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1.
Rev. enferm. UERJ ; 28: e48578, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1116102

RESUMO

Objetivo: conhecer a experiência dos pais como estratégia de avaliação da qualidade da assistência de enfermagem. Método: pesquisa descritiva com abordagem qualitativa, desenvolvida na Unidade Neonatal de um Hospital do sul do Brasil. A coleta de dados foi realizada através de entrevistas, utilizando a técnica do incidente crítico (TIC), com 18 pais que estavam com seus filhos internados por 20 dias ou mais e que tinham previsão e plano de alta hospitalar. Após, os dados foram submetidos à análise de conteúdo. Resultados: a análise revelou fragilidades no cuidado prestado pela equipe de enfermagem em relação à administração de medicamentos, ao uso de equipamentos, à monitorização e ao posicionamento dos bebês, aos cuidados com a pele e à higiene de mãos. Conclusão: a experiência dos pais revelou elementos que integram a avaliação da assistência em enfermagem, destacando-os como pilares para a segurança do paciente.


Objective: to learn the parents' experience as a strategy for assessing the quality of nursing care. Method: in this qualitative, descriptive study at the Neonatal Unit of a hospital in southern Brazil, data were collected by critical incident (CI) interviews of 18 parents whose children had been hospitalized for 20 days or more, and whose discharge was scheduled and planned for. The data subsequently underwent content analysis. Results: data analysis revealed weaknesses in the care provided by the nursing staff as regards administration of medication, use of equipment, monitoring and positioning of babies, skin care and hand hygiene. Conclusion: The parents' experience revealed elements that enter into evaluation of nursing care, revealing parents to be mainstays of patient safety.


Objetivo: conocer la experiencia de los padres como estrategia para evaluar la calidad de la atención de enfermería. Método: en este estudio cualitativo y descriptivo en la Unidad Neonatal de un hospital en el sur de Brasil, los datos fueron recolectados por entrevistas de incidentes críticos (IC) de 18 padres cuyos hijos habían estado hospitalizados durante 20 días o más, y cuyo alta fue programada y planificada para. Los datos posteriormente se sometieron a análisis de contenido. Resultados: el análisis de datos reveló debilidades en la atención brindada por el personal de enfermería en lo que respecta a la administración de medicamentos, uso de equipos, monitoreo y posicionamiento de bebés, cuidado de la piel e higiene de manos. Conclusión: la experiencia de los padres reveló elementos que entran en la evaluación de la atención de enfermería, revelando que los padres son pilares de la seguridad del paciente.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Adulto , Pais , Qualidade da Assistência à Saúde , Unidades de Terapia Intensiva Neonatal/normas , Segurança do Paciente , Equipe de Enfermagem/normas , Análise e Desempenho de Tarefas , Brasil , Terapia Intensiva Neonatal , Pesquisa Qualitativa , Dano ao Paciente/prevenção & controle
2.
Rev. enferm. UERJ ; 28: 42281, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1094844

RESUMO

Objetivo: identificar evidências acerca do uso seguro da hipotermia terapêutica em recém-nascidos. Método: revisão integrativa realizada entre junho e julho de 2018, em fontes eletrônicas da Biblioteca Virtual de Saúde e PubMed, por meio da pergunta:"Que evidências podem subsidiar o cuidado de enfermagem voltado para a redução de sequelas em recém-nascidos submetidos à hipotermia terapêutica?".Foram eleitos nove artigos para análise, sendo oito internacionais e um nacional. Resultados:o resfriamento deve acontecer por 72 horas, com hipotermia leve. As indicações para inclusão no protocolo foram: primeiras seis horas de vida, idade gestacional maior que 35 semanas e acidose na primeira hora de vida.São cuidados essenciais: monitoração hemodinâmica, observação da pele, controle térmico retal, vigilância do Eletroencefalograma de Amplitude Integrada. Conclusão: a terapêutica apresenta benefícios, porém sua aplicação depende de protocolo institucional e treinamento das equipes com foco nas potenciais complicações.


