Oral hygiene in critically ill patients at a tertiary hospital in São Paulo, Brazil: a best practice implementation project.

OBJECTIVES: This project aimed to promote evidence-based practices relat. ed to the oral health of critically ill patients in an intensive care unit in Brazil. INTRODUCTION: The oral hygiene of patients on mechanical ventilation is an essential component of nursing care quality, and well-defined guidelines ensure appropriate care. Mechanical ventilation is associated with the risk of ventilator-associated pneumonia, which can increase mortality, length of stay, time on mechanical ventilation, and hospital costs. METHODS: This project was guided by the JBI Evidence Implementation Framework, which consists of seven stages: (1) identification of the area of practice to be changed, (2) involvement of change agents, (3) context assessment and readiness for change, (4) review of practices against evidence-based audit criteria, (5) implementation of practice changes, (6) reassessment of practices using a follow-up audit and (7) consideration of the sustainability of changes in practice. RESULTS: Four audit criteria were developed to evaluate compliance with best practices. In the follow-up audit, Criteria 1, 2, and 3 obtained compliance of ≥ 80%. Thus, for Criterion 1, all the patients on mechanical ventilation for more than 24 hours were evaluated by the oral medicine team, resulting in 100% compliance. For Criterion 2 on appropriate oral hygiene measures, a compliance rate of 80% was achieved. For Criterion 3, 39 professionals (90.7%) participated in educational activities related to the oral health protocol for critically ill patients, obtaining 90.7% compliance. For Criterion 4 regarding patients being evaluated before receiving any oral health care, improvement was low (only 50%), revealing the need for further improvement. CONCLUSION: This best practice project improved the professional practice of nursing staff and increased compliance with best practices for the oral health of critically ill patients. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A175.

Mentoring in research: development of competencies for health professionals.

BACKGROUND: Mentoring programmes in health research are beneficial for both mentors and mentees and are essential for the development of the next generation of research leaders. This study describes the self-assessment of research skills in health professionals participating in a research mentoring programme and determines the correlation between the participants' self-assessment of research skills and professional characteristics. METHOD: This was a quasi-experimental, time-series study conducted in a Brazilian tertiary hospital. Thirty-five health professionals holding a master's or PhD degree were included. The participants answered a survey in which they self-assessed their research skills distributed into eight domains, with one group responding before training and another group responding after training. The level of significance was set at 5% (p < 0.05). RESULTS: Those who received training scored better in research skills related to two domains: critical analysis of the literature and identification of appropriate research methods (p = 0.0245). CONCLUSION: Trained professionals performed better in the domains of critical thinking and knowledge and management of steps in the research process.

Survival of cancer patients under treatment with the palliative care team in a Brazilian hospital in São Paulo.

Introduction: The Karnofsky Performance Status Scale is a relevant functional evaluation instrument that can be used to determine which patients should be followed by multidisciplinary palliative care teams. Objective: To analyze the clinical outcomes of patients with performance status lower than 70%, according to the Karnofsky Scale, who received care from a palliative care team compared to those who did not receive care from a palliative care team. Methods: In this retrospective cohort, follow-up of cancer patients by the palliative care team for 10 days was considered the exposure factor, while the dependent variable was patient survival. Data were extracted from medical records and descriptive and survival curve analyses were conducted. Results: Among 581 participants in the sample, 42.5% had metastasis, and the most prevalent medical diagnosis was gastrointestinal cancer (29.1%). Fifty-one (8.7%) were followed by the palliative care team. The mortality rate during the 10 days in the sample was 10.8%, and the rate was higher (15.7%) among patients followed by the palliative care team. Conclusion: Patients with a performance status below 70% who were followed by the palliative care team had poorer clinical conditions and a shorter survival than those who were not followed up by the team.

Survie des patients en oncologie traités par l'équipe de soins palliatifs d'un hôpital de São Paulo, au Brésil.

