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FUNCIONAMIENTO DE
APRIDE.ES
ALGORITMO DE PRIORIZACIN DE
DIAGNSTICOS ENFERMEROS
1 EDICION
Diciembre 2016
Impreso en Espaa
Editado por Bubok Publishing S.L.
La informacin contenida en este documento est sujeta a cambios sin previo aviso.
apride.es no ofrece ninguna garanta, expresa o implcita, con respecto a ste
documento o de su contenido.
AUTORES:
Contacto: pechevarria@ucam.edu
NDICE
1- INTRODUCCIN ............................................................................................................ 1
1.1 Origen de apride.es................................................................................................. 1
3. BIBLIOGRAFA ............................................................................................................. 40
salud, que mediante tcnicas de Lgica Difusa prioriza los diagnsticos enfermeros, lo
que supuestamente mejora la precisin y facilita la toma de decisin del profesional de
Enfermera (1).
que le asigna importancia a los signos, sntomas y causas dentro de cada etiqueta
diagnstica, punta los diagnsticos segn los impactos o repeticiones obtenidos,
establece asociaciones entre ellos y los muestra priorizados para facilitar el diagnstico
obviando la ambigedad inherente a la fase de valoracin.
principio no han sido observados por los expertos, proporcionando resultados muy
prometedores.
ms veces activado (impactos), ms importante ser respecto a los dems, aunque esto
no es determinante ya que en funcin del contexto del paciente se tienen en cuenta
varios 'factores cualitativos', aqu entramos en la fase de PRIORIZACIN donde actan
cuenta los dominios de los diagnsticos y sus grados de pertenencia (5), una forma de
aplicacin de la lgica difusa, con la que se logra optimizar los resultados. Todo ello se
implementa en una web denominada apride.es.
Mucho ms que una visin filosfica de conceptos, la Lgica Difusa ha sido aplicada en
Las aplicaciones para realizar planes de cuidados estn limitadas por el idioma.
Apride.es est desarrollada en ingls y espaol para que sea accesible por toda
la comunidad cientfica.
descarga.
conocido en ingls por las siglas RWD (Responsive Web Design), permite adaptar la
apariencia de las pginas web al dispositivo que se est utilizando para visualizarlas, por
lo que es totalmente compatible con dispositivos mviles.
propsito general ampliamente usado que puede ser incrustado dentro de cdigo
datos open source ms popular del mundo. Fuente abierta significa tiene licencia GNU
General Public License (GPL) por lo que cualquier persona puede modificarla para
ajustarla a sus necesidades y usarla sin pagar.
Imagen 2
En el mismo recuadro podemos observar los
recuadros de login y contrasea para acceder a la
Al introducir el email con el que se realiz el registro nos llegar un correo electrnico
con un recordatorio de contrasea.
Imagen 3
Los datos acerca de la Privacidad, Clases de Datos recogidos, Modalidad y lugar del
Tratamiento de los Datos recogidos y la Finalidad del Tratamiento de los Datos recogidos
Imagen 4
Imagen 5
Los Datos relativos al Usuario son recogidos para permitir a la web la prestacin de sus
valoracin del paciente, los datos recogidos en ste formulario sern determinantes
para activar diagnsticos (impactos). Los campos que lo componen se denominan tems
de valoracin.
10
Los tems estn filtrados por Gnero (masculino o femenino), rango de edad (adulto o
al
desplegable
modelo
de
11
Imagen 8
Imagen 9
Imagen 10
Imagen 11
2019 (14).
Imagen 12
12
Imagen 13
Imagen 14
Una vez seleccionado el modelo los tems estarn agrupados en pestaas, al cambiar de
pestaa se salvan los datos cumplimentados hasta ese momento.
mediante lgica difusa donde el sistema le asigna los grados de pertenencia a esos
contextos. Estos datos sern determinantes como factores cualitativos en la priorizacin
de los diagnsticos.
Imagen 15
Algunos tems tienen un icono de ayuda a continuacin del nombre del tem y est
simbolizado con
emergente con el rango del campo o con una descripcin del contenido.
13
Imagen 16
14
TAS (Tensin Arterial Sistlica) de 1200, en caso de poner un valor fuera de rango
el campo se remarcar de rojo y no permitir cambiar de pestaa, al poner el
puntero encima mostrar un texto de ayuda. Imagen 20.
