Browsing by Autor "A. Bernal"

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18-4E6X Enhancing nursing work environment: organizational and psychosocial interventions evaluation
(2024) A. Bernal; José Antonio de la Hoz; Andrés Felipe Bejarano; Diana Romero; María Luisa Sevillano García; Sandra Viviana Rodríguez
The SOT Impatient Unit (IU) and Intensive Care Unit (ICU) unitscame to Einstein Morumbi in 2021 and the structure of individual rooms needed to be adapted to a two-bed ward and ICU-hall to accommodate the number of beds necessary, 40 from IU and 10 from ICU.From August 2022 onwards, there was an increase in cases ofcentral line-associated bloodstream infections (CLABSI) in these units, with an average of one case of CLABSIevery 26 days.Data from the literature point to a negative impact, with unfavorable outcomes associated with CLABSI in general, and these may be even worse in transplant patients, due to immunosuppression.The aim of the project is to improve processes to reduce CLABSI and reduce the CLABSI rate by 40%, going from 2.90/1000 Central line-day to 1. 74 from July 2023 to August 2024 and increase the adherence to insertion, central line (CL) maintenance and hand hygiene (HH) bundles to 95%.All patients admitted to the two units using CL were included in the scope of the project.Meetings were held with representatives of the multidisciplinary team to raise problems and define priorities based on a risk matrix, with a description of a driver diagram with ideas for proposed changes to enable their implementation.The improvement model was used to carry out the project and tools such as PDSA (plan, do, check, act), fishbone diagrams and TWI (Training Within Industry).Bundles are created with immediate educational feedback and monitoring of results by sector coordination.In seven months of the project there was a reduction in the CLABSI rate from 2.9 to 0.57/1000
Social Learning Through Water Games in the Field
(World Scientific, 2024) A. Bernal; Juan-Camilo Cárdenas; Laia Domènech; Ruth Meinzen‐Dick; Paula Sarmiento
Economic experiments have traditionally been used as a tool for measuring human behavior in different contexts of social interaction. However, little has been discussed so far on the role of experiments as tools for learning and social change. We conducted a series of educational interventions in two municipal aqueducts in Guasca, Colombia using an irrigation collective action game where five people must decide over contributions to produce water and decide on the sequential allocation of the resource over an irrigation system. We used this setting as a pedagogical tool for understanding the effects of learning over a series of repetitions of these experiments to explore changes in the behaviors and attitudes of rural households in the sample. We ran two waves of games a few months apart with most of the same sample of 200 participants. In one of these aqueducts, we held workshops with the community to provide feedback on the results of the games. In both waves of the experiments, we find a powerful effect of face-to-face communication to improve both group efficiency in the provision of water and fairness in its distribution. Our results suggest that there are processes of learning from one wave to the next that could provide valuable lessons about the possibilities and difficulties that collective action faces within communities. In particular, we find that the workshop for discussing the results may have an effect on creating a better climate for the next wave of games, particularly with respect to average contributions and fair allocation across players. A combination of the experiments and the workshop increased individual cooperation levels, while also inducing upstream players to restrain themselves in extracting water, allowing players downstream to acquire more of the resource.