Objective: to identify the evidence on safe use of therapeutic hypothermia in newborns. Method: integrative review of the literature, conducted between June and July of 2018, in electronic sources from the Virtual Health Library and PubMed, through the question: "What evidence can support nursing care aimed at reducing sequelae in newborns undergoing therapeutic hypothermia?". Analysis was conducted for nine selected article, being eight from international literature and one from Brazilian national literature. Results: cooling should occur for 72 hours with mild hypothermia. Indications for inclusion in the protocol were: first six hours of life, gestational age greater than 35 weeks and acidosis in the first hour of life. Essential care includes hemodynamic monitoring, skin observation, rectal thermal control, Integrated Amplitude Electroencephalogram surveillance. Conclusion: the therapy has benefits, but its application depends on institutional protocol and team training focusing on potential complications.


Objetivo: identificar la evidencia sobre el uso seguro de la hipotermia terapéutica en recién nacidos. Método: revisión integradora de la literatura, realizada entre junio y julio de 2018, en fuentes electrónicas de la Biblioteca Virtual de Salud y PubMed, a través de la pregunta: "¿Qué evidencia puede apoyar la atención de enfermería dirigida a reducir las secuelas en los recién nacidos que sufren hipotermia terapéutica?". Se realizaron análisis para nueve artículos seleccionados, ocho de literatura internacional y uno de literatura nacional brasileña. Resultados: el enfriamiento debe ocurrir durante 72 horas con hipotermia leve. Las indicaciones para la inclusión en el protocolo fueron: primeras seis horas de vida, edad gestacional mayor de 35 semanas y acidosis en la primera hora de vida. El cuidado esencial incluye monitoreo hemodinámico, observación de la piel, control térmico rectal, vigilancia integrada de electroencefalograma de amplitud. Conclusión: la terapia tiene beneficios, pero su aplicación depende del protocolo institucional y del entrenamiento del equipo, enfocándose en posibles complicaciones.


Assuntos
Humanos , Recém-Nascido , Protocolos Clínicos/normas , Hipóxia-Isquemia Encefálica/terapia , Segurança do Paciente/normas , Hipotermia Induzida/métodos , Hipotermia Induzida/normas , Asfixia Neonatal/complicações , Hipóxia-Isquemia Encefálica/etiologia , Hipotermia Induzida/efeitos adversos , Hipotermia Induzida/enfermagem
3.
Texto & contexto enferm ; 29: e20200119, Jan.-Dec. 2020.
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1115946

RESUMO

ABSTRACT Objective: to describe the actions performed by nurses from the mobile pre-hospital service before, during, and after consultations and transfers of suspected and/or confirmed patients of Covid-19, and the limitations found by these professionals on reducing exposure to the disease. Method: a descriptive-reflective study about the actions performed by nurses from the mobile pre-hospital service in a capital city in southern Brazil to increase safety during consultations or transfers of suspected and/or confirmed patients of Covid-19. Results: the study allowed us to reflect on the multidimensionality of actions necessary for the prevention and control of the pandemic. Attitudes were identified to ensure instrumental safety in mobile units, professional safety, and patient safety in mobile pre-hospital care. Conclusion: regarding the nurses, concern with the safety of the professionals and patients was identified, since they adopted conducts for the prevention and control of the pandemic through the use of equipment, materials, and preparation of the ambulance. Subjective aspects of the professionals involved must be considered, such as technical and psychological preparation, which is a fundamental aspect both for serving the population and for the safety of the patient and the professional in terms of exposure to the virus.