Imagen 20
Imagen 21
Imagen 22
Independiente del tipo de tem, tal y como se puede ver en la imagen 23, los tems
15
Imagen 23
Imagen 24
16
Imagen 25
En el apartado Diagnsticos obtenidos del ejemplo podemos ver los tres diagnsticos
que consiguen clasificarse en las primeras posiciones tras el proceso de priorizacin.
En las columnas encontramos informacin acerca de los impactos obtenidos sobre cada
diagnstico, el tipo de diagnstico (real, riesgo o de mejora), su dominio y los puntos
totales obtenidos en el proceso de priorizacin.
17
los diagnsticos obtenidos por la aplicacin y las puntuaciones de cada uno de ellos.
(Apartado 2.7)
En el recuadro siguiente, titulado Etapa de precisin podremos ver los datos generales
de la valoracin, entre los que estn incluidos el modelo de enfermera utilizado, el
gnero del sujeto, su rango de edad, el lugar de la valoracin y los cuidados que espera
recibir. Tambin un cmputo total de los diagnsticos nicos (sin repeticiones), los
resumen de la valoracin con los tems y los diagnsticos que han activado. (Apartado
2.8)
18
Imagen 26
19
Inmediatamente debajo podemos ver una tabla donde cada fila corresponde a un
diagnstico de enfermera ordenado por importancia segn la valoracin realizada. Nos
En las columnas encontramos informacin acerca de los impactos obtenidos sobre cada
diagnstico, el tipo de diagnstico (real, riesgo o de mejora), el dominio y los puntos
totales obtenidos en el proceso de priorizacin.
Los puntos obtenidos son el resultado del valor obtenido por la aplicacin del algoritmo
apride, se explica su funcionamiento en el apartado 1.1.
Los diagnsticos de la tabla en gris y colocados en las ltimas posiciones han obtenido
una puntuacin de 0 puntos en el proceso de priorizacin, por lo tanto quedan
desestimados, se muestran a ttulo informativo.
20
Imagen 27
Este apartado consiste en una tabla donde cada fila se corresponde con algn tem de
valoracin donde se han introducido datos, en la primera columna vemos el nombre de
tem, en la segunda columna el valor introducido ya sea numrico, de texto,
tem SI/NO. La activacin del diagnstico estara relacionada con alguna de las
selecciones. P. Ej.:
22
Imagen 28
diagnstico principal obtenido tras aplicar el algoritmo APRIDE, y una serie de iconos
que se detallan a continuacin en la tabla 2.
23
De dicha seleccin de casos, los usuarios pueden realizar los casos clnicos de su inters
y al final deben puntuar el grado de correspondencia de los diagnsticos obtenidos por
la aplicacin respecto con lo que el usuario tiene en mente. As mismo, puede realizar
anotaciones en el campo de texto sobre las discrepancias encontradas.
24
Imagen 29
25
Acciones: Una serie de iconos con ayuda contextual para gestionar los casos
clnicos, se detallan a continuacin en la tabla 3.
Tabla 3
Abrir caso: Accede al caso clnico seleccionado. Imagen 30.
Ver Resultados de la valoracin: Se accede al resumen final de la
valoracin mostrando los 3 diagnsticos principales obtenidos en el
caso.
Realizar caso clnico: Esta opcin solo estar disponible en los casos
clnicos pendientes.
26
datos relevantes para realizar la valoracin ordenados por apartados o por dominios
segn el caso, as como un botn que abrir el formulario de valoracin en una nueva
ventana para facilitar la consulta de la informacin.
Imagen 30
27
Imagen 31
28
informacin de esta pgina web como una alternativa al consejo de su mdico u otro
profesional sanitario.
cualquier persona o empresa, y no debera tampoco ser considerado de este modo. Este
sitio web ha sido creado con fines de investigacin y validacin de un algoritmo
informtico aplicado a la salud.
