ABSTRACT
ABSTRACT Objective: To measure the level of satisfaction regarding the usability of a neonatal health information system and identify if demographic factors can influence the usability of a health information system. Methods: A cross-sectional, exploratory study was carried out with a convenience sample of 50 users of the Brazilian Neonatal Research Network. The instrument chosen for the usability evaluation was the System Usability Scale between February and March 2017. The statistical analysis of the collected variables was carried out in order to describe the sample, to quantify the level of satisfaction of the users and to identify the variables associated with the level of satisfaction. Results: The female gender represented 75% of the sample. The mean age was 52.8 years; 58% had a doctoral degree, average time of graduation was 17 years, with area of practice in medicine (neonatology), with intermediate knowledge in computer science (74%) and mean system use time of 52 months. Regarding usability, 94% rated the system as "good", "excellent" or "better than imaginable". The usability of the system was not associated with age, gender, education, profession, area of practice, knowledge in computer science and time of system use. Conclusion: The level of satisfaction of the computerized health system user was considered good. No demographic factors were associated with the satisfaction of the users.
RESUMO Objetivo: Mensurar o grau de satisfação de profissionais de saúde quanto à usabilidade de um sistema de informação em saúde neonatal e identificar os fatores que podem influenciar na satisfação do usuário frente à usabilidade. Métodos: Estudo transversal e exploratório realizado com 50 profissionais de saúde integrantes dos centros da Rede Brasileira de Pesquisas Neonatais. Para avaliação da usabilidade foi utilizado o instrumento System Usability Scale entre fevereiro e março de 2017. Realizou-se a análise estatística descritiva e inferencial das variáveis coletadas, com a finalidade de descrever a amostra, quantificar o grau de satisfação dos usuários e identificar as variáveis associadas ao grau de satisfação do usuário em relação à usabilidade. Resultados: Da população avaliada, 75% era do sexo feminino, com idade média 52,8 anos, 58% com pós-graduação (doutorado); tempo médio da última formação de 17 anos; área de atuação em medicina (neonatologia), grau intermediário de conhecimento em informática e tempo de utilização média do sistema de 52 meses. Quanto à usabilidade, 94% avaliaram o sistema como "bom", "excelente" ou "melhor impossível". A usabilidade do sistema não foi associada a idade, sexo, escolaridade, profissão, área de atuação, nível de conhecimento em informática e tempo de uso do sistema. Conclusões: O grau de satisfação do usuário do sistema informatizado de saúde foi considerado bom. Não foram identificados fatores demográficos que influenciassem sua avaliação.
Subject(s)
Attitude of Health Personnel , Infant Health/standards , Computer Literacy/statistics & numerical data , Brazil , Cross-Sectional Studies , Surveys and Questionnaires , Health Information Systems/standards , Health Information Systems/statistics & numerical data , /statistics & numerical data , Health Services Research , Middle Aged , Neonatology/methods , Neonatology/standardsABSTRACT
OBJECTIVE: To measure the level of satisfaction regarding the usability of a neonatal health information system and identify if demographic factors can influence the usability of a health information system. METHODS: A cross-sectional, exploratory study was carried out with a convenience sample of 50 users of the Brazilian Neonatal Research Network. The instrument chosen for the usability evaluation was the System Usability Scale between February and March 2017. The statistical analysis of the collected variables was carried out in order to describe the sample, to quantify the level of satisfaction of the users and to identify the variables associated with the level of satisfaction. RESULTS: The female gender represented 75% of the sample. The mean age was 52.8 years; 58% had a doctoral degree, average time of graduation was 17 years, with area of practice in medicine (neonatology), with intermediate knowledge in computer science (74%) and mean system use time of 52 months. Regarding usability, 94% rated the system as "good", "excellent" or "better than imaginable". The usability of the system was not associated with age, gender, education, profession, area of practice, knowledge in computer science and time of system use. CONCLUSION: The level of satisfaction of the computerized health system user was considered good. No demographic factors were associated with the satisfaction of the users.
Subject(s)
Attitude of Health Personnel , Health Information Systems , Infant Health/standards , Neonatology , Brazil , Computer Literacy/statistics & numerical data , Cross-Sectional Studies , Female , Health Information Systems/standards , Health Information Systems/statistics & numerical data , Health Services Research , Humans , Male , Middle Aged , Neonatology/methods , Neonatology/standards , Procedures and Techniques Utilization/statistics & numerical data , Surveys and QuestionnairesABSTRACT
Ultrasonography was a technological breakthrough for obstetrics, allowing visualization of fetal structures. However, the lack of a systematic approach to obstetric ultrasound examinations causes in Brazil, pregnant women do the exam on their own, which can sometimes lead to unexpected diagnosis of fetal malformation. In order to describe the reaction of women when surprised by the diagnosis of fetal malformation and therapeutic itineraries that follow, we conducted a study with nine pregnant women after ultrasound confirmation of fetal malformation. Through semi-structured interviews and content analysis of the narratives, the following categories were identified: motivation to perform ultrasonography; care at the referral; and coping strategies from the confirmation of fetal malformation. The interviews revealed failure to comply with the correct sequence of the prenatal care process. Definition of suitable moment for ultrasound test and guidance at each stage of pregnancy now represent a challenge for the improvement of perinatal care...
