RESUMEN
OBJECTIVES: to construct and validate the content of a checklist for the management of totally implanted catheters in hospitalized children and adolescents. METHODS: methodological research conducted from October 2021 to December 2022 in two stages: development of the instrument with care guidelines and content validation of the checklist. The instrument, containing 23 items presented in Likert format, was evaluated online by specialists in two rounds. The Content Validity Index was applied, considering indices above 0.8 as valid. RESULTS: the final checklist included four domains and 22 checklist items, validated with a Content Validity Index of 0.98. The overall evaluation of the instrument presented a global score of 9.9. CONCLUSIONS: the validation and application of instruments that standardize procedures, in addition to supporting professionals, promote autonomy and quality of care for children and adolescents using this device.
Asunto(s)
Catéteres de Permanencia , Lista de Verificación , Humanos , Lista de Verificación/métodos , Lista de Verificación/normas , Lista de Verificación/instrumentación , Niño , Adolescente , Catéteres de Permanencia/normas , Catéteres de Permanencia/estadística & datos numéricos , Reproducibilidad de los Resultados , Masculino , Femenino , Encuestas y Cuestionarios , PreescolarRESUMEN
OBJECTIVE: To summarize the measurement properties (reliability, validity, and responsiveness) and the clinical utility of measurement tools used in telerehabilitation in individuals with neurological conditions. DESIGN: Systematic review. SUBJECTS: Individuals with neurological conditions. INTERVENTION: Not applicable. MAIN MEASURES: The methodological quality of the studies using the COSMIN Risk of Bias Checklist, the quality of the measurement properties using the criteria for good measurement properties, and the clinical utility of the measurements using the Tyson & Connell scale. RESULTS: From the 22,188 identified studies, 47 were included. Forty-three measurement tools were identified. The main modes of administration were telephone and videoconference. Studies involved mostly individuals with stroke, multiple sclerosis, and Alzheimer's disease. Criterion validity and reliability were the most investigated measurement properties. None of the tools had their responsiveness investigated. Twenty-two measurement tools have at least one measurement property evaluated as "sufficient" in a study with appropriate methodological quality ("very good" or "adequate"). Nineteen measurement tools showed adequate clinical utility. Eight measurement tools, investigated in individuals with stroke, spinal cord injury or Alzheimer's disease, all administered by telephone, were recommended. CONCLUSION: The present results can be used to assist in choosing appropriate measurement tools, both in research and clinical practice, during telerehabilitation in individuals with neurological conditions. Measurement error, content validity, structural validity, and responsiveness need to be further investigated. In addition, the measurement properties of tools used in telerehabilitation in other neurological conditions, such as Huntington's disease, should also be investigated. REGISTRATION NUMBER: CRD42021257662.
Asunto(s)
Enfermedad de Alzheimer , Enfermedades del Sistema Nervioso , Accidente Cerebrovascular , Telerrehabilitación , Humanos , Lista de Verificación/métodos , Reproducibilidad de los Resultados , Enfermedades del Sistema Nervioso/diagnóstico , Evaluación de Resultado en la Atención de Salud , PsicometríaRESUMEN
BACKGROUND: The use of checklists in the pediatric intensive care unit can help improve the quality of care and patient safety. OBJECTIVES: To build and validate a checklist for use in interprofessional rounds in a pediatric intensive care unit. METHODS: This methodological study was conducted in a 20-bed pediatric intensive care unit serving children up to 14 years old. A checklist prototype was constructed through review of the literature and achievement of consensus among the professionals providing care in the unit. Content validation was performed using a modified Delphi technique involving specialists with more than 5 years of experience in pediatric intensive care, methodological studies, and patient safety. Content validity ratios were calculated for the elements of the checklist, which were considered valid when they reached values greater than 0.78. The checklist was tested for usability, application time, and effects on patient care, and feedback was obtained from potential users. RESULTS: Before content validation, the checklist contained 11 domains, 32 items, and 6 daily goals. The invitation to validate content was sent to 86 specialists, and content validity was achieved after 2 rounds of evaluation, with the checklist elements having content validity ratios ranging from 0.94 to 0.97. The mean application time of the checklist was 5 minutes. The final version consisted of 11 domains, 33 items, and 8 daily goals. CONCLUSIONS: This study resulted in a useful and valid instrument for application in interprofessional rounds that was tailored to the needs of local health care professionals.
