Salvador Pita‐Fernández

Universidade da Coruña

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Sonia Pértega‐Díaz

Instituto de Investigación Biomédica de A Coruña

Teresa Seoane‐Pillado

Universidade da Coruña

Beatriz López‐Calviño

Complexo Hospitalario Universitario A Coruña

Vicente Gil-Guillén

Red de Investigación en Actividades Preventivas y Promoción de la Salud

Domingo Orozco‐Beltrán

Universitat de Miguel Hernández d'Elx

Concepción Carratalá‐Munuera

Universitat de Miguel Hernández d'Elx

Vicente Pallarés‐Carratalá

Universitat Jaume I

Rocío Seijo-Bestilleiro

Complexo Hospitalario Universitario A Coruña

Alejandro Pazos

Universidade da Coruña

Josep Redón

Hospital Clínico Universitario de Valencia

Cooperative Institutions

Universidade da Coruña

131

Complexo Hospitalario Universitario A Coruña

125

Servicio Gallego de Salud

Instituto de Investigación Biomédica de A Coruña

Hospital San Juan de la Cruz

Universidade de Santiago de Compostela

Universitat de València

Hospital Clínico Universitario de Valencia

Instituto de Salud Carlos III

INCLIVA Health Research Institute

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Effectiveness of an educational intervention to improve the safety culture in primary care: a randomized trial

BMC Family Practice (2019)

Clara González-Formoso Ana Clavería Ma José Fernández-Domínguez Fernando Lago-Deibe Luis Hermida-Rial

Fostering a culture of safety is an essential step in ensuring patient safety and quality in primary care. We aimed to evaluate the effectiveness of an educational intervention to improve the safety culture in the family and community medicine teaching units in an Atlantic European Region. Randomized study conducted in family and community medicine teaching units in Galicia (Spain). Participants were all fourth-year residents and their tutors (N = 138). Those who agreed to participate were randomized into one of two groups (27 tutors/26 residents in the intervention group, 23 tutors/ 23 residents in the control one).All were sent the Survey on Patient Safety Culture. After that, the intervention group received specific training in safety; they also recorded incidents over 15 days, documented them following a structured approach, and had feedback on their performance. The control group did not receive any action. All participants completed the same survey four months later. Outcome measures were the changes in safety culture as quantified by the results variables of the Survey: Patient Safety Grade and Number of events reported. We conducted bivariate and adjusted analyses for the outcome measures. To explore the influence of participants' demographic characteristics and their evaluation of the 12 dimensions of the safety culture, we fitted a multivariate model for each outcome. Trial followed published protocol. There were 19 drop outs. The groups were comparable in outcome and independent variables at start. The experiment did not have any effect on Patient safety grade (− 0.040) in bivariate analysis. The odds of reporting one to two events increased by 1.14 (0.39–3.35), and by 13.75 (2.41–354.37) the odds of reporting 3 or more events. Different dimensions had significant independent effects on each outcome variable. A educational intervention in family and community medicine teaching units may improve the incidents reported. The associations observed among organizational dimensions and outcomes evidence the complexity of patient safety culture measurement and, also, show the paths for improvement. In the future, it would be worthwhile to replicate this study in teaching units from different settings and with different health professionals engaged. It was retrospectively registered with ( ISRCTN41911128 , 31/12/2010).

Safety Culture

Odds

10.1186/s12875-018-0901-8

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Citations (17)

Emergency presentation of colorectal patients in Spain

PLoS ONE (2018)

Magdalena Esteva Mercedes Ruiz-Díaz M. Antonia Sánchez Sonia Pértega‐Díaz Salvador Pita‐Fernández

Background Colorectal cancer (CRC) is the leading cause of cancer deaths in Europe. Survival is poorer in patients admitted to hospitals through the emergency department than in electively admitted patients. Knowledge of factors associated with a cancer diagnosis through presentation at an emergency department may reduce the likelihood of an emergency diagnosis. This study evaluated factors influencing the diagnosis of CRC in the emergency department. Methods and findings This is a cross-sectional study in 5 Spanish regions; subjects were incident cases of CRC diagnosed in 9 public hospitals, between 2006 and 2008. Data were obtained from patient interviews and primary care and hospital clinical records. We found that approximately 40% of CRC patients first contacted a hospital for CRC through an emergency service. Women were more likely than men to be emergency presenters. The type of symptom associated with emergency presentation differed between patients with colon cancer and those with rectal cancer, in that the frequency of "alarm symptoms" was significantly lower in colon than in rectal cancer patients who initially presented to emergency services. Soon after symptom onset, some patients went to a hospital emergency service, whereas others contacted their GP. Lack of contact with a GP for CRC-related symptoms was consistently related to emergency presentation. Among patients who contacted a GP, a higher number of consultations for CRC symptoms and any referral to outpatient consultations reduced the likelihood of emergency presentation. All diagnostic time intervals were shorter in emergency presenters than in elective patients. Conclusions Emergency presenters are not a uniform category and can be divided into categories according to their symptoms, help seeking behavior trajectory and interaction with their GPs. Time constraints for testing and delays in obtaining outpatient appointments led patients to visit a hospital service either on their own or after referral by their GP.

