{"id":3894,"date":"2026-10-02T06:33:50","date_gmt":"2026-10-02T06:33:50","guid":{"rendered":"https:\/\/abc-etiquetaje.com\/?p=3894"},"modified":"2026-10-02T07:28:53","modified_gmt":"2026-10-02T07:28:53","slug":"never-events-quirofano-identificacion-2","status":"publish","type":"post","link":"https:\/\/abc-etiquetaje.com\/en\/never-events-quirofano-identificacion-2\/","title":{"rendered":"Prevenci\u00f3n de \u00abNever Events\u00bb: El Papel de la Pulsera en el Checklist Quir\u00fargico"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"3894\" class=\"elementor elementor-3894\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0c6cbe2 e-flex e-con-boxed e-con e-parent\" data-id=\"0c6cbe2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-516231a elementor-widget elementor-widget-html\" data-id=\"516231a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<style>\n  .abc-surg-wrap { max-width: 820px; margin: 0 auto; font-family: inherit; color: #334155; line-height: 1.8; font-size: 17px; }\n  .abc-surg-tag { display: inline-block; background: #ccfbf1; color: #0f766e; padding: 6px 16px; border-radius: 4px; font-size: 13.5px; font-weight: 700; text-transform: uppercase; margin-bottom: 20px; border: 1px solid #99f6e4; letter-spacing: 0.5px; }\n  \n  \/* Alerta de Never Event *\/\n  .abc-surg-alert { border-left: 6px solid #115e59; background: #f0fdfa; padding: 25px 30px; margin: 30px 0; border-radius: 0 8px 8px 0; }\n  .abc-surg-alert h4 { color: #0f766e; margin-top: 0; font-size: 20px; margin-bottom: 10px; display: flex; align-items: center; gap: 8px; }\n  .abc-surg-alert p { margin: 0; font-size: 16px; color: #134e4a; }\n\n  \/* Cuadr\u00edcula de Errores Fatales (The 3 Wrongs) *\/\n  .abc-fatal-grid { display: grid; grid-template-columns: repeat(auto-fit, minmax(220px, 1fr)); gap: 20px; margin: 40px 0; }\n  .abc-fatal-card { background: #ffffff; border: 1px solid #e2e8f0; border-top: 5px solid #0f172a; padding: 25px; border-radius: 8px; box-shadow: 0 4px 10px rgba(0,0,0,0.02); }\n  .abc-fatal-card h4 { margin-top: 0; color: #b91c1c; font-size: 19px; margin-bottom: 10px; }\n  .abc-fatal-card p { margin: 0; font-size: 14.5px; color: #475569; }\n\n  \/* Caja T\u00e9cnica Quir\u00f3fano *\/\n  .abc-or-box { background: #ffffff; border: 2px solid #99f6e4; border-radius: 12px; padding: 40px; margin: 45px 0; box-shadow: 0 10px 25px rgba(15, 118, 110, 0.05); }\n  .abc-or-box h3 { color: #0f766e; font-size: 24px; margin-top: 0; margin-bottom: 15px; }\n\n  \/* Banner Final Cirug\u00eda *\/\n  .abc-surg-banner { background: linear-gradient(135deg, #0f172a 0%, #134e4a 100%); border-radius: 12px; padding: 50px 40px; text-align: center; color: #ffffff; margin-top: 60px; border-bottom: 5px solid #0f766e; box-shadow: 0 20px 40px rgba(15, 23, 42, 0.2); }\n  .abc-surg-banner h3 { font-size: 28px; font-weight: 800; margin-top: 0; margin-bottom: 15px; color: #ffffff; letter-spacing: -0.5px; }\n<\/style>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-4100a06 e-flex e-con-boxed e-con e-parent\" data-id=\"4100a06\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3f4efc8 elementor-widget elementor-widget-html\" data-id=\"3f4efc8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/abc-etiquetaje.com\/never-events-quirofano-identificacion\/#webpage\",\n      \"url\": \"https:\/\/abc-etiquetaje.com\/never-events-quirofano-identificacion\/\",\n      \"name\": \"Never events quirofano identificacion: Gu\u00eda cl\u00ednica\",\n      \"description\": \"An\u00e1lisis del papel de las pulseras de identificaci\u00f3n en el checklist quir\u00fargico de la OMS para evitar cirug\u00edas en el sitio o paciente equivocado.