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      "author": "steemitboard",
      "body": "Congratulations @jramirez! You received a personal award!\n\n<table><tr><td>https://steemitimages.com/70x70/http://steemitboard.com/@jramirez/birthday2.png</td><td>Happy Birthday! - You are on the Steem blockchain for 2 years!</td></tr></table>\n\n<sub>_You can view [your badges on your Steem Board](https://steemitboard.com/@jramirez) and compare to others on the [Steem Ranking](https://steemitboard.com/ranking/index.php?name=jramirez)_</sub>\n\n\n###### [Vote for @Steemitboard as a witness](https://v2.steemconnect.com/sign/account-witness-vote?witness=steemitboard&approve=1) to get one more award and increased upvotes!",
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      "body": "Hola @jramirez, upv0t3\r\nEste es un servicio <b>gratuito</b> para nuevos usuarios de steemit, para apoyarlos y motivarlos a seguir generando contenido de valor para la comunidad.\r\n<3 Este es un corazón, o un helado, tu eliges\r.\r\n\n<h1> : ) </h1>\r\nN0. R4ND0M: \r\n2835 4761 7295 4640\n9610 1956 6821 8809\n2973 7124 4021 9596\n1937 3555 1054 6798\n",
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      "author": "jramirez",
      "body": "![trufas de chocolate.jpg](https://steemitimages.com/DQmQxj3e1T8KYFysShwVMQhBxzuZJhFfjYQo8gZcQptuEKH/trufas%20de%20chocolate.jpg)\nIngredients\n\n2 cups flour leavening robin hood\n1 cup of brown sugar\n1/2 cup of milk\n1 Teaspoon vanilla extract\n8 tablespoons of butter\n4 eggs\n1 cup of chocolate powder\n2 pots of condensed milk\n1/2 cup of liquor\n1/4 kilo of chocolate rain\n\n\nPREPARATION\nThe butter is beaten vigorously, when this creamy is added little by little the sugar, later the eggs are added (one to one) then the vanilla and alternates between the flour (previously bound with the chocolate powder) and the milk and mixture. When this uniform is placed in a container and baked in the microwave for 14 minutes (the time may vary depending on the microwave). When it is cold the cake crumbles to create like a flour, then it is fried with liquor and condensed milk, (it is a sticky mixture) We form pellets and pass through granulated chocolate (for this part it is necessary to ask for help, so as not to fill up the hands of chocolate and so it will be more effective), should be immersed in the chocolate rain once the balls are formed because if it is not done they dry and do not adhere to the chocolate, then go to the fridge and good profit.",
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      "body": "TRUFAS DE CHOCOLATE\nIngredientes\n\n2 tazas de harina leudante robin hood\n1 taza de azúcar morena\n1/2 taza de leche\n1 cucharadita de esencia de vainilla\n8 cucharadas de mantequilla\n4 huevos\n1 taza de chocolate en polvo\n2 potes de leche condensada\n1/2 taza de licor\n1/4 kilo de lluvia de chocolate\n\n\nPREPARACIÓN\nLa mantequilla se bate enérgicamente, cuando este cremosa se agrega poco a poco el azúcar, posteriormente se agregan los huevos (uno a uno) luego la vainilla y se alterna entre la harina (previamente ligada con el chocolate en polvo) y la leche y se mezcla. Cuando este uniforme se coloca en envase y se hornea en microondas por 14 minutos (el tiempo puede variar dependiendo del microondas). Al estar fría se desmorona la torta hasta crear como una harina, luego se amaza con el licor y la leche condensada, (queda una mezcla pegajosa) Formamos bolitas y se pasan por chocolate granulado (para esta parte es necesario pedir ayuda, para no llenarse las manos de chocolate y así será mas efectivo), se debe sumergir en la lluvia de chocolate una vez formadas las bolitas ya que si no se hace se secan y no se adhiere a ellas el chocolate, luego van a la nevera y buen provecho.\n![trufas de chocolate.jpg](https://steemitimages.com/DQmQxj3e1T8KYFysShwVMQhBxzuZJhFfjYQo8gZcQptuEKH/trufas%20de%20chocolate.jpg)",
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      "body": "Prepare this nutritious cake special for children and adults for its great nutritional value of the banana.\n\nIngredients:\n\n2 large bananas\n250 grs. of margarine\n½ cup of granulated sugar\n½ cup of powdered sugar (micro powdered, glass, finite, neva sugar etc.)\n6 eggs\n200 grs. of prepared flour\n1 teaspoon baking powder\n150 grs. of raisins.\n\npreparation:\n\nPlace the margarine, powdered sugar and granulated sugar in a bowl, beat with an electric whisk cream (cream), then incorporate the eggs one by one, beating well between one and the other so that they integrate very well.\n\nPeel the plantains and mash them, process them or press them with a fork, add to the previous preparation, mix.\n\nIncorporate the previously sifted flour together with the baking powder, do it with a spatula in enveloping form.\n\nAdd the raisins, previously passed through a little flour.\n\nTo gum and flour a special mold for microwaves, empty the preparation and take to the microwave oven for 20 minutes.\n\nTips:\n\n    When preparing a cake, remember that all ingredients must be at room temperature.\n    You can enrich the flavor of banana keke by adding toasted and chopped pecans.\n    If you want you can prepare half of the recipe, this complete yields for 15 to 18 servings.",
