The Main Objective Of This Public Proposal Is The Purchase Of Comprehensive Service Management Of Specialty Care For Acute Renal Replacement Therapy, In Order To Maintain The Coverage Of Renal Replacement Therapies According To The Patients Clinical Requirement, Using Hemofiltration And Hemmodialysis Techniques, Either In Conventional Or Continuous Modality. This Is Based On The Fact That Renal Replacement Therapy Through Techniques Such As Dialysis And Extracorporeal Filtration Constitutes An Essential Clinical Need In Critical Patients That Require The Elimination Of Solutes And Excess Blood Fluids, Due To An Acute Or Chronic Commitment Of Renal Function. These Therapies Allow To Maintain Hydroelectrolytic And Acid-Base Balance, Which Is Essential To Preserve Hemodynamic Stability And Improve The Survival Of Hospitalized Patients In Critical Condition. On The Other Hand, Given The Growing Demand For Renal Replacement Procedures In The Adult Critical Patient Unit And The Complexity Of The Cases Attended, It Is Essential To Have Adequate Human And Technical Resources To Guarantee A Timely, Safe And Effective Execution Of These Procedures. This Includes The Mobile Dialysis Modality, Which Allows The Therapy To Be Carried Out Directly To The Patient When Its Transfer To A Conventional Hemodialysis Unit Is Not Possible. Likewise, It Is Imperative To Comply With Decree No. 45 Of The Ministry Of Health, Published On September 6, 2017 And Promulgated On November 11, 2016, Which Approves The Regulations On Dialysis Benefits And The Establishments That Grant Them. In Particular, Article 12 Of Said Regulation Establishes The Nurse Relationship (A) -Stype According To The Type Of Dialysis Administered, Specifying That, In The Case Of Mobile Dialysis, Each Nursing Professional May Be In Charge Of A Maximum Of A Patient, Given The Complexity And Individualized Care That These Therapies Require. This Regulatory Framework Requires An Adequate Provision Of Trained Nursing Personnel, Especially In High Complexity Contexts Such As The Critical Patient Unit, Where Timely And Specialized Care Can Make A Significant Difference In Clinical Outcomes. Therefore, The Increase In The Number Of Patients Diagnosed With Renal Disease, The Significant Increase In Dysfunction Or Exhaustion Of Vascular Access In Chronic Patients In Permanent Hemodialysis, The Limited Resolution Capacity Of Nodes Nodes To Perform Acute Hemodialysis, The Shortage Of Quotas In Chronic Hemodialysis Programs, The Lack Of Availability For Peritoneodialysis And The Low Rate Of Renal Transplants Have Generated A Growing Demand. This Demand Cannot Be Covered With The Current Institutional Endowment, Which Makes It Necessary To Hire This Specialized Service. This Measure Seeks To Respond To A Critical Care Need, With Direct Impact On The Quality Of Care Of Patients Who Require Renal Substitute Therapies In Situations Of High Clinical Complexity. The Service Will Be Carried Out In Hospital Units, In The Best Possible Conditions For Both Parties, As Detailed In These Administrative Bases, And Technical Bases, And According To Amounts Defined In Annex No. 1.
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