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1.
Esc. Anna Nery Rev. Enferm ; 25(2): e20200198, 2021. tab, graf
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1142951

RESUMO

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.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Meios de Comunicação de Massa , Pesquisa Qualitativa , Lista de Checagem/métodos , Segurança do Paciente , Dano ao Paciente/efeitos adversos , Dano ao Paciente/legislação & jurisprudência
2.
Esc. Anna Nery Rev. Enferm ; 25(2): e20200274, 2021. tab, graf
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1133827

RESUMO

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.


Assuntos
Humanos , Recém-Nascido , Qualidade da Assistência à Saúde , Ambulâncias , Gestão da Qualidade , Unidades de Terapia Intensiva Neonatal , Lista de Checagem/métodos , Segurança do Paciente , Enfermeiras e Enfermeiros
3.
PLoS One ; 15(12): e0244310, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33378372

RESUMO

Although strong evidence exists about the effectiveness of basic childbirth services in reducing maternal and newborn mortality, these services are not provided in every childbirth, even those at health facilities. The WHO Safe Childbirth Checklist (SCC) was developed as a job aide to remind health workers of evidenced-based practices to be provided at specific points in the childbirth process. The Zambian government requested context-specific evidence on the feasibility and outcomes associated with introducing the checklist and related mentorship. A study was conducted on use of the SCC in four facilities in Nchelenge District of Zambia. Observations of childbirth services were conducted just before and six months after the introduction of the intervention. Observers used a structured tool to record adherence to essential services indicated on the checklist. The primary outcome of interest was the change in the average proportion of essential childbirth practices completed. Feedback questionnaires were administered to health workers before and six months after the intervention. At baseline and endline, 108 and 148 pause points were observed, respectively. There was an increase from 57% to 76% of tasks performed (p = 0.04). Considering only these cases where necessary supplies were available, health workers completed 60% of associated tasks at baseline compared to 84% at endline (p<0.01). Some tasks, such as taking an infant's temperature and hand washing, were never or rarely performed at baseline. Feedback from the health workers indicated that nearly all health workers agreed or strongly agreed with positive statements about the intervention. The performance of health workers in Zambia in completing essential practices in childbirth was low at baseline but improvements were observed with the introduction of the SCC and mentorship. Our results suggest that such interventions could improve quality of care for facility-based childbirth. However, national-level commitment to ensuring availability of trained staff and supplies is essential for success. Trial registration Clinical Trials.gov (NCT03263182) Registered August 28, 2017 This study adheres to CONSORT guidelines.


Assuntos
Lista de Checagem/métodos , Fidelidade a Diretrizes/estatística & dados numéricos , Educação Pré-Natal/métodos , Adulto , Lista de Checagem/estatística & dados numéricos , Parto Obstétrico/normas , Parto Obstétrico/estatística & dados numéricos , Parto Obstétrico/tendências , Feminino , Instalações de Saúde/estatística & dados numéricos , Pessoal de Saúde , Humanos , Masculino , Serviços de Saúde Materna/normas , Serviços de Saúde Materna/estatística & dados numéricos , Serviços de Saúde Materna/tendências , Pessoa de Meia-Idade , Parto/psicologia , Gravidez , Melhoria de Qualidade , Inquéritos e Questionários , Organização Mundial da Saúde , Zâmbia/epidemiologia
4.
PLoS Med ; 17(9): e1003294, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32956344

