Tuesday, June 8, 2010

V International Conference on Patient Safety

Under the Spanish Presidency of the U.E. Madrid was held at the V International Conference on Patient Safety. Impeccable organization and excellent speakers at tables rather moderate.

A lot and very good. How to summarize? I chose to reflect what has impressed me most as a family doctor who has left these days its small and saturated query to continue learning to improve the safety of care patients receive.

I encourage the rest of the attendees to write their impressions on this blog from the same or from other points of view and thereby enrich my comment.

About infections associated with health care and antimicrobial resistance I noted: Over 50% of the Spanish adult population admitted having taken antibiotics in the last year (30% "with the flu").

Antibiotic consumption is associated with increased bacterial resistance which cause delays in the administration of effective treatments and therefore increase morbidity and mortality, prolonged hospital stay and high economic costs. Resistance increases with increased use. It is shown that less use increase complications in patients with infectious disease.
In Spain, 92% of antibiotics are acquired by prescription (in France 97%, with a European average of 95%).

Other data for comparison with the rest of Europe: we consume more broad-spectrum antibiotics and continues the upward trend in the prevalence of MRSA in our hospitals (the French show that this trend can be reversed).

Research on antibiotic therapy is virtually idle since the 60s (currently only a research compound against gram negative).

There is decrease in the supply of active ingredients while raising presentations. The EFG represent 43% of prescriptions.

What I can do?

Non-pharmacological interventions:

Prudent use of antibiotics: only when necessary, correct intervals and duration.

Optimization of empirical treatments. Prescribing based on evidence.

Help end the illegal practice of giving antibiotics without a prescription at the pharmacy (for example, not providing the same into the patient).

Ask to enhance research in antibiotics (eg, not favoring my requirements that the business is in selling so many drugs that do not represent steps)

Find information and training and quality transparent

Collaborate with health authorities in health education campaigns for proper use of antibiotics and other initiatives related to patient safety.

Regarding measures to be taken to prevent transmission of pathogens themselves that we use and abuse the most powerful tool to address infections associated with health care: hand hygiene. Compliance through this simple but effective measure is only 38% and fewer doctors that nurses meet.

I keep taking note of the representatives of our patients tell us they are in health care silence and concealment of errors, reactive actions to prevail against those aimed at preventing them.

We ask for proactive risk management, teamwork, improve communication with and among us, standardization of procedures based on best available knowledge to care "partnerships" with industry to establish and therefore we do not focus on the sophisticated technology in the pursuit of our interest but in the promotion of good practice and in them, our patients.

They in turn are considering what to do for health systems and better use of resources and effort to ask for and offer honesty, transparency and participation.

Already in the last speech heartened to hear that primary care matters a great deal, how to tell us so little!

But beyond the first moment of pride that we have to take rather this phrase as a warning: be so important in AP extent of the risk does not appear to be reaching for now strategies to achieve safer health care in the same So get to other levels of care.

I recommend to visit the website of the Linneaus project.

For my part I try, and this week in my small and saturated consultation, follow some concrete recommendations for action by his representative: Do not lose sight of the importance of good interaction with the patient to understand and follow my explanations, explanations should be improving day by day and manage my time so you can establish routines that allow me to advance the consultation of the patient if something can not go well and record, report, analyze and learn from the failures and errors.

Posted by Marian López Orive
English version by Jesús Moreno

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