RESUMEN Objetivo: describir las acciones llevadas a cabo por enfermeros del servicio prehospitalario móvil antes, durante y después de consultas y transferencias de pacientes sospechosos y/o confirmados respecto del Covid-19 y las limitaciones encontradas por estos profesionales para reducir la exposición a la enfermedad. Método: estudio descriptivo-reflexivo sobre las acciones realizadas por enfermeros del servicio móvil prehospitalario en una ciudad capital del sur de Brasil para aumentar la seguridad durante las consultas o transferencias de pacientes sospechosos y / o confirmados de Covid-19. Resultados: el estudio nos permitió reflexionar sobre el carácter multidimensional de las acciones necesarias para la prevención y el control de la pandemia. Se identificaron conductas para garantizar la seguridad instrumental en las unidades móviles, la seguridad profesional y la seguridad del paciente en la atención prehospitalaria móvil. Conclusión: de parte de los enfermeros, se identificó una preocupación por la seguridad de los profesionales y pacientes, ya que adoptaron conductas para la prevención y el control de la pandemia mediante el uso de equipos, materiales y preparación de la ambulancia. Se deben considerar los aspectos subjetivos de los profesionales involucrados, como la preparación técnica y psicológica, que es un aspecto fundamental tanto para atender a la población como para la seguridad del paciente y del profesional en términos de exposición al virus.


RESUMO Objetivo: descrever as ações realizadas por enfermeiros do serviço pré-hospitalar móvel antes, durante e após atendimentos e transferências de pacientes suspeitos e/ou confirmados para Covid-19 e as limitações encontradas por esses profissionais para diminuir a exposição à doença. Método: estudo descritivo-reflexivo acerca das ações realizadas por enfermeiros do serviço pré-hospitalar móvel de uma capital no Sul do Brasil para aumentar a segurança durante os atendimentos ou transferências de pacientes suspeitos e/ou confirmados para Covid-19. Resultados: o estudo permitiu refletir sobre a multidimensionalidade de ações necessárias para prevenção e controle da pandemia. Foram identificadas condutas para garantir a segurança instrumental nas unidades móveis, a segurança profissional e a segurança do paciente em atendimento pré-hospitalar móvel. Conclusão: por parte dos enfermeiros, identificou-se preocupação com a segurança dos profissionais e pacientes, uma vez que adotaram condutas para a prevenção e controle da pandemia mediante a utilização de equipamentos, materiais e preparo da ambulância. Aspectos subjetivos dos profissionais envolvidos devem ser considerados, como o preparo técnico e psicológico, sendo este um aspecto fundamental tanto para o atendimento à população como para a segurança do paciente e do profissional na exposição ao vírus.


Assuntos
Humanos , Enfermagem em Emergência , Infecções por Coronavirus , Pandemias , Segurança do Paciente , Profissionais de Enfermagem , Cuidados de Enfermagem
4.
Rev. enferm. UERJ ; 28: e42793, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1118060

RESUMO

Objetivo: descrever a elaboração de protocolo para a identificação do paciente com transtorno mental agudo. Método: estudo exploratório e qualitativo, realizado de maio 2018 a janeiro 2019, por meio das etapas: revisão integrativa da literatura, questionário online respondido por 17 profissionais de saúde vinculados à Sociedade Brasileira para a Qualidade do Cuidado e Segurança do Paciente, e grupo focal com 04 especialistas em Saúde Mental. Para tratamento dos dados, utilizou-se a análise descritiva e comparativa. Resultados: na revisão não se encontraram artigos sobre identificação do paciente com transtorno mental agudo. Na consulta aos especialistas da segurança do paciente identificou-se que 82,3% não possuíam em suas instituições protocolo específico. No grupo focal evidenciou-se dificuldade na identificação deste paciente. Conclusão: acreditase que o protocolo com a inserção da pulseira fotográfica apresenta-se como uma ferramenta inovadora na redução de riscos associados à identificação deste paciente.


