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Papers by José Ángel González Sánchez

Research paper thumbnail of Estándares técnicos y funcionales, y proceso de implantación, de un sistema de información clínica en unidades de cuidados intensivos

Medicina Intensiva, Nov 1, 2011

Los estándares se agruparon en cuatro categorías: técnica, funcional, datos y seguridad. Todos lo... more Los estándares se agruparon en cuatro categorías: técnica, funcional, datos y seguridad. Todos los estándares fueron clasificados en básicos y opcionales para permitir que el usuario final pueda decidir entre diferentes posibilidades, pero asegurando un mínimo básico de características útiles. También se propuso un cronograma de implantación del sistema.

Research paper thumbnail of Resultados de la implantación de la Guía de valoración y manejo del dolor en Centros Comprometidos con la Excelencia en Cuidados (CCEC®) en España

Enfermería Clínica, 2020

AIM to analyse the progress of implementing the process recommendations of the RNAO Assessment an... more AIM to analyse the progress of implementing the process recommendations of the RNAO Assessment and Management of Pain guideline and health outcomes. METHOD An observational, longitudinal, retrospective study conducted in 3tertiary-level hospitals in Spain. All patients discharged over the last 5 days of each month from the units selected in the implementation process were included. We evaluated structural data, mean hospital stay, implementation strategy and degree of implementation of the process recommendations of the RNAO guideline over the first 3 years of implementation, and outcomes. A descriptive analysis was performed by calculating means and absolute and relative frequencies in periods: baseline (T0), annual, over the 3first years of implementation (T1, T2 and T3 respectively), and inferential. RESULTS 8128 patients were included in the study. Hypotheses were contrasted between the different periods. The initial pain assessment in the first 24h following admission or post-surgery increased after the baseline period in all the hospitals, especially those that did not meet the guidelines from the outset. It continued to rise progressively up to 3 years following implementation (reaching 94.6% in hospital 2). By contrast, implementation of the care plan did not exceed 37.5% and 38.5% in hospitals 1 and 3 respectively. With regard to the outcome indicators, the prevalence of pain at 24hours and intense pain generally decreased in the 3hospitals from T0 or T1 to T3, however no conclusive statistically significant differences were obtained. CONCLUSIONS Implementation of the process recommendations improved from the outset, as did patient outcomes. A decrease in the prevalence and intensity of pain was achieved, although no conclusive data were obtained; all of which leads to better nursing practice with more recording, continuity of care and improved pain management for patients.

Research paper thumbnail of Implementation results of the assessment and management of pain guideline within Best Practice Spotlight Organisations (BPSO®)

Enfermería Clínica (English Edition), 2020

on behalf of the Methodological Working Group of the implementation program of good practices in ... more on behalf of the Methodological Working Group of the implementation program of good practices in Centers Committed to Excellence in Care ®♦

Research paper thumbnail of Technical and functional standards and implementation of a clinical information system in intensive care units

Medicina Intensiva (English Edition), 2011

Introduction: Clinical information systems (CIS) are becoming a useful tool for managing patients... more Introduction: Clinical information systems (CIS) are becoming a useful tool for managing patients and data in the ICU. However, the existing CIS differ in their capabilities and technical requirements. It is therefore essential for intensivists, as the end clients of these applications, to define the suitable minimum specifications required in order to be operative and helpful. Objectives: The Spanish Society of Intensive Care Medicine and Coronary Units, through its Organization and Management Workgroup, has designated a group of clinical and software experts to draft a document with the recommendable technical and operating requirements of these systems. Methods: The group was formed by ten people supported by managers or engineers from the five principal industries producing CIS in Spain. The project involved the following phases: a) Completion of a check list. This step was considered necessary in order to establish the precise current situation of CIS applications. b) Discussion of the results by the group of experts in a meeting and in online format. ଝ Please cite this article as: Gómez Tello V, et al. Estándares técnicos y funcionales, y proceso de implantación, de un sistema de información clínica en unidades de cuidados intensivos. Med Intensiva. 2011;35:484-96.