Asunto(s)
Lista de Verificación , Rondas de Enseñanza , Lista de Verificación/métodos , Niño , Cuidados Críticos/métodos , Humanos , Unidades de Cuidado Intensivo Pediátrico , Seguridad del PacienteRESUMEN
OBJECTIVE: To develop a comprehensive competency assessment tool for pediatric bag-mask ventilation (pBMV) and demonstrate multidimensional validity evidence for this tool. STUDY DESIGN: A novel pBMV assessment tool was developed consisting of 3 components: a 22-item-based checklist (trichotomized response), global rating scale (GRS, 5-point), and entrustment assessment (4-point). Participants' performance in a realistic simulation scenario was video-recorded and assessed by blinded raters. Multidimensional validity evidence for procedural assessment, including evidence for content, response-process, internal structure, and relation to other variables, was assessed. The scores of each scale were compared with training level. Item-based checklist scores also were correlated with GRS and entrustment scores. RESULTS: Fifty-eight participants (9 medical students, 10 pediatric residents, 18 critical care/neonatology fellows, 21 critical care/neonatology attendings) were evaluated. The pBMV tool was supported by high internal consistency (Cronbach α = 0.867). Inter-rater reliability for the item-based checklist component was acceptable (r = 0.65, P < .0001). The item-based checklist scores differentiated between medical students and other providers (P < .0001), but not by other trainee level. GRS and entrustment scores significantly differentiated between training levels (P < .001). Correlation between skill item-based checklist and GRS was r = 0.489 (P = .0001) and between item-based checklist and entrustment score was r = 0.52 (P < .001). This moderate correlation suggested each component measures pBMV skills differently. The GRS and entrustment scores demonstrated moderate inter-rater reliability (0.42 and 0.46). CONCLUSIONS: We established evidence of multidimensional validity for a novel entrustment-based pBMV competence assessment tool, incorporating global and entrustment-based assessments. This comprehensive tool can provide learner feedback and aid in entrustment decisions as learners progress through training.
Asunto(s)
Internado y Residencia , Estudiantes de Medicina , Lista de Verificación/métodos , Niño , Competencia Clínica , Cuidados Críticos , Evaluación Educacional , Humanos , Reproducibilidad de los ResultadosRESUMEN
Roraima is a Brazilian state located in the northern portion of the Amazon basin, with few studies regarding its biodiversity. The Ecological Station of Maracá (Brazil, state of Roraima) harbors the third largest Brazilian pluvial island and is composed of a transitional landscape of savanna and Amazon rainforest components. Despite its ecological importance and strategic localization, few studies covered the dipterofauna of this locality. An updated checklist addressing 41 families of true flies (Diptera) occurring in Roraima is presented based on the literature and the specimens collected during a field expedition that occurred in 2015. This checklist brings several improvements such as new records of 165 taxa to the state of Roraima, 29 taxa to Brazil, and 259 morphotypes, mostly likely representing undescribed species.(AU)
Asunto(s)
Animales , Biodiversidad , Dípteros , Lista de Verificación/métodosRESUMEN
The Amazon rainforest is the largest tropical rainforest in the world, with high biodiversity of organisms. Despite the increasing knowledge about fungal diversity in the last few years, many fungal taxa, including gasteroid clades, are still poorly known. Gasteroid fungi are recognized by the maturation of basidiospores inside the basidiomata and by the passive release of spores. We conducted a detailed survey of published data on the species that occur in Amazon forests. We confirmed the occurrence of 83 species distributed in 22 genera, eight families and four orders. The most representative genera was Geastrum, followed by Cyathus, Lycoperdon and Phallus. We present an identification key for Amazonian gasteroid genera and a map of record distribution. This review is expected to contribute to identify distribution gaps for further research on gasteroid fungi and to subsidize policies for the conservation of fungi in the Amazon region.(AU)
A floresta amazônica é a maior floresta tropical do mundo, com alta biodiversidade de organismos. Apesar do crescente aumento sobre o conhecimento da diversidade fúngica nos últimos anos, muitos táxons de fungos, especialmente clados gasteróides, ainda são pouco conhecidos. Os fungos gasteróides são reconhecidos pela maturação dos basidiósporos no interior do basidioma e pela liberação passiva de esporos. Baseado em dados publicados, realizamos um levantamento detalhado das espécies que ocorrem na floresta amazônica. Nós confirmamos a ocorrência de 83 espécies distribuídas em 22 gêneros, 8 famílias e 4 ordens. Os gêneros mais representativos foram Geastrum, seguido por Cyathus, Lycoperdon e Phallus. Apresentamos uma chave de identificação para gêneros de gasteróides amazônicos e um mapa de distribuição de registros. Espera-se que esta revisão contribua para identificar lacunas de distribuição para futuras pesquisas sobre fungos gasteroides e para subsidiar políticas de conservação de fungos na região amazônica.(AU)
Asunto(s)
Especificidad de la Especie , Basidiomycota/clasificación , Lista de Verificación/métodos , Brasil , Ecosistema Amazónico/análisis , Biodiversidad , Bosque LluviosoRESUMEN
Coastal islands of Grande Rio, located south Rio de Janeiro and Maricá cities have been under multiple anthropogenic impacts. Despite these problems, these insular systems shelter a high diversity of fish species. Reef fishes are essential components of tropical marine coastal communities, also providing food and income for millions of people around the world. In this work, we generated an updated checklist from Cagarras Islands Natural Monument and surrounding areas based on fisheries data, literature records and multiple sampling techniques, including the Submersible Rotating Video technique, used for the first time in Brazil. We present an inventory of 282 fish species representing 91 different families, with 21 new records for the study area, including a non-native species (Heniochus acuminatus). In addition, our results show a moderate endemism level for the Brazilian province (approximately 6.0%), while 10.5% of species are assigned to one of IUCN's threatened categories. Our efforts show the fish biodiversity scenario and their distribution on coastal islands more than 10 years after the Cagarras Islands Natural Monument establishment, reinforcing the importance of monitoring research programs for the management of this Marine Protected Area and surrounding waters, that play a key role for artisanal fisheries.
