protocolo ostomias

7/24/2019 PROTOCOLO OSTOMIAS

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CALIDAD DE ATENCIN DE ENFERMERA A PACIENTES PEDITRICOS CON

OSTOMAS DEL HOSPITAL DE ESPECIALIDADES PEDITRICAS DE TUXTLA

GUTIRREZ CHIAPAS

INTRODUCCIN

El presente tr!"# t$ene %# '$nl$(( %#n#%er l %l$(( (e ten%$)n (e

en'er&er* +,e se !r$n( l#s p%$entes pe($-tr$%#s %#n #st#&*s (el .#sp$tl (e

espe%$l$((es pe($-tr$%s (e T,/tl G,t$0rre1 C.$ps2 3 +,e &,%.#s (e l#s

n$4#s +,e $n5resn est $nst$t,%$)n re+,$eren (e este pr#%e($&$ent#6

Ls #st#&*s s#n t0%n$%s !-s$%s en l %$r,5* (el prt# ($5est$7#2

,r$nr$# 3 resp$rt#r$#6 Pr#!!le&ente ls #st#&*s $ntest$nles ',er#n ls

$nter7en%$#nes &-s nt$5,s rel$1(s s#!re el $ntest$n#2 pr ,s# (er$7t$7#2per($0n(#se en el t$e&p# s,s #r*5enes6

Ls #st#&*s ($5est$7s s#n %#&,n$%%$#nes rt$'$%$les (e ,n )r5n# %#n l

pre( !(#&$nl &e($nte ,n $nter7en%$)n +,$r8r5$%2 %#n l '$nl$(( (e s,pl$r

ls 7*s nt,rles (e e/%re%$)n # (e l$&ent%$)n2 %,n(# ests se $nter7$enen p#r

%,l+,$er %,s %l*n$%6 Se58n el t$e&p# (e per&nen%$ ser-n9 Te&p#rles9 S$

,n 7e1 res,elt l %,s2 +,e ls . #r$5$n(# se p,e( rest!le%er l ',n%$)n

n#r&l (el prt# 'e%t(#6 De'$n$t$7s9 S$ n# e/$ste s#l,%$)n (e %#nt$n,$(( 3

se p#r &p,t%$)n t#tl (e )r5n# 'e%t(# # %$erre (el &$s

Un #st#&* es ,n trt&$ent# +,e 2s$ !$en es lt&ente e'$%12 %#&p#rt

,n 5res$)n '*s$% 3 ps*+,$% +,e2 l 'e%tr l $nte5r$(( %#rp#rl2 'e%t

t&!$0n l pr#p$ $&5en2 l %p%$(( ',n%$#nl2 rel%$#nl 3 l %l$(( (e

7$(2 p#r l# +,e se s,p#ne ,n 5rn $&p%t# en l 7$( ($r$ (el p%$ente6

L (pt%$)n l est#& 7 (epen(er (e 7r$#s '%t#res %# s#n l

en'er&e(( (e !se2 l#s trt&$ent#s %#n%#&$tntes 3 el pr#n)st$%#2 ls

%#n($%$#nes (e l $nter7en%$)n +,$r8r5$%2 ls %#&pl$%%$#nes ',n%$#nles (el

est#& 3 se%,els p#st+,$r8r5$%s 3 ls %r%ter*st$%s en t#rn# ps$%#s#%$l 3

%,lt,rl :%reen%$s2 7l#res2 %#n%ept#s 3 %t$t,(es en rel%$)n l en'er&e((2 l#s

pr#!le&s '*s$%#s 3 el (#l#r6


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ANTECEDENTES

L %re%$)n (e ,n !#%&$ent# rt$'$%$l (el $ntest$n# es ,n t0%n$% !-s$% en l

%$r,5* (el prt# ($5est$7#2 e/$sten pr,e!s (e +,e el Dr6 Pr/)5#rs (e l#s

lre(e(#r (el ;


3/30

.ern$s en%n%er(s %#n ,n .$err# %n(ente2 %#n l '$nl$(( (e pr#(,%$r ,n

'*st,l rt$'$%$l +,e per&$t* l s,per7$7en%$ (el p%$ente2>

En el -re pe($-tr$% el ,s# (e #st#&*s se rent >?>=2 4# en +,e el Dr6

L$tre s,5$r$) p#r pr$&er 7e1 (e '#r& s$ste&-t$% l %#l#st#&* en %s#s (e&l'#r&%$)n n# re%tl6D,rnte el s$5l# X@III se e'e%t,r#n ($'erentes t$p#s (e

#st#&*s 're%,ente&ente en ,n $ntent# (e l#5rr l s#!re 7$( (e ($'erentes

p%$entes tnt# (,lt#s %# n$4#s2 s$n e&!r5#2 n# ',e s$n# .st (#s s$5l#s

(esp,0s2 +,e se $n$%$ el %,$((# espe%$l$1(# pr l#s p%$entes #st#&$1(#s2

%t,l&ente s#n ,n estrte5$ terp0,t$% &,3 $&p#rtnte6

En >B el Dr6 D#!#$s %#&en1) es%r$!$r s#!re l ne%es$(( (e !r$n(r est#s

%,$((#s2 (( l %re%$ente p#!l%$)n (e en'ers +,e re+,er*n (e ,n

(er$7%$)n (e '#r& te&p#rl # (e'$n$t$72 est# ($# l,5r (estrr l es%se1 (e

%#n#%$&$ent# pr el &ne"# (e%,(# (el p%$ente #st#&$1(#2 p#r prte (el

pers#nl (e sl,(2 &s tr(e en l (0%( (e l#s %$n%,ents el Dr6 R,pert e%.