Research paper thumbnail of Evaluación del efecto de una intervención de limpieza/desinfección sobre la incidencia de infecciones por microorganismos multirresistentes en una Unidad de Cuidados Intensivos

Enfermería Intensiva, 2009

Infección hospitalaria; Acinetobacter; Infecciones por Acinetobacter; Cuidados Intensivos Resumen... more Infección hospitalaria; Acinetobacter; Infecciones por Acinetobacter; Cuidados Intensivos Resumen Objetivo. Evaluar el efecto de una intervención sobre la incidencia de infecciones nosocomiales (IN) por microorganismos multirresistentes en las Unidades de Cuidados Intensivos (UCI). Material y métodos. Se realizó un estudio antes-después de una intervención para el control de un brote de Acinetobacter baumannii multirresistente (ABMR) en dos UCI. Durante el brote (del 22-12-06 al 12-2-07) se procedió al cierre y limpieza/desinfección de las salas y equipamiento de las dos UCI, con muestreo microbiológico antes y después. Se comparó la densidad de incidencia de IN por microorganismos multirresistentes entre los pacientes ingresados: preintervención (del 1-3-2006 al 15-12-2006) y posintervención (del 1-3-2007 al 15-12-2007). Para comprobar si existían diferencias estadísticamente signifi cativas se calculó la razón de tasas (RT) y su intervalo de confi anza (IC) al 95%. El nivel de signifi cación estadística se estableció en p < 0,05. Se estratifi có por unidad, tipo de microorganismo y localización de la infección. Resultados. La tasa de incidencia global de IN por microorganismos multirresistentes disminuyó signifi cativamente tras la intervención en ambas unidades (RT: 1,83, IC 95% 1,34-2,50), p < 0,005. También existió disminución signifi cativa en la tasa de incidencia de IN para los microorganismos:

Research paper thumbnail of Plan de cuidados frente a protocolo asistencial. Análisis comparativo en pacientes sometidos a cateterismo cardíaco

Enfermería Intensiva, 2006

Research paper thumbnail of Repercusión en las mediciones hemodinámicas a través de un Swan-Ganz con los cambios posturales

Enfermería Intensiva, 2004

... Wilson AE, Berminghan-Citchell K, Wells N, Zachary K. Effect of backrest position on hemodyna... more ... Wilson AE, Berminghan-Citchell K, Wells N, Zachary K. Effect of backrest position on hemodynamic and right ventricular measurements in critically ... Blanca a ; Muñoz Muñoz, Ismael a ; Simón García, María Jesús b ; González Sánchez, José Ángel a ; Martín Benítez, Juan Carlos ...

Research paper thumbnail of Registros de enfermería: convencional frente a informatizado. Unidad de cuidados críticos

Enfermería Intensiva, 2004

... Crew AD, Stoodley KDC, Old S, Unsworth GD, Martin WN, Kincaid K. A sampling study of bedside ... more ... Crew AD, Stoodley KDC, Old S, Unsworth GD, Martin WN, Kincaid K. A sampling study of bedside nursing activity in a cardiac surgical intensive care unit. ... González Sánchez, José Ángel a ; Cosgaya García, Onofre a ; Simón García, María Jesús b ; Blesa Malpica, Antonio L c. ...

Research paper thumbnail of NEMS: ¿nuevo predictor de mortalidad en el paciente crítico?

Enfermería Intensiva, 2012

Numerical scales are commonly used in intensive care units to predict hospital mortality and to a... more Numerical scales are commonly used in intensive care units to predict hospital mortality and to assess the therapeutic effort and care that critically ill patients require. The aim of this work was to study whether the NEMS value can be used as a predictor of mortality, comparing it with the APACHE II. A prospective study in a 24 intensive care unit beds was conducted. The APACHE II and NEMS values were stratified into three levels. Demographic data and the first 24 hours values of APACHE II and NEMS scales were collected. A total of 1257 patients were included, 16.4% of whom died. 69.6% were surgical; median stay was 2 days (1-4). Median age was 66 years (50-77), 59.3% were men. The median APACHE II and NEMS for the living and the dead in the subsequent course was 10 (6-20) versus 22.5 (17.25 to 29) (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) and 24 (18-29) versus 34 (25 to 39.7) (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) respectively. The correlation between both scales was rho=0.457 (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01). Logistic regression controlled for age, sex and APACHE II showed an OR of 3.1 (95% CI: 1.5-6.6) only for high NEMS, compared to the lowest level. According to the results NEMS should not be used as a predictor of mortality, although the risk of death increases by three times with high NEMS.