RESUMO

BACKGROUND: Placebo or sham controls are the standard against which the benefits and harms of many active interventions are measured. Whilst the components and the method of their delivery have been shown to affect study outcomes, placebo and sham controls are rarely reported and often not matched to those of the active comparator. This can influence how beneficial or harmful the active intervention appears to be. Without adequate descriptions of placebo or sham controls, it is difficult to interpret results about the benefits and harms of active interventions within placebo-controlled trials. To overcome this problem, we developed a checklist and guide for reporting placebo or sham interventions. METHODS AND FINDINGS: We developed an initial list of items for the checklist by surveying experts in placebo research (n = 14). Because of the diverse contexts in which placebo or sham treatments are used in clinical research, we consulted experts in trials of drugs, surgery, physiotherapy, acupuncture, and psychological interventions. We then used a multistage online Delphi process with 53 participants to determine which items were deemed to be essential. We next convened a group of experts and stakeholders (n = 16). Our main output was a modification of the existing Template for Intervention Description and Replication (TIDieR) checklist; this allows the key features of both active interventions and placebo or sham controls to be concisely summarised by researchers. The main differences between TIDieR-Placebo and the original TIDieR are the explicit requirement to describe the setting (i.e., features of the physical environment that go beyond geographic location), the need to report whether blinding was successful (when this was measured), and the need to present the description of placebo components alongside those of the active comparator. CONCLUSIONS: We encourage TIDieR-Placebo to be used alongside TIDieR to assist the reporting of placebo or sham components and the trials in which they are used.


Assuntos
Lista de Checagem/métodos , Lista de Checagem/normas , Humanos , Placebos/farmacologia , Placebos/normas , Projetos de Pesquisa , Pesquisadores , Relatório de Pesquisa , Inquéritos e Questionários
5.
Medicine (Baltimore) ; 99(32): e21548, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32769893

RESUMO

Novel coronavirus disease (COVID-19) emerged in Wuhan in December 2019, has spread in many countries affected people globally. In response to the economic requirement of the nation and meet the need of patient's, a momentous event was going back to work step by step as fighting against COVID-19. Safety in clinical work is of priority as elective surgery in the department of surgery progressing. We used checklists based on our experiences on COVID-19 control and reality of clinical work from February to March in the West China Hospital, involving events of screening patient, chaperonage, and healthcare workers. Checklist summarized the actual clinical nursing work and management practices, hope to provide a reference for the order of surgery during the epidemic prevention and control, and standardize the clinical nursing work of surgery during pandemic.


Assuntos
Lista de Checagem/métodos , Infecções por Coronavirus/prevenção & controle , Procedimentos Cirúrgicos Eletivos/métodos , Controle de Infecções/organização & administração , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Procedimentos Cirúrgicos Vasculares/organização & administração , Distribuição de Qui-Quadrado , China , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Corpo Clínico Hospitalar , Saúde do Trabalhador , Avaliação de Resultados em Cuidados de Saúde , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Centro Cirúrgico Hospitalar/organização & administração
6.
J. negat. no posit. results ; 5(8): 792-805, ago. 2020. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-199312

RESUMO

ANTECEDENTES: La seguridad en la atención de los pacientes es un aspecto prioritario en la organización y funcionamiento de todo sistema de salud. La valoración de enfermería en las salas de internación permite detectar dificultades o problemas en el preoperatorio que pueden poner en riesgo la vida del paciente o el resultado esperado de la intervención. Se deben generar protocolos que garanticen seguridad para los pacientes disminuyendo al máximo los errores. OBJETIVO: Implementar la lista de verificación preoperatoria de enfermería para disminuir los errores en el ingreso de pacientes a quirófanos. LUGAR: Hospital Universitario-. División Quirófanos - Departamento de Cirugía - Dirección de Enfermería. POBLACIÓN: Pacientes internados para cirugías programadas. MÉTODO: Observacional, exploratorio, longitudinal prospectivo con análisis retrospectivo. Implementación preoperatoria de lista de verificación en sala de internación por enfermería. RESULTADOS: En Mayo de 2018 se operaron 355 pacientes en los quirófanos centrales. Hubo 183 errores de un total de 158 cirugías programadas. La falla más frecuente fue el ingreso de pacientes con ropa interior o ropa de cama en 59 (32,2%), seguido por falta de gorro o cofia en 22 (12%), e ingreso de pacientes con prótesis dental en 21 (11,5%). En la segunda etapa aún con la planilla de verificación de enfermería preoperatoria implementada persistieron los errores en un 48 %. CONCLUSIÓN: se deben promover acciones específicas para que los equipos quirúrgicos alcancen de forma sistemática las medidas de seguridad esenciales sin poner en riesgo la vida y bienestar de los pacientes quirúrgicos


