Trabajo final de los alumnos de la Carrera Diseño Profesional de Interiores de la Universidad Peruana de Ciencias Aplicadas (UPC). Curso Taller 7, ciclo 2015-2, alumnos: Vargas Acuña, Candy Claudia y Larrea León, Alejandra Karina. / El curso de especialidad Patrimonio Histórico de la carrera Diseño Profesional de Interiores, de carácter teórico, está dirigido a los alumnos de séptimo ciclo y busca desarrollar la competencia general de Ciudadanía y la competencia específica de Diseño Multidisciplinario. El curso está orientado al desarrollo de un proyecto de intervención en un espacio patrimonial, el estudiante experimenta con patologías de deterioro en edificaciones antiguas y aprende técnicas de conservación a fin de que pueda utilizarlas en su desempeño profesional recuperando el valor de un inmueble. Como competencia de ciudadanía el alumno adquiere su compromiso con la historia y el patrimonio de su ciudad. El Perú tiene un importante Patrimonio cultural edificado y requiere profesionales con formación en temas de puesta en valor y adecuación a un nuevo uso.

This study compares selected social characteristics of first admissions to a private psychiatric hospital in the calendar years 1940 and 1960 with the white populations of Texas and Dallas County. In addition, this study compares selected background characteristics of first admissions to determine what, if any, change occurred in these characteristics between 1940 and 1960.

The primary purposes of the present study were (1) to see in which way, if any, the measured attitudes of psychiatric aides employed on geriatric wards differed from those of aides employed on non-geriatric wards at the same hospital; and (2) to explore the relationships between measured attitudes and other variables such as age, education, amount of experience as an aide, amount of experience on either geriatric or non-geriatric wards, and the number of patients per aide on each ward.

The role of marketing and marketing communication in hospitals has grown in the last decade. The need for hospitals to make careful decisions about their marketing communication efforts is mandated, given the changes taking place in the hospital industry. The purpose of this dissertation was to conduct empirical research to determine whether for-profit and non-profit hospitals perceive and utilize promotion as a marketing strategy element. The two steps taken included: identifying important factors considered by hospital administrators and marketing staff in the development of communication messages designed for patients, hospital staff and medical staff; and testing the factors developed and studying the attitudes of hospital personnel toward promotion using a national sample of hospitals. In phase 1, focus group interviews were conducted in a surrogate for-profit hospital and a surrogate non-profit hospital. In phase 2, an original mail questionnaire was used to collect data from a sample of 80 hospitals. A total of 38 hospitals participated, providing 114 usable responses. Test statistics included content analysis, Chi-Square, Pearson correlation coefficient and Analysis of Variance. The results of the focus group study indicated the practice of marketing in hospitals is in its early growth stages and marketing is viewed as nothing more than advertising and public relations. The results of the mail survey indicated that respondents in small for-profit hospitals with 20 to 30 years of experience as professionals, with key decision making authority, are favorably disposed to marketing and marketing communication. It was also found that respondents in large non-profit hospitals are very positive towards marketing. In contrast, respondents in medium and large for-profit hospitals, who are not directly involved in decision making, tend to be less positive towards marketing. The study serves as a basis for future research which may involve, (1) a larger sample frame, (2) hospitals in inner-city and rural areas, (3) investigation of the association between hospital ownership and hospital efficiency, and (4) development of a profile of respondents by title held, in hospitals.

Class of 2007 Abstract / Objectives: The purpose of this study is to determine the direct costs of scorpion envenomation events in the acute care setting for patients treated in a southern Arizona hospital. Methods: A chart review analysis of documented treatment of scorpion envenomations at a university hospital was conducted to compile demographic, drug use, and resource utilization information. Patients were selected based on an ICD-9 code diagnosis of scorpion envenomation within the years 1993 to 2001. Results: 103 patient charts were reviewed. The average length of stay was 1.21 days (range 0.5-6.5 days), the average age was 4.7 years (range 0.2-53 years old). Males comprised 54% of the patients, 51.9% Caucasian, 41.6% Hispanic, and 60.2% were from an urban setting. The average drug cost was $51.82 (SD=53.22). The total average cost in the entire population was $6,764.54, (SD= $3,866.55). The average cost of rural versus urban was $7,535.74 and $6,254.55, respectively (p=0.100). The average cost for male versus female was $6,949.64 and $6,520.90 (p= 0.581), and the average cost for the 0-3 years group was $6,721.10, the >3 years to 14 years group’s average cost was $6,643.33, and the >14 years of age group’s average cost was $8,578.42. None of the comparisons between age groups were statistically significant, with p values ranging from 0.274 to 0.922. Conclusions: Although scorpion envenomations were costly, there were no statistically significant differences noted between any of the comparison groups. Transportation, including air transport in the rural setting, did not account for a significant change in cost. Many of the patients that were envenomated in the rural setting were seen at a regional hospital and then transported as necessary.

