scholarly journals Ações preventivas em úlceras por pressão realizadas por enfermeiros na atenção básica Preventive actions in pressure ulcers carried out by nurses in primary care

2016 ◽  
Vol 8 (2) ◽  
pp. 4447
Author(s):  
Chrystiany Plácido de Brito Vieira ◽  
Expedito Weslley Ferreira de Oliveira ◽  
Márcia Gabriela Costa Ribeiro ◽  
Maria Helena Barros Araújo Luz ◽  
Olívia Dias de Araújo ◽  
...  
Keyword(s):  
Primary Care ◽  
Pressure Ulcers ◽  
Preventive Actions

scholarly journals The CUORE project cardiovascular risk assessment in primary care: the ongoing experience in Italy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Palmieri ◽  
S Vannucchi ◽  
C Lo Noce ◽  
A Di Lonardo ◽  
B Unim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Assessment ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Adult Population ◽  
Cardiovascular Risk Assessment ◽  
Project Risk ◽  
Preventive Actions

Abstract Background Italian National Prevention Plan 2005-08 included 10-year cardiovascular risk assessment (10-CR) for the general population aged 35-69 years using the CUORE Project risk score. GPs were encouraged to perform 10-CR and send data to the Cardiovascular Risk Observatory (CRO). Aim To show updated data of the ongoing surveillance system of the 10-CR in the Italian adult population. Methods Data were collected using the cuore.exe software, freely downloadable by GPs from the CUORE Project website (www.cuore.iss.it). The CRO provides a web-platform to compare data on 10-CR and risk factors at regional/national level. For persons examined at least twice, variations in risk factors from baseline to follow-up and 95% confidence intervals (C.I.) were calculated using methods for matched pair samples. Results Up to February 2019, about 3,500 GPs downloaded cuore.exe; about 300,000 CR assessments on about 140,000 persons were sent to CRO. Mean CR was 3.1% in women (W), 8.5% in men (M); 28% of M, 64% of W were at low risk (CR < 3%); 9.9% of M, 0.4% of W were at high risk (CR ≥ 20%); 26% of M, 16% of W were current smokers; 13% of M, 10% of W were diabetic; 33% of hypertensive M, 35% of hypertensive W were under specific treatment. Among those with at least two risk assessments (31% of the sample), 11% shifted to a lower risk class after one year (14% of M, 7% of W). Systolic blood pressure mean levels decreased by 0.6 mmHg (95%-C.I. 0.3-0.8 mmHg), diastolic blood pressure by 0.5 mmHg (0.2-0.7 mmHg), total cholesterol by 4.1 mg/dl (3.0-5.2 mg/dl), smokers prevalence by 3.1% (2.3%-4.0%); HDL-cholesterol increased in W by 0.3 mg/dl (0.1-0.5 mg/dl). Conclusions Data demonstrate that 10-CR assessment can be an effective first step to implement preventive actions in primary care. Individual risk score is a useful tool for GPs to assess CR and promote primary prevention focusing on the adoption of healthy lifestyles. Data can be used to support health policy decision process. Key messages The cuore.exe software, freely downloadable from the CUORE Project website-www.cuore.iss.it, allows GPs to assess the CUORE Project risk score, to collect and to send data to the CVD Risk Observatory. 10 year Cardiovascular Risk assessment in the general adult population can be an effective first step to implement preventive actions in primary care.

scholarly journals Knowledge of nursing professionals about Pressure Ulcers in the Medical Clinic/Conhecimentos dos profissionais de enfermagem sobre úlceras por Pressão na Clínica Médica/Conocimiento de los profesionales de enfermería sobre úlceras por presión en Clínica