Tr,&!,ll2 "e'e (el Ser7$%$# (e C$r,5* (e C#l#n 3 Re%t# en el H#sp$tl (e

Cle7eln(2 O.$#2 ( el n#&!r&$ent# l Sr6 N#r& G$ll %# t0%n$% en

est#&s2 ll&(s %t,l&ente terpe,ts enter#st#&les l Sr6 G$ll es

%#ns$(er( %# l pr$&er terpe,t enter#st#&l (el &,n(#2 n# #!stnte (e

+,e n# er en'er&er2 s$n# ,n p%$ente p#rt(#r (e ,n $le#st#&*6 En >B>2 l

terpe,t enter#st#&l ',e re%#n#%$( %# ,n pr#'es$)n en l#s Est(#s Un$(#s9

l#s pr$&er#s est,($ntes n# ern en'er&ers2 s$n# p%$entes #st#&$1(#s

1 Dr6 Mr$# De G$#r5$s St,7en6 e%(# C$r,5*6 H#sp$tl R#!ert# (el

R*#66pre&t,r#s6%le!5#st#=Ost#&$s.

2G#n1-le1 Sl)n L6 A!(#&en A5,(# G-str$%#6 >BB;6 Art$%,l# (e l re7$st &0($% (el H#sp$tl Generl (eM0/$%#2 s6s6 @#l6 B2 N8&6 A!r6J,n6 ==
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re.!$l$t(#s6 Pr#nt# se 7$# 3 se e/ten($) l ne%es$(( (e (+,$r$r .!$l$((es en

el &ne"# (e l#s #st#&$1(#s2 p#r t#(# el &,n(#2 s* es %# s,r5$er#n &0($%#s

%# en'er&er#s en est#&terp*6

En l (0%( (e l#s ?= l espe%$l$(( (e en'er&er* est#&terpe,t se e/ten($)r-p$(&ente tr70s (e A,strl$2 Cn(-2 Grn ret42 N,e7 Zeln( 3 'r$%

(el S,r2 s* &$s en >B? se %re)2 en L#n(res2 l pr$&er As#%$%$)n

Intern%$#nl (e Ost#&$1(#s6 El > (e &3# (e >B?2 en M$l-n2 se %re#

'#r&l&ente el KCET %#n ;= terp$sts enter#st#&les2 representntes (e >B2 el Dr6 H0%t#r Ort$1 H,rt(# 3 l D$re%t#r (e l Es%,el Un$7ers$tr$ (e

En'er&er* @$r5en (el C&$n# (el INSALUD en P&pl#n2 Enr$+,et P0re1

Gr%*2 t#&r#n %#nt%t# %#n Pr$ll$ Ste7ens 3 %#n r!r- F,les 3 en >B< se

rel$1! l '#r&%$)n (e ls pr$&ers est#&terpe,t esp4#ls %#n el

re%#n#%$&$ent# (el pr#5r& (el KCET6;