Class of 2007 Abstract / Objectives: Medication reconciliation is a formal process of obtaining a complete and accurate list of each patient’s current home medications. This process is done to prevent errors of omission, therapeutic duplication, dosing/frequency errors, or drug-drug/drug-disease interactions. As of January 1, 2006, University Medical Center (UMC) implemented a new, comprehensive medication reconciliation form which was intended to prevent medication-related discrepancies upon admission. The purpose of this study was to compare the percent of missing required prescription information upon hospital admission before and after the implementation of the medication reconciliation form. Methods: This study was an inferential retrospective chart review of patients admitted to UMC in Tucson, Arizona, between January 1, 2005 and August 1, 2006. While the overall goal was to measure the impact of a new medication reconciliation form on the completeness of a patient's medication history, the specific study objectives were to: (1) evaluate medication reconciliation form utilization and compliance and (2) compare the completeness of medication information upon hospital admission before and after the implementation of the comprehensive medication reconciliation form. Patients were included in the study if they were over 18 years of age and admitted to UMC at least once in 2005, and at least once between January 1, 2006 and August 1, 2006. The following patients were excluded: patients that were institutionalized in an assisted living facility or nursing home, admitted to the emergency room, intubated, transferred to the hospital from a nursing home or a long term care facility, and discharged from the hospital within 24 hours of admit. Two hundred and thirty-four patients, who met the inclusion criteria, were randomly selected from a UMC hospital census. The researchers reviewed each medical chart and recorded the physician-reported medication history, reason for admit, length of stay, and demographic information. Descriptive and inferential statistical analysis was completed using SPSS Version 11.0 (SPSS Inc., Chicago, IL). After collecting the data, counts were taken on missing prescription information, such as missing medication names, dose, route, and frequencies. If the collected data were normally distributed and were interval/ratio level data, a paired t- test was used for analysis. If the data were not normally distributed or were of nominal/ordinal level, a McNemar test was used. An a priori alpha level of 0.05 was used for all statistical tests. Results: A total of 234 patients were included in both the pre and post analysis. Approximately 53.8% of the sample was male. Fifty-one percent of the population was categorized as white in the patient’s chart. The average age at time of first admit was 50.3 years. Fifty-three percent of the population had a past medical history that included cardiovascular disease. Over 28% of the patients in the sample had diabetes and over 18% had pulmonary disease. The most common admit diagnoses for the population included shortness of breath, chest pain, and abdominal pain. Medication reconciliation forms were found in the chart 71.4% of the time. Of the 71.4% of the forms present in the patient’s medical chart, the form was utilized 66.6% of the time. The percentage of allergies recorded in the patient’s chart decreased from 89.3% before implementation of the form to 65.9% after implementation. This movement repeated itself with the recording of social history, which fell from 92.3% recorded before the form to 52.6% after implementation. Introduction of the new medication reconciliation form at UMC resulted in significantly fewer drug names missing, incorrect, or illegible from the patient’s medication history between pre and post (p=0.034), as well as a greater amount of medications recorded in the patient’s medication history (p=0.006). However, the use of the form did not result in significant differences between pre and post in the route, frequency, and dosing information being recorded. It also did not result in a significantly greater amount of non- prescription drugs recorded. Conclusions: The results of this study indicate the need for a systematic approach to ensure the process of obtaining accurate medication histories at the time of hospital admission. Utilization of a new comprehensive medication reconciliation form in this academic institution is far from optimal, and could have significant healthcare implications. Better methods of ensuring medication reconciliation at the time of hospital admission are needed.

