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    • Renown Health
    • Educación
    • Nursing
    • University of Nevada, Reno

    Celebrating Renown Health's Nursing Excellence Conference

    Renown Health recently wrapped up the twentieth annual Nursing Excellence and Excellence in Critical Care Conferences, the conference theme was the Courageous Calling and over 400 nurses from specialty fields across the region attended to learn, reflect, build relationships and obtain continuing education units (CEUs).   Celebrating The Courageous Calling During the first day of the Nursing Excellence Conference, local and national leaders presented topics including redefining resilience, documentation liability, transgender healthcare and caring for the homeless population. Among the list of impressive speakers were Chief Nurse Executive at Renown Health, Melodie Osborn, and Nora McInerny, writer and host of the "Terrible Thanks for Asking" podcast.   On day two,speakers focused on the critical care specialties within nursing, including intensive care, emergency room, pediatric intensive care and neonatal intensive care. Topics covered included post-COVID-19 pulmonology with Dr. Graham, traumatic brain injuries with Dr. Demers, COVID-19 reflections with Anicia Beckwith, a discussion about "Mis C” with Dr. Healy, innovations in imaging with Dr. Rangaswamy and cardiology with Dr. Danaf. Thank you to our sponsors and raffle donors for making this event possible: Erik Olson and Larry Duncan, Jana Elliott, Melodie Osborn, Becky Haase, Lori Tuntland, Dr. Akbar, Dr. Lous, Mel Morris, Grand Sierra Resort, Renown Health Gift Shops, Renown Health Directors of Nursing, Renown Health Marketing & Communications Department, Renown Health Dermatology, Laser, & Skin Care and Renown Health Foundation.   Learn more about finding purpose in the health of our community when working at Renown Health here.