3 C,rs# Te)r$%#Pr-%t$%# (e Cp%$t%$)n pr el C,$((# (el P%$ente Ost#&$1(# Dr6 Mr%#s H,r7$t1


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JUSTIFICACION

L #st#&* $ntest$nl en el p%$ente pe($-tr$%# p,e(e ser ne%esr$ p#r

($7erss r1#nes6 Se ,t$l$1n en s$t,%$#nes en l %,les l (er$7%$)n2

(es%#&pres$)n # el %%es# l l,&en $ntest$nl es ne%esr$#6 Ls #st#&*s (el

$ntest$n# (el5(# se ,t$l$1n %,n(# .3 per'#r%$)n # $s+,e&$2 en ls %,les ,n

nst#s$s se %#ns$(er p#%# se5,r6 Un $le#st#&* pr#/$&l es

're%,ente&ente ,s( pr pr#te5er l nst#s$s ($stl (esp,0s (e ,n

pr#%t#%#le%t#&* rest,rt$7 en p#l$p#s$s '&$l$r # %#l$t$s ,l%er#s6 I5,l&ente2 l

%#l#st#&* se ,s %#n 're%,en%$ tnt# ntes %# (esp,0s (e ,n pr#%e($&$ent#

(e res%te p#r n# $&per'#r(#6

En el .#sp$tl (e espe%$l$((es pe($-tr$%s (e T,/tl G,t$0rre12 C.$ps2 l

ten%$)n (e en'er&er* l p%$ente pe($-tr$%# %#n est#&s2 se . %#n7ert$(# en ,n

5rn pr#!le& (e sl,( (e!$(# l lt $n%$(en%$ 3 ,n %#nstnte $n%re&ent# (e

p(e%$&$ent#s %#n est#&s6

Pr .%er 'rente este pr#!le&2 el .#sp$tl (e espe%$l$((es pe($-tr$%s

(e T,/tl G,t$0rre12 C.$ps2 re+,$ere (e pers#nl (e en'er&er* lt&ente

%p%$t(# %#n %#n#%$&$ent#s espe%$l$1(#s pr el &ne"# (e este t$p# (e

p(e%$&$ent#2 +,e le per&$tn %t,r (e '#r& $nte5rl 3 #p#rt,n2 %#n n,e7s

lternt$7s (e ten%$)n2 pr !r$n(r 3 &e"#rr l %l$(( (e 7$( (el p%$ente

pe($-tr$%# p#rt(#r (e ,n est#&6

D$%.# tr!"# se rel$1 %#n l '$nl$(( (e %#n#%er l ten%$)n (e

en'er&er* +,e se !r$n( p%$entes %#n #st#&*s en el H#sp$tl (e

Espe%$l$((es Pe($-tr$%s (e T,/tl G,t$0rre12 C.$ps s* &$s $(ent$'$%r s$

l#s %,$((#s (e en'er&er* $n'l,3en en ls %#&pl$%%$#nes (e est#s p%$entes6

3


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PLANTEAMIENTO DEL PROLEMA

L $n%$(en%$ (e en'ers pe($-tr$%#s %#n ($'erentes %lses (e .er$(s 3

est#&s . ,&ent(# en l#s 8lt$s 4#s2 l# +,e s$5n$'$% 5rn(es %#st#s p#r

,n estn%$ pr#l#n5( en el .#sp$tl2 el ,s# (e re%,rs#s &0($%#+,$r8r5$%#s 3 (e

en'er&er* espe%$l$1(#s2 s* %# el %#ns, (e &ter$les pr %,r%$)n 3

&e($%&ent#s6

En n,estr# p*s e/$ste ,n 5r,p# (e Est,($ntes @#l,ntr$#s (e l

Un$7ers$(( (e C#l$& :E@UC (es(e s,s $n$%$#s en sept$e&!re (e ==2 %#n

($'erentes pr#3e%t#s %# Q@$7$r l 7$( %#n plen$t,(2 QIn'#r&%$)n en t, $($#&2

QSnn(# Her$(s2 QL e/$sten%$ (el #st#&$1(#s en el &,n(# 3 QAspe%t#s

'$nn%$er#s (e l As#%$%$)n (e Ost#&$1(#s en l#s %,les l#s 7#l,ntr$#s .n

prt$%$p(# (e &ner %t$72 pr 3,(r l#s p%$entes +,e re+,$ern (e este

t$p# (e %,$((#s6L#s resp#ns!les (e est s#%$%$)n .n prt$%$p(# en n,&er#s#s

e7ent#s n$7el $ntern%$#nl %# %p%$t%$)n 3 %t,l$1%$)n en el -re (e l

#st#&*s2 p,es s, #!"et$7# es #'re%er l p%$ente #st#&$1(#2 s#!re t#(# l#s (e

es%s#s re%,rs#s2 ,n ten%$)n $nte5rl2 pr#p#r%$#n-n(#les p#3# &ter$l2 '*s$%#

3 e%$#nl pr &e"#rr s, %l$(( (e 7$(2 3,(-n(#les $nte5rrse l

s#%$e((6 T#(# est# (e &ner ltr,$st 3 s$n '$nes (e l,%r#2 s$en(# ,n e"e&pl#

&-s (e tr!"# 3 entre5 pr l#s est,($ntes 7#l,ntr$#s6

4 PROGRAMA UNI@ERSITARIO MADRILEO DE @OLUNTARIADO EN UNI@ERSIDADES LATINOAMERICANAS6II

EDICIN2 AO ==B

4


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Se58n ls est(*st$%s n$7el n%$#nl s#!re pt#l#5*s +,$r8r5$%s +,e

re+,$eren l %re%$)n (e ,n est#&2 $n($%n +,e el &3#r *n($%e (e l p#!l%$)n

+,e s,'re este p(e%$&$ent# s#n (e #r$5en ne#pl-s$%2 le s$5,en l#s (e #r$5en

tr,&-t$%# 3 el rest# %#rresp#n(e en'er&e((es %#n50n$ts p#r l# +,e %( (*

,&ent el n,&er# (e pers#ns ls +,e se les pr%t$% ,n est#& %#n el '$n (erest,rr el ',n%$#n&$ent# n#r&l $ntest$nl en l &3#r* (e l#s %s#s2 3 +,e

e/$sten #st#&*s ($'erentes ls $ntest$nles6 E/$sten l5,n#s pr#5r&s 3

l,5res en l#s %,les se !r$n( 3,( ls pers#ns #st#&$1(s 3 s,s

'&$l$res pr ,n &e"#r en l %l$(( (e 7$(66 Stel1ner HF6 Re%t# 3 An#6 En9 D$e!#l( O6 Trt(# (e Pt#l#5* Cl*n$% W,$r8r5$%r%el#n6 r%el#n6 Sl7tE($t#res2 SA >B66 Pr#!le&-t$% %t,l (el p%$ente %#n #st#&*6 Re7 C,!n Me( M$l ==>;=:9


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S,&(# l#s %,$((#s '*s$%#s2 l esen%$ (el pr#!le& +,e %,s l %re%$)n (e

,n #st#&* es ,n (ese+,$l$!r$# ps$%#s#&-t$%#2 l re%,per%$)n '*s$% p,e(e

5r7r 8n &-s el %#n'l$%t#2 3 +,e 0st %#ntrst (e '#r& r($%l %#n el

sent$&$ent# (e p0r($(2 p#r est r1)n el trt&$ent# (el n$4# #st#&$1(# $&pl$%

s$e&pre ,n terp$ (e %#n(,%t2 +,e p,e(e 3 (e!e (rse # rel$1rse en ($st$nt#sn$7eles (e ten%$)n6

