, with special emphasis on the nursing diagnoses present in these patients, as well as activities that should incorporate nursing plans that focus on people with this type of condition. To carry out the search for information on this topic, a bibliographic review of the scientific literature was carried out in different databases. Ulcers are a type of crater-like wound on the skin or mucous membrane, and in the case of pressure ulcers they appear because of prolonged pressure over time on a bony prominence. In addition, knowing about these types of lesions and how to act on them is of vital importance for clinical practice, as they are one of the most common conditions in the hospital setting. This paper details the general measures for the care of all types of wounds (evaluation, cleaning, control of exudate, debridement, prevention of infection...), in addition to the classification of pressure ulcers, their epidemiology, prevention, Scales of assessment, treatment and, above all, of the care plans that we will be able to develop with this type of patient in detail.

17

Authors: Martín Vázquez, L

Current evidence suggests that the nutritional status of patients plays an important role in the prevention, healing and healing of pressure ulcers. Thus, our main objective has been to carry out a bibliographic review on the relationship between the appearance of pressure ulcers and the nutritional status of patients. Therefore, we carried out a bibliographic review using one of the main databases that exist in health sciences such as: PubMed, Medline plus, Cochrane Library, Dialnet plus and Scopus to search for clinical trials and experimental studies published in the last ten years . In addition to using the MeSH and DeSH descriptors to narrow the search. Consequently, 10 studies conducted in older adult patients met the inclusion criteria. On the other hand, food and nutritional supplements, especially arginine and zinc, are the most used for the prevention and healing of pressure ulcers. Pressure ulcers cause pain, discomfort, long hospital stays, long illness, and high cost of care for the health economy. Because nutritional status can influence the integrity of the skin and the healing of pressure ulcers, malnutrition should be prevented or treated whenever possible in all patients. Therefore, appropriate nutritional interventions are effective in the prevention and treatment of pressure ulcers. Nutrition and hydration, as well as wound mobilization and management, are considered the main key factors in the prevention and treatment of pressure ulcers in older adults.

20

Authors: Mediavilla Álvarez, E

During the first definition set forth in the Declaration of the Alma-Ata at the International Conference on Primary Health Care convened by the World Health Organization in 1978, in which the Primary Health Care was appointed responsible for carrying out a series of public health actions in terms of diagnosis, prevention, cure and rehabilitation, Primary Care has been considered the best mechanism to provide an improvement in the health of the population. As can be expected, over the years it has made changes to have the Primary Care that we know today. The nursing staff is an important link in the care and prevention of skin lesions, since the skin is the main mechanism (first line) of defense that the organism has against the external environment. When due to certain circumstances, from which we highlight immobility in patients, in which a deterioration or rupture of the skin integrity occurs, pressure ulcers arise as a consequence. Because these care require an individualized plan of care, the Primary Care Nursing should perform an evaluation of the same and pattern of treatment and care to manage to control the external factors, and thus together with the help of the patient and caregivers, prevent or cure these injuries. It is important to involve all agents and they will act in the care of the person at risk of suffering from pressure ulcers. In this work we will define the main terms on which this work is focused, and we will not forget the treatment of associated pathologies and the importance of the Primary Care team for the improvement of health status.

26

Authors: González Huergo, C.M

Introduction: The care of pressure ulcers has been carried out throughout history, although it is in the last decades that the most has been investigated in this regard. Risk factors have been described, dividing them into intrinsic and extrinsic, to achieve greater prevention and control of complications. General objective: The general objective of this study is to study the nursing interventions used to minimize the psychological impact of pressure ulcers on patients. Methodology: The bibliographic search for this thesis was developed between the months of April and November 2019, using the databases of health sciences PubMed, Cochrane, Cuiden, SciElo and Lilacs. A total of 43 bibliographic references were obtained. Development: The characteristics of pressure ulcers have been described, as well as their epidemiology and the areas where they may appear. The different existing treatments have been compared and special attention has been paid to those who consider the patient as a bio-psycho-social being, and then look for the most appropriate nursing interventions in this regard. Discussion: Despite the lack of care plans and clinical guidelines that address the holistic aspects of the patient with pressure ulcers and the difficulties in finding good quality studies, the continuing training of successful people is demonstrated.

4

Authors: Gracia Gómez, Cristina

Background: The COVID-19 pandemic has caused a health crisis that has forced to increase digital resources for patient care, detection and case management. Methodology: A literature review was made from databases, clinical guides and web pages, selecting the information published in the last 5 years. Results: Digital health has been a great help, but user training, regulation and evaluation of its impact are needed. Conclusion: Telematic assistance offers numerous advantages to consider to improve healthcare.