Objective: to describe the development of a protocol for identification of patients with acute mental disorders. Method: this qualitative exploratory study was carried out from May 2018 to January 2019 through an integrative literature review, an online questionnaire answered by 17 health personnel belonging to the Brazilian Society for Quality of Care and Patient Safety, and a focus group of four mental health experts. Results: no articles specifically on identification for patients with acute mental disorders were found in the review. The consultation of patient safety experts found that 82.3% had no specific protocol in their institutions. The focal group highlighted difficulties communicating with these patients. Conclusion: the protocol including the photographic bracelet is believed to constitute an innovative tool for reducing risks associated with identification of these patients.


Objetivo: describir el desarrollo de un protocolo para la identificación de pacientes con trastornos mentales agudos. Método: este estudio exploratorio cualitativo se realizó de mayo de 2018 a enero de 2019 a través de una revisión integradora de la literatura, un cuestionario en línea respondido por 17 miembros del personal de salud pertenecientes a la Sociedad Brasileña de Calidad de Atención y Seguridad del Paciente, y un grupo focal de cuatro personas de salud mental expertos. Resultados: en la revisión no se encontraron artículos específicos sobre identificación de pacientes con trastornos mentales agudos. La consulta de expertos en seguridad del paciente encontró que el 82,3% no tenía un protocolo específico en sus instituciones. El grupo focal destacó las dificultades para comunicarse con estos pacientes. Conclusión: se cree que el protocolo que incluye la pulsera fotográfica constituye una herramienta innovadora para reducir los riesgos asociados a la identificación de estos pacientes.


Assuntos
Humanos , Sistemas de Identificação de Pacientes , Qualidade da Assistência à Saúde , Medidas de Segurança , Pessoas Mentalmente Doentes , Segurança do Paciente , Brasil , Inquéritos e Questionários , Grupos Focais , Pesquisa Qualitativa , Inovação
6.
Med. clín (Ed. impr.) ; 155(7): 281-287, oct. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-191724

RESUMO

OBJETIVOS: Determinar la prevalencia de interacciones potenciales en pacientes COVID-19 en tratamiento con lopinavir/ritonavir (LPV/r). El objetivo secundario fue elaborar recomendaciones e identificar los factores de riesgo asociados a presentar interacciones potenciales con LPV/r. SUJETOS Y MÉTODOS: Estudio transversal y multicéntrico con la participación de 2 hospitales. Se incluyeron pacientes COVID-19 mayores de 18 años, con ingreso hospitalario y en tratamiento con LPV/r. Se realizó un cribado de las interacciones potenciales relacionadas con LPV/r y la medicación domiciliaria y hospitalaria. Se utilizó como base de datos de consulta Lexicomp® (Uptodate), HIV-drug interacctions y COVID-drug interacctions. RESULTADOS: Se incluyeron 361 pacientes con una media de edad de 62,77 ± 14,64 años, donde el 59,6% (n = 215) fueron hombres. El 62,3% (n=225) tuvieron una o más interacciones potenciales y el 26, 87% (n = 97) 2 o más. Las variables independientes asociadas a presentar ≥ 1 interacciones potenciales fueron la edad (> 65) (OR 1,95; IC 95% 1,06-3,59; P = 0,033), el ingreso en UCI (OR 9,22; IC 95% 1,98-42,93; P = 0,005), la enfermedad previa respiratoria (OR 2,90; IC 95% 1,15-7,36; P = 0,024), psiquiátrica (OR 4,14; IC 95% 1,36-12,61; P = 0,013), la dislipemia (OR 3,21; IC 95% 1,63-6,35; P = 0,001) y el número de fármacos prescrito (OR 4,33; IC 95% 2,40-7,81; P = 0,000). CONCLUSIÓN: La prevalencia de interacciones potenciales en paciente COVID-19 en tratamiento con LPV/r es elevada, comportándose como factores de riesgo asociados la edad (> 65), el ingreso en UCI, la enfermedad previa respiratoria, psiquiátrica y la dislipemia y el número de fármacos prescritos