L ne%es$(( (el %,$((# espe%$l$1(# en n$4#s #st#&$1(#s s,r5e $n$%$l&ente

p#r l %re%$ente p#!l%$)n (e n$4#s %#n &l'#r&%$)n n#rre%tl2 en'er&e(( (e

H$rs%.spr,n5 3 @e"$5 ne,r#50n$% per&$t$en(# l %re%$)n (e ,n %l*n$% pr l

ten%$)n $nte5rl (e est#s p%$entes6 A%t,l&ente e/$sten ,n 5r,p# $&p#rtnte (e

($'erentes pt#l#5*s +,e %# prte (e s, trt&$ent# es ne%esr$# rel$1r ,n

#st#&*6

El &ne"# (e%,(# (e #st#&*s es ,n 7er((er# ret# pr !r$n(r l#s

est-n(res (e %l$(( pr l ten%$)n $nte5rl !-s$% 3 espe%$l$1( (e pers#ns

%#n est#&s 3 +,e &e"#rn s$5n$'$%t$7&ente l %l$(( (e 7$( (el p%$ente l

ser ten($(s p#r pr#'es$#nles (e en'er&er* espe%$l$1(s en l terp$

enter#st#&l6

L#s est#&s en l#s n$4#s2 l $5,l +,e en l#s (,lt#s2 re+,$eren (e %,$((#s

espe%$les (epen($en(# (el t&4#2 '#r& 3 ,!$%%$)n (e l#s &$ss2 en l#s

n$4#s p,e(e .!er est#&s sen%$ll#s2 (e (#s !#%s # en s 3 %#n '*st,l &,%#s6

C,n(# .3 ,n est#& 3 #tr !#% ll&( '*st,l2 p#r el pr$&er# sle &ter$

'e%l 3 p#r el #tr# %#6 L# &-s $&p#rtnte en l#s n$4#s2 (esp,0s (e s, est#& es

l p$el2 ell#s t$enen ,n p$el &,3 (el$%( 3 %#n &3#r '%$l$(( se les$#n %#n el

e'l,ente (e l est#&6

Pr .%er 'rente este pr#!le&2 el .#sp$tl (e espe%$l$((es

pe($-tr$%s (e T,/tl G,t$0rre12 C.$ps2 re+,$ere (e pers#nl (e en'er&er*

86&e5%,rtel6%#&ostomias

8
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11/30

lt&ente %p%$t(# %#n %#n#%$&$ent#s espe%$l$1(#s pr el &ne"# (e este

t$p# (e p(e%$&$ent#2 +,e le per&$tn %t,r (e '#r& $nte5rl 3 #p#rt,n2 %#n

n,e7s lternt$7s (e ten%$)n2 pr !r$n(r 3 &e"#rr l %l$(( (e 7$( (el

p%$ente pe($-tr$%# p#rt(#r (e ,n est#&6

OJETI@OS6

'jetivo genera)

I(ent$'$%r el n$7el (e %l$(( (e ten%$)n (e en'er&er* +,e se !r$n( p%$entes

%#n #st#&*s en el H#sp$tl (e Espe%$l$((es Pe($-tr$%s (e T,/tl G,t$0rre12

C.$ps6

'jetivos espec*icos)

Cr%ter$1r l p#!l%$)n prt$%$pnte en l $n7est$5%$)n %#n respe%t# l

spe%t# s#%$#(er-'$%#6

C#n#%er el n$7el (e %#n#%$&$ent# (el pers#nl (e en'er&er* s#!re el &ne"#(e p%$entes pe($-tr$%#s #st#&$1(#s6

C#n#%er s$ el pers#nl (e en'er&er* rel$1 ls t0%n$%s (e seps$ en l#s

p%$entes pe($-tr$%#s %#n est#&s6

9


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HIPTESIS @ARIALES6

!ip+tesis)

HA9 L %l$(( (e ten%$)n (e en'er&er* +,e se !r$n( l p%$ente %#n

#st#&*2 est (eter&$n(# p#r el n$7el (e %#n#%$&$ent#s +,e ($%.# pers#nl p#se

%#n respe%t# l te&6

HO9 L %l$(( (e ten%$)n (e en'er&er* +,e se !r$n( l p%$ente %#n

#st#&*2 n# est (eter&$n(# p#r el n$7el (e %#n#%$&$ent#s +,e ($%.# pers#nlp#se %#n respe%t# l te&6

ariaes)

@r$!le (epen($ente9 Pers#nl (e en'er&er*6

@r$!le $n(epen($ente9 N$7el (e %l$(( (e ten%$)n6

10


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1


14/30

1.4.- OPERACIONALIZACION DE VARIABLES.

12

VARIABLE

DEPENDIENTE

DEFINICION

CONCEPTUAL DE LA

VARIABLE

DEFINICION

OPERACIONAL DE

LA VARIABLE

INDICADORES ESCALA

Caa!"#a!"$% &'(

')*+%a( &'

'%,')')"a

E* % )+!'*+

'#+&+($/"!+ &'

a!#""&a&'* '%!a"%a&a* a(a '+)a "%!)''%#+

&'*a))+((+ &' (a !a("&a& &'

(+* !+%+!""'%#+*

a"("&a&'* a!#"#&'* &'(

!a"#a( a%+ !+% (a

%a("&a& &' '('a) *

&'*''+ )+,'*"+%a(

a)a '+)a) (+* !"&a&+*

a a!"'%#'* '&"#)"!+* !+%

+*#+a*.