As ilhas costeiras do Grande Rio, ao sul das cidades do Rio de Janeiro e Maricá, têm sofrido múltiplos impactos antrópicos. Apesar destes problemas, esses sistemas insulares abrigam uma grande diversidade de espécies de peixes. Os peixes recifais são componentes essenciais das comunidades costeiras marinhas tropicais, fornecendo alimento e fonte de renda para milhões de pessoas em todo o mundo. Neste trabalho, geramos uma lista de verificação atualizada do Monumento Natural das Ilhas Cagarras e áreas do entorno com base em dados de pesca, registros da literatura e múltiplas técnicas de amostragem, incluindo a técnica de vídeo rotacional subaquático usada pela primeira vez no Brasil. Apresentamos um inventário de 282 espécies de peixes representando 91 famílias, com 21 novos registros para área de estudo, incluindo uma espécie não nativa (Heniochus acuminatus). Além disso, nossos resultados mostram um nível de endemismo moderado da província brasileira (aproximadamente 6,0%), sendo 10,5% das espécies classificadas em uma das categorias ameaçadas da IUCN. Nossos esforços mostram o cenário da biodiversidade de peixes e sua distribuição nas ilhas costeiras mais de 10 anos após o estabelecimento do Monumento Natural das Ilhas Cagarras, reforçando a importância de programas de pesquisa de monitoramento para a gestão desta Área Marinha Protegida e suas águas adjacentes, que desempenham papel fundamental para a pesca artesanal.
Asunto(s)
Animales , Biodiversidad , Peces/clasificación , Océano Atlántico , Lista de Verificación/métodosRESUMEN
INTRODUCTION: Objective: to describe an evaluation of interobserver agreement in the use of a checklist related to the use of nasoenteral tube (NSS) as a presupposition for quality in obtaining data. Method: a methodological study conducted in 2018 in a Brazilian hospital, preceding the data collection of an open-label clinical trial. Independent observers, blinded to the evaluation of their peers, evaluated patients with NSS through a 25-item checklist. The data collected by eight previously trained research assistants (RA) were compared to those obtained by an experienced nurse (reference standard). Agreement was measured using the kappa coefficient and PABAK. Results: a total of 451 observations were made in pairs. Considering the total items on the checklist there was almost perfect agreement (k > 0.80) in all observation pairs (nurse vs. each RA): RA 1 (k = 0.91; 95 % CI = 0.89-0.93); RA 2 (k = 0.83; 95 % CI = 0.80-0.85); RA 3 (k = 0.92; 95 % CI = 0.90-0.94); RA 4 (k = 0.83; 95 % CI = 0.80-0.86); RA 5 (k = 0.94; 95 % CI = 0.92-0.96); RA 6 (k = 0.94; 95 % CI = 0.92-0.96); RA 7 (k = 0.96; 95 % CI = 0.95-0.98); RA 8 (k = 0.73; 95 % CI = 0.70-0.77). However, for isolated items, and in specific RAs, there were fair agreements, unacceptable to effectively collect data from a clinical trial. Retraining and supervision of RAs were able to improve agreement between observers. Conclusion: an evaluation of interobserver agreement proved to be fundamental to ensure the reliability of data collection and, therefore, to avoid measurement biases.
INTRODUCCIÓN: Objetivo: describir una evaluación de la concordancia entre observadores en el uso de una lista de verificación en la atención a pacientes con sonda nasoenteral (SNE) como premisa de la recogida de datos. Método: este estudio de fiabilidad se realizó en 2018 en un hospital brasileño, antes de la recogida de datos para un ensayo clínico abierto. Ocho observadores independientes, previamente capacitados y "cegados" con respecto a las evaluaciones de los demás, evaluaron a pacientes con SNE por medio de una lista de comprobación de 25 elementos. Los datos obtenidos por estos asistentes de investigación (AI) se compararon con los obtenidos por una enfermera experimentada. Se midió la concordancia mediante los coeficientes kappa y PABAK. Resultados: se realizaron 451 observaciones por pares. Considerando la totalidad de los elementos, hubo una concordancia casi perfecta (k > 0,80) en todos los pares de observación (enfermera vs. cada AI): AI 1 (k = 0,91; IC95 % = 0,89-0,93); AI 2 (k = 0,83; IC95 % = 0,80-0,85); AI 3 (k = 0,92; IC95 %= 0,90-0,94 ); AI 4 (k = 0,83; IC95 % = 0,80-0,86); AI 5 (k = 0,94; IC95 % = 0,92-0,96); AI 6 (k = 0,94; IC95 % = 0,92-0,96); AI 7 (k = 0,96; IC95 % = 0,95-0,98); AI 8 (k = 0,73; IC95 % = 0,70-0,77). Se identificó un menor número de concordancia en los elementos individuales y en determinados AI. La recapacitación y supervisión de los AI mejoró su desempeño y la concordancia entre observadores. Conclusión: la evaluación de la concordancia entre observadores resultó fundamental para asegurar la fiabilidad de la recogida de datos y, por consiguiente, evitar sesgos de medición en los estudios clínicos de enfermería.