BACKGROUND: The safety of patient care is a priority aspect in the organization and functioning of all health systems with direct implications on the quality of care. The assessment of nursing in the internment rooms allows to detect difficulties or problems in the preoperative that can endanger the life of the patient or the expected outcome of the intervention. This is where protocols must be generated to ensure safety for patients, minimizing errors. OBJECTIVE: To implement the pre-operative nursing checklist to reduce errors in the admission of patients to operating room. SETTING: University Hospital. Surgical Division - Department of Surgery - Nursing management. POPULATION: internal patients for scheduled surgeries. METHOD: Observational, exploratory, longitudinal prospective with retrospective analysis. Checklist preoperative nursing implementation. RESULTS: In May 2018, 355 patients were operated in the central operating rooms. 183 errors were found on 158 surgeries scheduled in a first stage. The most frequent failure was the admission of patients with underwear or bedding 59 (32.2%), followed by lack of cap or cap 22 (12%), and admission of patients with dental prosthesis 21 (11.5%). In the second stage, the nursing check list form was implemented but which could reduce the number of errors in the preoperative period to 48%. CONCLUSION: Specific actions should be promoted so that surgical teams systematically reach essential safety measures that jeopardize the life and well-being surgical patients


Assuntos
Humanos , Lista de Checagem/métodos , Cuidados Pré-Operatórios/enfermagem , Enfermagem Perioperatória/métodos , Gestão da Segurança/métodos , Segurança do Paciente/normas , Erros Médicos/prevenção & controle , Vestimenta Cirúrgica/normas , Consentimento Livre e Esclarecido
7.
J. negat. no posit. results ; 5(7): 721-725, jul. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-192329

RESUMO

INTRODUCCIÓN: Pandemia infectocontagiosa puede afectar a los equipos quirúrgicos actuantes. OBJETIVO: Presentar nuevo listado de verificación de cirugía segura. MÉTODO: Verificación en potenciales pacientes COVID-19 en el uso de instrumentos y vestuario tanto en la entrada como al finalizar el acto quirúrgico registrada en el reverso de la actual lista de verificación por el equipo quirúrgico actuante. CONCLUSIÓN: Aporte para prevención de equipos quirúrgicos actuantes


BACKGROUND: Infected pandemic may affect surgical team. OBJECTIVE: New safe surgery checklist was presented. METHOD: Checklist of safe surgery in potential COVID-19 patients with verification of the equipment surgical and the locker room used at the initial as well as in the removal end of surgical act registered on the back of the current checklist by the operating surgical team. CONCLUSION: Selfless contribution to protect the surgical team


Assuntos
Humanos , Pandemias/estatística & dados numéricos , Infecções por Coronavirus/complicações , Procedimentos Cirúrgicos Operatórios/normas , Gestão da Segurança/métodos , Infecção Hospitalar/prevenção & controle , Infecções por Coronavirus/epidemiologia , Precauções Universais/métodos , Segurança do Paciente/normas , Lista de Checagem/métodos , Controle de Doenças Transmissíveis/normas , Argentina/epidemiologia
8.
Br J Anaesth ; 125(2): 208-215, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32571570

RESUMO

INTRODUCTION: In the context of an increasing number of publications of trial data analysed by Bayesian methods, clinicians need support to better understand Bayesian statistical methods. The existing checklists are intended for people who already know these methods. We aimed to establish and validate a checklist that contains a group of items considered crucial in interpreting the results of a phase III RCT analysed with Bayesian methods. METHODS: A team of biostatisticians created a checklist of previously reported items and additional items identified from a literature review. Using three different articles in three rounds, the items were then validated by residents in anaesthesiology with no skills in statistics. RESULTS: Based on an initial item list, three rounds led to a consensus checklist. Eleven items were considered important information to be specified for understanding the validity of the results. Of these, three were considered essential: specification of the prior, source of the prior (when prior is informative), and the effect size point estimate with its credible interval. CONCLUSION: The checklist can help clinicians interpret the results of a phase III randomised clinical trial analysed by Bayesian methods, even clinicians with no particular knowledge of statistics, to ensure that the major elements of the statistical section are present and valid. Care should be taken in interpreting the results of a trial analysed by Bayesian methods that are not reported with these three essential items because the validity of the results cannot be established.