18

Authors: Siles Puerma, Javier

Introduction: Nosocomial infection is defined as a disease caused by microorganisms, provoked as a consequence of the sanitary activity, and that was not present nor in the incubation period at the moment of the beginning of the sanitary attention. WHO emphasizes that nosocomial infections are the leading preventable cause of adverse effects in hospitalized patients, and stresses the critical role of prevention strategies. Objectives: To describe nursing care that reduces the incidence of nosocomial infections in Critical Care Units. Methodology: Using the search formula "Infection Control AND Nursing AND Intensive Care Units", a bibliographic search was performed in the LiLacs, Scielo, CINALH, Scopus, and Pubmed databases. Inclusion criteria were: Full-text articles in English or Spanish, published between January 1, 2017, and present, investigating primary prevention of nosocomial infections in the Intensive Care Unit. Results: After the development of the bibliographic search, 29 articles were included in the study. As a whole, the articles consulted highlight the effectiveness of universal infection prevention measures, mainly in hand hygiene. In addition to universal measures, specific infection prevention measures are described, which are only applicable in certain situations. Conclusion: A large percentage of nosocomial infections can be prevented by applying the precautions and interventions described in the scientific literature; their application is a responsibility for all members of society, highlighting the fundamental role of health care personnel.

20

Authors: Canuto Martín, María Eugenia

Introduction Recurring ear infections in your child can cause hearing problems. Social, economic and demographic changes have led to the entry of new bacteria and viruses. Repeatedly consuming antibiotics makes them resistant, with the consequent danger that this poses to the hearing of children. Main goal The main part of this bibliographic review is to understand and understand the main infections that can affect the child´s ear and their treatments, in order to prevent any complications, revealing all the updated and necessary information to be able to carry out this action. Method A comprehensive discussion of ear anatomy and infections is presented. The sample is composed of 35 articles selected from a search carried out in the main medical journals and in the most distinguished databases: Medline Plus, Dialnet, Google Scholar, Spanish pediatric guide, Scielo, Lilacs, Kidsttealth, Neumours Foundation, etc. Results are analyzed are the causes, as well as the habits to promote them and the most effective treatments along with their contraindications, tips to avoid them, etc. Outcome Infections in the child´s ear is a very extensive subject whose information is not well known by the population. Therefore, the results obtained showed very positive progress and achievements, being able to publicize the veracity of this topic through the study of various and extensive medical articles.

28

Authors: Arroyo Ruiz, Luis Miguel

Introduction: Nosocomial diseases are a serious public health problem worldwide. It is one that develops during the patient´s stay in the hospital center. Objectives: To know the incidence of nosocomial infections in health centers and the repercussions they have on the evolution of hospitalized patients. Know the main microorganisms that cause them and the antibiotic resistance that can be generated. Methodology: A bibliographic review of articles has been carried out in the Pubmed, Gerión, Medline, Cochrane Plus and Google Academic databases using the keywords. A total of 15 articles have been selected using different inclusion criteriaL. Results / Discussion: Pseudomona Aeruginosa, Klebsiella Pneumoniae and E. Coli are very common microorganisms in Intensive Care Units. Depending on the study, antibiotic resistance is generated, which is broken down in our review article and the most appropriate prevention mechanisms. Conclusions: There is a higher incidence of nosocomial infections in patients over 60 years, female gender and with multiple risk factors. It is essential to develop surveillance equipment to use the most appropriate therapy for each microorganism

4

Authors: Quiles Mateo, Antonio

Introducción. La reeducación postural global es un método de diagnostico y terapia indicado en patologías anatómicas y fisiológicas caracterizado por un estudio multifactorial de las patologías crónicas a través de la valoración sintomatológica de cada persona a través de un enfoque global. Descripción del caso. Varón con dolor sacroiliaco relacionado con la actividad deportiva de la carrera que presenta tensión en la musculatura isquiosural. Se realiza un examen clínico basado en la anamnesis y la aplicación de la Escala Analógica Visual, el test de Fukuda, el test de Cyon, el test de Romberg y el test de Bassani. Resultados. Diagnóstico de predominio posteromedial que tras el tratamiento miofascial disminuye el dolor de 6/10 a 0/10. Conclusión. La reeducación postural global modificó la biomecánica del sujeto disminuyendo el dolor tras una semana del tratamiento.

21

Authors: Menéndez Fernández, María

Ante el aumento en la incidencia de la Diabetes Mellitus y dado que es un problema de salud que afecta en su debut tanto a personas jóvenes (en su minoría) como a personas de edad adulta y tercera edad, es importante conocer cómo prevenir la aparición de complicaciones tanto a corto como a largo plazo. Es sabido que una estandarización de los cuidados siguiendo protocolos y guías proporcionadas por diferentes entidades disminuye las complicaciones derivadas de esta enfermedad y mejora la calidad de vida de las personas que la padecen. Ante ello se desarrolla este Trabajo Fin de Máster (TFM) Teórico- Conceptual y de búsqueda bibliográfica con el fin de determinar el papel de enfermería en el seguimiento de la diabetes, especialmente cuando los pacientes comienzan con alteraciones que afectan a los pies. Para ello se realiza una búsqueda y revisión bibliográfica en distintas bases de datos (Lilacs, Fisterra, PubMed), páginas webs institucionales (Ministerio de Sanidad, Servicios Sociales e Igualdad, Asociación Española de Diabetes…) y otras fuentes documentales en formato papel Una vez más se pone de manifiesto que la protocolización y desarrollo de una correcta educación en diabetes es fundamental retrasar la aparición de complicaciones asociadas a un mal control de esta enfermedad. En Asturias existen guías (PCAIS) que estandarizan de una u otra manera los pasos a seguir en el tratamiento contra la diabetes, con apartados sobre el tratamiento del síndrome de pie diabético, lo cual facilita la asistencia enfermera a la vez que permite realizar un seguimiento de las acciones que se realizan con nuestros pacientes.

