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Aranaz Ostáriz V, Gea Velázquez de Castro MT, López Rodríguez-Arias F, Valencia Martín JL, Aibar Remón C, Requena Puche J, Díaz-Agero Pérez C, Compañ Rosique AF, Aranaz Andrés JM. Risk Analysis for Patient Safety in Surgical Departments: Cross-Sectional Design Usefulness. Int J Environ Res Public Health 2020; 17:ijerph17072516. [PMID: 32272647 PMCID: PMC7177398 DOI: 10.3390/ijerph17072516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 11/27/2022]
Abstract
(1) Background: Identifying and measuring adverse events (AE) is a priority for patient safety, which allows us to define and prioritise areas for improvement and evaluate and develop solutions to improve health care quality. The aim of this work was to determine the prevalence of AEs in surgical and medical-surgical departments and to know the health impact of these AEs. (2) Methods: A cross-sectional study determining the prevalence of AEs in surgical and medical-surgical departments was conducted and a comparison was made among both clinical areas. A total of 5228 patients were admitted in 58 hospitals in Argentina, Colombia, Costa Rica, Mexico, and Peru, within the Latin American Study of Adverse Events (IBEAS), led by the Spanish Ministry of Health, the Pan American Health Organization, and the WHO Patient Safety programme. (3) Results: The global prevalence of AEs was 10.7%. However, the prevalence of AEs in surgical departments was 11.9%, while in medical-surgical departments it was 8.9%. The causes of these AEs were associated with surgical procedures (38.6%) and nosocomial infections (35.4%). About 60.6% of the AEs extended hospital stays by 30.7 days on average and 25.8% led to readmission with an average hospitalisation of 15 days. About 22.4% resulted in death, disability, or surgical reintervention. (4) Conclusions: Surgical departments were associated with a higher risk of experiencing AEs.
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Affiliation(s)
- Verónica Aranaz Ostáriz
- Hospital Universitario Sant Joan d’Alacant. Ctra, N-332, s/n, Sant Joan d´Alacant, 03550 Alicante, Spain; (M.T.G.V.d.C.); (A.F.C.R.)
- Correspondence: ; Tel.: +34-676707517
| | | | | | - José Lorenzo Valencia Martín
- Hospital Universitario Ramón y Cajal, IRYCIS. M-607, km 9100, 28034 Madrid, Spain; (J.L.V.M.); (C.D.-A.P.); (J.M.A.A.)
| | - Carlos Aibar Remón
- Hospital Clínico Universitario Lozano Blesa, Avda. San Juan Bosco, 15, 50009 Zaragoza, Spain;
| | - Juana Requena Puche
- Hospital General Universitario de Elda, Ctra, Sax-La Torreta, s/n, Elda, 03600 Alicante, Spain;
| | - Cristina Díaz-Agero Pérez
- Hospital Universitario Ramón y Cajal, IRYCIS. M-607, km 9100, 28034 Madrid, Spain; (J.L.V.M.); (C.D.-A.P.); (J.M.A.A.)
| | - Antonio Fernando Compañ Rosique
- Hospital Universitario Sant Joan d’Alacant. Ctra, N-332, s/n, Sant Joan d´Alacant, 03550 Alicante, Spain; (M.T.G.V.d.C.); (A.F.C.R.)
| | - Jesús María Aranaz Andrés
- Hospital Universitario Ramón y Cajal, IRYCIS. M-607, km 9100, 28034 Madrid, Spain; (J.L.V.M.); (C.D.-A.P.); (J.M.A.A.)
- Center for Biomedical Research in the Epidemiology and Public Health Network (CIBERESP), 28029 Madrid, Spain
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López Rodríguez-Arias F, Sánchez-Guillén L, Armañanzas Ruiz LI, Díaz Lara C, Lacueva Gómez FJ, Balagué Pons C, Ramírez Rodríguez JM, Arroyo A. A Narrative Review About Prehabilitation in Surgery: Current Situation and Future Perspectives. Cir Esp 2020; 98:178-186. [PMID: 31987464 DOI: 10.1016/j.ciresp.2019.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 11/05/2019] [Accepted: 11/09/2019] [Indexed: 01/07/2023]
Abstract
Prehabilitation has a multimodal conception based on three fundamental pillars: improvement of the patient's physical condition, nutritional optimization and cognitive intervention to reduce stress and anxiety, as well as other measures such as smoking cessation and correction of anemia. The aim of prehabilitation programs is to optimize the patient from the moment of diagnosis until the surgical intervention in order to reduce postoperative complications. As in the case of multimodal rehabilitation protocols, the actions of prehabilitation programs have synergistic effects, that is, small changes that, by themselves, do not have clinical significance but when added up, they produce a significant improvement in the postoperative evolution of patients. Although more studies are required to evaluate the impact of these programs on patients groups with different pathologies, interventions and risk factors, their progressive implementation is necessary in the daily clinical practice of our patients. The objective of this narrative review is to evaluate the available evidence about prehabilitation in surgery, focusing on current established strategies, knowledge gaps and future research.
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Affiliation(s)
- Francisco López Rodríguez-Arias
- Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario de Elche, Universidad Miguel Hernández, Elche, Alicante, España
| | - Luis Sánchez-Guillén
- Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario de Elche, Universidad Miguel Hernández, Elche, Alicante, España.
| | - Laura Irene Armañanzas Ruiz
- Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario de Elche, Universidad Miguel Hernández, Elche, Alicante, España
| | - Carlos Díaz Lara
- Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario de Elche, Universidad Miguel Hernández, Elche, Alicante, España
| | - Francisco Javier Lacueva Gómez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario de Elche, Universidad Miguel Hernández, Elche, Alicante, España
| | - Carmen Balagué Pons
- Servicio de Cirugía General y del Aparato Digestivo, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España
| | - José Manuel Ramírez Rodríguez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Universidad de Zaragoza, Zaragoza, España
| | - Antonio Arroyo
- Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario de Elche, Universidad Miguel Hernández, Elche, Alicante, España
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