Se estima que los hechos y la informacin son precisos al momento en el que fueron
publicados en Este Sitio Web. Toda la informacin provista en este sitio web persigue
slo propsitos informativos. Los productos y servicios descritos aqu slo se ofrecen en
Los casos de estudio y los ejemplos hallados en Este Sitio Web son resultados no
verificados, enviados por los usuarios, y podran no ser reflejo de la experiencia tpica
de los pacientes, podran no aplicarse a la persona promedio, y no intentan representar
o garantizar que cualquier persona alcanzar resultados similares o idnticos.
Este descargo de responsabilidad ha sido creado usando como base un modelo estndar
de http://www.freenetlaw.com
30
El licenciante no puede revocar estas libertades siempre y cuando siga los trminos de
la licencia bajo los siguientes trminos:
La informacin contenida en este documento est sujeta a cambios sin previo aviso.
apride.es no ofrece ninguna garanta, expresa o implcita, con respecto a ste
documento o de su contenido.
grabacin, o de otra manera), o por cualquier propsito, sin tener en cuenta esta
licencia.
El uso del software descrito en esta web est sujeta en todos los aspectos a los trminos
marcas, derechos de autor y los derechos de las invenciones (en todos los casos
registrados o no, nacionales o extranjeros, e incluyendo todos los derechos para solicitar
tambin acepta y reconoce que, en todos los casos, su uso de sta propiedad intelectual
redundar en beneficio de apride.es. El usuario tiene estrictamente prohibido sublicencias, asignar o transferir sus derechos con respecto a la propiedad intelectual o
cualquier parte del mismo a cualquier otra persona o entidad sin el consentimiento
contenido de este sitio web para sin el consentimiento previo por escrito. Todos los
derechos de Propiedad Intelectual de apride.es quedan reservados.
32
Los Datos Personales pueden ser proporcionados por el Usuario por su propia voluntad,
o bien ser recogidos automticamente durante la utilizacin de esta Aplicacin.
por esta Aplicacin o por los propietarios de servicios de terceros utilizados por esta
algunos casos podrn acceder a los Datos ciertas categoras de personas encargadas
providers) que sern nombrados por el Titular como Encargados del Tratamiento, si
fuera necesario. Se podr solicitar al Responsable de Tratamiento en cualquier
momento una lista actualizada de dichas personas.
LUGAR
Los Datos sern tratados en la sede operativa del Responsable de Tratamiento, as como
en otros lugares en los que se encuentren situadas las partes que tambin estn
PERODO DE CONSERVACIN
Los Datos sern tratados durante el plazo necesario para prestar el servicio solicitado
por el Usuario, o el que se requiera en funcin de las finalidades descritas en este
Los Datos Personales utilizados para cada finalidad son descritos en los apartados
especficos de este documento.
Google Analytics (Google Inc.): Google Analytics es un servicio de anlisis web prestado
por Google Inc. (Google). Google utiliza los Datos recogidos para rastrear y examinar
el uso de esta Aplicacin, para preparar informes de sus actividades y compartirlos con
otros servicios de Google. Google puede utilizar los Datos recogidos para contextualizar
35
en juicio o en las fases prejudiciales previas a un posible pleito derivado del uso abusivo
por parte del Usuario de esta Aplicacin o de los servicios relacionados.
El Usuario es consciente de que el Titular puede ser requerido por autoridades pblicas
a fin de revelar Datos Personales.
sistema, esto es, archivos que registren las interacciones y que pueden contener Datos
Personales, tales como la direccin IP del Usuario.
36
anonimizados o a que se bloqueen aquellos Datos Personales que estn siendo tratados
los servicios de terceros que utiliza acepta solicitudes Do Not Track, por favor lea sus
polticas de privacidad.
Usuario est en desacuerdo con alguna de las modificaciones realizadas a esta Poltica,
el Usuario deber cesar en el uso de esta Aplicacin y podr solicitar al Responsable de
Tratamiento que elimine sus Datos Personales. Salvo que se indique lo contrario, la
poltica de privacidad vigente en cada momento ser de aplicacin a todos los Datos
Personales que el Responsable de Tratamiento haya recogido hasta entonces.