Asunto(s)
Lista de Verificación/normas , Nutrición Enteral/instrumentación , Personal de Salud/psicología , Variaciones Dependientes del Observador , Seguridad del Paciente/normas , Brasil , Lista de Verificación/métodos , Lista de Verificación/estadística & datos numéricos , Competencia Clínica/normas , Competencia Clínica/estadística & datos numéricos , Nutrición Enteral/efectos adversos , Nutrición Enteral/métodos , Personal de Salud/estadística & datos numéricos , Humanos , Seguridad del Paciente/estadística & datos numéricos , Reproducibilidad de los ResultadosRESUMEN
OBJECTIVE: To build and validate a checklist for disinfecting ambulances transporting patients with Covid-19. METHOD: Methodological study composed by the construction of a checklist and validation by 42 professionals, of which 35 professionals had expertise in patient transport/transfer and seven in hospital infection control. The item with a minimum agreement of 80% was considered valid, based on the Content Validation Index and binomial test. RESULTS: The checklist had the steps performed for terminal disinfection of ambulances. It had 54 items, which included the personal protective equipment and used materials, disinfection of the driver's cabin, equipment, and the patient care cabin. The minimum agreement obtained was 85% and the mean of the Content Validation Index was 0.96. CONCLUSION: The checklist was considered valid in terms of content and can be used to disinfect ambulances transporting patients with Covid-19.
Asunto(s)
Ambulancias , COVID-19/prevención & control , Lista de Verificación/métodos , Desinfección/métodos , SARS-CoV-2 , Transporte de Pacientes , Humanos , Equipo de Protección PersonalRESUMEN
Most children with autism spectrum disorder (ASD), in resource-limited settings (RLS), are diagnosed after the age of four. Our work confirmed and extended results of Pierce that eye tracking could discriminate between typically developing (TD) children and those with ASD. We demonstrated the initial 15 s was at least as discriminating as the entire video. We evaluated the GP-MCHAT-R, which combines the first 15 s of manually-coded gaze preference (GP) video with M-CHAT-R results on 73 TD children and 28 children with ASD, 36-99 months of age. The GP-MCHAT-R (AUC = 0.89 (95%CI: 0.82-0.95)), performed significantly better than the MCHAT-R (AUC = 0.78 (95%CI: 0.71-0.85)) and gaze preference (AUC = 0.76 (95%CI: 0.64-0.88)) alone. This tool may enable early screening for ASD in RLS.
Asunto(s)
Trastorno del Espectro Autista/diagnóstico , Lista de Verificación/métodos , Tecnología de Seguimiento Ocular , Fijación Ocular/fisiología , Recursos en Salud , Tamizaje Masivo/métodos , Trastorno del Espectro Autista/epidemiología , Trastorno del Espectro Autista/fisiopatología , Lista de Verificación/normas , Niño , Preescolar , Tecnología de Seguimiento Ocular/normas , Femenino , Recursos en Salud/normas , Humanos , Masculino , Tamizaje Masivo/normas , Perú/epidemiologíaRESUMEN
RESUMO Objetivo verificar as causas da não conferência do carro de emergência e o efeito sobre a taxa de adesão, por meio do emprego de ferramentas da qualidade em uma Unidade de Terapia Intensiva Neonatal. Método pesquisa mista do desenho exploratório sequencial, desenvolvida com enfermeiros e fonte documental na Unidade de Terapia Intensiva Neonatal de hospital universitário, em três etapas: 1) Brainstorming para levantamento das causas de não conferência/construção de Lista de Verificação; 2) Coleta/análise de dados pela aplicação da Lista de Verificação e Diagrama de Pareto; 3) Análise documental. Utilizou-se o teste qui-quadrado para verificar o efeito do emprego das ferramentas de qualidade na adesão à conferência. Resultados 13 causas de não conferência do carro de emergência foram identificadas, sendo oito evitáveis e cinco não evitáveis. As causas evitáveis (n=63) representaram 87,5%, sendo as principais: falta de hábito (n=17; 27%), priorizar atividades assistenciais (n=17; 27%) e realizar divisão do cuidado dos pacientes/priorizar atividades administrativas (n=9; 14,3%). A aplicação das ferramentas da qualidade teve efeito significativo (p-valor<0,001) na adesão à conferência. Conclusão e implicações para a prática o emprego das ferramentas da qualidade foi factível para a identificação causal da não conferência do carro de emergência e melhoria na sua adesão.