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Authors: Del Val Zaballos, Florentino

La diabetes tipo 2 es un grave problema de salud pública por la alta incidencia y prevalencia de la misma. Las cifras acerca de esta enfermedad son alarmantes y presentan una tendencia creciente en los últimos años. Así, la diabetes es una de las principales causas de enfermedad cardiovascular, ceguera, amputaciones y enfermedad renal crónica. La Federación Internacional para la Diabetes (IDF) en su Atlas de Diabetes de 2015 estima una prevalencia mundial del 8.8% (7,2-11.4) con unas previsiones para el año 2040 que alcanzan una prevalencia de 10.4 % (8,5-10.5)

7

Authors: Quiles Mateo, Antonio

Introduction: Obesity is a factor that characterizes a population group that may require Physiotherapy, especially respiratory. In postoperative rehabilitation, a respiratory force training device called an incentive inspirometer is widely used in the field of physiotherapy. The objective of the study was to analyze the possible differences regarding the maximum volume obtained between two types of incentive inspirometer in obese subjects and the relationship with their anthropometric and pulmonary variables. Methods: The study that was carried out was of a cross-sectional observational type. Lung functions were recorded by a spirometer, to which the volumetric incentive inspirometer and the flow incentive inspirometer were connected (raising 2 balls and 3 balls) to calculate the maximum volume reached. Results: Data from 30 people with obesity were analyzed. The differences in the maximum volume obtained, expressed in percentage and volume, were not statistically significant between the devices despite there being some statistically significant differences with the anthropometric variables. Conclusion: The results obtained would indicate that there would be no statistically significant differences in the use of incentive inspirometers in this population with respect to the maximum volume obtained. The variables that influence the use of the incentive inspirometer would be different for each device and use.

12

Authors: Fernández Huerta, María Lorena

La Diabetes Mellitus Gestacional, un cuadro difícil de diagnosticar y que crea incertidumbre y preocupación en los padres. Es la tercera gran categoría clínica en la clasificación actual de la diabetes y representa un factor de riesgo para la mujer y un problema de salud. La DM puede ocurrir en dos situaciones durante el embarazo: puede surgir en mujeres que ya padecen diabetes tipo 1 o tipo 2 desde antes del embarazo o puede desarrollarse durante el embarazo. Las complicaciones maternas más importantes incluyen HTA durante el embarazo; preeclampsia y eclampsia. En condiciones ideales, el éxito en el manejo de la DMG depende de la capacidad y motivación de los recursos de la paciente para alcanzar las metas del control de la glucemia. El plan de autocuidados de la DMG incluye plan de nutrición y ejercicio, automonitoreo de glucosa, examen de cetonas en orina y esquemas de aplicación de insulina. Es una enfermedad que día a día ha cobrado más relevancia en nuestro mundo pero muchas personas a pesar de sufrirla o de tener una elevada probabilidad de heredarla saben poco o nada de esta enfermedad.

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Authors: García Fernández, Yolanda

Introduction: Gestational diabetes is characterized by an alteration of carbohydrate tolerability that leads to hyperglycemia of variable severity and is initiated or diagnosed during pregnancy. It is the most frequent metabolic complication in pregnancy and constitutes a major current health problem whose prevalence is increasing. Goals: The main objective of the work is: To know the fetal and neonatal morbidity and mortality associated with gestational diabetes The secondary objectives are: Know the main maternal consequences derived from gestational diabetes Know the long-term risks of gestational diabetes in the mother and child Highlight the importance of preconception care, during pregnancy, delivery and postpartum to reduce possible sequelae Results: Gestational diabetes favors macrosomia and its consequences per partum, as well as maternal complications (vascular complications and dystocic deliveries). In the long term, it produces a greater risk of developing carbohydrate intolerance, type II diabetes mellitus, overweight and obesity, in addition to affecting neurodevelopment. In the mother, the risk of developing type II diabetes, the presence of diabetes in a future pregnancy and cardiovascular complications increases. Conclusions: Promoting physical exercise and a balanced diet reduces the risk of developing gestational diabetes. Proper pregnancy planning, with early diagnosis and adequate treatment, reduces the risk of both maternal and fetal complications. Health professionals must offer appropriate multidisciplinary treatment to each patient, from before the pregnancy occurs, to the first months of the child's life, to reduce fatal consequences in the short, medium and long term.