2014 ◽  
Vol 3 (3) ◽  
pp. 5
Author(s):  
Débora De Sousa Sousa Lemos ◽  
Aline Batista Mauricio ◽  
Nathalia Ingrid Crosewski ◽  
Hellen Roehrs ◽  
Marineli Joaquim Meier
Keyword(s):  
Pressure Ulcers ◽  
Educational Interventions ◽  
Prevention Measures ◽  
Friction Forces ◽  
Knowledge Deficit ◽  
Preventive Actions ◽  
Practical Nurses ◽  
Nursing Professionals ◽  
Hospital School ◽  
Insufficient Knowledge

ABSTRACT Objective: To identify the knowledge that nurses have related to prevention, monitoring and treatment of pressure ulcers in the Clinical Medical. Methodology: this is a descriptive study of a quantitative approach conducted with nursing professionals in a Hospital School of Curitiba and approved by the Research Ethics Committee of the institution. The collection took place from December 2012 to March 2013, with an instrument composed of a form of socio-demographic questions and 41 true or false, it was considered a satisfactory professionals who have obtained 90% correct or more. Results: The overall results of the units were 75.7% accuracy, and the nurses had a mean accuracy of 78.7% and auxiliary / practical nurses 74.5%. The set of questions with greater knowledge deficit was related prevention measures relating to friction forces, shear and pressure and mobility of the patient with only 57.5% correct overall. Conclusions: By identifying the themes that professionals have insufficient knowledge, there is the need for planning educational interventions to upgrade the professionals so that preventive actions are implemented to care. Keywords: Nursing, Pressure Ulcer, Knowledge. RESUMO Objetivo: Identificar os conhecimentos que os profissionais de enfermagem possuem relacionados às medidas de prevenção, monitoramento e tratamento das úlceras por pressão na Clínica Médica. Metodologia: Trata-se de um estudo descritivo de abordagem quantitativa realizado com profissionais de enfermagem em um Hospital Escola de Curitiba e aprovado pelo Comitê de Ética em Pesquisa da instituição. A coleta ocorreu no período de dezembro de 2012 a março de 2013, com um instrumento composto de um formulário sociodemográfico e 41 questões de verdadeiro ou falso, em que foi considerado um resultado satisfatório os profissionais que obtiveram 90% de acertos ou mais. Resultados: Os resultados gerais das unidades foram de 75,7% de acerto, sendo que os enfermeiros tiveram média de acerto de 78,7% e os auxiliares/técnicos de enfermagem de 74,5%. O bloco de questões com maior déficit de conhecimento foi o relacionado com medidas de prevenção referentes às forças de fricção, cisalhamento e pressão e a mobilidade do paciente com apenas 57,5% de acerto no geral. Conclusão: Ao identificar os temas em que os profissionais possuem conhecimentos insuficientes, existe a necessidade de planejamento a fim de viabilizar intervenções educativas para os profissionais. Descritores: Enfermagem, Úlcera por Pressão, Conhecimento. RESUMÉN Objetivo: Identificar el conocimiento que las enfermeras han relacionado con la prevención, control y tratamiento de las úlceras por presión en clínicas médicas. Metodología: ste es un estudio descriptivo de un enfoque cuantitativo realizado con enfermería profesionales en un Hospital Escuela de Curitiba y aprobado por el Comité de ética de investigación de la institución. La colección tuvo lugar en diciembre 2012 hasta marzo 2013, con un instrumento compuesto por un formulario de preguntas socios demográficas y 41 verdadero o falso, se consideró satisfactorios a los profesionales que hayan obtenido el 90% de aciertos o más. Resultados: Los resultados globales de las unidades fueron 75.7% de precisión, y las enfermeras tenían una precisión media del 78.7% y auxiliares / técnicos con 74,5%. El conjunto de preguntas con mayor déficit de conocimiento fue las medidas de prevención relacionadas con las fuerzas de fricción, cizallamiento y presión y la movilidad del paciente con sólo con 57,5​​% de aciertos. Conclusiones: Mediante la identificación de los temas que los profesionales tienen un conocimiento insuficiente, hay una necesidad de planificación con el fin de facilitar las intervenciones educativas para los profesionales. Descriptores: Enfermería, Úlceras por Presión, Conocimiento.