A&"'*#)a"'%#+

#'$)"!+- )!#"!+ :'

)'!"' '( ')*+%a( &''%,')')"a a)a

)++)!"+%a)

!"&a&+* '% '(

a%'+ &' a!"'%#'*

!+% '*#+a*.

E( ')*+%a( &'

'%,')')"a

)'!"'!aa!"#a!"$%

a)a )"%&a)

!"&a&+* a

a!"'%#'* !+%

'*#+a*.

S"')'

; a!"$% &' (+*

)+!'&""'%#+* a

a!"'%#'* !+%

'*#+a*.

S"')'

; a!"$% &' (+*

)+!'&""'%#+* aa!"'%#'* !+%

'*#+a*.

S"')'

; =

L '$nl$(( (e ls #st#&*s es per&$t$r l el$&$n%$)n (e pr#(,%t#s (e

(es.e%.# :%#nten$(# $lel2 .e%es , #r$n l e/ter$#r 3 re%#5erl#s en ,n ($sp#s$t$7#

(est$n(# tl '$n2 3 e/$sten t$p#s (e #st#&*s %# s#n %#l#st#&* +,e es ,n

pert,r +,$r8r5$% (el %#l#n l p$el pr l el$&$n%$)n (el tr-ns$t# $ntest$nl 3#

(es#!str,%%$)n (el $ntest$n# 5r,es#6 En ',n%$)n (e l p#r%$)n !#%( ser-9

s%en(ente2 trns7ers2 (es%en(ente # s$5$(e2 $le#st#&* +,e es ,n pert,r

(el *le#n ($stl .%$ l pre( !(#&$nl2 Ur#st#&* pert,r (e l 7* ,r$nr$ l

e/ter$#r6 En ',n%$)n (el tr +,e se e/ter$#r$%e .!lres (e9 ne'r#st#&*2

,reter#st#&*2 7e"$5 $lel :%#ne/$)n (e &!#s ,r0teres l *le#n 3 0ste !#%(# l

e/ter$#r2 el$&$n-n(#se l 7e"$56 #st#&*s (e l$&ent%$)n9 s, '$nl$(( es

per&$t$r l n,tr$%$)n (el p%$ente tr70s (e ells9 5str#st#&* 3 3e3,n#st#&*6

Depen($en(# (e l $n($%%$)n +,$r8r5$% # t$e&p# (e per&nen%$ se %ls$'$%n en

te&p#rles s#n +,ells +,e se rel$1n en p%$entes en l#s +,e se pre7ee l

re%#nstr,%%$)n # nst#s$s (e l 7*s%er en ,n se5,n(# t$e&p#2 Per&nentes

se rel$1n s$ n# e/$ste s#l,%$)n (e %#nt$n,$((2 p#r &p,t%$)n t#tl (el )r5n#

'e%t(# # p#r %$erre (el &$s

10 ACC0 ACT0A & Nros $ al 1(

15


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L#s %,$((#s (el est#& en p%$entes pe($-tr$%#s s#n l @l#r%$)n In$%$l2

C,n(# tenes l n$4# %#((# en l %,n # en l $n%,!(#r pr#%e(es

7l#rr el spe%t# (el s $ntest$nl9 %#l#r2 t&4# 3 sn5r(#6 P,e(e estr

e(e&t#s p#r l pr#p$ &n$p,l%$)n +,$r8r5$%6 A %#nt$n,%$)n (e%$($s 3

%#l#%s el ($sp#s$t$7# (e%,(#6 El #!"et$7# l p#ner ,n !#ls %#le%t#r

lre(e(#r (el est#& es l re%#5$( e'$%1 (el e'l,ente2 &nten$en(# l $nte5r$((

(e l p$el per$#st#&l6 El ($sp#s$t$7# (e!e '7#re%er l 7$s,l$1%$)n (el est#&

pr '%$l$tr l (ete%%$)n 3 7l#r%$)n (e %#&pl$%%$#nes6 El ne#nt# 3 el l%tnte

pe+,e4# se (e!en (e &ne"r %#n !#lss pe($-tr$%s l#s pr$&er#s (*s # .st

+,e el est#& se ',n%$#nnte6 L %,r2 +,e (e!e ser 're%,ente2 %#ns$st$r- en l

l$&p$e1 (el est#& 3 l 1#n %$r%,n(nte %#n 5, est0r$l t$!$ pr el$&$nr !$en

l#s rest#s2 $(ent$'$%r el t$p# (e est#&2 l#s est#&s en l#s n$4#s2 l $5,l +,e enl#s (,lt#s2 re+,$eren (e %,$((#s espe%$les (epen($en(# (el t&4#2 '#r& 3