\",\n      \"aspect\": \"Surgery, Patient Safety, Anesthesiology\"\n    },\n    {\n      \"@type\": \"Article\",\n      \"@id\": \"https:\/\/abc-etiquetaje.com\/never-events-quirofano-identificacion\/#article\",\n      \"headline\": \"Prevenci\u00f3n de Never Events: El Papel de la Pulsera en el Checklist Quir\u00fargico\",\n      \"inLanguage\": \"es-ES\",\n      \"articleSection\": \"Sectores y Especialidades\",\n      \"keywords\": \"never events quirofano identificacion, checklist quirurgico oms\"\n    },\n    {\n      \"@type\": \"FAQPage\",\n      \"@id\": \"https:\/\/abc-etiquetaje.com\/never-events-quirofano-identificacion\/#faq\",\n      \"mainEntity\": [\n        {\n          \"@type\": \"Question\",\n          \"name\": \"\u00bfC\u00f3mo prevenir los never events quirofano identificacion?\",\n          \"acceptedAnswer\": {\n            \"@type\": \"Answer\",\n            \"text\": \"Se previenen realizando una pausa de seguridad (Time-Out) antes de la incisi\u00f3n, donde todo el equipo verifica verbal y electr\u00f3nicamente la pulsera del paciente anestesiado.\"\n          }\n        }\n      ]\n    }\n  ]\n}\n<\/script>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-8d3a8fc e-flex e-con-boxed e-con e-parent\" data-id=\"8d3a8fc\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c9c8bec elementor-widget elementor-widget-text-editor\" data-id=\"c9c8bec\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"abc-surg-wrap\">\n  <div class=\"abc-surg-tag\">Cirug\u00eda y Anestesiolog\u00eda<\/div>\n\n  <h1 style=\"color:#0f172a; font-size:38px; font-weight:800; line-height:1.2; margin-bottom:24px; letter-spacing:-0.5px;\">Prevenci\u00f3n de \u00abNever Events\u00bb: El Papel de la Pulsera en el Checklist Quir\u00fargico<\/h1>\n\n  <p>La prevenci\u00f3n de los <strong>never events quirofano identificacion<\/strong> es el pilar central de la gesti\u00f3n de riesgos hospitalarios. En primer lugar, un \u00abNever Event\u00bb (evento que nunca deber\u00eda ocurrir) incluye negligencias tan graves como operar al paciente equivocado o amputar el miembro incorrecto. Por consiguiente, las indemnizaciones derivadas de estos errores pueden quebrar la reputaci\u00f3n de cualquier centro m\u00e9dico.<\/p>\n\n  <p>Adem\u00e1s, cuando un paciente ingresa en el bloque quir\u00fargico, sufre los efectos de la pre-anestesia o sedaci\u00f3n profunda. Por tanto, pierde su capacidad de confirmar su propia identidad. A continuaci\u00f3n, analizamos c\u00f3mo el escaneo del brazalete sostiene todo el andamiaje de la seguridad en cirug\u00eda.<\/p>\n\n  <div class=\"abc-surg-alert\">\n    <h4>\ud83e\ude7a El \u00abTime-Out\u00bb Quir\u00fargico<\/h4>\n    <p>\n      La Organizaci\u00f3n Mundial de la Salud (OMS) exige una \u00abpausa quir\u00fargica\u00bb antes de la incisi\u00f3n cut\u00e1nea. En este momento cr\u00edtico, la pulsera del paciente act\u00faa como el \u00fanico testigo objetivo de su identidad ante todo el equipo m\u00e9dico.\n    <\/p>\n  <\/div>\n<\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dfb7700 elementor-widget elementor-widget-image\" data-id=\"dfb7700\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/abc-etiquetaje.com\/wp-content\/uploads\/elementor\/thumbs\/ABC-logotipo-1200x675-1-ru8igo9tk03ev2sspvulrfx478flm132odokk1b6fy.webp\" title=\"ABC logotipo 1200\u00d7675\" alt=\"ABC Etiquetaje fabricante de pulseras para hospitales y centros medicos\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ec0abbc elementor-widget elementor-widget-text-editor\" data-id=\"ec0abbc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"abc-surg-wrap\">\n  <h2 style=\"color:#0f172a; font-size:28px; font-weight:700;\">La \u00abTriada del Error\u00bb en Cirug\u00eda<\/h2>\n  <p>El Joint Commission Center for Transforming Healthcare identifica tres fallos catastr\u00f3ficos que se desencadenan sistem\u00e1ticamente por una mala pol\u00edtica de identificaci\u00f3n en el preoperatorio.<\/p>\n\n  <div class=\"abc-fatal-grid\">\n    <div class=\"abc-fatal-card\">\n      <h4>\u274c Paciente Equivocado<\/h4>\n      <p>Ocurre cuando se traslada a la camilla de quir\u00f3fano a un paciente con un nombre similar al programado, omitiendo la lectura del n\u00famero de historia cl\u00ednica (NHC) impreso en la pulsera.