Presentation (obstetrics)

Outpatient clinic

10.1371/journal.pone.0203556

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Citations (16)

Representación gráfica en el análisis de datos

Cadernos de atención primaria (2001)

Sonia Pértega‐Díaz Salvador Pita‐Fernández

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Epidemiología y prevención de las enfermedades mentales

Salvador Pita‐Fernández Sonia Pértega‐Díaz Jesús Alberdi Sudupe

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Quality of life and related factors in a cohort of plaque‐type psoriasis patients in La Coruña, Spain

International Journal of Dermatology (2014)

Rosa Fernández‐Torres Salvador Pita‐Fernández Eduardo Fonseca

Abstract Background Psoriasis can significantly affect the physical, psychological, and social aspects of a patient's life. Many studies have evaluated the effects of psoriasis on quality of life ( Q o L ), but results in many cases are contradictory. Objectives This study was conducted to assess the relationships between the characteristics of psoriasis (cutaneous severity, arthropathy, treatment) and comorbidities with Q o L and to determine which factors have a major influence. Methods We assessed demographic data, the severity of cutaneous involvement, psoriasis treatment, presence of arthropathy, psoriasis duration, smoking status, alcohol intake, and the presence of comorbidities. Concomitant diseases were evaluated using the C harlson C omorbidity I ndex and the N ational C holesterol E ducation P rogram A dult T reatment P anel III ( ATP ‐ III ) criteria for metabolic syndrome. Q uality of life was assessed using the D ermatology L ife Q uality I ndex ( DLQI ). Results Multivariate analysis showed that factors associated with Q o L impairment included gender (women experienced greater impact: odds ratio [ OR ] 2.85, 95% confidence interval [ CI ] 1.48–5.49; P = 0.002); psoriasis duration (patients with longer durations of psoriasis and psoriasis treatment experienced less impairment: OR 0.96, 95% CI 0.94–0.99; P = 0.004); and treatment type (impact was lower in patients receiving biologic drugs than in those using topical treatment [ OR 3.15, 95% CI 1.50–6.62; P = 0.002] and in those using biologics compared with those using conventional systemic treatment [ OR 2.23, 95% CI 0.98–5.05; P = 0.053]). Psoriasis severity measured according to scores on the P soriasis A rea and S everity I ndex ( PASI ) and body surface area affected was not related to Q o L impairment. C omorbidities were associated with impaired Q o L in the univariate analysis but not after adjusting for other covariates. Conclusions Factors associated with greater impairment of Q o L were gender, psoriasis duration, and type of treatment. Patients receiving systemic and biologic therapies reported better Q o L .

Arthropathy

10.1111/ijd.12294

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Citations (31)

Diez años de Cadernos de Atención Primaria: Publicaciones en Cadernos de Atención Primaria (1994-2002) y Comunicaciones en Congresos Galegos de Medicina Familar y Comunitaria (1984-2002)

Cadernos de atención primaria (2003)

Salvador Pita‐Fernández

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Métodos paramétricos para la comparación de dos medias

Cadernos de atención primaria (2001)

Sonia Pértega‐Díaz Salvador Pita‐Fernández

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Nomogram and Validity of a Model for Predicting Malnutrition in Patients on Liver Transplant Lists

Digestive Diseases and Sciences (2018)

María Teresa García-Rodríguez Sonia Pértega‐Díaz Beatriz López‐Calviño María del Carmen Piñón-Villar Alejandra Otero-Ferreiro

Nomogram

Hepatic Encephalopathy

10.1007/s10620-018-5079-3

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Concordance Between Automatic and Manual Recording of Blood Pressure Depending on the Absence or Presence of Atrial Fibrillation

American Journal of Hypertension (2010)

B. Vazquez-Rodriguez Salvador Pita‐Fernández M. Regueiro-Lopez D. Garcia-Pedreira M. J. Carro-Rodriguez

The aim of this study was to determine the concordance between two instruments for measuring blood pressure (BP) and its modification due to the presence or absence of atrial fibrillation (AF).In 107 patients with AF and a sinus rhythm (SR) of 100, BP was recorded using two sphygmomanometers: one automatic and the other manual. Four readings were made with each at 5-min intervals, and the mean was calculated for the statistical calculations. The correlation was determined using Pearson's correlation coefficient, and the concordance using the Bland-Altman plot and the κ index.The correlation coefficients (r) for the systolic (SBP) and diastolic BP (DBP) were 0.92 and 0.76. If the patient had AF, these were 0.91 and 0.75, respectively. The difference between the automatic and manual SBP measurements depending on whether the patient presented AF was -0.21 and -1.03 mm Hg. In DBP, this was -4.61 and 0.44 mm Hg. This discordance is not modified for low or high BP values, both in patients with AF and those without it. If we classify the patients as hypertensive or not (≥140/90 mm Hg), the concordance between both methods has high κ indices (0.72 and 0.89) both in AF and SR.There is a high correlation between both measurements, which decreased slightly in patients with AF. The difference when comparing the means is clinically irrelevant, and there is a substantial level of concordance between the two measurements for classifying patients as hypertensive or not.

Concordance

Sphygmomanometer

Concordance correlation coefficient

Bland–Altman plot

10.1038/ajh.2010.137

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Citations (16)

Determinación de factores pronósticos

Cadernos de atención primaria (1997)

Salvador Pita‐Fernández Francisco Valdés Cañedo

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Citations (4)