,!$%%$)n (e l#s &$ss6>>

En l#s n$4#s p,e(e .!er est#&s sen%$ll#s2 (e (#s !#%s # en s 3 %#n

'*st,l &,%#s6 L# +,e sle (el &$s p,e(e ser &ter$ 'e%l2 s$ es ,n est#& (e

prt# ($5est$7#2 , #r$n s$ (e trt (e ,n prt# ,r$nr$#6 C,n(# .3 ,n

est#& 3 #tr !#% ll&( '*st,l2 p#r el pr$&er# sle &ter$ 'e%l 3 p#r el #tr#%#2 l# &-s $&p#rtnte en l#s n$4#s2 (esp,0s (e s, est#& es l p$el2 ell#s

t$enen ,n p$el &,3 (el$%( 3 %#n &3#r '%$l$(( se les$#n %#n el e'l,ente (el

est#&6

El est#& se (e!er- &ne"r (epen($en(# (e %) se en%,entre6 En %s#

(e .!er (#s est#&s el 8n$%# +,e ne%es$tr- l !#ls es +,0l p#r (#n(e sle l

&ter$ 'e%l2 #tr# (e l#s %,$((#s (e en'er&er* es l sele%%$)n (e E+,$p#s %#

l# es l !#ls pe($-tr$% se ,t$l$1 pr re%#5er (e &ner %)( 3 e'$%1 lse/%re%$#nes $ntest$nles 3 ,r$nr$s6 Est- '#r&( p#r ,n prte (.es$7 +,e se

re%#rt 3 se pe5 lre(e(#r (el est#& pr re%#5er l#s pr#(,%t#s (e (es.e%.#

%#n ,n p#(er (e (.es$)n +,e 5rnt$%e l $l$(( (el p#rt(#r l 7e1 +,e

11 2elabert ., 3e4 . Tius -e -isositius. 5n# Curs -6atenci3 integral al acient ostomit4at.

Cororaci3 Parc Taul7. aig $((8


19/30

pre7$ene l $rr$t%$)n (e l p$el per$#st#&l6 L !#ls t$ene ,n &ter$l +,e n# .%e

r,$(#2 res$stente e $&per&e!le l #l#r2 (e &ne"# '-%$l pr pl$%rl # ret$rrl 3

e'$%1 pr re%#5er l#s res$(,#s 3 el$&$nr l#s 5ses2 en %s# (e #!ser7r

$rr$t%$)n (e l p$el2 se re%#&$en( l7r el -re %#n "!)n ne,tr#2 en",5r 3 se%r

%#n 5s esp#n"en(# l p$el2 se p,e(e r#%$r el p#l7# (e Cr3-2 ($spersr en l

1#n 'e%t( 3 ret$rr t#(# el p#l7#6

Se re%#&$en( %#l#%r pr$&er# ,n .$(r#%#l#$(e e/tr(el5(#2 +,e %,!r el

est#& 3 s$ l p$el est- sn2 ense4r l '&$l$r9 Es &,3 $&p#rtnte +,e l#s

p(res (el !e!0 re%$!n $n'#r&%$)n 3 p#3# en el &ne"# (e l#s pr#(,%t#s pr

,&entr s,s %#n#%$&$ent#s en l#s %,$((#s (e en'er&er* (e tl '#r& +,e ell#s

p,e(en rel$1r el pr#%e($&$ent# pr l %#l#%%$)n 3 %&!$# (e l#s e+,$p#s6

L en'er&er* . e7#l,%$#n(# 3 en l %t,l$(( pr s, pr-%t$% se

re+,$ere &-s +,e 7#%%$)n 3 !,en 7#l,nt(2 (e .* el $nter0s (e .%er ,n

re'le/$)n 3 ,n re7$s$)n %er% (el %,$((#2 l nt,rle1 (el &$s 3 l

$&p#rtn%$ +,e t$ene pr l pr#'es$)n (e en'er&er* 3 pr ls pers#ns ls

%,les se ($r$5e6

L esen%$ (e l en'er&er* es el %,$((#2 l %,l p#(es (e'$n$r %# ls

%%$#nes +,e rel$1 l en'er&er 3 +,e t$enen %# '$nl$(( trtr (e res#l7er

pr#!le&s +,e se $nterp#nen # $n'l,3en en l %l$(( (e 7$( (e ls pers#ns6 El

%,$((# se ($r$5e l pers#n :$n($7$(,#2 '&$l$2 5r,p# 3 %#&,n$((2 +,e en

%#nt$n, $nter%%$)n %#n s, ent#rn#2 7$7e e/per$en%$s (e sl,(6 >

L#s %,$((#s s#n l r1)n (e ser (e l pr#'es$)n 3 %#nst$t,3en el t#r (e n,estr#

+,e.%er 3 p#r l# tnt# n,estr# '#%# (e ten%$)n 3 #!"et# (e l en'er&er* %#

($s%$pl$n pr#'es$#nl6 El %,$((# %#&pren(e ele&ent#s t0%n$%#s2 spe%t#s

'e%t$7#s2 %t$t,( 3 %#&pr#&$s# (e +,$en l# pr#p#r%$#n2 per# (e&-s es (e

espe%$l $&p#rtn%$ el s$5n$'$%(# (el %,$((# pr +,$en l# #t#r5 3 pr +,$0n l#

re%$!e2 l $nten%$)n 3 l &et +,e pers$5,e6 P#r l# tnt# l pr-%t$% (e en'er&er*

$&pl$% %rer ,n %,$((# +,e re%,rr ($7ers#s pr#%es#s %# s#n9 l re'le/$)n2 l

12 K9rouac, Susane. 5l ensamiento enfermero, 1:. 5-ici3n, 5-. asson, 5sa;a $((1, . 8).

16

17


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$nte5r%$)n (e %reen%$s 3 7l#res2 el n-l$s$s %r$t$%#2 l pl$%%$)n (e