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      "body": "Strawberry jam in the microwave\nTake advantage of the strawberry season and prepare this delicious jam in a few minutes.\n\nIngredients:\n\n½ kilo of ripe strawberries\n½ kilo of granulated sugar\nJuice of a lemon\n\npreparation:\n\nWash the strawberries well, then remove the bowl, drain well.\n\nPlace them in a bowl or deep bowl, especially for microwaves (not metal), add sugar and lemon juice, let stand for 30 minutes.\n\nTake to the microwave oven uncovered, for 10 minutes in medium power, remove and mix very well and again take it to the oven for 10 minutes more.\n\nLet warm to pack.\n\nTips:\n\n    You must be alert or careful not to spill the jam, as the strawberry when boiling with sugar tends to produce foam, so I suggest a deep bowl.\n    The advisable thing is that it is the same quantity of strawberries and sugar.",
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      "body": "Cheese Cookies\n\nAn alternative to prepare salty crackers, fast and economical.\n\nIngredients:\n\n200 grs. of prepared flour\n1 teaspoon baking powder\n½ teaspoon of salt\n1 cup of grated cheese\nWhite pepper (amount needed)\n50 grs. of margarine or butter\n1 yolk\n\npreparation:\n\nPlace in a bowl or bowl the sifted flour, the baking powder, salt, pepper (1/4 teaspoon) and the grated cheese, mix well, then add the margarine or butter with the help of a fork, add the yolk and knead gently. Make a roll and let rest for 15 to 20 minutes.\n\nPut a little flour on the table, stretch the dough, rather thin, with a rolling pin or rolling pin, and cut the cheese crackers with cutters or cut pasta.\n\nPlace on a plate and bring to a preheated oven at 180 ° for 10 to 12 minutes.\n\nTips:\n\n    If you want the cheese cookies to have a better color you can add a little bit of paprika to the dough.\n    Also another alternative would be to put some oregano powder.",
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      "body": "![cubierta chocolate.jpg](https://steemitimages.com/DQmSTHxoQs9KLhX8d3ALAxvAiV2SHzkbrb8eZ25jnpeJCGT/cubierta%20chocolate.jpg)\nChocolate Fondant\n1 envelope of unflavored gelatin\n  1/4 cup of cold water\n1 Kg of nevazucar\n  1/2 Tz of cocoa without sugar\n  1/2 Tz glucose\n  1/4 Tz of vegan oil\n1 g of glycerin (optional)\n\npreparation:\nMix the gelatin and water, let it rest for 5 '', and then heat it to a water bath without letting it boil, until it becomes crystalline. Sink the nevazucar and the cocoa in a bowl, make a little hole in the center. Add the glucose, oil and glycerin to the gelatin mixture, dissolving it well, and add it to the nevazucar with a wooden spoon. Start mixing until all the ingredients are united. Pour on the table and knead with the remaining nevazucar until a soft dough forms that does not stick. Wrap in plastic wrap and let stand for 15 '' before using.",
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      "author": "resteembot",
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      "body": "NATIONAL PLAN OF QUALITY AND SECURITY IN HEALTH CARE\n\n  General Objectives\n\nEstablish guidelines that guide the development of interventions aimed at improving the quality of hospital health care; also aims to support the development of clinical excellence and adoption of good practices based on scientific evidence available so far.\n\nSpecific objectives.\n\n• To have organizational bases that allow the integral and permanent development for the continuous improvement of the hospital quality.\n• To fully evaluate the quality of the healthcare process and its results. Guarantee the competence, safety and motivation of health personnel.\n• Evaluate the satisfaction of patients, family members, workers and other institutions related to hospital activity.\n• Define and disseminate the Quality Policy of the institution.\n• Define Quality Indicators for all levels of the organization.\n• Carry out necessary research on quality to improve and improve the service provided by the institution in search of excellence.",