RESUMEN Objetivo verificar las causas de la no conferencia del automóvil de emergencia y el efecto sobre la tasa de adherencia, mediante el uso de herramientas de calidad en una Unidad de Cuidados Intensivos Neonatales. Método investigación de métodos mixtos de diseño exploratorio secuencial. Fue desarrollado con enfermeras y una fuente documental en la Unidad de Cuidados Intensivos Neonatales de un hospital universitario, en tres etapas: 1) Brainstorming (Lluvia) de ideas para estudiar las causas de la no conferencia y construir una Lista de verificación; 2) Recopilación/análisis de datos mediante la aplicación de la Lista de verificación y el Diagrama de Pareto; 3) Análisis documental. Se utilizó la prueba de chi-cuadrado para verificar el efecto del uso de herramientas de calidad en la adherencia a la conferencia. Resultados se identificaron 13 causas de no conferencia del automóvil de emergencia, ocho eran prevenibles y cinco no prevenibles. Las causas evitables (n=63) representaron el 87,5%, siendo las principales: falta de hábito (n=17; 27%), priorizar las actividades de atención (n=17; 27%) y realizar la división de la atención a los pacientes/priorizar las actividades administrativas (n=9; 14.3%). La aplicación de herramientas de calidad tuvo un efecto significativo (p<0,001) en la adherencia a la conferencia. Conclusión e implicaciones para la práctica el uso de herramientas de calidad fue factible para la identificación causal del control no diario del carro de emergencia y en la mejora de su adherencia.
ABSTRACT Objective to verify the causes of the not checking of the emergency car and the effect on the adherence rate by using quality tools in a Neonatal Intensive Care Unit. Method mixed methods research of sequential exploratory design, developed with nurses and a documentary source in the Neonatal Intensive Care Unit of a university hospital, in three stages: 1) Brainstorming to survey the causes of not checking/ building a Checklist; 2) Data collection/analysis by applying the Pareto Checklist and Diagram; 3) Documentary analysis. The chi-square test was used to verify the effect of using quality tools in the adherence to checking. Results 13 causes of not checking of the emergency car were identified, eight of which are preventable and five non-preventable. The preventable causes (n=63) represented 87.5%, the main ones being: lack of habit (n=17; 27%), prioritizing care activities (n=17; 27%), and dividing the care of patients / prioritize administrative activities (n=9; 14.3%). The application of quality tools had a significant effect (p-value <0.001) in the adherence to checking. Conclusion and implications for practice the use of quality tools was feasible for the causal identification of the daily emergency car not checking and improvement in its adherence.
Asunto(s)
Humanos , Recién Nacido , Calidad de la Atención de Salud , Ambulancias , Unidades de Cuidado Intensivo Neonatal , Lista de Verificación/métodos , Seguridad del Paciente , Enfermeras y EnfermerosRESUMEN
RESUMO Objetivo analisar os eventos adversos cirúrgicos divulgados por uma mídia brasileira. Método pesquisa documental, qualitativa. A fonte de informação consistiu em reportagens audiovisuais sobre danos decorrentes de intervenções cirúrgicas, noticiadas em uma mídia brasileira. Para as buscas no portal eletrônico, consideraram-se as publicadas até junho de 2019. O referencial de Bardin foi empregado na análise temática. Os incidentes mencionados foram classificados segundo as barreiras de segurança contidas na Lista de Verificação de Segurança Cirúrgica (LVSC) da Organização Mundial da Saúde. Resultados foram analisados 16 casos apresentados através de 17 reportagens. Do total de falhas cometidas (n=16), a maioria (n=13) poderia ser prevenida através da checagem de itens contidos na LVSC. Na análise temática, três categorias emergiram: i. incidente relacionado à intervenção cirúrgica; ii. danos físicos, psicológicos e socioeconômicos decorrentes; iii. consequências ético-profissionais e/ou jurídicas. Conclusão e implicações para a prática os eventos adversos cirúrgicos divulgados pelas reportagens impactaram sobremaneira a vida dos pacientes, nos aspectos físicos, emocionais e socioeconômicos. Ainda trouxeram implicações para os profissionais envolvidos e instituições de saúde. Acredita-se que, as barreiras de segurança contidas em instrumento de verificação mundialmente reconhecido, são importantes ferramentas a serem empregadas para promover a segurança do paciente cirúrgico e salvar vidas.
RESUMEN Objetivo analizar los eventos quirúrgicos adversos reportados por un medio brasileño. Método investigación documental, cualitativa. La fuente de información consistió en reportajes audiovisuales sobre daños resultantes de intervenciones quirúrgicas, reportados en un medio brasileño. Para las búsquedas en el portal electrónico, se consideraron las publicaciones realizadas hasta junio de 2019. En el análisis temático se utilizó el marco de Bardin. Los incidentes mencionados fueron clasificados de acuerdo a las barreras de seguridad contenidas en la Lista de Verificación de Seguridad Quirúrgica (LVSC) de la Organización Mundial de la Salud. Resultados se analizaron 16 casos presentados a través de 17 informes. Del total de fallas cometidos (n = 16), la mayoría (n = 13) podría evitarse mediante la verificación de los elementos contenidos en el LVSC. En el análisis temático surgieron tres categorías: i. Incidente relacionado con la intervención quirúrgica; ii. daño físico, psicológico y socioeconómico resultante; iii. Consecuencias ético-profesionales y / o legales. Conclusión e implicaciones para la práctica los eventos quirúrgicos adversos reportados por los informes impactaron enormemente en la vida de los pacientes, en los aspectos físicos, emocionales y socioeconómicos. También trajeron implicaciones para los profesionales involucrados y las instituciones de salud. Se cree que las barreras de seguridad contenidas en un instrumento de verificación reconocido mundialmente son herramientas importantes que se utilizarán para promover la seguridad de los pacientes quirúrgicos y salvar vidas.
