Evaluación del impacto de una trayectoria clínica sobre el ictus isquémico
Impact of a clinical pathway for stroke patients
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[ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "<span class="elsevierStyleItalic">Dirección de Enfermería. Hospital de Mataró. Mataró. Barcelona</span>" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "<span class="elsevierStyleItalic">Unidad de Investigación. Consorci Sanitari del Maresme. Mataró. Barcelona</span>" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "<span class="elsevierStyleItalic">Dirección Médica. Hospital de Mataró. Mataró. Barcelona</span>" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "<span class="elsevierStyleItalic">Gerencia. Hospital de Mataró. Mataró. Barcelona. España</span>" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Unitat de Recerca. Hospital de Mataró. Ctra. de Cirera, s/n. 08304 Mataró (Barcelona). España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Impact of a clinical pathway for stroke patients" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-10-09" "fechaAceptado" => "2004-01-22" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec268628" "palabras" => array:6 [ 0 => "Trayectorias clínicas" 1 => "Vías clínicas" 2 => "Planes estandarizados de los cuidados enfermeros" 3 => "Ictus" 4 => "Calidad" 5 => "Eficiencia" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec268627" "palabras" => array:6 [ 0 => "Critical pathways" 1 => "Clinical pathways" 2 => "Care maps" 3 => "Stroke" 4 => "Quality" 5 => "Efficiency" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Evaluar el impacto de la introducción de una trayectoria clínica sobre la atención a los pacientes con un ictus isquémico.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Se diseñó un estudio de intervención, controlado, sin asignación aleatoria, de seguimiento de 2 cohortes de pacientes, no coincidentes en el tiempo, correspondiente a los períodos inmediatamente anterior (grupo PRE o control) y posterior (grupo POST o intervención) a la introducción de la trayectoria clínica. Las principales medidas del resultado fueron: <span class="elsevierStyleItalic">a)</span> indicadores de calidad asistencial; <span class="elsevierStyleItalic">b)</span> mejora en la capacidad funcional (índice de Barthel) y la función neurológica (escala Canadiense); <span class="elsevierStyleItalic">c)</span> complicaciones intrahospitalarias; <span class="elsevierStyleItalic">d)</span> satisfacción, y <span class="elsevierStyleItalic">e)</span> estancia media.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Se reclutó a 139 pacientes, 69 correspondientes al período PRE y 70 al período POST, sin que se observaran diferencias significativas al ingreso entre ambos grupos. Se constató una reducción del 36,5% en el tiempo transcurrido desde el ingreso hasta el inicio de la movilización, aunque no se observaron diferencias significativas en los otros indicadores de calidad ni en el incremento de la función neurológica o la capacidad funcional. El porcentaje de individuos con alguna complicación durante el ingreso fue del 44,6% en el período PRE y del 28,6% en el período POST (p = 0,039). No se observaron diferencias significativas en la valoración global del cuestionario de satisfacción, pero los pacientes del período POST presentaron una mayor satisfacción en las dimensiones «información recibida» y «profesionalidad y confianza ». La estancia media se redujo de 11 a 10 días.