INFORMACIN ACERCA DE ESTA POLTICA DE PRIVACIDAD
El Responsable de Tratamiento es responsable de esta poltica de privacidad, que ha sido
37
Datos de Uso: Las informaciones recogidas de forma automtica por esta Aplicacin (o
por servicios de terceros utilizados por esta Aplicacin), que podrn incluir: las
direcciones IP o nombres de dominio de los ordenadores utilizados por el Usuario que
se conecte a esta Aplicacin, las direcciones URI (Uniform Resource Identifier), la hora
caractersticas del navegador y del sistema operativo utilizados por el visitante, las
Usuario: El individuo que utiliza esta Aplicacin, que debe coincidir con el Titular de los
Datos o bien haber sido autorizado por ste y cuyos Datos Personales son objeto de
tratamiento.
Titular de los Datos: La persona fsica o jurdica a la que se refieren los Datos Personales.
Encargado del Tratamiento: La persona fsica, jurdica, administracin pblica o
INFORMACIN LEGAL
Aviso a los Usuarios europeos: la presente declaracin de privacidad ha sido redactada
39
4. L. Page, S. Brin, R. Motwani, and T. Winograd. (1998). The pagerank citation ranking:
Bringing order to the web. Technical Report, Stanford University.
5. Smithson, M. (1987). Fuzzy set Analysis for Behavioral and Social Sciences. N.Y.:
Springer-Verlag.
7. Pesut D. & Herman J. (1999).Clinical Reasoning: The Art and Science of Critical and
Creative Thinking. Kentucky:Delmar Cengage Learning.
9. Lunney M. (2001). Critical thinking and nursing diagnosis: Case studies and analyses.
Philadelphia: NANDA International.
criterios
de
valoracin
de
ome.fuden.es/media/docs/ccve_cd.pdf
40
enfermera.
FUDEN.
Disponible
en
13. Gordon, M. (1982). Nursing diagnosis: process and application. New York: McGrawHill Book Co.
14. Herdman, T.H. & Kamitsuru, S. (Eds.). (2014). NANDA International Nursing
Diagnoses: Definitions & Classification, 20152017. Oxford: Wiley Blackwell.
15. Henderson V. (1997). Basic Principles of Nursing Care. American Nurses Association.
16. Roper N, Logan WL, Tierney AJ. (1993). Modelo de enfermera. Interamericana
McGraw-Hill.
17. Gimnez-Fernndez M., Snchez-Aylln F, Morales-Moreno I, Flores-Martn JA,
Echevarra-Prez P. Coleccin casos clnicos de Enfermera (en prensa). Elsevier.
41
APRIDE.ES OPERATION
MANUAL
1st EDITION
December 2016
Printed in Spain
Edited by Bubok Publishing S.L.
AUTHORS:
Contact: jsoto@ucam.edu
INDEX
1- INTRODUCTION ............................................................................................................ 1
1.1 The origin of apride.es ............................................................................................ 1
1.2 Characteristics of the assessment and diagnoses prioritization tool ..................... 2
2. APP OPERATION............................................................................................................ 5
2.1 Home Screen ........................................................................................................... 5
2.2 Register and user login ........................................................................................... 6
2.3 Users Menu ............................................................................................................ 8
3. BIBLIOGRAPHY ............................................................................................................ 40
For this, it's built an algorithm called "Impact Prioritization Algorithm" who assigns
importance to signs, symptoms and roots within each diagnostic label. It also scores the
diagnoses according to the "impacts" or repetitions gained, establishing associations
between them, and shows them prioritized to make the diagnostic process easier
obviating the ambiguity inherent to the assessment phase.
Afterwards, it was decided that the algorithm shall collect data from the assessment
phase independently of the nursing model used by means of the use of assessment
items, because depending on the model used, there were biases in some diagnostic
domains. The design of a nurse registry should be based on a model that is adaptable to
our different realities (2).
cases, the algorithm suggests others nursing diagnoses that were not initially observed
by the experts, providing very promising results.
To this end the system evolves and APRIDE "Nursing Diagnoses Prioritization Algorithm"
is created, which prioritizes nursing diagnoses in 2 stages, the first one or PRECISION
phase works similar to Google PageRank (4), when an assessment item is altered, it
activates a diagnose, basically more the times it is activated (impacts), more important
will be with respect to the others, although this is not determinant since there are
several "qualitative factors" related to the patient context. This last part refers to the
PRIORITIZATION phase where the variables "assessment place" and "expected care" act.