ABSTRACT Objective to analyze surgical adverse events reported by a Brazilian media. Method documentary and qualitative research. The source of information consisted of audiovisual reports on damages resulting from surgical interventions, reported in a Brazilian media. For searches on the electronic portal, those published until June 2019 were considered. Bardin's framework was used in the thematic analysis. The aforementioned incidents were classified according to the safety barriers contained in the Surgical Safety Checklist (SSC) of the World Health Organization. Results a total of 16 cases presented through 17 reports were analyzed. Of the total number of failures committed (n = 16), the majority (n = 13) could be prevented by checking items contained in the SSC. In the thematic analysis, three categories emerged: i. incident related to surgical intervention; ii. physical, psychological and socioeconomic resulting damage; iii. ethical-professional and/or legal consequences. Conclusion and implications for the practice the adverse surgical events disclosed by the reports greatly impacted on the lives of patients, in physical, emotional and socioeconomic aspects. They also brought implications for the professionals and health institutions involved. It is believed that the safety barriers contained in a globally recognized verification instrument are important tools to be used to promote the safety of surgical patients and save lives.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Procedimientos Quirúrgicos Operativos/efectos adversos , Medios de Comunicación de Masas , Investigación Cualitativa , Lista de Verificación/métodos , Seguridad del Paciente , Daño del Paciente/efectos adversos , Daño del Paciente/legislación & jurisprudenciaRESUMEN
Introducción: Durante las cirugías ocurren complicaciones y muertes, las que pueden ser prevenibles. Esta circunstancia hizo que la Organización Mundial de la Salud estableciera una lista de verificación de cirugía segura, que debe aplicarse para aminorar posibles riesgos y favorecer la seguridad del paciente durante la cirugía. Objetivo: Identificar la relación entre la aplicación de la lista de verificación de cirugía segura y utilidad según la opinión de las enfermeras. Métodos: Estudio cuantitativo, diseño correlacional y trasversal, realizado en sala de operaciones del Instituto Nacional de Enfermedades Neoplásicas, Lima - Perú, desde setiembre hasta octubre de 2018. La población de estudio quedó conformada por 46 enfermeras, las técnicas utilizadas fueron la encuesta y la observación. Los instrumentos fueron el cuestionario y la lista de observación, el cuestionario fue validado por 8 expertos y prueba piloto, tuvo un alfa de Crombach de 0,731. La lista de observación fue elaborada por la Organización Mundial de la Salud. Los datos fueron procesados a través del programa Excel, a fin de realizar el análisis de frecuencias y porcentajes, se aplicó la prueba chi cuadrado para identificar la relación entre las variables de estudio. Resultados: Al aplicar la prueba estadística Chi cuadrado se evidenció que no existe relación entre ambas variables (p > 0,06); el 66 por ciento de los profesionales de enfermería consideraron que es útil y el 56,5 por ciento aplican la lista de verificación de cirugía segura. Conclusiones: No se encontró relación entre la aplicación de la lista de verificación de cirugía segura y la utilidad según la opinión de las enfermeras(AU)
ABSTRACT Introduction: During surgeries complications and deaths occur, which can be preventable, this circumstance led the World Health Organization to establish a safe surgery checklist, which must be applied to reduce possible risks and promote patient safety during surgery. Objective: To identify the relationship between the application of the safe surgery checklist and its usefulness according to the opinion of the nurses. Methods: Quantitative study, correlational and cross-sectional design, carried out in the operating room of the National Institute of Neoplastic Diseases, Lima - Peru, from September to October 2018, the study population made up of 46 nurses, the techniques used were observation and poll; the instruments the questionnaire and observation list, the questionnaire was validated by 8 experts and a pilot test, had a Crombach alpha of 0.731. The watchlist was developed by the World Health Organization. The data were processed through the Excel program, in order to carry out the analysis of frequencies and percentages, the chi square test was applied to identify the relationship between the study variables. Results: When applying the Chi square statistical test, it was evident that there is no relationship between both variables (p > 0.06); 66.00 percent of nursing professionals consider it to be useful and 56.50 percent apply the safe surgery checklist. Conclusions: No relationship was found between the application of the safe surgery checklist and its usefulness according to the nurses' opinion(AU)
Asunto(s)
Humanos , Quirófanos , Complicaciones Posoperatorias/prevención & control , Organización Mundial de la Salud , Lista de Verificación/métodos , Seguridad del Paciente , Estudios TransversalesRESUMEN
BACKGROUND: The quality of clinical care of brain-dead potential organ donors may help reduce donor losses caused by irreversible or unreversed cardiac arrest and increase the number of organs donated. We sought to determine whether an evidence-based, goal-directed checklist for donor management in intensive care units (ICUs) can reduce donor losses to cardiac arrest. METHODS/DESIGN: The DONORS study is a multicentre, cluster-randomised controlled trial with a 1:1 allocation ratio designed to compare an intervention group (goal-directed checklist for brain-dead potential organ donor management) with a control group (standard ICU care). The primary outcome is loss of potential donors due to cardiac arrest. Secondary outcomes are the number of actual organ donors and the number of solid organs recovered per actual donor. Exploratory outcomes include the achievement of relevant clinical goals during the management of brain-dead potential organ donors. The present statistical analysis plan (SAP) describes all primary statistical procedures that will be used to evaluate the results and perform exploratory and sensitivity analyses of the trial. DISCUSSION: The SAP of the DONORS study aims to describe its analytic procedures, enhancing the transparency of the study. At the moment of SAP subsmission, 63 institutions have been randomised and were enrolling study participants. Thus, the analyses reported herein have been defined before the end of the study recruitment and database locking. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03179020. Registered on 7 June 2017.