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">La introducción de la trayectoria clínica del ictus isquémico puede contribuir a reducir el número de complicaciones y los días de estancia, así como mejorar la calidad de la atención y la satisfacción de los pacientes.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">To assess the impact of the implementation of a clinical pathway for stroke patients.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">We performed a controlled intervention study without random allocation that compared two non-concomitant cohorts of stroke patients corresponding to the periods immediately before (control group) and after (intervention group) the implementation of a clinical pathway. The main outcome measures were: <span class="elsevierStyleItalic">a)</span> quality of care indicators; <span class="elsevierStyleItalic">b)</span> improvements in functional capacity (Barthel score) and neurological function (Canadian scale); <span class="elsevierStyleItalic">c)</span> nosocomial complications; <span class="elsevierStyleItalic">d)</span> satisfaction, and <span class="elsevierStyleItalic">e)</span> mean length of hospital stay.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">One hundred and thirty-nine patients were recruited. Sixty-nine corresponded to the period before implementation of the pathway and 70 corresponded to the period after implementation. There were no significant differences between the two groups on admission. A 36.5% reduction in the time from admission to mobilization was observed. No significant differences were observed between the groups for the other quality of care indicators, or in improvements in functional and neurological capacity. Nosocomial complications occurred in 44.5% of patients in the control group compared with 28.6% in the intervention group (p = .039). No significant differences were observed in the overall satisfaction assessment, but patients in the intervention group showed greater satisfaction in the dimensions of «information» and «trust and professionalism ». The mean length of hospital stay was reduced from 11 to 10 days.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">The implementation of the stroke clinical pathway contributed to reducing the length of hospital stay and the number of inpatient complications, as well as to improving some quality of care indicators.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">Este proyecto ha sido financiado con fondos del Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo (ayuda de investigación, expediente 01/10047).</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 12 | 4 | 16 |
| 2024 Octubre | 58 | 38 | 96 |
| 2024 Septiembre | 47 | 26 | 73 |
| 2024 Agosto | 59 | 27 | 86 |
| 2024 Julio | 44 | 20 | 64 |
| 2024 Junio | 41 | 16 | 57 |
| 2024 Mayo | 42 | 26 | 68 |
| 2024 Abril | 31 | 11 | 42 |
| 2024 Marzo | 40 | 29 | 69 |
| 2024 Febrero | 46 | 51 | 97 |
| 2024 Enero | 33 | 13 | 46 |
| 2023 Diciembre | 30 | 15 | 45 |
| 2023 Noviembre | 32 | 18 | 50 |
| 2023 Octubre | 31 | 11 | 42 |
| 2023 Septiembre | 34 | 13 | 47 |
| 2023 Agosto | 44 | 16 | 60 |
| 2023 Julio | 30 | 12 | 42 |
| 2023 Junio | 41 | 15 | 56 |
| 2023 Mayo | 42 | 14 | 56 |
| 2023 Abril | 31 | 17 | 48 |
| 2023 Marzo | 47 | 32 | 79 |
| 2023 Febrero | 28 | 11 | 39 |
| 2023 Enero | 33 | 16 | 49 |
| 2022 Diciembre | 43 | 31 | 74 |
| 2022 Noviembre | 42 | 35 | 77 |