<\/p>\n    <\/div>\n    \n    <div class=\"abc-fatal-card\">\n      <h4>\u274c Procedimiento Equivocado<\/h4>\n      <p>Asociado a fallos en el consentimiento informado. Si la pulsera es ilegible, el cirujano no puede cruzar los datos f\u00edsicos del paciente con el documento legal firmado en planta.<\/p>\n    <\/div>\n    \n    <div class=\"abc-fatal-card\">\n      <h4>\u274c Lado Equivocado<\/h4>\n      <p>Cirug\u00edas en \u00f3rganos pares (ojos, ri\u00f1ones, rodillas). El marcaje quir\u00fargico con rotulador en la piel debe coincidir milim\u00e9tricamente con el diagn\u00f3stico vinculado al c\u00f3digo de barras del brazalete.<\/p>\n    <\/div>\n  <\/div>\n\n  <p>En efecto, si el brazalete llega borrado al quir\u00f3fano a causa de los antis\u00e9pticos aplicados en planta, el equipo se enfrenta a una decisi\u00f3n cr\u00edtica: retrasar la cirug\u00eda o asumir un riesgo ciego.<\/p>\n<\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-09b1949 elementor-widget elementor-widget-text-editor\" data-id=\"09b1949\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"abc-surg-wrap\">\n  <p>Por otro lado, el bloque quir\u00fargico es un entorno extremadamente hostil para los pl\u00e1sticos comunes. Durante la intervenci\u00f3n, la mu\u00f1eca del paciente puede quedar expuesta a soluciones de povidona yodada, clorhexidina, sangre y fluidos corporales.<\/p>\n\n  <p>Asimismo, los procesos de esterilizaci\u00f3n perif\u00e9rica y el uso de mantas t\u00e9rmicas convectivas someten al brazalete a temperaturas extremas. Finalmente, la direcci\u00f3n m\u00e9dica debe licitar consumibles que soporten este rigor cl\u00ednico sin degradarse.<\/p>\n\n  <div class=\"abc-or-box\">\n    <div style=\"display: flex; flex-wrap: wrap; align-items: center; gap: 30px;\">\n      <div style=\"flex: 1; min-width: 250px;\">\n        <h3>Soportes Inertes para Zonas Est\u00e9riles<\/h3>\n        <p style=\"font-size:15.5px; color:#475569; margin-bottom:20px; line-height:1.7;\">\n          Nuestros brazaletes de impresi\u00f3n t\u00e9rmica directa cuentan con recubrimiento sint\u00e9tico antimicrobiano. Repelen el 100% de los fluidos biol\u00f3gicos y quir\u00fargicos, asegurando que el c\u00f3digo DataMatrix permanezca intacto para la fase de reanimaci\u00f3n postoperatoria (URPA).\n        <\/p>\n        <a href=\"https:\/\/abc-etiquetaje.com\/pulseras-identificacion-adulto-25\/\" style=\"background-color:#0f766e; color:#ffffff; padding:12px 26px; border-radius:6px; font-weight:700; text-decoration:none; font-size:15px; display:inline-block; transition: background-color 0.2s;\">\n          Ver Ficha T\u00e9cnica para Quir\u00f3fanos &rarr;\n        <\/a>\n      <\/div>\n    <\/div>\n  <\/div>\n<\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3b2509d elementor-widget elementor-widget-image\" data-id=\"3b2509d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/abc-etiquetaje.com\/wp-content\/uploads\/elementor\/thumbs\/ABC-logotipo-1200x675-1-ru8igo9tk03ev2sspvulrfx478flm132odokk1b6fy.webp\" title=\"ABC logotipo 1200\u00d7675\" alt=\"ABC Etiquetaje fabricante de pulseras para hospitales y centros medicos\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f0433e9 elementor-widget elementor-widget-text-editor\" data-id=\"f0433e9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"abc-surg-wrap\">\n  \n  <!-- BLOQUE DE INTERLINKING B2B Y SEGURIDAD -->\n  <div style=\"margin: 40px 0; border-top: 1px solid #e2e8f0; padding-top: 25px;\">\n    <h3 style=\"color: #0f172a; font-size: 20px; margin-top: 0; margin-bottom: 15px;\">\ud83d\udee1\ufe0f Ampl\u00ede su Estrategia de Seguridad<\/h3>\n    <ul style=\"margin: 0; padding-left: 20px; font-size: 15.5px; line-height: 1.8; color:#475569;\">\n      <li><a href=\"https:\/\/abc-etiquetaje.com\/joint-commission-identificacion-pacientes\/\" style=\"color: #0f766e; font-weight: 600; text-decoration: none;\">Acreditaci\u00f3n JCI en Cirug\u00eda<\/a> \u2014 Normativa internacional sobre el objetivo de seguridad quir\u00fargica.