A ultrassonografia representou um avanço tecnológico para a obstetrícia, por permitir a visualização das estruturas fetais. Entretanto, a falta de uma abordagem sistemática para os exames de ultrassom obstétrico faz com que, no Brasil, mulheres grávidas façam o exame por iniciativa própria, o que às vezes pode levar a um diagnóstico inesperado de malformação fetal. Com o objetivo de descrever a reação das mulheres quando surpreendidas pelo diagnóstico de malformação fetal e os itinerários terapêuticos que se sucedem, foi realizado estudo com nove gestantes, após a confirmação ultrassonográfica de malformação fetal. Através de entrevistas semiestruturadas e análise de conteúdo das narrativas, foram identificadas as seguintes categorias: motivação para realizar ultrassonografia; atendimento na unidade de referência; e estratégias de enfrentamento a partir da confirmação de malformação fetal. As entrevistas revelaram uma falha em cumprir com a sequência correta do processo de cuidado pré-natal. A definição do momento adequado para o teste de ultrassom e orientação em cada etapa da gravidez representam um desafio para a melhoria da assistência perinatal...
Subject(s)
Humans , Female , Pregnancy , Congenital Abnormalities/diagnosis , Prenatal Care , Pregnancy, High-Risk/psychology , Ultrasonography, Prenatal , Perinatal Care/trends , Maternal and Child Health , Maternal Health ServicesABSTRACT
BACKGROUND: Guidelines for red blood cell (RBC) transfusions exist; however, transfusion practices vary among centers. This study aimed to analyze transfusion practices and the impact of patients and institutional characteristics on the indications of RBC transfusions in preterm infants. STUDY DESIGN AND METHODS: RBC transfusion practices were investigated in a multicenter prospective cohort of preterm infants with a birth weight of less than 1500 g born at eight public university neonatal intensive care units of the Brazilian Network on Neonatal Research. Variables associated with any RBC transfusions were analyzed by logistic regression analysis. RESULTS: Of 952 very-low-birth-weight infants, 532 (55.9%) received at least one RBC transfusion. The percentages of transfused neonates were 48.9, 54.5, 56.0, 61.2, 56.3, 47.8, 75.4, and 44.7%, respectively, for Centers 1 through 8. The number of transfusions during the first 28 days of life was higher in Center 4 and 7 than in other centers. After 28 days, the number of transfusions decreased, except for Center 7. Multivariate logistic regression analysis showed higher likelihood of transfusion in infants with late onset sepsis (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.8-4.4), intraventricular hemorrhage (OR, 9.4; 95% CI, 3.3-26.8), intubation at birth (OR, 1.7; 95% CI, 1.0-2.8), need for umbilical catheter (OR, 2.4; 95% CI, 1.3-4.4), days on mechanical ventilation (OR, 1.1; 95% CI, 1.0-1.2), oxygen therapy (OR, 1.1; 95% CI, 1.0-1.1), parenteral nutrition (OR, 1.1; 95% CI, 1.0-1.1), and birth center (p < 0.001). CONCLUSIONS: The need of RBC transfusions in very-low-birth-weight preterm infants was associated with clinical conditions and birth center. The distribution of the number of transfusions during hospital stay may be used as a measure of neonatal care quality.
Subject(s)
Erythrocyte Transfusion/statistics & numerical data , Hospitals, University/statistics & numerical data , Infant, Newborn, Diseases/epidemiology , Infant, Newborn, Diseases/therapy , Infant, Premature , Intensive Care Units, Neonatal/statistics & numerical data , Apgar Score , Brazil/epidemiology , Diabetes, Gestational/epidemiology , Female , Guideline Adherence/statistics & numerical data , Hospitals, Public/statistics & numerical data , Humans , Hypertension, Pregnancy-Induced/epidemiology , Infant, Newborn , Infant, Very Low Birth Weight , Length of Stay/statistics & numerical data , Logistic Models , Multivariate Analysis , Practice Guidelines as Topic , PregnancyABSTRACT
OBJECTIVE: To evaluate the predictive value of cerebral ultrasound in infants diagnoses on meningitis neonatal to the neurological outcome. METHOD: A retrospective study of 16 children admitted at Institute Fernandes Figueira RJ-Brazil, who had neonatal meningitis and were examined by cerebral ultrasound. The neurologic outcome was evaluated until 12 years of age. Positive and negative predictive values, sensitivity and specificity were calculated. RESULTS: 56.25% were male and 81.25% premature. Hydrocephalus was the most frequent finding (56.25%) followed by normal exam (43.75%). Findings of hydrocephalus (9) only one had good neurologic outcome; and normal exam (7): only 57.14% without brain damage. Findings of ventriculitis (4) and brain abscesses (2) all had neurologic damage. Diagnosis of encephalomalacia (2): only one had good cognitive function. Findings of cerebral atrophy (2) all with severe outcome. CONCLUSION: The positive and predictive values were: 88.89%; 57.14% negative; sensitivity was 72.73% and specificity 80%.