| 2022 Octubre | 34 | 31 | 65 |
| 2022 Septiembre | 28 | 35 | 63 |
| 2022 Agosto | 37 | 50 | 87 |
| 2022 Julio | 38 | 43 | 81 |
| 2022 Junio | 35 | 36 | 71 |
| 2022 Mayo | 40 | 35 | 75 |
| 2022 Abril | 46 | 31 | 77 |
| 2022 Marzo | 42 | 34 | 76 |
| 2022 Febrero | 52 | 43 | 95 |
| 2022 Enero | 41 | 32 | 73 |
| 2021 Diciembre | 31 | 34 | 65 |
| 2021 Noviembre | 39 | 40 | 79 |
| 2021 Octubre | 36 | 45 | 81 |
| 2021 Septiembre | 39 | 55 | 94 |
| 2021 Agosto | 21 | 27 | 48 |
| 2021 Julio | 18 | 27 | 45 |
| 2021 Junio | 27 | 27 | 54 |
| 2021 Mayo | 20 | 27 | 47 |
| 2021 Abril | 89 | 46 | 135 |
| 2021 Marzo | 53 | 28 | 81 |
| 2021 Febrero | 30 | 12 | 42 |
| 2021 Enero | 29 | 21 | 50 |
| 2020 Diciembre | 22 | 18 | 40 |
| 2020 Noviembre | 16 | 15 | 31 |
| 2020 Octubre | 30 | 16 | 46 |
| 2020 Septiembre | 12 | 8 | 20 |
| 2020 Agosto | 10 | 16 | 26 |
| 2020 Julio | 21 | 12 | 33 |
| 2020 Junio | 21 | 2 | 23 |
| 2020 Mayo | 19 | 11 | 30 |
| 2020 Abril | 22 | 9 | 31 |
| 2020 Marzo | 20 | 18 | 38 |
| 2020 Febrero | 29 | 29 | 58 |
| 2020 Enero | 22 | 17 | 39 |
| 2019 Diciembre | 27 | 28 | 55 |
| 2019 Noviembre | 37 | 6 | 43 |
| 2019 Octubre | 34 | 14 | 48 |
| 2019 Septiembre | 14 | 3 | 17 |
| 2019 Agosto | 21 | 10 | 31 |
| 2019 Julio | 21 | 6 | 27 |
| 2019 Junio | 8 | 6 | 14 |
| 2019 Mayo | 18 | 6 | 24 |
| 2019 Abril | 16 | 10 | 26 |
| 2019 Marzo | 10 | 9 | 19 |
| 2019 Febrero | 17 | 5 | 22 |
| 2019 Enero | 13 | 10 | 23 |
| 2018 Diciembre | 5 | 19 | 24 |
| 2018 Noviembre | 15 | 22 | 37 |
| 2018 Octubre | 31 | 19 | 50 |
| 2018 Septiembre | 11 | 19 | 30 |
| 2018 Agosto | 26 | 12 | 38 |
| 2018 Julio | 27 | 7 | 34 |
| 2018 Junio | 23 | 11 | 34 |
| 2018 Mayo | 24 | 11 | 35 |
| 2018 Abril | 18 | 8 | 26 |
| 2018 Marzo | 9 | 7 | 16 |
| 2018 Febrero | 14 | 9 | 23 |
| 2018 Enero | 7 | 6 | 13 |
| 2017 Diciembre | 17 | 9 | 26 |
| 2017 Noviembre | 18 | 9 | 27 |
| 2017 Octubre | 8 | 11 | 19 |
| 2017 Septiembre | 15 | 9 | 24 |
| 2017 Agosto | 10 | 7 | 17 |
| 2017 Julio | 12 | 9 | 21 |
| 2017 Junio | 27 | 9 | 36 |
| 2017 Mayo | 21 | 3 | 24 |
| 2017 Abril | 28 | 10 | 38 |
| 2017 Marzo | 31 | 7 | 38 |
| 2017 Febrero | 15 | 1 | 16 |
| 2017 Enero | 17 | 3 | 20 |
| 2016 Diciembre | 31 | 4 | 35 |
| 2016 Noviembre | 38 | 13 | 51 |
| 2016 Octubre | 27 | 20 | 47 |
| 2016 Septiembre | 22 | 9 | 31 |
| 2016 Agosto | 33 | 9 | 42 |
| 2016 Julio | 18 | 5 | 23 |
| 2016 Junio | 0 | 7 | 7 |
| 2016 Mayo | 0 | 12 | 12 |
| 2016 Abril | 1 | 0 | 1 |
| 2016 Marzo | 2 | 6 | 8 |
| 2016 Febrero | 1 | 0 | 1 |
| 2015 Diciembre | 1 | 14 | 15 |
| 2015 Noviembre | 0 | 17 | 17 |
| 2015 Octubre | 2 | 12 | 14 |
| 2015 Septiembre | 1 | 0 | 1 |
| 2015 Agosto | 1 | 0 | 1 |
| 2015 Julio | 1 | 15 | 16 |
| 2015 Junio | 2 | 7 | 9 |
| 2015 Mayo | 1 | 0 | 1 |
| 2015 Abril | 3 | 0 | 3 |
| 2015 Marzo | 2 | 1 | 3 |
| 2015 Febrero | 3 | 5 | 8 |
| 2015 Enero | 3 | 2 | 5 |
| 2014 Diciembre | 3 | 1 | 4 |
| 2014 Noviembre | 2 | 2 | 4 |
| 2014 Octubre | 3 | 1 | 4 |
| 2014 Septiembre | 1 | 2 | 3 |
| 2014 Agosto | 10 | 1 | 11 |
| 2014 Julio | 11 | 1 | 12 |
| 2014 Junio | 15 | 2 | 17 |
| 2014 Mayo | 8 | 1 | 9 |
| 2014 Abril | 6 | 0 | 6 |
| 2014 Marzo | 6 | 1 | 7 |
| 2014 Febrero | 8 | 0 | 8 |
| 2014 Enero | 6 | 1 | 7 |
| 2013 Diciembre | 18 | 4 | 22 |
| 2013 Noviembre | 35 | 3 | 38 |
| 2013 Octubre | 36 | 2 | 38 |
| 2013 Septiembre | 20 | 2 | 22 |
| 2013 Agosto | 21 | 2 | 23 |
| 2013 Julio | 26 | 1 | 27 |
| 2004 Abril | 2037 | 0 | 2037 |
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