Research paper thumbnail of Estándares técnicos y funcionales, y proceso de implantación, de un sistema de información clínica en unidades de cuidados intensivos

Medicina Intensiva, Nov 1, 2011

Los estándares se agruparon en cuatro categorías: técnica, funcional, datos y seguridad. Todos lo... more Los estándares se agruparon en cuatro categorías: técnica, funcional, datos y seguridad. Todos los estándares fueron clasificados en básicos y opcionales para permitir que el usuario final pueda decidir entre diferentes posibilidades, pero asegurando un mínimo básico de características útiles. También se propuso un cronograma de implantación del sistema.

Research paper thumbnail of Resultados de la implantación de la Guía de valoración y manejo del dolor en Centros Comprometidos con la Excelencia en Cuidados (CCEC®) en España

Enfermería Clínica, 2020

AIM to analyse the progress of implementing the process recommendations of the RNAO Assessment an... more AIM to analyse the progress of implementing the process recommendations of the RNAO Assessment and Management of Pain guideline and health outcomes. METHOD An observational, longitudinal, retrospective study conducted in 3tertiary-level hospitals in Spain. All patients discharged over the last 5 days of each month from the units selected in the implementation process were included. We evaluated structural data, mean hospital stay, implementation strategy and degree of implementation of the process recommendations of the RNAO guideline over the first 3 years of implementation, and outcomes. A descriptive analysis was performed by calculating means and absolute and relative frequencies in periods: baseline (T0), annual, over the 3first years of implementation (T1, T2 and T3 respectively), and inferential. RESULTS 8128 patients were included in the study. Hypotheses were contrasted between the different periods. The initial pain assessment in the first 24h following admission or post-surgery increased after the baseline period in all the hospitals, especially those that did not meet the guidelines from the outset. It continued to rise progressively up to 3 years following implementation (reaching 94.6% in hospital 2). By contrast, implementation of the care plan did not exceed 37.5% and 38.5% in hospitals 1 and 3 respectively. With regard to the outcome indicators, the prevalence of pain at 24hours and intense pain generally decreased in the 3hospitals from T0 or T1 to T3, however no conclusive statistically significant differences were obtained. CONCLUSIONS Implementation of the process recommendations improved from the outset, as did patient outcomes. A decrease in the prevalence and intensity of pain was achieved, although no conclusive data were obtained; all of which leads to better nursing practice with more recording, continuity of care and improved pain management for patients.

Research paper thumbnail of Implementation results of the assessment and management of pain guideline within Best Practice Spotlight Organisations (BPSO®)

Enfermería Clínica (English Edition), 2020

on behalf of the Methodological Working Group of the implementation program of good practices in ... more on behalf of the Methodological Working Group of the implementation program of good practices in Centers Committed to Excellence in Care ®♦

Research paper thumbnail of Technical and functional standards and implementation of a clinical information system in intensive care units

Medicina Intensiva (English Edition), 2011

Introduction: Clinical information systems (CIS) are becoming a useful tool for managing patients... more Introduction: Clinical information systems (CIS) are becoming a useful tool for managing patients and data in the ICU. However, the existing CIS differ in their capabilities and technical requirements. It is therefore essential for intensivists, as the end clients of these applications, to define the suitable minimum specifications required in order to be operative and helpful. Objectives: The Spanish Society of Intensive Care Medicine and Coronary Units, through its Organization and Management Workgroup, has designated a group of clinical and software experts to draft a document with the recommendable technical and operating requirements of these systems. Methods: The group was formed by ten people supported by managers or engineers from the five principal industries producing CIS in Spain. The project involved the following phases: a) Completion of a check list. This step was considered necessary in order to establish the precise current situation of CIS applications. b) Discussion of the results by the group of experts in a meeting and in online format. ଝ Please cite this article as: Gómez Tello V, et al. Estándares técnicos y funcionales, y proceso de implantación, de un sistema de información clínica en unidades de cuidados intensivos. Med Intensiva. 2011;35:484-96.

