Subutilización de camas en el Area de Cuidados Intensivos. Pautas para la creación de una Unidad de Tratamientos Intermedios, Hospital Dr. Francisco de Ycaza Bustamante, 2009
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2011
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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En el Hospital del Niño Francisco de Ycaza Bustamante existe necesidad permanente de espacio físico para el manejo de pacientes con patologías complejas y pacientes críticos. Su UCIP con solo 11 camas mantiene las actividades de forma permanente, por no contar con un área de cuidados intermedios, el limitado número de camas, es mal aprovechado con pacientes que deberían ser manejados en unidades menos complejas. Mediante el presente trabajo se pretende evidenciar la subutilización del espacio físico en la UCIP mediante la aplicación de la escala PRISM III, demostrando que no se está definiendo claramente los criterios de ingreso, alta y triage en esta unidad. A través de un estudio de tipo descriptivo y diseño no experimental longitudinal retrospectivo, se aplicó un formulario para compilar la información de los expedientes clínicos de 112 pacientes ,entre 30 días y 15 años de edad ,que ingresaron entre enero a diciembre del 2009 a la UCIP, cumpliendo con los criterios clínicos y de laboratorio para poderse aplicar la Escala de Riesgo de Mortalidad (PRISM III),se analizaron los valores de esta Escala y el porcentaje de mortalidad de los pacientes , diagnósticos de ingreso ,tratamiento prescrito , evolución clínica y complicaciones. Determinándose que un 56.15% debieron ser manejados en sala de hospitalización general; 20.6% ingresaron para postoperatorio y un 28 % permanecieron menos de 48 horas en la UCIP. Estos resultados dan a conocer la necesidad de creación de una UTIP, destinada a observar, valorar y continuar con los cuidados de vigilancia estrecha que los proporcionados en salas de cuidados intensivos, reduciendo costos, optimizando en esta forma el uso de la UCIP evitando readmisiones y contribuyendo a la disminución de la tasa de mortalidad hospitalaria.
In the Children's Hospital Francisco of Ycaza Bustamante exists continuing need physical space for the management of patients with complex illnesses and chronic patients. Its 11-bed PICU just kept permanently activities, not to have an intermediate care area, the limited number of beds, is underutilized in patients should be managed in less complex units. Through this work is to demonstrate the underutilization of physical space in the PICU by the scale PRISM III, demonstrating that there is clearly defining the criteria for admission, discharge and triage in this unit. Through a descriptive study and retrospective longitudinal non-experimental design was applied a questionnaire to collect information from medical records of 112 patients between 30 and 15 years of age who were admitted between January and December 2009 to PICU, fulfilling the clinical and laboratory criteria for being able to implement the Risk of Mortality Scale (PRISM III), we analyzed the values of this scale and the mortality rate of patients, admission diagnoses, prescribed treatment, clinical course and complications. Determined that a 56.15% had to be handled in general ward, 20.6% were admitted for postoperative and 28% stayed less than 48 hours in the PICU. These Results show the need to create a Pediatric Intensive Care Unit, designed to provide, monitor, evaluate and continue close monitoring of care provided in the general hospital environments, reducing costs, optimizing in this way the use of avoiding PICU readmissions and contributing to the decline in hospital mortality rate.
In the Children's Hospital Francisco of Ycaza Bustamante exists continuing need physical space for the management of patients with complex illnesses and chronic patients. Its 11-bed PICU just kept permanently activities, not to have an intermediate care area, the limited number of beds, is underutilized in patients should be managed in less complex units. Through this work is to demonstrate the underutilization of physical space in the PICU by the scale PRISM III, demonstrating that there is clearly defining the criteria for admission, discharge and triage in this unit. Through a descriptive study and retrospective longitudinal non-experimental design was applied a questionnaire to collect information from medical records of 112 patients between 30 and 15 years of age who were admitted between January and December 2009 to PICU, fulfilling the clinical and laboratory criteria for being able to implement the Risk of Mortality Scale (PRISM III), we analyzed the values of this scale and the mortality rate of patients, admission diagnoses, prescribed treatment, clinical course and complications. Determined that a 56.15% had to be handled in general ward, 20.6% were admitted for postoperative and 28% stayed less than 48 hours in the PICU. These Results show the need to create a Pediatric Intensive Care Unit, designed to provide, monitor, evaluate and continue close monitoring of care provided in the general hospital environments, reducing costs, optimizing in this way the use of avoiding PICU readmissions and contributing to the decline in hospital mortality rate.
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UNIDADES DE CUIDADO INTENSIVO PEDIATRICO, UNIDADES DE TRATAMIENTO INTERMEDIO PEDIÁTRICO, EPIDEMIOLOGÍA DESCRIPTIVA, ESTUDIOS RETROSPECTIVOS, HOSPITAL DEL NIÑO FRANCISCO DE ICAZA BUSTAMANTE, CANTÓN GUAYAQUIL, ECUADOR, MOBILIARIO HOSPITALARIO, PROYECTOS PILOTOS