These variables take into account the diagnostics domains and their degrees of
belonging (5), an application form of the fuzzy logic, with whom it is possible to optimize
the results. All this is set in a web called apride.es.
Much more than a philosophical view of concepts, Fuzzy Logic has been applied in
the Outcome Present State Test (OPT) model of clinical reasoning, developed by
Pesut and Herman (7) as well as the Maslow hierarchy of Needs of (8) or Lunney
(9).
Although most of the applications analysed have a free demo version, full
versions are available at a high price. Apride.es is completely free and doesn't
contain advertisements.
Not all applications are available for all operating systems (Android, iOS,
in the computer application, it has been shown that use of a single model
predisposes to bias (10) since some of them commit omissions of certain spheres
moreover incorporate two innovative features, the use of items for the assessment
phase and the classification of the diagnoses obtained in an orderly and prioritized way.
All this combined helps in planning the next phases of the nursing process.
acronym RWD (Responsive Web Design), allows to adapt the appearance of web pages
3
The apride.es web application was made using PHP, CSS and MySQL. It was decided to
use these technologies because they are specifically designed to develop web
runs on a web server, taking the code in PHP as its input and creating web pages as
output. Cascading Stylesheets (CSS) is a graphic design language designed to detach the
speed and flexibility. It is considered the most popular open source database in the
world. Open source means General Public License (GPL) so anyone can modify it to fit
their needs and use it without paying.
In addition to the previous points, the design of the application has tried to cover the
marked guidelines concerning to the assessment and diagnostic phase by an
Options menu:
About: It explains the function of the web and the terminologies used.
Image 32
Image 33
In the same box there are the login and password
boxes to access the application. In the login field
Image 34
Data regarding privacy, types of data collected, modality and place of treatment of
collected data and purpose of collected data are shown in section 2.11 Disclaimer,
Copyright & Privacy.
Image 35
Image 36
Help: Contextual Help, depending on the screen you are at, it will display the
Help text corresponding with that screen.
Contact: Get in touch with the author to notify problems and give your
suggestions.
2.4 User Data
In this section, image 6 we shall find the next screen.
Image 37
You can change your password writing it in the same way in the fields password and
change password.
Even though you can change the language in any screen of the app, in this particular
screen you can select the language with a combo menu to be as default.
Data related to the user are collected to let the web work, and also to provide for the
following purposes: Statistics and Contact with the user. You can find more detailed
information regarding the collected and treatment of personal data on section 2.11
Disclaimer, Copyright & Privacy
assessment; the data collected in this form will be determinant to activate diagnoses
(impacts). The fields that compose this form are called Assessment Items.
10
Items are filtered by gender (Male or Female), age range (adult or child) and the
Assessment model to use. The gender and age range are selected at the beginning and
are fixed during all the assessment, because they act as filters and thus you will see more
or less items depending on what you selected.
11
Image 39
Functional Health Patterns: Marjory Gordon Model (13), the most used
nowadays.
Image 40
Image 41
NANDA III Taxonomy Domains: NANDA 2017-2019 taxonomy will be applied (14).
Image 42
Image 43
12
Image 44
Image 45
Once the model is selected the items will be grouped in tabs, changing the tab will save
the data that has been filled up to that moment.
There are also two dropdown menus where the user must select the Assessment place
and the Expected cares you intend to provide to the patient. Image 15. The data
obtained from these last two fields are processed using fuzzy logic where the system
Image 46
Some items have a help icon next to the Item name, and its symbolized as , image 16.
When mouse over, a pop-up text will be displayed with the value range or the content
description.
13
Image 47
14
Image 48
Image 49
Image 50
Image 51
Text. Allows introduction of any length text, as well as to copy and to paste.
Formula: Numbers which value have been calculated automatically with the
Image 52
Image 53
Regardless of the type of item, as can be seen in figure 23, the items can be primary
(always activated) or secondary (disabled and grey). The primaries activate the
secondary ones, since the value of the secondary ones depends on that it complies what
indicates the primary, this way it is limited the number of items to fill and facilitates their
fulfilment.
Image 54
15
The form can be saved at any time by pressing the Save/Send button, image 24, as well
as resetting and cleaning all the values of the form sheet.