Abstract P394: The Ongoing Experience of Cardiovascular Risk Assessment Implementation in Primary Care of The Cuore Project

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Luigi Palmieri ◽  
Rita Rielli ◽  
Chiara Donfrancesco ◽  
Patrizia De Sanctis Caiola ◽  
Francesco Dima ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Assessment ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Lower Risk ◽  
Matched Pair ◽  
Cardiovascular Risk Assessment ◽  
Preventive Actions

Background: The Italian National Prevention Plan 2005–2008 included a 10-year cardiovascular risk assessment (10-CR) for the general population aged 35–69 years using the CUORE-Project risk score. GPs were encouraged to collect data on risk factors, perform a 10-CR and send these data to the Cardiovascular Risk Observatory (CRO). Aim: The aim of this study is to show updated data of the ongoing surveillance system of the 10-CR in the Italian adult population, a first step to implement primary preventive actions at individual level. Methods: A training plan for GPs was launched by the Ministry of Health. Data were collected using the cuore.exe software, easily and freely downloadable by GPs from the CUORE-Project website ( www.cuore.iss.it ). The CRO provides a web-platform to analyze and compare data on 10-CR and risk factors at both regional and national level. In the subgroup of persons examined at least twice a year, variations in continuous risk factors mean levels and categorical risk factors prevalences between baseline and follow-up and their 95% confidence intervals (C.I.) were calculated using methods for matched pair samples. Results: By October 2011, more than 3,000 GPs downloaded cuore.exe ; 146,322 CR assessments on 137,773 persons were sent to CRO. CR mean was 3.0% in women, 8.4% in men; 30% of men and 65% of women were at lower risk (CR<3%), 9.3% of men and 0.4% of women were at high risk (CR≥20%). Thirty-four percent of men and 19% of women were current smokers, 13% of men and 10% of women were diabetic, and 33% of hypertensive men and 35% of hypertensive women were under specific treatment. Among those with at least two risk assessments (n=8,495), 7% (95%–C.I. 6%–8%) shifted to a lower risk class after one year (9% of men and 5% of women respectively). Systolic blood pressure mean levels decreased by 1.3 mmHg (95%–C.I. 0.9–1.8 mmHg), diastolic blood pressure by 0.9 mmHg (95%–C.I. 0.5–1.3 mmHg), total cholesterol level by 5.7 mg/dl (95%–C.I. 4.4–6.9 mg/dl),6.6 mg/dl6 and smokers prevalence by 3.6% (95%–C.I. 2.6%–4.7%)6.6 mg/dl6; HDL-cholesterol increased in women by 0.8 mg/dl (95%–C.I. 0.4–1.2 mg/dl). Conclusions: Data demonstrate that 10-CR assessment can be an effective first step to implement preventive actions in primary care. The individual risk score is becoming a useful tool for GPs to assess their patients’ CR and promote primary prevention by focusing attention on the adoption of healthy lifestyles. These encouraging data can be used to support health policy decision processes.

Abstract P118: The Ongoing Experience of Cardiovascular Risk Assessment Implementation in Primary Care of the CUORE Project

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Luigi Palmieri ◽  
Serena Vannucchi ◽  
Cinzia Lo Noce ◽  
Anna Di Lonardo ◽  
Daniela Minutoli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Assessment ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Lower Risk ◽  
Matched Pair ◽  
Cardiovascular Risk Assessment ◽  
Preventive Actions