Assuntos
Teorema de Bayes , Lista de Checagem/métodos , Ensaios Clínicos como Assunto/estatística & dados numéricos , Consenso , Humanos , Reprodutibilidade dos Testes
10.
Medicine (Baltimore) ; 99(21): e20244, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32481301

RESUMO

BACKGROUND: Alzheimer's disease (AD) is the fifth-leading cause of death in people more than 65 years old. Acupuncture therapy has been traditionally used to treat various kinds of health problems including AD. This protocol aims to summarize the available evidence from current systematic reviews (SRs) for the efficacy of acupuncture therapy for AD. METHODS: Seven databases will be searched: PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Data, Chongqing VIP (CQVIP), and Chinese Biomedical Literature Database (CBM). SRs/meta-analyses (MAs) of acupuncture therapy for AD which were reported in Chinese or English will be included. Study selection, data extraction, and assessment of the study quality will be performed independently by 2 or more reviewers. And the methodological quality, report quality and evidence quality will be evaluated by Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool, Preferred Reporting Items for Systematic Reviews and Meta Analyses Statement (PRISMA) checklist and Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, respectively. RESULTS: The article in this overview will be submitted for publication in a peer-reviewed journal. CONCLUSION: We expect to compile evidence from multiple systematic reviews of acupuncture therapy in AD patients in an accessible and useful document.Registration number: INPLASY202040035.


Assuntos
Terapia por Acupuntura/métodos , Doença de Alzheimer/mortalidade , Doença de Alzheimer/terapia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/epidemiologia , Lista de Checagem/métodos , China/epidemiologia , Bases de Dados Factuais , Feminino , Humanos , Masculino , Editoração/provisão & distribução , Pesquisa Qualitativa , Resultado do Tratamento
11.
Geriatr Gerontol Int ; 20(7): 674-679, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32469470

RESUMO

AIMS: Existing analysis methods about the relationships between the long-term care (LTC) risks and determinants of the elderly often experience issues of independence, linearity and homogeneity. Such methodological issues are particularly problematic when the relationships are complicated, making the prioritization of LTC interventions to groups with different care needs difficult. To overcome these shortcomings, this study made an initial attempt to identify representative patterns of elderly people's LTC risks associated with different determinants, from a methodological perspective. METHODS: A data mining approach (Exhaustive CHAID) is applied to data collected from 26 357 elderly people in a Japanese city in 2016. It can automatically segment the samples into a tree structure that accommodates nonlinear, heterogeneous and sequential relationships, without caring about issues of independence across determinants. RESULTS: In total, 16 representative patterns are derived, among which four patterns are considerably riskier (the unhealthy percentage >10.0%), and five are moderately riskier (the unhealthy percentage is 5.0%-10.0%). Age is the most important determinant, followed by locomotor function, cognitive function, homebound, gender and residential location, in that order, which all show heterogeneous associations with the risk patterns. CONCLUSIONS: The Exhaustive CHAID is suitable to derive scientifically-sound insights into an early screening of risk factors for pre-frail groups and tailor-made preventive LTC interventions for frail groups in a flexible and objective way. Geriatr Gerontol Int 2020; 20: 674-679.


Assuntos
Idoso Fragilizado/estatística & dados numéricos , Avaliação Geriátrica/métodos , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Lista de Checagem/métodos , Cognição/fisiologia , Feminino , Humanos , Japão , Locomoção/fisiologia , Assistência de Longa Duração/estatística & dados numéricos , Masculino , Fatores de Risco , Inquéritos e Questionários
12.
Am J Emerg Med ; 38(6): 1171-1177, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32340822