    Read More About Celebrating Renown Health's Nursing Excellence Conference

    • Thursday, Aug 13, 2020

    Renown Recognized for Quality Care for Heart Attack & Failure

    American Heart Association awards shine national spotlight on care offered in northern Nevada. Renown Regional Medical Center has been honored once again by the American Heart Association (AHA) for high quality heart care. Renown’s focus on quality and applying the most up-to-date, evidenced-based treatment guidelines improves patient outcomes, getting people home sooner and back to doing what they love. “We are pleased to recognize Renown for their commitment to heart failure care,” said Lee H. Schwamm, M.D., national chairperson of the Quality Oversight Committee and Executive Vice Chair of Neurology, Director of Acute Stroke Services, Massachusetts General Hospital, Boston, Massachusetts. “Recognizing the significance of preventing, diagnosing and caring for people with heart and vascular disease, which continues to be on the rise and taking far too many lives, is of critical importance to us at Renown,” says Tony Slonim, M.D., DrPH, FACHE, president and CEO, Renown Health. “We are proud of our incredible team for providing the highest-quality clinical care, and thank the American Heart Association for this national recognition.” Renown Regional was awarded The Get with the Guidelines – Heart Failure Gold Plus Quality Achievement award for continually ensuring heart failure patients receive the most appropriate treatment according to nationally recognized, research-based guidelines, as well as AHA’s Mission: Lifeline Gold Receiving honor for the treatment of patients who suffer severe heart attacks. “Renown offers the most highly-skilled and experienced heart and vascular team and the most advanced heart center in the region. Having national recognition for being the region’s heart care leader is critical to a Destination Health strategy,” said Josiah "Sy" Johnson, MBA, chief of staff for Renown Health. “We at Renown are proud to bring a high level of world-class care providers, leading-edge care and new delivery approaches to meet the needs of people in northern Nevada through our Institute for Heart & Vascular Health.” Por qué este reconocimiento es importante para usted: atención del ataque cardíaco Cada año, más de 250,000 personas experimentan un infarto de miocardio con elevación del segmento ST (STEMI), el tipo más mortal de ataque cardíaco, causado por un bloqueo del flujo sanguíneo al corazón que requiere tratamiento oportuno. Renown earned the award by meeting specific criteria and standards of performance for quick treatment to re-establish blood flow to blocked arteries in heart attack patients. “Our expert staff treat problems that extend from mild to the most critical of emergencies,” said Christopher M. Kozlowski, MD, MHA, vice president and medical director of Renown Institute for Heart & Vascular Health. “Specialized physicians including cardiologists, interventional radiologists, heart and vascular surgeons, emergency medicine and trauma surgeons, primary care providers, nurses and other clinicians work as a team to determine the best treatment plan for each patient. We encourage all patients to discuss with their care team whether they should undergo formal screening for early heart disease.” Por qué este reconocimiento es importante para usted: atención de la insuficiencia cardíaca De acuerdo con la AHA, más de 6.5 millones de adultos en los Estados Unidos experimentan insuficiencia cardíaca. Heart failure patients can lead full, enjoyable lives when their condition is managed with proper medications or devices and with healthy lifestyle changes. “Renown’s reputation as the region’s heart care leader has been built over many years. We performed the area’s first open-heart surgery, angioplasty, stent and valve replacements decades ago. Renown Regional offers incredible advancements like trans-catheter aortic valve replacement (TAVR) and trans-catheter mitral valve repair (TMVr) with MitraClip therapy, lifesaving alternatives to open-heart surgery for patients considered high-risk or inoperable,” said Erik Olson, chief executive officer of Renown Regional Medical Center. “Al ofrecer el más alto nivel de cuidado completo a los pacientes que sufren enfermedades cardíacas y vasculares, Renown desarrolló su primera división de cirugía cardiotorácica dedicada a los pacientes elegibles para cirugía cardíaca en 2019”. The Renown Institute for Heart & Vascular Health program now offers a Diagnostic Electrophysiology Lab; a Chest Pain Center using the D-SPECT® heart camera; multiple Interventional Labs; Heart Failure Program; several Cardiac Catheterization Labs; Interventional Cardiology and Cardiac Surgery when necessary; and the only Pritikin-certified Healthy Heart Program in the West, creating individualized rehabilitation plans tailored to each patient’s needs, so they can exercise safely, eat healthy, manage stress and cook nourishing, balanced meals, all while gaining a healthy mindset. Renown se encuentra entre los hospitales de mejor desempeño del país para el tratamiento de ataques cardíacos y es uno de los únicos 105 hospitales de todo el país en recibir el premio ACTION Registry Silver Performance Achievement Award del Colegio Estadounidense de Cardiología, que reconoce el éxito en la implementación de un estándar de atención más alto para pacientes con ataques cardíacos. Renown’s Roseview, Sierra and Cardiac Intensive Care Units (ICUs) are the only ICUs in Nevada to receive the Beacon Award of Excellence from the American Association of Critical Care Nurses. U.S. News and World Report’s Best Hospital rankings recently named Renown hospitals as best in the state of Nevada. Los pacientes que necesitan atención cardíaca avanzada pueden hablar con su proveedor de atención médica sobre la atención de especialidad del Renown Medical Group, con el que puede comunicarse llamando al 775-982-6270 o si visita renown.org/HeartCare.   About Renown Health Renown Health is the region’s largest, locally owned and governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. Con una fuerza laboral diversa de más de 7,000 empleados, Renown ha fomentado una cultura de excelencia, determinación e innovación de larga data. La organización se compone de un centro de urgencias, dos hospitales de cuidados agudos, un hospital infantil, un hospital de rehabilitación, un grupo médico y una red de atención de urgencias y Hometown Health, la compañía de seguros sin fines de lucro más grande de la región y de propiedad local, Hometown Health. Renown’s institute model addresses social determinants of health and includes: Child Health, Behavioral Health & Addiction, Healthy Aging and Health Innovation. Clinical institutes include: Cancer, Heart and Vascular Heath, Neurosciences and Robotic Surgery. Actualmente, Renown está inscribiendo participantes en el estudio genético de salud poblacional basado en la comunidad más grande del mundo, el Healthy Nevada Project®. Visite renown.org para obtener más información. About Mission: Lifeline The American Heart Association’s Mission: Lifeline program helps hospitals and emergency medical services develop systems of care that follow proven standards and procedures for STEMI patients. The program works by mobilizing teams across the continuum of care to implement American Heart Association/American College of Cardiology Foundation clinical treatment guidelines. For more information, visit heart.org. About Get With The Guidelines Get With The Guidelines® is the American Heart Association/American Stroke Association’s hospital-based quality improvement program that provides hospitals with the latest research-based guidelines. Desarrollado con el objetivo de salvar vidas y acelerar la recuperación, Get With The Guidelines ha influido en la vida de más de 9 millones de pacientes desde 2001. For more information, visit heart.org.