Asunto(s)
Lista de Verificación/métodos , Interpretación Estadística de Datos , Obtención de Tejidos y Órganos/métodos , Obtención de Tejidos y Órganos/organización & administración , Muerte Encefálica/diagnóstico , Brasil , Medicina Basada en la Evidencia , Humanos , Unidades de Cuidados Intensivos , Estudios Multicéntricos como Asunto , Evaluación de Resultado en la Atención de Salud , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
AIM: The aim of this evidence implementation project was to improve the documentation of chemotherapy administration by nursing staff in a bone marrow transplant unit, to improve patient care and safety, as well as meet the legal and educational responsibilities of the nursing staff. METHODS: This evidence implementation project used the Joanna Briggs Institute's Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback framework for the design and development of an evidence-based audit and feedback change project. A baseline audit was conducted to assess current practices against best practice and identify areas requiring improvement. Next, the project team reflected on the results of the audit to develop and implement strategies for documentation improvement. Lastly, a follow-up audit was conducted to assess changes in practice improvement. RESULTS: The baseline audit results revealed practice areas requiring improvement; facilitators of and barriers to nursing documentation and practice improvement were identified. A checklist, educational session, Nursing Documentation Guidelines for Chemotherapy Administration, was implemented to improve nursing documentation. The follow-up audit demonstrated improved adherence across all audit criteria. CONCLUSION: The checklist implemented for nursing documentation and education contributed to improved practices. To promote additional improvements, nurses will continue to utilize the tools developed and receive continued education through formal training and staff meetings. Future auditing is planned to ensure sustainability.
Asunto(s)
Antineoplásicos/administración & dosificación , Trasplante de Médula Ósea , Documentación/normas , Enfermería Oncológica/métodos , Antineoplásicos/efectos adversos , Brasil , Lista de Verificación/métodos , Adhesión a Directriz , Hospitales Universitarios , Humanos , Personal de Enfermería en Hospital/normas , Enfermería Oncológica/educación , Guías de Práctica Clínica como AsuntoRESUMEN
RESUMO Objetivo verificar a efetividade da intervenção com atividades lúdicas grupais que visam desenvolver a autoadvocacia e a autocidadania como prática de empoderamento de adolescentes com deficiência auditiva. Métodos trata-se de um estudo experimental pré e pós-intervenção, de abordagem quantitativa e qualitativa. Participaram quatro adolescentes com idades entre 12 e 17 anos, usuários de aparelho de amplificação sonora individual e/ou implante coclear, oralizados. Foram realizados cinco encontros presenciais, nos quais foram abordados temas relacionados à autoadvocacia, por meio de atividades lúdicas. Os instrumentos Checklist de Autoadvocacia "Eu consigo" e o Questionário de participação em sala de aula foram aplicados na pré e pós- intervenção. Foram aplicados o Inventário de Habilidades Sociais para Aadolescentes (IHS-Adolescente) e a Escala Wechsler Abreviada de Inteligência. Os dados foram analisados de forma qualitativa e quantitativa. Resultados No Inventário de Habilidades Sociais para Adolescentes, para frequência, todos os participantes foram classificados como abaixo da média ou média inferior. No teste de Escala Wechsler Abreviada de Inteligência, observando o dado de quociente de inteligência de execução, todos ficaram na média. Houve diferenças na comparação dos resultados pré e pós-intervenção do Checklist de Autoadvocacia "Eu consigo", principalmente no domínio compreensão da audição e da perda auditiva e uso dos dispositivos auditivos. No Questionário de participação em sala de aula, foi observada piora em alguns domínios, como compreensão dos professores e aspectos negativos. Conclusão O programa de intervenção com a estruturação proposta neste estudo foi eficiente para desenvolver as habilidades de autoadvocacia e autocidadania para o empoderamento de adolescentes com deficiência auditiva.