RESUMO

OBJECTIVE: The extent of intervention reporting in emergency medicine journals remains unclear. The primary objective is to assess overall completion of the Template for Intervention Description and Replication (TIDieR) checklist described in emergency medicine randomized clinical trials (RCTs). The secondary outcomes were to (1) compare reporting before and after TIDieR publication; (2) evaluate factors associated with intervention reporting. METHODS: Our cross-sectional study used Google Scholar's metrics to identify seven emergency medicine journals; of which, we randomly sampled 300 articles. Using two PubMed searches, we extracted 150 RCTs before and after publications of TIDieR. Two investigators independently extracted data. The primary analysis to measure overall completion included descriptive statistics for each checklist item. Our secondary analysis used an interrupted time series analysis and generalized estimating equations to determine the effect of TIDieR publication on intervention reporting. RESULTS: Our initial search yielded 635 articles; from which, we randomly sampled 300 articles. We excluded 67 articles, leaving 233 for analysis. The mean number of TIDieR items reported was 5.4 (standard deviation = 1.18). Of the 233 trials, 42.9% provided information about materials, 67% provided intervention procedures, and 99.1% provided intervention delivery. The least reported items were intervention modifications (2.6%), intervention adherence assessment methods (3.4%), and intervention adherence assessment outcomes (2.2%). CONCLUSIONS: The completeness of intervention reporting is suboptimal in emergency medicine journals, necessitating improvement. The current state of adherence could be improved through the combined efforts of journal editors, major editorial organizations, and authors.


Assuntos
Ensaios Clínicos como Assunto/normas , Fidelidade a Diretrizes/normas , Editoração/instrumentação , Projetos de Pesquisa/normas , Lista de Checagem/instrumentação , Lista de Checagem/métodos , Lista de Checagem/estatística & dados numéricos , Ensaios Clínicos como Assunto/instrumentação , Ensaios Clínicos como Assunto/estatística & dados numéricos , Estudos Transversais , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Revisão por Pares/métodos , Editoração/normas , Editoração/estatística & dados numéricos , Projetos de Pesquisa/estatística & dados numéricos
13.
World Neurosurg ; 139: e769-e773, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32344143

RESUMO

The management of patients with novel coronavirus 2019 (COVID-19) represents a new challenge for medical and surgical teams. Each operating room in the world should be prepared thoughtfully, and the development of a protocol and patient route seems mandatory. An adequate degree of protection must be used. We propose recommendations to help different professionals in the establishment of protocols for the management of patients with COVID-19. We also offer a checklist that could be used in the operating room.


Assuntos
Betacoronavirus , Lista de Checagem/normas , Infecções por Coronavirus/cirurgia , Controle de Infecções/normas , Salas Cirúrgicas/normas , Pneumonia Viral/cirurgia , Guias de Prática Clínica como Assunto/normas , Lista de Checagem/métodos , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Pessoal de Saúde/normas , Humanos , Controle de Infecções/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão
15.
Medicine (Baltimore) ; 99(11): e19279, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32176051

RESUMO

The present study aims to analyze the effects of breast-conserving surgery and modified radical mastectomy on operation indexes, Symptom checklist-90 scores and prognosis in patients with early breast cancer.The clinical data of 128 patients with breast cancer who were treated in our hospital from May 2015 to May 2016 were included into the analysis. These patients were divided into 2 groups, according to the different modes of operation (n = 64): control group, patients underwent modified radical mastectomy; observation group, patients underwent early breast conserving surgery. Then, the surgical indexes and prognosis were compared between these 2 groups.Intraoperative bleeding volume, incision length and hospitalization duration were better in the observation group than in the control group (P < .05). Furthermore, postoperative symptom checklist-90 scores in the observation group were better than scores before the operation, and were better than the scores in the control group (P < .05). Moreover, the incidence of postoperative complications was lower in the observation group (3.13%) than in the control group (21.88%, P < .05).Early breast-conserving surgery is more advantageous for breast cancers and results to lesser bleeding, rapid recovery, and fewer complications.