Background: The Italian National Prevention Plan 2005-2008 included a 10-year cardiovascular risk assessment (10-CR) for the general population aged 35-69 years using the CUORE-Project risk score. GPs were encouraged to collect data on risk factors, perform a 10-CR and send data to the Cardiovascular Risk Observatory (CRO). Aim: The aim of this study is to show updated data of the ongoing surveillance system of the 10-CR in the Italian adult population, a first step to implement primary preventive actions at individual level. Methods: A training plan for GPs was launched by the Ministry of Health. Data were collected using the cuore.exe software, easily and freely downloadable by GPs from the CUORE-Project website (www.cuore.iss.it). The CRO provides a web-platform to analyze and compare data on 10-CR and risk factors at both regional and national level. In the subgroup of persons examined at least twice a year, variations in continuous risk factors mean levels and categorical risk factors prevalence between baseline and follow-up and their 95% confidence intervals (C.I.) were calculated using methods for matched pair samples. Results: By October 2019, about 3,500 GPs downloaded cuore.exe ; about 300,000 CR assessments on about 140,000 persons were sent to CRO. CR mean was 3.1% in women, 8.5% in men; 28% of men and 64% of women were at lower risk (CR<3%), 9.9% of men and 0.4% of women were at high risk (CR≥20%). Twenty-six percent of men and 16% of women were current smokers, 13% of men and 10% of women were diabetic, and 33% of hypertensive men and 35% of hypertensive women were under specific treatment. Among those with at least two risk assessments (31% of the sample), 11% shifted to a lower risk class after one year (14 of men and 7% of women respectively). Systolic blood pressure mean levels decreased by 0.6 mmHg (95%-C.I. 0.3-0.8 mmHg), diastolic blood pressure by 0.5 mmHg (95%-C.I. 0.2-0.7 mmHg), total cholesterol level by 3.1% (95%-C.I. 2.3%-4.0%)6.6 mg/dl6; HDL-cholesterol increased in women by 0.3 mg/dl (95%-C.I. 0.1-0.5 mg/dl). Conclusions: Data demonstrate that 10-CR assessment can be an effective first step to implement preventive actions in primary care. The individual risk score is becoming a useful tool for GPs to assess their patients’ CR and promote primary prevention by focusing attention on the adoption of healthy lifestyles. These encouraging data can be used to support health policy decision processes.

Clinical evaluation with long-term follow-up of patients with pressure ulcers in one Swedish county

2020 ◽  
Vol 29 (8) ◽  
pp. 472-478
Author(s):  
Rut Frank Öien ◽  
Hanna Wickström ◽  
Nina Åkesson ◽  
Suzana Selan ◽  
Linda Söderlundh
Keyword(s):  
Risk Assessment ◽  
Primary Care ◽  
Mortality Rate ◽  
Ulcer Healing ◽  
Pressure Ulcers ◽  
Community Care ◽  
Preventive Measures ◽  
Advisory Panel ◽  
Skin Examination

Objective: To conduct a screening, skin examination and risk assessment of patients with pressure ulcers (PUs) in one Swedish county (inpatient, primary and community care) with follow-up after six months to investigate ulcer healing, frequency of amputation and mortality rate linked to preventive measures. Method: The methodology recommended by the European Pressure Ulcer Advisory Panel was used. Screening, risk assessment and skin examination were performed during March 2017. The modified Norton scale was used to assess PU risk, with a score of ≤20 indicating presence of risk. A research questionnaire was used to document prevention and treatment. Follow-up was performed after six months, during September 2017. The same research questionnaire was used to capture the current situation of the patients, including ulcer healing, frequency of amputation, and mortality rate. Results: Screening covered 464 patients: 303 hospitalised, 68 in community care, and 93 in primary care. A total of 110 patients—55 at risk of PU and 55 with PUs, the majority of which were category 2–4 PUs—were included in the study. At follow-up, 67% were treated in community care, 32% in primary care, and 1% in hospital. Mortality rate for patients with PUs was 44%. Of the remaining 31 patients, 17 had unhealed PUs, 10 had healed PUs, two had undergone amputation, and complete follow-up data was missing in the remaining two patients. Conclusion: These results reflect the complex situation of an aged and frail patient group, including a lack of preventive measures and follow-up routines in community and primary care.

scholarly journals A framework to help defining relevant preventive actions in multi-professional health care centers