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      "body": "Advance in the search for excellence in the hospital health system.\n\nIn the current process of strengthening the National Health System, the transformation of hospital services is necessary: ​​changes in the mentality and behavior of workers as a core element, the installation of new technologies, the revitalization of health care units and their integration, the universalization of education as well as an appropriate organization and direction. All aimed at ensuring a continuous institutional process of high quality patient care, as an essential requirement to achieve Excellence.\nThe conduction of quality processes by the management of hospital institutions is based on personal example and requires a high efficiency in the integral training of workers, so that they adopt the right decisions in each moment of action.\nIn this endeavor, the analysis of their own behavior and that of the collective should be encouraged, stimulating them to carry out assessments with independence and creativity, in order to respond to the problems identified based on the concepts, principles and values ​​contained in the existing legal framework.\nInternational strategies in patient safety are mainly oriented in two major areas: the cultural change of professionals and the implementation of safe practices.\n\nThe cultural change of professionals towards a positive culture on patient safety in health institutions is an indispensable requirement to prevent and minimize incidents related to patient safety and to be able to learn from mistakes to reduce the likelihood of their recurrence.\nTo improve the safety culture, we must continue developing actions aimed at measuring and improving the safety environment, inform and train all health system professionals on safety issues, promote effective care training, train work teams in risk management, promote leadership in security, communicate and learn from incidents and keep professionals informed of the evaluation data of their health organizations, stimulating their active participation in the proposed improvements.\nKnowing the security culture of an organization is the first step to its improvement. The research is in safety culture have been oriented primarily to assess the safety environment (attitudes and perceptions that professionals have about safety) and its association with different clinical outcomes, as well as the satisfaction of professionals and patients. 76 Flin R, Mearns K, O'Connor P and Bryden R. Measuring safety climate: identifying the common features. [Internet] Safety Science, Vol 34 (1-3), Feb 2000, 177-192.\nOrganizations committed to the safety culture focus their efforts on four key aspects: promoting a culture of safety at all levels; evaluate and promote a good safety climate; increase training in patient safety and in the so-called human factors or non-technical factors of the professionals; and develop safety elements at the level of clinical units. Carthey J, Clarke J.Implementing Human factors in health care; [Internet] Patient Safety First. How to Guide 2015. [Accessed February 20, 2015] Available at http://www.patientsafetyfirst.nhs.uk/Content.aspx?path=/interventions/humanfactors/\nThe importance of the human factor in improving patient safety has grown in recent years and there are several experts who recommend training health professionals in this aspect and favor the incorporation of the principles of the human factor to the organization taking into account physical aspects (design, equipment, etc.), cognitive aspects (status and situation of the professional, communication skills, teamwork (\"teamwork to teamwork\"), and organizational aspects (organizational culture). Human Factors in Patient Safety Review of Topics and Tools Report for Methods and Measures [Internet] Working Group of WHO Patient Safety WHO 2009; [Accessed February 4, 2015] Available at: http://www.who.int/patientsafety /research/methods_measures/human_factors/humn_factors_review.pdf Gurses AP, Ozok AA, Pronovost PJ.Time to acelérate integration of human factors and ergonomics in patient safety BMJ Qual Saf; 2012: 21 (4): 34 7-51). Carayon et al. Systems Engineering Initiative for Patient Safety (SEIPS) model of work system and patient safety. [Internet] Qual Saf Health Care 2006; 15: i50-i58. doi: 10.1136 / qshc.2005.015842 [Accessed 23 January 2015] Available at: http://qualitysafety.bmj.com/content/15/suppl_1/i50.short. World Health Organization. Multi-professional Patient Safety Curriculum Guide. [Internet] Patient Safety. World Health Organization; 2011. [Accessed February 20, 2015] Available at: http://www.who.int/patientsafet",