Assuntos
Neoplasias da Mama/cirurgia , Lista de Checagem/métodos , Detecção Precoce de Câncer , Mastectomia Radical Modificada/métodos , Mastectomia Segmentar/métodos , Adulto , Idoso , Perda Sanguínea Cirúrgica , Neoplasias da Mama/mortalidade , Estudos de Casos e Controles , China , Intervalo Livre de Doença , Feminino , Humanos , Complicações Intraoperatórias/epidemiologia , Complicações Intraoperatórias/fisiopatologia , Tempo de Internação , Mastectomia Radical Modificada/mortalidade , Mastectomia Segmentar/mortalidade , Pessoa de Meia-Idade , Duração da Cirurgia , Prognóstico , Valores de Referência , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento
16.
Behav Ther ; 51(2): 310-319, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32138940

RESUMO

Given the prominence of the Aberrant Behavior Checklist (ABC), Irritability Subscale (ABC-I), in treatment outcome studies, we conducted a critical examination of its internal consistency and relationship to other measures of irritability in 758 psychiatrically hospitalized youth with autism spectrum disorder. In exploratory and confirmation samples, we conducted factor and bifactor analyses to describe the internal structure of the ABC-I. Our results suggest that the ABC-I roughly represents a unidimensional construct of irritability, as indicated by a general factor in bifactor analysis. In addition to irritability, subordinate factors are presented that represent tantrums, verbal outbursts, self-harm, and negative affect. Notably, self-harm items explain a large proportion of variance independent of irritability. Therefore, their contribution in analyses of treatment effects should be considered. Further study or revision of the ABC-I may improve convergent validity with transdiagnostic formulations of irritability as well as prevent confound from self-harm in treatment studies for irritability in ASD.


Assuntos
Transtorno do Espectro Autista/psicologia , Lista de Checagem/métodos , Transtornos do Comportamento Infantil/diagnóstico , Humor Irritável , Escalas de Graduação Psiquiátrica , Adolescente , Agressão , Criança , Pré-Escolar , Feminino , Hospitais Psiquiátricos , Humanos , Masculino , Comportamento Autodestrutivo/psicologia
17.
Int J Evid Based Healthc ; 18(1): 75-85, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32141949

RESUMO

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.


Assuntos
Antineoplásicos/administração & dosagem , Transplante de Medula Óssea , Documentação/normas , Enfermagem Oncológica/métodos , Antineoplásicos/efeitos adversos , Brasil , Lista de Checagem/métodos , Fidelidade a Diretrizes , Hospitais Universitários , Humanos , Recursos Humanos de Enfermagem no Hospital/normas , Enfermagem Oncológica/educação , Guias de Prática Clínica como Assunto
18.
BMJ Open Qual ; 9(1)2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32019751

RESUMO

Over 90% of patients with head trauma seen in emergency departments (EDs) are diagnosed with minor head injuries. Over-utilisation of CT scans results in unnecessary exposure to radiation and increases healthcare utilisation. Using recommendations from the Choosing Wisely Canada (CWC) campaign and quality improvement (QI) methodology, we aimed to reduce the CT scan rate for head injuries by 10% over a 6-month period.Baseline CT scan rates were determined through a 27-month retrospective cohort review. We used stakeholder engagement and provider surveys to develop our driver diagram and Plan-Do-Study-Act (PDSA) cycles, which included (1) improving provider knowledge about the CWC campaign recommendations; (2) testing, refining and implementing a modified Canadian CT Head Rule checklist; (3) developing CWC-themed head injury-specific patient handouts; and (4) feedback on CT scan group ordering rates to providers. Our primary outcome measure was the number of CT scans performed for patients with head injuries. Process measures included the number of checklists completed and ED length of stay (LOS). Our balancing measure was return ED visits within 72 hours (with or without admission).Baseline CT scan rates prior to our interventions was 46.1%. Our QI initiative resulted in a 'shift' in the Statistical Process Control chart of the weekly CT scan rates, associated with the first and second PDSA cycles, resulting in a 13.9% reduction in CT rates during the initial 3 months, and a sustained reduction of 8% at 16 months (p<0.05). Mean ED LOS for all patients with head injuries decreased by 1.5 min (p=0.74). 33% of checklists were completed. 72-hour return visits did not change significantly (p=0.68).Through provider and patient education, and the creation of a user-friendly evidence-based tool, our local QI initiative was successful in achieving long-term reduction in CT rates for patients presenting to EDs with head injuries.