Research paper thumbnail of Evaluación del efecto de una intervención de limpieza/desinfección sobre la incidencia de infecciones por microorganismos multirresistentes en una Unidad de Cuidados Intensivos

Enfermería Intensiva, 2009

Infección hospitalaria; Acinetobacter; Infecciones por Acinetobacter; Cuidados Intensivos Resumen... more Infección hospitalaria; Acinetobacter; Infecciones por Acinetobacter; Cuidados Intensivos Resumen Objetivo. Evaluar el efecto de una intervención sobre la incidencia de infecciones nosocomiales (IN) por microorganismos multirresistentes en las Unidades de Cuidados Intensivos (UCI). Material y métodos. Se realizó un estudio antes-después de una intervención para el control de un brote de Acinetobacter baumannii multirresistente (ABMR) en dos UCI. Durante el brote (del 22-12-06 al 12-2-07) se procedió al cierre y limpieza/desinfección de las salas y equipamiento de las dos UCI, con muestreo microbiológico antes y después. Se comparó la densidad de incidencia de IN por microorganismos multirresistentes entre los pacientes ingresados: preintervención (del 1-3-2006 al 15-12-2006) y posintervención (del 1-3-2007 al 15-12-2007). Para comprobar si existían diferencias estadísticamente signifi cativas se calculó la razón de tasas (RT) y su intervalo de confi anza (IC) al 95%. El nivel de signifi cación estadística se estableció en p < 0,05. Se estratifi có por unidad, tipo de microorganismo y localización de la infección. Resultados. La tasa de incidencia global de IN por microorganismos multirresistentes disminuyó signifi cativamente tras la intervención en ambas unidades (RT: 1,83, IC 95% 1,34-2,50), p < 0,005. También existió disminución signifi cativa en la tasa de incidencia de IN para los microorganismos:

Research paper thumbnail of Plan de cuidados frente a protocolo asistencial. Análisis comparativo en pacientes sometidos a cateterismo cardíaco

Enfermería Intensiva, 2006

Research paper thumbnail of Repercusión en las mediciones hemodinámicas a través de un Swan-Ganz con los cambios posturales

Enfermería Intensiva, 2004

... Wilson AE, Berminghan-Citchell K, Wells N, Zachary K. Effect of backrest position on hemodyna... more ... Wilson AE, Berminghan-Citchell K, Wells N, Zachary K. Effect of backrest position on hemodynamic and right ventricular measurements in critically ... Blanca a ; Muñoz Muñoz, Ismael a ; Simón García, María Jesús b ; González Sánchez, José Ángel a ; Martín Benítez, Juan Carlos ...

Research paper thumbnail of Registros de enfermería: convencional frente a informatizado. Unidad de cuidados críticos

Enfermería Intensiva, 2004

... Crew AD, Stoodley KDC, Old S, Unsworth GD, Martin WN, Kincaid K. A sampling study of bedside ... more ... Crew AD, Stoodley KDC, Old S, Unsworth GD, Martin WN, Kincaid K. A sampling study of bedside nursing activity in a cardiac surgical intensive care unit. ... González Sánchez, José Ángel a ; Cosgaya García, Onofre a ; Simón García, María Jesús b ; Blesa Malpica, Antonio L c. ...

Research paper thumbnail of NEMS: ¿nuevo predictor de mortalidad en el paciente crítico?

Enfermería Intensiva, 2012

Numerical scales are commonly used in intensive care units to predict hospital mortality and to a... more Numerical scales are commonly used in intensive care units to predict hospital mortality and to assess the therapeutic effort and care that critically ill patients require. The aim of this work was to study whether the NEMS value can be used as a predictor of mortality, comparing it with the APACHE II. A prospective study in a 24 intensive care unit beds was conducted. The APACHE II and NEMS values were stratified into three levels. Demographic data and the first 24 hours values of APACHE II and NEMS scales were collected. A total of 1257 patients were included, 16.4% of whom died. 69.6% were surgical; median stay was 2 days (1-4). Median age was 66 years (50-77), 59.3% were men. The median APACHE II and NEMS for the living and the dead in the subsequent course was 10 (6-20) versus 22.5 (17.25 to 29) (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) and 24 (18-29) versus 34 (25 to 39.7) (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) respectively. The correlation between both scales was rho=0.457 (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01). Logistic regression controlled for age, sex and APACHE II showed an OR of 3.1 (95% CI: 1.5-6.6) only for high NEMS, compared to the lowest level. According to the results NEMS should not be used as a predictor of mortality, although the risk of death increases by three times with high NEMS.