%#n#%$&$ent#s2 el ",$%$# %l*n$%#2 l $nt,$%$)n2 l #r5n$1%$)n (e l#s re%,rs#s 3 l

e7l,%$)n (e l %l$(( (e ls $nter7en%$#nes6 1'

L %l$(( (e l ten%$)n en en'er&er*2 es el l#5r# (e l#s res,lt(#s (ese(#s

en l sl,( (e l#s $n($7$(,#s 3 p#!l%$)n en 5enerl 3 l5,ns se re'$eren l

pr#p$ (e'$n$%$)n (e sl,( 3 ls $n'l,en%$s (el p%$ente2 '&$l$ 3 s$ste& (e

sl,(6 En el e+,$p# (e sl,( el pers#nl (e En'er&er* &nt$ene el 7*n%,l# &-s

estre%.# %#n l#s p%$entes6 >

El %,$((# (e l p$el 3 (e ls .er$(s es ,n %#nt$n,# (es'*# pr en'er&er#s 3

#tr#s pr#'es$#nles (el %,$((# (e l sl,(6

C!e se4lr +,e en >B6Dr6 Mr$# De G$#r5$s St,7en6 e%(# C$r,5*6 H#sp$tl

R#!ert# (el R*#

Pr#nt# se 7$# 3 se e/ten($) l ne%es$(( (e (+,$r$r .!$l$((es en el&ne"# (e l#s #st#&$1(#s2 p#r t#(# el &,n(#6 De .e%.#2 en >B> 3 e/$st* ,n

pr#5r& re%#n#%$(# (e ense4n1 pr preprr espe%$l$sts2 tnt# &0($%#s

%# en'er&er#s en est#&terp*6 De .e%.#2 en l (0%( (e l#s ?= l

espe%$l$(( (e en'er&er* est#&terpe,t se e/ten($) r-p$(&ente tr70s (e

A,strl$2 Cn(-2 Grn ret42 N,e7 Zeln( 3 'r$% (el S,r6

En el n$4# ls #st#&*s :%#&,n$%%$)n l e/ter$#r &-s 're%,entes s#n l9

Gstr#st#&* :est)&5#2 C#l#st#&* :%#l#n # $ntest$n# 5r,es#2 3e3,n#st#&*

13 ales, Rosa A. a gesti3n -el cui-a-o -e enfermer7a. Disonible

14?ern=n-e4 Caballero 5. Cali-a- -e la atenci3n m9-ica. Notas -e clase -el curso sobre t9cnicas -e

-irecci3n a ersonal -irigente -e enfermer7a, SC&H, Cuba, 1(. Paganini @A. Cali-a- / eficiencia -e la

atenci3n hositalaria. ashington DC# BPS&BS, 1'.

18


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es#'5#st#&* :es)'5#6

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trns$t#r$s6 En +,ell#s %s#s +,e ls re+,$eren en '#r& (e'$n$t$7 ter&$nn

$n%#rp#r-n(#se l 7$( ($r$ %#n &*n$&s restr$%%$#nes s#%$les6

Ls pt#l#5*s +,e #r$5$nn l #st#&*2 n# est-n (eter&$n(s p#r '%t#res

(e estt,s s#%$l2 n$7el e%#n)&$%#2 se/#2 etn$ # %re(# rel$5$#s#6 S, $n%$(en%$ se

",st 8n$%&ente '%t#res (er-'$%#s2 #!ser7-n(#se en el %#n%$ert# &,n($l

+,e l#s p#r%ent"es s#n2 en 5enerl2 &-s lt#s en p*ses %#n &3#r n$7el (e

!$enestr2 p#r l s$&ple r1)n (e l &e"#r espern1 (e 7$(2 +,e #'re%e &3#r

&r5en l (esrr#ll# (e ls en'er&e((es2 &,%.s (e ells $n'l,en%$(s s$n (,(

p#r '%t#res (es'7#r!les %# el estr0s # l#s $n%#rre%t#s .-!$t#s l$&entr$#s6

P#r #tr# l(# es &,3 $&p#rtnte el e'e%t# +,e l #st#&* pr#(,%e n$7el $n($7$(,l

3 +,e (es(e s$e&pre2 $n(,(!le&ente (e!$(# $5n#rn%$ 3 pre",$%$#s s#%$les2

l#s #st#&$1(#s se .n retr*(# en s,s n$7eles #r($nr$#s (e 7$( s#%$l !,s%n(#

el n#n$&t#2 press (el sent$&$ent# (e ser p#rt(#res (e l5# nt$s#%$l6

En ls s#%$e((es %p$tl$sts 5enerl&ente l# &-s %#st#s# es el tr!"#

pr#'es$#nl espe%$l$1(# 3 pr&0($%#2 l#s $ns,s p#r %#n%ept# (e

.#sp$tl$1%$)n +,e (epen(e (e l %te5#r* (e l $nst$t,%$)n2 3 ls %$r%,nstn%$s

en +,e este pr#%e(er se rel$%e6

En C,!2 el %#st# (e ls #st#&*s es %s$ t#tl&ente s,!s$($(# p#r el

est(#2 3 +,e l ten%$)n .#sp$tlr$ es t#tl&ente 5rt,$t se $n%l,3en l#sre%,rs#s e&ple(#s :nest0s$%#s2 s,t,rs2 !#lss2 s#n(s2 entre #tr#s +,e se