Introduction: L'échelle de l'indice fonctionnel de Karnofsky (Karnofsky Performance Status Scale) est un instrument d'évaluation pertinent et fonctionnel qui sert à déterminer quelles personnes devraient être suivies par des équipes multidisciplinaires de soins palliatifs. Objectif: Analyser les résultats cliniques de patients, suivis par une équipe de soins palliatifs, dont l'indice fonctionnel de Karnofsky est inférieur à 70 %, et les comparer aux résultats de personnes n'ayant pas bénéficié de ce type de soins. Méthodologie: Dans la présente étude de cohorte rétrospective, le suivi pendant 10 jours des patients par l'équipe de soins palliatifs constituait le facteur d'exposition et la survie, la variable dépendante. Des données ont été extraites des dossiers médicaux afin de réaliser des statistiques descriptives et des analyses des courbes de survie. Résultats: Parmi les 581 participants de l'échantillon, 42,5 % avaient des métastases. Le cancer gastro-intestinal était le diagnostic plus prévalent (29,1 %). Du groupe, 51 participants (8,7 %) étaient suivis par l'équipe de soins palliatifs. Le taux de mortalité pendant les 10 jours de suivi s'élevait à 10,8 %; il était plus élevé encore (15,7 %) chez les patients suivis par l'équipe de soins palliatifs. Conclusion: Les patients ayant un indice fonctionnel inférieur à 70 % qui étaient suivis par l'équipe de soins palliatifs présentaient un piètre état clinique et une période de survie plus réduite comparativement aux autres patients.

Perfil do ingressante na residência multiprofissional e em área de saúde de um hospital privado brasileiro / Admission profile in a multiprofessional residence education in a Brazilian private hospital

Resumen

Objetivo: describir el perfil de los nuevos estudiantes en los programas de residencia multidisciplinar en el campo profesional de la salud en una institución privada en Sao Paulo, Brasil.

Método: estudio exploratorio, descriptivo de los nuevos estudiantes en los programas de residencia multidisciplinar de profesionales de la salud en un hospital grande, privado y filantrópico, con sede en Sao Paulo, en abril de 2015.

Resultados: 105 participantes con una edad media de 25,45 + 3,83 años, con predominio femenino y estado civil solteros, el 93,3% del estado de Sao Paulo. El 30,5% tenía experiencia previa de trabajo, el 76,1% eran graduados entre 2013 a 2015, el 50,4% de los encuestados pertenece a los programas uniprofesionales y solo el 30,5% practica algún tipo de deporte. En cuanto a satisfacción, el 54,3% informó de satisfacción con el programa.

Discusión/conclusión: la comprensión del perfil del estudiante que ingresa en el programa de residencia permite a los profesores crear estrategias para desarrollar las habilidades necesarias para ejercer la profesión.

Abstract

Purpose: to describe the profile of new students being admitted in multidisciplinary residence programs for healthcare professionals in a private institution in Sao Paulo, Brazil.

Methods: an exploratory, descriptive study on new students being admitted to multidisciplinary residence programs for healthcare professionals in a large, private, philanthropic hospital in Sao Paulo, in April 2015.

Results: a hundred and five participants, mean age 25.45 ± 3.83, predominantly women, most of them single were included; 93.3% were from Sao Paulo state. Some 30.5% had previous work experience, 76.1% graduated from 2013 to 2015; 50.4% of respondents were in monoprofessional programs; and only 30.5% were regular sport players. Satisfaction with the program was stated by 54.3%.

Discussion/Conclusions: student profile understanding for students being admitted in a residence program allow teachers creating strategies to develop skills needed for professional practice.

Objetivo: descrever o perfil do aluno ingressante nos programas de residência multiprofissional e em área profissional da saúde de uma instituição privada no município de São Paulo - Brasil.

Método: estudo exploratório, descritivo realizado com alunos ingressantes em programas de residências multiprofissionais em área profissional da saúde em um hospital de grande porte, privado e filantrópico localizado no município de São Paulo, no mês de abril de 2015.

Resultados: 105 participantes com idade média de 25,45 + 3,83 anos. Houve predominância do sexo feminino, estado civil solteiro, 93,3% do estado de São Paulo. 30,5% possuem experiência profissional prévia, 76,1% foram graduados entre 2013-2015, 50,4% dos respondentes pertencem a programas uniprofissionais e apenas 30,5% pratica algum tipo de esporte. Quanto a satisfação, 54,3% relataram satisfação com o programa.

Conclusão: compreender o perfil de aluno inserido no programa de residência permite aos docentes a criação de estratégias para desenvolver as competências necessárias a pratica da profissão.