Subject(s)
Brain Diseases/diagnostic imaging , Meningitis, Bacterial/diagnostic imaging , Brain Diseases/etiology , Cognition Disorders/etiology , Female , Follow-Up Studies , Humans , Infant, Newborn , Infant, Newborn, Diseases , Infant, Premature , Male , Meningitis, Bacterial/complications , Predictive Value of Tests , Psychomotor Disorders/etiology , Retrospective Studies , Sensitivity and Specificity , Severity of Illness Index , UltrasonographyABSTRACT
OBJETIVO: Avaliar o valor preditivo da ultra-sonografia do cérebro, para o dano cerebral, em crianças com diagnóstico de meningite neonatal. MÉTODO: Estudo retrospectivo realizado no Instituto Fernandes Figueira (FIOCRUZ-RJ) em 16 crianças que realizaram ultra-sonografia do cérebro por diagnóstico de meningite no período neonatal e tiveram seguimento neurológico até 12 anos. Foram calculados: valores preditivos positivo e negativo, sensibilidade e especificidade. RESULTADOS: 56,25 por cento eram do sexo masculino e 81,25 por cento prematuros. Hidrocefalia foi o achado mais freqüente (56,25 por cento), seguido pelo exame normal (43,75 por cento). Achados de hidrocefalia (9), somente em um havendo evolução favorável e achados normais (7), em 4 (57,14 por cento) não havendo déficit neurológico. Achados de ventriculite (4) e abscesso cerebral (2): todos evoluíram com dano cerebral. Diagnóstico de encefalomalácia (2); em 50 por cento havendo desenvolvimento cognitivo satisfatório. Diagnostico de atrofia (2), todos com dano cerebral severo. CONCLUSÃO: Valor preditivo positivo de 88,89 por cento, negativo de 57,14 por cento, sensibilidade de 72,73 por cento e especificidade de 80 por cento.
Subject(s)
Female , Humans , Infant, Newborn , Male , Brain Diseases , Meningitis, Bacterial , Brain Diseases/etiology , Cognition Disorders/etiology , Follow-Up Studies , Infant, Newborn, Diseases , Infant, Premature , Meningitis, Bacterial/complications , Predictive Value of Tests , Psychomotor Disorders/etiology , Retrospective Studies , Sensitivity and Specificity , Severity of Illness IndexABSTRACT
OBJETIVO: Descrever a freqüência de utilização de corticosteróide antenatal e a evolução clínica dos recém-nascidos pré-termo. MÉTODOS: Estudo observacional prospectivo tipo coorte de todos os neonatos com idade gestacional entre 23 e 34 semanas nascidos na Rede Brasileira de Pesquisas Neonatais entre agosto e dezembro de 2001. Os prontuários médicos foram revistos, as mães entrevistadas e os pré-termos acompanhados. A análise dos dados foi realizada com o teste do qui-quadrado, t de Student, Mann-Whitney, ANOVA e regressão logística múltipla, com nível de significância de 5 por cento. RESULTADOS: Avaliaram-se 463 gestantes e seus 514 recém-nascidos. As gestantes tratadas tiveram mais gestações prévias, consultas de pré-natal, hipertensão arterial e maior uso de tocolíticos. Suas crianças apresentaram melhores escores de Apgar no 1º e 5º minutos, menor necessidade de intervenção na sala de parto e menor SNAPPE II. Nasceram com maior peso e idade gestacional, receberam menos surfatante exógeno, ventilação mecânica e oxigenoterapia. Após regressão logística, o uso pré-natal de corticosteróides manteve de forma independente o efeito protetor para as condições de nascimento e para a diminuição do tempo de ventilação mecânica e esteve associado com aumento na ocorrência de sepse neonatal. CONCLUSAO: O uso do corticosteróide antenatal foi associado a melhor atendimento pré-natal. As crianças nasceram em melhores condições e tiveram melhor evolução, porém com maior risco de infecção.