<\/li>\n      <li><a href=\"https:\/\/abc-etiquetaje.com\/pulseras-hospital-gel-hidroalcoholico-se-borran\/\" style=\"color: #0f766e; font-weight: 600; text-decoration: none;\">Resistencia Qu\u00edmica (Top-Coat)<\/a> \u2014 Por qu\u00e9 la clorhexidina de quir\u00f3fano borra las pulseras baratas.<\/li>\n      <li><a href=\"https:\/\/abc-etiquetaje.com\/identificacion-activa-y-pasiva-del-paciente\/\" style=\"color: #0f766e; font-weight: 600; text-decoration: none;\">Pacientes Sedados<\/a> \u2014 El paso cr\u00edtico de la identificaci\u00f3n verbal a la identificaci\u00f3n pasiva (electr\u00f3nica).<\/li>\n    <\/ul>\n  <\/div>\n\n  <h2 style=\"color:#0f172a; font-size:28px; font-weight:700; margin-top:45px;\">Preguntas Frecuentes en el \u00c1rea Quir\u00fargica<\/h2>\n\n  <div style=\"border-bottom: 1px solid #e2e8f0; padding-bottom: 15px; margin-bottom: 20px;\">\n    <h3 style=\"font-size: 19px; color: #0f172a; margin: 0 0 8px 0;\">\u00bfC\u00f3mo prevenir los never events quirofano identificacion?<\/h3>\n    <p style=\"margin: 0; font-size: 15.5px; color: #475569;\">Se previenen institucionalizando la pausa de seguridad (Time-Out). El cirujano, anestesista y enfermero circulante deben detenerse y verificar el c\u00f3digo de la pulsera mediante lectura PDA antes de realizar cualquier incisi\u00f3n.<\/p>\n  <\/div>\n  <div style=\"border-bottom: 1px solid #e2e8f0; padding-bottom: 15px; margin-bottom: 20px;\">\n    <h3 style=\"font-size: 19px; color: #0f172a; margin: 0 0 8px 0;\">\u00bfQu\u00e9 hacer si el paciente llega a preanestesia sin pulsera?<\/h3>\n    <p style=\"margin: 0; font-size: 15.5px; color: #475569;\">Por protocolo de seguridad estricto, la intervenci\u00f3n debe paralizarse. Se debe contactar con la planta de origen para que emitan una nueva pulsera, verifiquen la identidad de forma activa y trasladen el soporte f\u00edsico al bloque quir\u00fargico.<\/p>\n  <\/div>\n\n  <!-- BANNER FINAL CIRUG\u00cdA -->\n  <div class=\"abc-surg-banner\">\n    <h3>Blinde Jur\u00eddicamente su Bloque Quir\u00fargico<\/h3>\n    <p style=\"font-size:16.5px; line-height:1.6; color:#ccfbf1; max-width: 650px; margin: 0 auto 30px;\">\n      Un solo Never Event cuesta millones en indemnizaciones y destruye la confianza del paciente. Equipe sus quir\u00f3fanos con tecnolog\u00eda de identificaci\u00f3n infalible frente a fluidos quir\u00fargicos.\n    <\/p>\n    <a href=\"https:\/\/abc-etiquetaje.com\/contacta\/\" style=\"background-color:#ffffff; color:#0f172a; padding:16px 40px; border-radius:6px; font-weight:800; text-decoration:none; display:inline-block; font-size:16px; transition: transform 0.2s;\">\n      Solicitar Auditor\u00eda de Seguridad Quir\u00fargica\n    <\/a>\n  <\/div>\n<\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Cirug\u00eda y Anestesiolog\u00eda Prevenci\u00f3n de \u00abNever Events\u00bb: El Papel de la Pulsera en el Checklist Quir\u00fargico La prevenci\u00f3n de los [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":3815,"comment_status":"open","ping_status":"open","sticky":false,"template":"elementor_header_footer","format":"standard","meta":{"_templately_pack_id":"","_templately_imported_at":"","_templately_source":"","_templately_import_session_id":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[18],"tags":[],"class_list":["post-3894","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sectores-especialidades"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Never events quirofano identificacion: Gu\u00eda cl\u00ednica<\/title>\n<meta name=\"description\" content=\"Descubra c\u00f3mo prevenir los never events quirofano identificacion. 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