    Leer más About Renown Recognized for Quality Care for Heart Attack & Failure

    • Martes, 21 de diciembre de 2021

    Reflexión tras un año: miles de trabajadores de atención médica y ciudadanos del norte de Nevada se vacunaron contra la COVID-19, lo que da esperanzas para esta temporada de fiestas

    La mejor protección sigue siendo recibir una vacuna y un refuerzo contra la COVID-19, usar mascarilla, mantener una distancia mínima de 6 pies de las otras personas, evitar las multitudes y lavarse las manos con frecuencia. For the thousands of physicians and health care workers of Renown Health, this week is etched into the pandemic timeline as the start date of a nationwide wave that signaled the first vaccinations against COVID-19 and a beacon of hope for the future. A year ago, the nation’s health care systems in communities across the U.S. first began vaccinating physicians and health care workers caring for patients with COVID-19, and thousands received their first vaccine. One year ago, Renown Health, the Washoe County Health District (WCHD), the state and the Centers for Disease Control and Prevention (CDC) began to distribute the initially available, limited supplies of the COVID-19 vaccines in Washoe County. Media representatives viewed the first healthcare workers as they obtained their first dose of the life-saving vaccines. Luis Martinez, first health care worker vaccinated, now plans to attend medical school Luis Martinez, who served on the front-line of the pandemic at Renown Regional Medical Center, received the first of his Pfizer-BioNTech vaccine a year ago this week, after it received emergency use authorization from the Food and Drug Administration. Recibió la segunda y última vacuna de la serie 21 días después. Luis forma parte de Renown desde 2016. Aquí comenzó como flebotomista y lo alentaron a seguir una carrera profesional en el campo de la medicina. He works as a technician on Renown’s Clinical Decision Unit — a short stay unit within the hospital for people who need clinical care, but do not need admittance to the hospital. Luis worked with patients and clinicians in the Clinical Decision Unit for a year before requesting to work in Renown’s Alternate Care Site, built in the Mill Street parking structure as a place to care for patients recovering from COVID-19 before they returned home. Today, Luis is working to fulfill his dreams of becoming a doctor. A principios de este año realizó la Medical College Admission Test® (prueba de ingreso a la Facultad de Medicina), tuvo una entrevista virtual y se postuló para 24 facultades de medicina. Luis has shadowed physicians in a number of medical fields, including internal medicine, emergency medicine, cardiology and orthopedics, and would be thrilled to train in any one of those areas. As for medical school, Luis was excited to hear about Renown’s new clinical affiliation with the University of Nevada, Reno School of Medicine (UNR Med). He is enthusiastic about becoming part of the next generation of Nevada's health care professionals, and his first choice is UNR Med. He expects an admission decision by UNR Med this winter. If that doesn’t work out, he says, he has an interview with leaders at the Kirk Kerkorian School of Medicine at UNLV in January. Luis is bilingual and understands that Nevada continues to face a shortage of physicians and affordable medical care. He volunteers with CARE Chest of Sierra Nevada, a non-profit organization that provides free medical equipment, supplies, and prescription assistance to underserved populations when he is not working at Renown. His dream is to graduate medical school and stay in the community to provide medical care as a physician. Luis knows the importance of excellent medical care, and the importance of the vaccines against COVID-19. El pasado octubre, Luis cumplió 33 años y se contagió de COVID-19 después de una fiesta de cumpleaños familiar. Because of his experience, his interest in medicine and his research, Luis obtained his COVID-19 vaccines- and his booster, and is pleased that everyone in his family is triple vaccinated too. He says they are all feeling well and looking forward to being together at the holidays. “As we celebrate this holiday season, we give thanks for Luis and the thousands of health care heroes who have been fighting this pandemic with care and compassion; continuing to safely screen, diagnose, care for and vaccinate thousands of employees and community members,” said Tony Slonim, MD, DrPH, President & CEO of Renown Health. “It has been an honor to assist local and statewide health partners in the herculean vaccination effort. Durante el año pasado, el equipo de vacunas de Renown administró más de 58,000 vacunas de primera dosis y 2 de segunda dosis a los residentes de Nevada mayores de cinco años. We continue to