Image 55
This assessment can be opened later from the section Saved Assessment
Edit Assessment icon
with the
The same Save/Send button, image 24, is also used when you finish the whole
assessment in order to get the next screen and be able to see the results obtained.
16
In the Diagnoses Obtained section from the example, we shall see the three diagnoses
that are classified in the first positions after the prioritization process.
In the columns there is information about the obtained impacts from every diagnose,
the type of diagnose (real, risk, or enhancement), its domain and the total score gained
in the prioritization process.
17
the diagnoses obtained by the application and the scores of each of them. (Section 2.7)
In the box below, entitled "Precision Stage", we can see the general data of the
assessment, including the nursing model used, the subject's gender, age range, place of
assessment and the expected care that will be given. Also a total count of the unique
diagnoses (without repetitions), the total found diagnoses (a.k.a. impacts) including the
repetitions, as well as the count of the types of diagnoses.
If the icon
Assessment Summary within the items and the diagnoses that have been activated.
(Section 2.8)
18
Image 57
19
The white box at the top of the document contains an assessment summary, the same
that we have seen in the previous screen, image 25.
Immediately below we can see a table. Each row corresponds to a nursing diagnose
scenery where 2 diagnoses get the same score, in that case its importance is the same
and the position between them in the table would be irrelevant.
In the columns we find information about the impacts obtained on each diagnose, the
type of diagnose (real, risk or improvement), the domain and the total points obtained
in the prioritization process.
The scores obtained are the result of the value obtained by the application of the apride
algorithm, its operation is explained in section 1.1.
The diagnoses of the table displayed in grey and placed in the last positions have
obtained a score of 0 points in the prioritization process, therefore they are rejected,
and they are shown for information.
20
This section consists in a table where each row corresponds to some assessment item.
In the first column we see the item name, in the second column the value entered either
numeric, text, selected from a dropdown menu or YES/NO type. In the third column, we
shall find the NANDA diagnose (14) that has been activated by that particular item.
21
Age and Gender application of the diagnose, since some diagnoses might just be
applied if those items coincide. E.g.
Numerical type item. The diagnose activation is related with the inclusion or
exclusion within a numerical range. E.g.
Combo Item. The diagnose activation is related with the selection of a concrete
value from a drop down menu. E.g.
YES/NO Item. The diagnose activation is related with some of the selections.
22
sorted by creation date. There are saved those done freely and the related with any
clinical case from the Clinical Case section.
Image 59
In the image it is shown an assessments list with the creation date, the main diagnose
obtained with the APRIDE algorithm, and a series of icons detailed bellow in the table 2.
23
See Diagnoses Results: List of the obtained diagnoses with its individual
scores after the application of APRIDE.
Comments: It let you write comments about the assessment process, the
red icon means that the screen has comments, in blue it shows it doesnt
have comments.
Edit Assessment: Let you edit the assessment form sheet previously stored,
letting change items, its data and the applied model.
Delete Assessment: Let you delete an assessment
been randomly selected with the intention to evaluate the functioning of the APRIDE
algorithm.
From this cases selection, the users can enter the clinical cases of their own interest and
when finish they shall score the level of correspondence between the diagnoses
obtained by the application respect with what the user had in mind. Moreover, you can
write down notes in the text field about discrepancies found.
24
Image 60
Now there are descripted the different columns and icons that we can find in the table
of this screen.
Title: Contains a descriptive tittle based on a medical diagnose that will be useful
as mnemonic reference for the case.
Status: Comprises two states, pending and done, when it is completed, this last
state becomes a link to Assessment Results screen (section 2.6).
25
Main Diagnose: In this column the application indicates the NANDA diagnose
Actions: A series of icons with contextual help to manage the Clinical Cases are
Table 6
Solve Clinical Case: This option will only be available in the pending
clinical cases
Punctuate clinical
means that the case has been punctuated, the blue without
punctuation, in grey valuation of the case still pending. Image 31.
the status of the case will go into pending, displays grey when the
assessment is pending.
26
Image 61
27
Image 62
28
kind, either express or implied. The information provided is not medical advice, or nurse
or medical recommendations of any kind, and should never be treated as such.