Assuntos
Traumatismos Craniocerebrais/terapia , Diagnóstico por Imagem/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Melhoria de Qualidade , Lista de Checagem/métodos , Lista de Checagem/normas , Lista de Checagem/estatística & dados numéricos , Traumatismos Craniocerebrais/fisiopatologia , Diagnóstico por Imagem/normas , Gerenciamento Clínico , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Ontário , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos , Tomografia Computadorizada por Raios X/estatística & dados numéricos
19.
Brain Connect ; 10(2): 53-71, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32093486

RESUMO

Response variability between individuals (interindividual variability) and within individuals (intraindividual variability) is an important issue in the transcranial magnetic stimulation (TMS) literature. This has raised questions of the validity of TMS to assess changes in corticospinal excitability (CSE) in a predictable and reliable manner. Several participant-specific factors contribute to this observed response variability with a current lack of consensus on the degree each factor contributes. This highlights a need for consistency and structure in reporting study designs and methodologies. Currently, there is no summarized review of the participant-specific factors that can be controlled and may contribute to response variability. This systematic review aimed to develop a checklist of methodological measures taken by previously published research to increase the homogeneity of participant selection criteria, preparation of participants before experimental testing, participant scheduling, and the instructions given to participants throughout experimental testing to minimize their effect on response variability. Seven databases were searched in full. Studies were included if CSE was measured via TMS and included methodological measures to increase the homogeneity of the participants. Eighty-four studies were included. Twenty-three included measures to increase participant selection homogeneity, 21 included measures to increase participant preparation homogeneity, while 61 included measures to increase participant scheduling and instructions during experimental testing homogeneity. These methodological measures were summarized into a user-friendly checklist with considerations, suggestions, and rationale/justification for their inclusion. This may provide the framework for further insights into ways to reduce response variability in TMS research.


Assuntos
Lista de Checagem , Tratos Piramidais , Estimulação Magnética Transcraniana/métodos , Lista de Checagem/métodos , Humanos , Seleção de Pacientes , Tratos Piramidais/fisiologia , Tratos Piramidais/fisiopatologia , Reprodutibilidade dos Testes , Estimulação Magnética Transcraniana/normas
20.
J Clin Nurs ; 29(7-8): 1267-1275, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31944438

RESUMO

AIMS AND OBJECTIVES: To explore the extent to which a checklist designed to support patient safety in hospital Emergency Departments was recognised and used by staff. BACKGROUND: Patient crowding in UK Emergency Departments makes it difficult for staff to monitor all patients for signs of clinical deterioration. An Emergency Department Safety Checklist was developed at a UK hospital to ensure patients are regularly monitored. It was subsequently implemented in six hospitals and recommended for use across the National Health Service in England. METHODS: This was a qualitative study in two UK hospital Emergency Departments. Data collection consisted of sixty-six hours of nonparticipant observation and interviews with twenty-six staff. Observations were sampled across different days and times. Interviews sampled a range of staff. Data were analysed thematically. The study was undertaken in accordance with COREQ guidelines. RESULTS: Staff described the Emergency Department Safety Checklist as a useful prompt and reminder for monitoring patients' vital signs and other aspects of care. It was also reported as effective in communicating patient care status to other staff. However, completing the checklist was also described as a task which could be overlooked during busy periods. During implementation, the checklist was promoted to staff in ways that obscured its core function of maintaining patient safety. CONCLUSIONS: The Emergency Department Safety Checklist can support staff in maintaining patient safety. However, it was not fully recognised by staff as a core component of everyday clinical practice. RELEVANCE TO CLINICAL PRACTICE: The Emergency Department Safety Checklist is a response to an overcrowded environment. To realise the potential of the checklist, emergency departments should take the following steps during implementation: (a) focus on the core function of clinical safety, (b) fully integrate the checklist into the existing workflow and (c) employ a departmental team-based approach to implementation and training.


Assuntos
Lista de Checagem/métodos , Serviço Hospitalar de Emergência/organização & administração , Segurança do Paciente/normas , Inglaterra , Feminino , Humanos , Masculino , Recursos Humanos de Enfermagem no Hospital/organização & administração , Pesquisa Qualitativa , Melhoria de Qualidade , Fluxo de Trabalho
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