work closely with our community health leaders and are always ready to assist. We are proud to be part of the solution for our community and pleased to have made a genuine difference in the health and well-being of others throughout this unprecedented time in our history.” Renown continues to use current local and national data, analytics, and public data sets for predictive modeling in service to our community. When there is heightened concern around an illness, enhanced infection prevention strategies are in place to ensure Renown is ready with the appropriate supplies and alternate plans should the need arise. La vacunación sigue siendo la mejor protección contra la cepa Ómicron y el coronavirus Hoy también marca un hito negativo para el condado de Washoe: más de 1,010 muertes por COVID-19 confirmadas y un total de más de 70,549 casos en una población de casi 500,000 personas. El punto positivo es que más de 65,714 personas se han recuperado en el condado de Washoe, aunque muchas aún lidian con los efectos a largo plazo de la enfermedad. El mundo y los EE. UU. continúan experimentando un aumento en los casos de COVID-19 y las hospitalizaciones por la altamente contagiosa variante Ómicron, que ahora representa el 50 por ciento de los casos de coronavirus en partes del país. In some areas, there is a significant stress on the hospital system, particularly where vaccination rates are low. “The most important action you can take to protect yourself from the Delta and Omicron strains and the COVID-19 virus is to get fully vaccinated,” says Susan Lee, DO, MBA, Chief Medical Officer, Acute Care. “El virus de la COVID 19 y sus diferentes cepas son prevenibles y controlables mediante vacunas seguras y eficaces contra la COVID-19, que son gratuitas y ahora están ampliamente disponibles en nuestra área. Los CDC recomiendan que todas las personas mayores de 5 años se vacunen contra la COVID-19. Data shows that nearly all COVID-19 deaths are now occurring among unvaccinated individuals.” A list of providers in our area offering vaccines is available at vaccines.gov.” “La mejor protección contra la COVID-19 ha sido la combinación de vacunarse contra la COVID-19, usar mascarilla, mantener una distancia de al menos 6 pies de otras personas, evitar las multitudes y lavarse las manos con frecuencia”, explica Amy McCombs, máster en enfermería, enfermera certificada, CCRN, CNML, vicepresidenta de Calidad de Servicios Agudos para Renown y gran contribuidora al esfuerzo de vacunación de Renown. “No one tool alone will stop this pandemic; it will take a combination of all of us using all of these efforts to fight the spread of this virus, especially through the holidays.” “Vaccinations have been a game-changer in terms of improving the health of our community,” said Rahul Mediwala, MD, Chief Medical Officer, Health Services. "Given the demands of this COVID-19 pandemic, we have been pleased to help in the fight by providing vaccinations. Our goal a year ago, was that all Renown physicians; employees and their family members; and all Hometown Health members and Renown patients interested in receiving the vaccine would have an opportunity to be vaccinated, we are excited to help make that dream a reality for all.” The COVID-19 vaccine is now mandatory for all Renown employees in an effort to protect those who are ill and physically vulnerable, and ensure a safe environment for patients and health care workers. Renown is covering all costs of the vaccine, and it is being offered free of charge to employees. Al día de hoy, el 97 % del total de 6,750 empleados de Renown Health están vacunados o tienen una exención o aplazamiento aprobado. “This year was a year no one will forget. For everyone- and for our health care workers at Renown, the year presented countless challenges and opportunities. Those of us who choose healthcare as our life’s work answer a true calling to serve others; this field requires a self-less commitment and a tireless dedication to caring for people when they are at their most vulnerable,” said Renown’s Chief of Staff, Sy Johnson, MBA. “I applaud the entire team- every physician, nurse and health care hero for their valor, their strength and perseverance in serving our patients and community during these unprecedented times.” What follows are highlights of some of the most remarkable moments and events that have taken place at Renown Health over the past year in relation to the response to COVID-19. Estructura médica desplegable temporal fuera del Departamento de Emergencias del Renown Regional El 12 de marzo de 2020, Renown instaló un centro médico desplegable para que sirviera como centro de evaluación y detección de enfermedades respiratorias para pacientes de la sala de emergencias en el Renown Regional Medical Center. A similar tent was also set up outside