For symptoms, questions or medical or nursing advice visit your doctor or nurse. This
site is made for research purposes. You should not take the information from this site
as an alternative to advice from your doctor or other health professional.
Apride.es not responsible for any advice, treatment, diagnosis, medications and
application of devices or other information, services or products obtained through this
website.
MEDICAL DISCLAIMER:
As an express condition of using this website, you must accept the following terms. If
you do not accept any of them, do not use the website. Your use of this website, and
any involvement of the activities mentioned in this website, you signify acceptance and
legal submission to these terms:
29
None of the diagnoses listed on this website should be applied or used in any way
It is estimated that the facts and information are accurate at the time which were
informational purposes only. The products and services described herein are only
offered in jurisdictions where they may be legally offered. The information provided is
not exhaustive, is limited to available information, and such information should not be
considered exhaustive or accurate.
You agree to release from any liability to this website, members apride.es Project and
their owners, freeing them from claims for damages or injury, including lawsuits and
costs, incurred by you or third parties caused by you, that arising from the results
provided by this website.
Case studies and examples found on this website are unverified results posted by users,
and may not be reflective of the typical experience of patients, may not apply to the
average person, and are not intended to represent or guarantee that anyone will
achieve similar or identical results.
This disclaimer has been created using as a basis a standard model from
http://www.freenetlaw.com
30
The licensor cannot revoke these freedoms as long as you follow the license terms as
long as go under the following terms:
Attribution You must give appropriate credit, provide a link to the license, and
indicate if changes were made. You may do so in any reasonable manner, but
not in any way that suggests the licensor endorses you or your use.
NonCommercial You may not use the material for commercial purposes.
ShareAlike If you remix, transform, or build upon the material, you must
distribute your contributions under the same license as the original.
Complying with all applicable copyright laws is the responsibility of the user. Without
limiting the rights under copyright, no part of this document may be reproduced, stored
website or his documents does not give you any license to these patents, trademarks,
copyrights, or other intellectual property.
The use of the software described in this website is subject in all respects to the terms
and conditions set forth in a definitive agreement entered into between the user and
apride.es.
All intellectual property rights (including, without limitation, all database rights, rights in
designs, rights in know-how, patents, trademarks, copyrights and rights in inventions (in
all cases whether registered or unregistered, foreign or domestic, and including all rights
to apply for registration) and all other intellectual or industrial property rights in any
acknowledges that, in all instances, its use of this Intellectual Property shall inure to the
otherwise transferring its rights with respect to the Intellectual Property or any part
thereof to any other person or entity without the prior written consent of apride.es.
Without limiting the foregoing, the user shall not transfer or sub-license the Intellectual
Property or reproduce, disclose or disseminate the contents of this website without
apride.es express prior written consent. All rights of apride.es in the Intellectual
Property are hereby reserved.
32
parties, there are: Cookies, Usage Data, first name, last name, gender, country and email
address.
Other Personal Data collected may be described in other sections of this privacy policy
or by dedicated explanation text contextually with the Data collection.
The Personal Data may be freely provided by the User, or collected automatically when
using this Application.
Any use of Cookies - or of other tracking tools - by this Application or by the owners of
third party services used by this Application, unless stated otherwise, serves to identify
Users and remember their preferences, for the sole purpose of providing the service
required by the User.
Failure to provide certain Personal Data may make it impossible for this Application to
provide its services.
Users are responsible for any Personal Data of third parties obtained, published or
shared through this Application and confirm that they have the third party's consent to
provide the Data to the Owner.
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The Data processing is carried out using computers and/or IT enabled tools, following
types of persons in charge, involved with the operation of the site (administration, sales,
marketing, legal, system administration) or external parties (such as third party technical
service providers, mail carriers, hosting providers, IT companies, communications
agencies) appointed, if necessary, as Data Processors by the Owner. The updated list of
these parties may be requested from the Data Controller at any time.
PLACE
The Data is processed at the Data Controller's operating offices and in any other places
where the parties involved with the processing are located. For further information,
please contact the Data Controller.
RETENTION TIME
The Data is kept for the time necessary to provide the service requested by the User, or
stated by the purposes outlined in this document, and the User can always request that
the Data Controller suspend or remove the data.