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      "body": "ELIMINATE THE BARRIERS OF ACCESS TO HEALTH SERVICES, ACHIEVING EFFECTIVE, EFFICIENT AND SAFE ACCESS, RESPECTING THE INTERCULTURALITY AND HUMAN RIGHTS OF THE WHOLE POPULATION.\n\nTo fulfill this conceptual approach, it is necessary to make joint efforts to seek continuous improvement in the provision of health services to the person, families and communities, guaranteeing timely access with efficient, effective care with equity, security, comprehensiveness, respecting interculturality of the entire population of the country; for which it is necessary to design a tracer instrument for health care and a section for Maternal and Child Care, which will concentrate efforts on the mission of reducing the risks inherent in health care and improving user satisfaction.\n\nIt is considered an unavoidable responsibility of the government and an inherent commitment to the social function of the State, the continuous improvement of the QUALITY and SECURITY of the services offered in the health dispensing organizations. That is why it is necessary to Strengthen the Health Authority, understanding it as: \"the set of actors / institutions of the State responsible for ensuring the public good in health, where its primary objective is the protection and promotion of health of the population, and it is expressed as the power of the State to influence the functions, responsibilities, and substantive powers that are proper and non-delegable, to effectively ensure the public good in health. (PAHO / USAID, Role of the Health Authority, Conceptual Framework, Methodological Instrument, 2007)\n\nStrengthening governance and accountability consists of promoting transparency in decision making and the generation of solid systems for the collective responsibility of health providers and system managers through alignment, governance and accountability. . It is imperative that the different authorities assume the responsibility of protecting and improving the wellbeing of the Venezuelan population, emphasizing the child population in the female population of childbearing age; by building scenarios of trust and legitimacy with citizens through the effective administration of resources. The mechanisms that the state implements with citizens and communities in the rendering of accounts are necessary to improve the dialogue on health policies at the national level.\n\nThe development of mutual accountability among those who live and work in the community should be promoted; since they provide essential information on the local situation, achieving with this plan the appropriate health services. The accountability structures must have three characteristics: first, that there are mechanisms through which the service providers are responsible; second, that there must be adequate information to evaluate the services provided; and third, that patients have the power to take action.\n\nStrengthening transformational leadership, distributed leadership and management for change are fundamental to consolidate successful management of change within a health system. The development of an organizational culture that supports monitoring and evaluation, exchange of knowledge and demand for data in decision-making is also a prerequisite for transformation. The team of leaders must keep in force the actors the need to improve the quality and safety in organizations in both the technical aspects and the perceived by users.\n\nThe management of organizational change should start from the exhaustive review of clinical management and quality assurance and the continuous improvement of the organization. The workforce will be reoriented so that the team of health workers approaches patients, users and communities more openly to work as a team, to obtain more effective use data; besides being willing to innovate in their practice. In addition, they must receive training to form multi-professional teams that work across organizational boundaries and organizations must guarantee the improvement of working conditions and compensation mechanisms.\n\nRegulation plays a key role in establishing the rules within which professionals and organizations will feel compelled to operate within more integrated and people-centered health systems - for example, in terms of establishing new quality standards and / or the payment of performance objectives.\n\nIt seeks to improve the provision of maternal and child care through the alignment and harmonization of the processes of the different services. A key part of providing maternal and child care involves the continuous improvement of care; regulating waiting times for obtaining clinical care and even performing interconsultations and / or required auxiliary tests, determination of clinical and social risk factors.\n\nNew technologies, including information and communication technologies, such as the use of electronic medical records that can be accessed at any point in the health network and can be a tool for the reorganization of health services around the needs of the patient; which will result in the achievement of quality clinical management.\n\nSuccessful coordination involves multiple actors both within and outside the health system, and requires the functional alignment of activities and communication. Coordination does not do it by itself; it necessarily requires the merging of different services or workflows.",
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