the Emergency Room at South Meadows Medical Center. An additional layer of protection, this proactive measure helped to care for people with symptoms of respiratory illness, and to protect patients and staff in the Emergency Department and other areas of the hospital. Las carpas se desarmaron el 20 de enero de 2021. (See photo here.) Alternate Care Site at Mill Street Parking Structure at Renown Regional As many communities across the nation experienced an increase in COVID-19 cases, including significant surges in hospitalized patients, Renown’s leadership had the foresight to create an Alternate Care Site (ACS) in the Renown Regional Medical Center Mill Street Parking structure. The ACS served additional hospitalized patients and allowed caregivers to remain on campus and still have access to existing hospital infrastructure such as lab, pharmacy, imaging, food services and other critical services. This solution also supported an efficient level of care escalation and other emergent interventions as needed. Después de solo 10 días de una complicada construcción, que incluyó pisos, infraestructura eléctrica, iluminación, agua, tecnología y paredes divisorias, el ACS estuvo listo el 3 de abril de 2020 con espacio para hasta 1,400 pacientes. El 12 de noviembre de 2020, Renown inauguró el ACS para atender a más pacientes hospitalizados con diagnóstico de COVID-19 que estaban clínicamente estables o en mejoría. Healthcare workers at Renown cared for hundreds of patients in this site. A principios de enero de 2021, los pacientes restantes regresaron a sus hogares. The Site has been decommissioned and leaders expect the area to be available for additional parking later this winter. (Alternate Care Site B-Roll.) Renown invests in Remote Patient Monitoring (RPM) ‘Hospital at Home’ Monitoring Systems Appropriate patients (including those recovering from COVID-19) are now offered a telehealth solution using wearable, continuous pulse oximetry, and the convenience of being in their own homes, with the confidence and security of knowing that Renown clinical staff are closely monitoring their health data through the Renown Transfer and Operations Center, and regularly communicating with them through their recovery process. El Renown Transfer and Operations Center ocupa 6,000 pies cuadrados y es uno de los centros más grandes de su tipo en el país, equipado con 28 paneles de alta definición en la pared frontal, dos en el centro de la sala y cuatro monitores colgados en la parte posterior. Large plasma screens display important metrics such as patient vital signs, bed availability, facility capacity, staffing, technology and more. Los enfermeros certificados y despachantes registrados monitorean continuamente la actividad durante todo el día, en el área de servicio de 100,000 millas cuadradas de Renown, con más de 100 ubicaciones e instalaciones asociadas para tomar las mejores decisiones para los pacientes, proveedores y equipos de atención. “LOVE” se abre paso en Renown El 16 de abril de 2020, durante un momento de oscuridad e incertidumbre, Artown le prestó a Renown la escultura “LOVE”, una estructura de aluminio soldado de una tonelada, diseñada por la artista Laura Kimpton y fabricada por Jeff Schomberg. La obra iluminó la entrada principal del Regional Medical Center en Mill St. La escultura se había inaugurado anteriormente en Burning Man en 2019 El 13 de julio de 2020, gracias al apoyo del expresidente de la junta y defensor de la comunidad Blake Smith y a la Keyser Foundation, “LOVE” sigue resplandeciendo cada noche en el púrpura característico de Renown, con un brillo radiante para el disfrute de los pacientes, empleados, visitantes y transeúntes. Throughout the pandemic, this sculpture has served as a source of inspiration, hope and positivity for our community. (LOVE sign B-Roll.) When Words Fail, Art Speaks Recognizing art’s powerful healing capabilities, Renown collaborated with prominent artist and fine art photographer, Anicia Beckwith, to immortalize the many battles fought against and amidst COVID-19 within the healthcare system’s walls. Beckwith captured portrait images of Renown caregivers, patients and their loved ones, showing raw and touching scenes from the COVID Intensive Care Unit, Emergency Departments, Neonatal Intensive Care Unit, Wilbur D. May Pediatric Intensive Care Unit and the Alternate Care Site field hospital. A group of Renown caregivers hold a COVID patient’s hand. Tears well up in their eyes as the patient takes his last breath. Care providers respond to a patient’s only request – a facial shave. The man beams at the sight of his freshly groomed face, and is visibly touched by the tender care he received to make it happen. Lupe, una trabajadora de servicios ambientales, pone especial cuidado en sus esfuerzos por limpiar y desinfectar