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The Personal Data used for each purpose is outlined in the specific sections of this
document.
authorizes this Application to use these details to reply to requests for information,
quotes or any other kind of request as indicated by the forms header. Personal Data
collected: country, email address, first name, gender and last name.
Analytics: The services contained in this section enable the Owner to monitor and
analyze web traffic and can be used to keep track of User behavior.
Google Analytics (Google Inc.): Google Analytics is a web analysis service provided by
Google Inc. (Google). Google utilizes the Data collected to track and examine the use
of this Application, to prepare reports on its activities and share them with other Google
services. Google may use the Data collected to contextualize and personalize the ads of
its own advertising network. Personal Data collected: Cookies and Usage Data. Place of
processing: US Privacy Policy Opt Out
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or in the stages leading to possible legal action arising from improper use of this
Application or the related services.
The User declares to be aware that the Data Controller may be required to reveal
personal data upon request of public authorities.
may collect files that record interaction with this Application (System logs) or use for this
purpose other Personal Data (such as IP Address).
from the Data Controller at any time. Please see the contact information at the
beginning of this document.
36
and can consult the Data Controller to learn about their contents and origin, to verify
of the law, as well as to oppose their treatment for any and all legitimate reasons.
Requests should be sent to the Data Controller at the contact information set out above.
This Application does not support Do Not Track requests.
To determine whether any of the third party services it uses honor the Do Not Track
requests, please read their privacy policies.
often, referring to the date of the last modification listed at the bottom. If a User objects
to any of the changes to the Policy, the User must cease using this Application and can
request that the Data Controller remove the Personal Data. Unless stated otherwise, the
then-current privacy policy applies to all Personal Data the Data Controller has about
Users.
37
institution or an association, which is, or can be, identified, even indirectly, by reference
to any other information, including a personal identification number.
Usage Data: Information collected automatically from this Application (or third party
services employed in this Application), which can include: the IP addresses or domain
names of the computers utilized by the Users who use this Application, the URI
addresses (Uniform Resource Identifier), the time of the request, the method utilized to
submit the request to the server, the size of the file received in response, the numerical
code indicating the status of the server's answer (successful outcome, error, etc.), the
country of origin, the features of the browser and the operating system utilized by the
User, the various time details per visit (e.g., the time spent on each page within the
Application) and the details about the path followed within the Application with special
reference to the sequence of pages visited, and other parameters about the device
operating system and/or the User's IT environment.
User: The individual using this Application, which must coincide with or be authorized
by the Data Subject, to whom the Personal Data refers.
Data Subject: The legal or natural person to whom the Personal Data refers.
Data Processor (or Data Supervisor): The natural person, legal person, public
administration or any other body, association or organization authorized by the Data
Controller to process the Personal Data in compliance with this privacy policy.
Data Controller (or Owner): The natural person, legal person, public administration or
any other body, association or organization with the right, also jointly with another Data
Controller, to make decisions regarding the purposes, and the methods of processing of
Personal Data and the means used, including the security measures concerning the
operation and use of this Application. The Data Controller, unless otherwise specified, is
the Owner of this Application.
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LEGAL INFORMATION
Notice to European Users: this privacy statement has been prepared in fulfillment of the
39
19. Garca Suso, A, Francisco del Rey C, Palazuelos Puerta P, de Bustos M. L. (2004). El
21. L. Page, S. Brin, R. Motwani, and T. Winograd. (1998). The pagerank citation ranking:
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Creative Thinking. Kentucky:Delmar Cengage Learning.
26. Lunney M. (2001). Critical thinking and nursing diagnosis: Case studies and analyses.
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ome.fuden.es/media/docs/ccve_cd.pdf
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30. Gordon, M. (1982). Nursing diagnosis: process and application. New York: McGrawHill Book Co.
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Diagnoses: Definitions & Classification, 20152017. Oxford: Wiley Blackwell.
32. Henderson V. (1997). Basic Principles of Nursing Care. American Nurses Association.
33. Roper N, Logan WL, Tierney AJ. (1993). Modelo de enfermera. Interamericana
McGraw-Hill.
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Echevarra-Prez P. Coleccin casos clnicos de Enfermera (en prensa). Elsevier.
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