(+,$eren en p*ses (esrr#ll(#s %#n ne( l$!re&ente %#n7ert$!le6

En l#s p*ses (el Ter%er M,n(# %#n te%n#l#5* trs( 3 en &,%.#s %s#s

r,($&entr$ # sen%$ll&ente $ne/$stente2 l#s trt&$ent#s s#n &,3 sele%t$7#s 3 se

19


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(est$nn s#l# l %lse s#%$l %#n p#s$!$l$((es e%#n)&$%s2 est# .%e +,e l#s

p%$entes %,(n en etps 7n1(s (e l en'er&e((2 (#n(e l 8n$%

lternt$7 es l #st#&*6 En 'r$%2 espe%*'$%&ente l#s et*#pes2 p#r s, !"# n$7el

%,lt,rl 3 %reen%$s rel$5$#ss n# %eptn este pr#%e(er +,$r8r5$%# 3 en #%s$#nes

lle5n l s,$%$($#2 l (espertr (e l nestes$ 3 7erse %#n ,n #st#&*6

En Esp4 el %#st# s#%$l 7$ene (eter&$n(# p#r el t$e&p# &e($# +,e el

p%$ente per&ne%e $n%t$7# entre l $nter7en%$)n +,$r8r5$% 3 l re%,per%$)n t#tl

%#n ,n &e($ (e ; &eses p#r pers#n6 El t#tl s%$en(e ,n#s > &$ll#nes (e

()lres ten($(#s p#r l se5,r$(( s#%$l2 l +,e se (e!en 4($r 5st#s

prt$%,lres %# %#nse%,en%$ ($re%t (e l $nter7en%$)n2 e"e&pl#9 ($et espe%$l2

&ter$les2 !#lss2 p#&(s2 l5#()n2 5ss2 entre #tr#s2 +,e (,rnte 4#s

represent ,n 5st# '$"# $&p#rtnte6 S,'r$r l p0r($( (e %#ntr#l (el es'*nter (e&-s

(e #tr#s $n%#n7en$entes2 p,e(e lterr s, (esrr#ll# s#%$l6 >BB;6Art$%,l# (e l re7$st &0($% (el H#sp$tl Generl (e M0/$%#2 s6s6

@#l6 B2 N8&6 A!r6J,n6 ==6!%.#sp$tl6%#&(#&$n#!%.#sp$tle!p5e!%=6ns'In($%eB p59 >B >;=BB p59 BB;6
http://www.prematuros.cl/webagosto08/Ostomiashttp://www.abchospital.com/domino/abchospital/webpageabc08.nsf/Indice/5.2http://www.prematuros.cl/webagosto08/Ostomiashttp://www.abchospital.com/domino/abchospital/webpageabc08.nsf/Indice/5.2


27/30

Le7er#n$ J2 T#,re CL6 Pr#!le&-t$% (el #st#&$1(#6 En9 Te&s C#l#pr#%t#l#5*6 L

H!n9 Inst$t,t# C,!n# (el L$!r#2 >B9 CUESTIONARIO6

En%,est pr el pers#nl (e en'er&er* (el t,rn# &t,t$n# 7espert$n# (el

ser7$%$# l UCIN (el H#sp$tl Re5$#nl (e Alt Espe%$l$(( Pe($-tr$% (e T,/tl

G,t$0rre1 C.$ps6

INSTRUCTI@O9

Le %,$((#s&ente ls pre5,nts 3 &r+,e %#n ,n / l resp,est +,e

%#ns$(ere %#rre%t6

s$e&pre

! 7e%es% n,n%

6 L $nst$t,%$)n le #t#r5 t$e&p# l pers#nl (e en'er&er* pr re%$!$r

%p%$t%$)nV

s$e&pre! 7e%es% n,n%

24

>6 El pers#nl (e en'er&er* re%$!e %p%$t%$)n pr !r$n(r %,$((#s p%$entes %#n est#&sV


28/30

;6 C,ent el pers#nl (e en'er&er* %#n &n,les (e pr#%e($&$ent#s en el

ser7$%$#V

s$e&pre! 7e%es

% n,n%

6 L en'er&er %,ent %#n l#s %#n#%$&$ent#s pr l prepr%$)n (e %r3-V



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6 Pr#p#r%$#n #r$ent%$)n l '&$l$r s#!re el pr#%e($&$ent# (e l#s %,$((#s (elpe($-tr$%# #st#&$1(#V


B6 Apl$% %#rre%t&ente ls t0%n$%s (e%,(s pr el &ne"# (e ls #st#&*spr pre7en$r ls $n'e%%$#nes e $rr$t%$)n ep$(0r&$%V


>=6 C#n#%e per'e%t&ente el &ter$l 3 e+,$p# +,e 7 ,t$l$1r pr elpr#%e($&$ent# (e ls #st#&*sV


>>6 El pers#nl (e en'er&er* ,n$'$% %r$ter$#s pr l rel$1%$)n (e l#s

pr#%e($&$ent#s (e ls #st#&*sV


>6 C#n#%e %#n +,e 're%,en%$ se (e!e rel$1r el %&!$# (e ls !#lss (e ls

#st#&*sV


26


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>;6 Re%#n#%e %,n(# se le . present(# l5,n %#&pl$%%$)n en el

pr#%e($&$ent# (e l #st#&*V

s$e&pre! 7e%es

% n,n%

>6 Rel$1 ,ste( el l7(# (e &n#s re5l&entr$#s ntes 3 (esp,0s (e

&n$p,lr l p%$ente pe($-tr$%# #st#&$1(#V


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