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
B Pluvinage ◽  
F Dugué ◽  
D Dépinoy
Keyword(s):  
Primary Care ◽  
Public Policy ◽  
Health Professionals ◽  
Preventive Action ◽  
Specific Context ◽  
Preventive Actions ◽  
Primary Care Teams ◽  
Professional Health ◽  
Team Setting ◽  
Health Care Centers

Abstract For more than 10 years in France, multi-professional healthcare centers have been considered as innovative organizations, which offer attractive work conditions for health professionals and help to structure primary care. Their development is strongly supported by public policy (e.g. specific funding methods, a target of 2000 teams by 2022) and is seen as a mean to enhance preventive actions. From a public health perspective, when professionals define their collective project, preventive actions should be chosen according to their relevance (by considering local population needs), effectiveness (based on evidence) and realism (in terms of implementation). Our goal was to make an inventory of existing tools and recommendations but also to propose a framework that considers the actual practicing conditions of French primary care teams. Three methods were used: a bibliographic study, feedback from a consulting firm with a 10 years’ experience in supporting new teams in defining their multi-professional project, and interviews from experts and health professionals. Due to professional training and practice, preventive actions are less familiar to professionals when they are not integrated into individual and curative cares. Indeed, most existing recommendations are designed from a macroscopic point of view, dismissing the particularities of multi-professional private practice. Thus, we could identify 9 categories of factors likely to determine the relevance of a preventive action, including a specific context-population-team setting. Although this is an exploratory work, feedback from professionals confirms the potential positive or negative influence of these items on the implementation of an action. Our framework could be converted into a tool consisting of a list of questions to ask before primary care teams choose a preventive action to implement. Frequent assessments should be carried out and shared in order to develop empirical and reliable knowledge in this field. Key messages Despite a strong public policy to develop multi-professional health care centers in France, recommendations about preventive actions insufficiently consider specific conditions of practice. Mixing theoretical and practical perspectives, our framework could help to improve the relevance, effectiveness and realism of preventive actions considering a specific context-population-team setting.

Fool’s Gold: Psychologists Using Disingenuous Reasoning to Mislead Legislatures into Granting Psychologists Prescriptive Authority

2003 ◽  
Vol 29 (4) ◽  
pp. 489-524
Author(s):  
Brent Pollitt
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Nurse Practitioners ◽  
Primary Care Physicians ◽  
American Psychological Association ◽  
The United States ◽  
Psychotropic Medications ◽  
American Psychological ◽  
Training Requirements ◽  
Prescriptive Authority

Mental illness is a serious problem in the United States. Based on “current epidemiological estimates, at least one in five people has a diagnosable mental disorder during the course of a year.” Fortunately, many of these disorders respond positively to psychotropic medications. While psychiatrists write some of the prescriptions for psychotropic medications, primary care physicians write more of them. State legislatures, seeking to expand patient access to pharmacological treatment, granted physician assistants and nurse practitioners prescriptive authority for psychotropic medications. Over the past decade other groups have gained some form of prescriptive authority. Currently, psychologists comprise the primary group seeking prescriptive authority for psychotropic medications.The American Society for the Advancement of Pharmacotherapy (“ASAP”), a division of the American Psychological Association (“APA”), spearheads the drive for psychologists to gain prescriptive authority. The American Psychological Association offers five main reasons why legislatures should grant psychologists this privilege: 1) psychologists’ education and clinical training better qualify them to diagnose and treat mental illness in comparison with primary care physicians; 2) the Department of Defense Psychopharmacology Demonstration Project (“PDP”) demonstrated non-physician psychologists can prescribe psychotropic medications safely; 3) the recommended post-doctoral training requirements adequately prepare psychologists to prescribe safely psychotropic medications; 4) this privilege will increase availability of mental healthcare services, especially in rural areas; and 5) this privilege will result in an overall reduction in medical expenses, because patients will visit only one healthcare provider instead of two–one for psychotherapy and one for medication.

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