Class of 2007 Abstract / Objectives: To evaluate the impact of decentralized clinical staff pharmacists (CSPs) on nursing staff in a university- affiliated teaching hospital. Areas of interest include perceived quality of patient care, job satisfaction and nursing job retention. Methods: CSP impact was evaluated using a print-based survey utilizing outcomes items and a four-point Likert-type scale with response options ranging from “Agree” to “Disagree.” Nurses also answered demographic questions about experience, time at the institution, education leve and frequency of interaction with a CSP. Analysis of the data included use of descriptive statistics as well as use of Kendall’s tau-b to evaluate differences between groups based frequency of CSP interaction. Results: Respondents included 122 nurses at University Medical Center (UMC) in Tucson, Arizona in positions supported by a CSP during the summer of 2006. Nurses overwhelmingly selected “Agree” or “Somewhat Agree” for all 12 statements about the CSPs indicating that they found their interaction with CSPs valuable. Nurses who interacted more frequently with CSPs were more likely to “Agree” or “Somewhat agree that CSPs were valuable members of the hospital (p=.049), one reason they remained at UMC (p=.007), helpful with medication questions (p=.008) and improved job satisfaction (p=.013), made their job easier (p=<.001) as well as more enjoyable (p=.027)

INTRODUCCION: La colecistitis crónica calculosa es la inflamación e irritación prolongada de la vesícula biliar asociada a la presencia de cálculos vesiculares. La vesícula biliar es un saco localizado debajo del hígado que almacena la bilis que se produce en el hígado. OBJETIVO GENERAL: Identificar los factores de riesgo asociados a pacientes con diagnostico confirmatorio de colecistitis crónica calculosa en el Hospital Nacional Hipólito Unanue durante el 2015. METODOLOGÍA: Es un estudio de tipo retrospectivo, transversal, analítico y observacional que fue realizado con el objetivo de Identificar los factores de riesgo asociados a pacientes con diagnostico confirmatorio de colecistitis crónica calculosa en el Hospital Nacional Hipólito Unanue durante el año 2015, con una ficha de datos con 397 pacientes como universo y una muestra de 195. RESULTADOS: La prevalencia de colecistitis crónica calculosa fue de 100% ya que todos los pacientes fueron intervenidos por el cuadro. Con respecto al sexo, en el cuadro se demuestra que el mayor número de casos (58.5%), correspondieron al sexo masculino. Con respecto a la edad, el grupo etareo con el mayor número de casos fue de los 36 a los 45 años con 100 pacientes (51.3%). En relación a las comorbilidades la obesidad fue la de mayor frecuente con 30 casos (15.4%), En relación al tiempo de evolución de la enfermedad, tenemos que en su totalidad 129 pacientes con el (66.2%) la tuvieron 11 a 20 meses. Según el tiempo de pre hospitalización encontramos que 100 pacientes (51.3%) estuvieron hospitalizados de 8 a 13 días. En cuanto al consumo de dieta rica en fibras; en el 77.9% de los casos no consume dicha dieta. Con respecto al tipo de herida encontramos que en su totalidad, el 100% de los casos fue una herida limpia .En cuanto al peso en kilos se encontró que (55.9 %) tienen peso entre 70 a 85 kilos. Con respecto a la talla en metros se encontró que 109 casos (55.9 %) midieron entre 1,66 – 1,77 metros. En cuanto al IMC, se encontró (55.9 %) está dentro 23,7 – 28,84. La asociación entre las variables presentadas en este estudio 4 en su mayoría fue estadísticamente significativas con los pacientes con diagnóstico de colecistitis crónica calculosa. CONCLUSIONES: La asociación entre las variables presentadas en este estudio en su mayoría fue estadística mente significativas siendo entre ellas la obesidad, IMC y el no consumo de dieta los factores más predisponentes de la formación de cálculos vesiculares.

