A Abelleira | PubMed Health

PubMed2005

[Occult chronic kidney disease (OCKD), and cardiovascular risk factors. Epidemiologic study].

UNLABELLED: Vascular diseases are the first cause of mortality within the occidental world. In Spain, they represent 35.5% within the total of deceases. Vascular diseases, jointly with Diabetic Nephropaty, are the first cause of inclusion of patients in dialysis. In precocious stages of renal disease, and as a consequence of the inflammatory condition generated already exists vascular damage. But its prevention is difficult, because habitually GFR is evaluated by means of plasmatic creatinin rate impeding the suitable detection of renal disease prevailing. OBJECTIVE: The purpose of this study is to evaluate the prevailing of Occult Chronic Kidney Disease (OCKD) and its association with conventional vascular risk factors (VRF). MATERIAL AND METHODS: The epidemiologic study was made in a randomly selected population elder than 18 years. GFR was calculated using Cockcroft-Gault and MDRD methods, and the results were correlated with VRF. RESULTS: The studied population mean age is 50.49 +/- 16.28 years, hypertension prevailing is 31.5%, diabetes: 7.5%, obesity: 21.9%, dislipènic: 35.62%, anemia: 1.4%. IV degree IRCO rate (GFR: 15-30 ml/min) is 0.7 (MDRD) with 69.43 +/- 12.58 years of age, and 1.5% (C-G) with 76.25 +/- 10.64 years of age. GFR, independently on the method used in its calculation, is significantly correlated with TAS (< 0.0001), pulse pressure (< 0.0001), Hb (0.0001), obesity (< 0.0001), Total Cholesterol (< 0.0001), triglycerides (< 0.0018), c-HDL (< 0.0001), c-LDL (< 0.0001) e hiperuricemic (< 0.0001). GFR disparity depends on the equation used. It could be explained because C-G overestimate by "weigh" and it has higher deviation in lower renal function values. Whereas, using MDRD equation there is an overestimation by "age" and it has lower variability. CONCLUSIONS: In an aged population, the prevailing of OCKD and the rate of VRF are high conferring high vascular risk. It will be necessary to adopt intervention measures in order to avoid renal disease progress and its high morbid-mortality.

Adult↗

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Code 50: an orientation matrix to track orientation cost.

Estimates of staff orientation costs can range from $20,000-50,000 per person. The Director of Finance and the Director of Nursing Education and Research developed a system to track the orientation process to determine the actual costs. Head nurses and educators approached the orientation process differently; therefore, there was no consistency as to the time allotted for orientation. Although competency-based orientation tools were used for all new orientees, the average amount of time for new orientees to become productive ranged from 3-9 months. By creating the orientation matrix, a unique pay class (code 50) was assigned for all new orientees, and a computer program was developed to track costs. The overtime hours for orientees dropped to 159 from 941, resulting in an 83% reduction in overtime hours. The matrix ensured a more cost effective approach to orientation.

Clinical Competence↗