ABSTRACT Purpose To verify the effectiveness of an intervention with recreational activities that aim to develop self-advocacy and citizenship as a practice of empowerment for adolescents with hearing impairment. Methods This is a pre- and post-intervention experimental study with a quantitative and qualitative approach. Four oral hard-of-hearing adolescents aged between 12 and 17 years, users of hearing aids and/or cochlear implants, participated in this study. Five face-to-face meetings were held, in which topics related to self-advocacy were addressed through recreational activities. The Self-advocacy Checklist "I can" and the Classroom Participation Questionnaire (CPQ) were applied pre- and post-intervention. The Social Skills Inventory for Adolescents (IHSA-Del-Prette) and the Wechsler Abbreviated Scale of Intelligence (WASI) were also used. The data were analyzed utilizing qualitative and quantitative methods. Results In the Frequency Indicator of the IHSA-Del-Prette, all participants were classified as low average or below average. In the WASI, which analyzed performance IQ, all participants were classified as average. Differences were observed when comparing the Self-advocacy Checklist "I can" pre- and post-intervention, especially regarding hearing and hearing loss and the use of hearing devices. In the CPQ, worsening was observed in some domains, such as teachers' understanding and negative aspects. Conclusion The intervention program with the structure proposed in this study was efficient in developing self-advocacy and citizenship skills to empower adolescents with hearing impairment.
Asunto(s)
Humanos , Niño , Adolescente , Efectividad , Participación de la Comunidad , Habilidades Sociales , Pérdida Auditiva , Escalas de Wechsler , Encuestas y Cuestionarios , Implantación Coclear , Lista de Verificación/métodos , AudífonosRESUMEN
OBJECTIVE: To conduct a cross-cultural adaptation of the Preterm Parenting & Self-Efficacy Checklist to the Brazilian Portuguese. METHOD: A methodological study was carried out with 51 parents of premature infants. Data analysis was based on psychometric and inferential statistical analyses. RESULTS: The instrument content validation by experts obtained excellent agreement (97%) and the semantic analysis by the target population showed good understanding of the terms and ease of use. In test-retest, most participants were female (64.7%); and parents with higher education (47.1%). The instrument showed stability over time, with good internal consistency (α = 0.84). Four factors were generated in the subscales parenting self-efficacy, importance of tasks and self-perceived parental competence (67.0% to 74.2% of the variance). CONCLUSION: The properties of the Preterm Parenting & Self-Efficacy Checklist - Brazilian Version were maintained, which is a reliable indicator to evaluate the hospital discharge of premature infants.
Asunto(s)
Lista de Verificación/normas , Recien Nacido Prematuro/psicología , Responsabilidad Parental/psicología , Psicometría/normas , Autoeficacia , Adolescente , Adulto , Brasil , Lista de Verificación/métodos , Asistencia Sanitaria Culturalmente Competente , Femenino , Humanos , Recién Nacido , Masculino , Psicometría/instrumentación , Psicometría/métodos , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
A sophisticated literature review (LR) can result in a robust dissertation/thesis by scrutinizing the main problem examined by the academic study; anticipating research hypotheses, methods and results; and maintaining the interest of the audience in how the dissertation/thesis will provide solutions for the current gaps in a particular field. Unfortunately, little guidance is available on elaborating LRs, and writing an LR chapter is not a linear process. An LR translates students' abilities in information literacy, the language domain, and critical writing. Students in postgraduate programs should be systematically trained in these skills. Therefore, this paper discusses the purposes of LRs in dissertations and theses. Second, the paper considers five steps for developing a review: defining the main topic, searching the literature, analyzing the results, writing the review and reflecting on the writing. Ultimately, this study proposes a twelve-item LR checklist. By clearly stating the desired achievements, this checklist allows Masters and Ph.D. students to continuously assess their own progress in elaborating an LR. Institutions aiming to strengthen students' necessary skills in critical academic writing should also use this tool.
Asunto(s)
Tesis Académicas como Asunto/normas , Lista de Verificación/normas , Literatura de Revisión como Asunto , Lista de Verificación/métodos , HumanosRESUMEN
INTRODUCTION: There is an increasing demand for multi-organ donors for organ transplantation programmes. This study protocol describes the Donation Network to Optimise Organ Recovery Study, a planned cluster randomised controlled trial that aims to evaluate the effectiveness of the implementation of an evidence-based, goal-directed checklist for brain-dead potential organ donor management in intensive care units (ICUs) in reducing the loss of potential donors due to cardiac arrest. METHODS AND ANALYSIS: The study will include ICUs of at least 60 Brazilian sites with an average of ≥10 annual notifications of valid potential organ donors. Hospitals will be randomly assigned (with a 1:1 allocation ratio) to the intervention group, which will involve the implementation of an evidence-based, goal-directed checklist for potential organ donor maintenance, or the control group, which will maintain the usual care practices of the ICU. Team members from all participating ICUs will receive training on how to conduct family interviews for organ donation. The primary outcome will be loss of potential donors due to cardiac arrest. Secondary outcomes will include the number of actual organ donors and the number of organs recovered per actual donor. ETHICS AND DISSEMINATION: The institutional review board (IRB) of the coordinating centre and of each participating site individually approved the study. We requested a waiver of informed consent for the IRB of each site. Study results will be disseminated to the general medical community through publications in peer-reviewed medical journals. TRIAL REGISTRATION NUMBER: NCT03179020; Pre-results.