las habitaciones de los pacientes, una destreza en la que se ha perfeccionado y que le ha dado orgullo durante los más de 25 años en los que ha trabajado en Renown. These are just a few of the captivating moments Beckwith illustrates through her art. Beckwith’s full photo gallery of images from Renown are located here; and downloadable visual assets are available here. Evolving in an Ever-Changing World: Long-Term Remote Work for Renown Employees The COVID-19 pandemic pushed healthcare leaders throughout the world to determine how best to provide care in this ever-changing environment. Leaders in Renown’s Human Resources department evaluated the thoughts and opinions of employees working remotely throughout Renown Health. Debido a los comentarios positivos de los empleados, que incluyen menos tiempo de viaje, menos distracciones, un mejor equilibrio entre el trabajo y la vida personal y una huella de carbono reducida, más de 700 empleados de Renown continuarán trabajando de manera remota. Renown ofrece pruebas de COVID internas El 2020 de junio, el equipo del laboratorio de Renown entró en acción para ayudar a satisfacer la creciente demanda de pruebas de COVID-19 de los residentes y negocios del condado de Washoe. Renown invirtió en ampliar la plantilla de personal y la capacidad de hacer pruebas de forma interna, lo que les permitió hacer hisopados y procesar hasta 1,000 pruebas de COVID para pacientes cada día y entregar los resultados en cuestión de horas. El director ejecutivo de Renown, el Dr. Tony Slonim, también colaboró con el grupo especial del alcalde dedicado a la COVID-19, con líderes comunitarios y religiosos locales desde el 2020 de octubre para abordar la equidad en la salud mediante pruebas gratuitas de COVID-19 para las comunidades de color. (Lab B-Roll). An Extraordinary Year of Service Renown’s leadership remains steadfast commitment to keeping our community safe. “We thank the community for standing by us and helping us all emerge as stronger people with hope for the future. We continue to fight the good fight,” said Dr. Slonim. “With COVID now imbedded into our daily lives, it’s remarkable to reflect on the progress we’ve made and the obstacles we’ve overcome. I will be forever grateful for the precautionary measures, innovation, and acts of service and love implemented by our dedicated team over the past two years. We hope by demonstrating our caring values and exhibiting hope and determination, we are inspiring others.” Stay Up-to-date on COVID-19 Renown Health is prepared to safely screen, diagnose and care for patients with respiratory illness, including COVID-19. Para mantenerse actualizado sobre las comunicaciones relacionadas con la distribución de la vacuna contra la COVID-19 por parte de Renown, las preguntas frecuentes y la evidencia científica detrás de la vacuna, visite https://covid.renown.org/  Únase al equipo de Renown Renown Health continúa comprometido con la contratación de personas para ocupar puestos clave en la organización para apoyar la salud y el bienestar de nuestra comunidad. Para unirse a la familia de Renown y luchar por la causa justa, postúlese en línea en https://careers.renown.org/ Apoye al equipo de Renown Renown Health, una organización benéfica sin fines de lucro está agradecida por el apoyo de la comunidad durante estos momentos sin precedentes. If you are interested in supporting Renown Health, a charitable, non-profit health organization, please consider giving to Renown Health Foundation. Donations are accepted through the following ways: Realice una donación a www.renown.org/give Llame a la Fundación de Renown Health al 775982-5545 Envíe un cheque por correo postal a Renown Health Foundation, 1155 Mill St., O2, Reno, NV 89502 Venmo: @RenownFoundation     About Renown Health Renown Health is the region’s largest, locally governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. Con una fuerza laboral diversa de más de 6,500 empleados, Renown ha fomentado una cultura de excelencia, determinación e innovación de larga data. La organización se compone de un centro de urgencias, dos hospitales de cuidados agudos, un hospital infantil, un hospital de rehabilitación, un grupo médico y una red de atención de urgencias y Hometown Health, la compañía de seguros sin fines de lucro más grande de la región y de propiedad local, Hometown Health. Actualmente, Renown está inscribiendo participantes en el estudio genético de salud poblacional basado en la comunidad más grande del mundo, el Healthy Nevada Project®. Visite renown.org para obtener más información.

    Leer más About Reflexión tras un año: miles de trabajadores de atención médica y ciudadanos del norte de Nevada se vacunaron contra la COVID-19, lo que da esperanzas para esta temporada de fiestas

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