Magister Public Health - MPH / Background: Healthcare providers are critical to collecting information on drug safety and successful adverse drug reaction (ADR) reporting. The roles of doctors and pharmacists have been recognized as important to voluntary ADR reporting and their roles are consistently being investigated. However, despite the strategic role of nurses in medicine administration, their role in ADR reporting has not been widely explored, particularly in sub-Saharan African countries. Aim: To assess the knowledge, attitudes and practice of ADR reporting amongst nurses in Lagos University Teaching Hospital (LUTH), a tertiary hospital located in Lagos; the economic centre of Nigeria, as well as the most populous city in the country. Methodology: A cross-sectional descriptive survey with analytical components was conducted among nurses in a tertiary institution. All nurses working in major specialties - out-patients’ clinics, theatre and clinical wards in the facility, were eligible to participate in the study. Student nurses undergoing training or postings in the facility were excluded from the study. A sample size of 124 nurses was calculated using OpenEpi sample size calculator based on an estimated study population of 400 with a 95% confidence interval and an assumed 5% of nurses reporting an ADR based on National Pharmacovigilance Centre database. A sample of 140 nurses was selected in an attempt to realize sample. Cluster sampling was used to randomly select clinics and wards and all nurses in the selected clusters were included in the study. A structured questionnaire consisting of close-ended questions was used. It comprised sections on nurses’ characteristics, knowledge of pharmacovigilance concepts, attitudes towards ADR reporting, and barriers to and practice of ADR reporting. Data collected were entered into an Excel spreadsheet and imported to the SPSS version 20 software for analysis. Descriptive analyses were conducted on all the variables and cross-tabulation between selected variables was explored to test for statistical significance using chi-squared test.

Unidad de Práctica Prolongada para optar al título de Químico Farmacéutico / Desde el inicio de la Farmacia Hospitalaria, ésta se ha tenido que ir actualizando según los diferentes contextos sociales, económicos y tecnológicos, siendo necesaria la evaluación constante de los procesos que se llevan a cabo para implementar estrategias que ayuden a solucionar y a optimizar los procesos en la farmacia asistencial. Es por esto que se decide revisar y mejorar el proceso de dispensación de recetas a pacientes hospitalizados en el Hospital Clínico de la Universidad de Chile. Para este fin se diseñó un estudio prospectivo en el que se evaluó el sistema de dispensación de Farmacia Central, el cual incluyó detectar los errores más comunes en las recetas físicas que eran despachadas, seguido de una encuesta a los técnicos en farmacia para conocer cuál de estos errores eran más importantes para ellos, la revisión de recetas físicas por un mes con el fin de generar datos cuantitativos sobre cuáles de estos errores eran los más frecuentes y los cuatro servicios clínicos que más incidían en estos y por último, la visita a estos servicios para conocer sus protocolos en la generación de recetas. Posteriormente se diseñó una intervención farmacéutica en donde se aplicó una modificación al flujo normal de las recetas desde que son prescritas por el médico, hasta que los técnicos de la farmacia preparan las caseteras con los medicamentos del día para los servicios. La intervención realizada correspondió a la validación de recetas con ayuda de la revisión de las indicaciones y pautas de medicación de cada paciente en el sistema informático. Geriatría, Cirugía, Nefrología y Medicina Interna fueron los servicios que presentaron la mayor cantidad de problemas en las recetas, lo que podría influir en errores en la dispensación de los medicamentos desde la farmacia. Se implementó la validación de las recetas en Geriatría y Cirugía. Para objetivar los resultados de la intervención se consideró la cantidad de devoluciones que se generaron a raíz de estos errores por medio del sistema informático del hospital, resultando en una disminución de los medicamentos devueltos a Farmacia Central en los meses intervenidos. Además se midió el tiempo que demoraban los técnicos de farmacia en revisar las devoluciones y la cantidad de medicamentos que no se enviaron de forma errónea y por lo tanto, no generaron estos retornos, lo que contribuyó en una disminución en el tiempo dedicado a esta actividad. En base a los resultados obtenidos, la validación de recetas por parte del Químico Farmacéutico permite la reducción en el número de devoluciones de medicamentos desde los servicios clínicos, además de la disminución de la carga asistencial de los técnicos en farmacia, siendo recomendable mantener esta intervención aplicándose en el resto de los servicios de forma paulatina y a futuro lograr que exista un profesional farmacéutico exclusivamente dedicado a esta actividad