OBJECTIVES: To determine the prevalence of potential interactions in COVID-19 patients receiving lopinavir/ritonavir (LPV/r). The secondary objective was to develop recommendations and identify the risk factors associated with presenting potential interactions with LPV/r. SUBJECTS AND METHODS: Cross-sectional and multicenter study with the participation of 2 hospitals. COVID-19 patients over 18 years of age, admitted to hospital and under treatment with LPV/r were included. A screening of potential interactions related to LPV/r and home and hospital medication was carried out. Lexicomp® (Uptodate), HIV-drug interactions and COVID-drug interactions were used as the query database. RESULTS: 361 patients with a mean age of 62.77 ± 14.64 years were included, where 59.6% (n = 215) were men. 62.3% (n = 225) had 1 or more potential interactions and 26, 87% (n = 97) 2 or more. The independent variables associated with presenting ≥ 1 potential interactions were age (> 65) (OR 1.95; 95% CI 1.06-3.59, P =.033), ICU admission (OR 9.22; CI 95% 1.98-42.93; P = .005), previous respiratory pathology (OR 2.90; 95% CI 1.15-7.36; P =.024), psychiatric (OR 4.14; 95 CI % 1.36-12.61; P =.013), dyslipidemia (OR 3.21; 95% CI 1.63-6.35; P = .001) and the number of drugs prescribed (OR 4.33; 95% CI 2.40-7.81; P =.000). CONCLUSION: The prevalence of potential interactions in COVD-19 patient undergoing treatment with LPV/r is high, with age (> 65), ICU admission, previous respiratory and psychiatric pathology, dyslipidemia and the number of prescribed drugs acting as risk factors


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Lopinavir/farmacocinética , Ritonavir/farmacocinética , Infecções por Coronavirus/tratamento farmacológico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Fatores de Risco , Pneumonia Viral/tratamento farmacológico , Lopinavir/uso terapêutico , Ritonavir/uso terapêutico , Interações Medicamentosas , Inibidores de Proteases/uso terapêutico , Betacoronavirus/efeitos dos fármacos , Segurança do Paciente
7.
ScientificWorldJournal ; 2020: 7945309, 2020.
Artigo em Inglês | MEDLINE | ID: covidwho-840648

RESUMO

As early as December 2019 in the province of Hubei, China, contamination of patients with pneumonia of an unknown etiology occurred. These patients presented with symptoms such as coughing, sore throat, malaise, diarrhea, high fever, and dyspnea. This emerging disease was named COVID-19 due to being part of the group of coronaviruses (CoVs) belonging to the subfamily Orthocoronavirinae, in the Coronaviridae family and in the Nidovirales order. COVID-19 is most commonly transmitted through speech, coughing, sneezing, and salivary sputum. Because dental professionals work closely with the oral cavity, it is imperative that infection prevention controls are strictly adhered to. It is important that the dental profession treats patients while also limiting the possible contamination through the production of aerosol in the dental environment. Furthermore, the dental professional also has a key role in raising awareness and guidance amongst the population concerning COVID-19 related biosafety measures. This literature review aims to inform dental professionals about the COVID-19 pandemic and to present the implications of the virus to the dentist. Dental professionals are considered to be at high risk for contracting SARS-CoV-2.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Odontólogos , Procedimentos Cirúrgicos Bucais , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Papel Profissional , Segurança , Infecções por Coronavirus/epidemiologia , Humanos , Segurança do Paciente , Pneumonia Viral/epidemiologia , Medição de Risco
8.
PLoS One ; 15(10): e0240397, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33031464

RESUMO

BACKGROUND: There is a need to understand the impact of COVID-19 on colorectal cancer care globally and determine drivers of variation. OBJECTIVE: To evaluate COVID-19 impact on colorectal cancer services globally and identify predictors for behaviour change. DESIGN: An online survey of colorectal cancer service change globally in May and June 2020. PARTICIPANTS: Attending or consultant surgeons involved in the care of patients with colorectal cancer. MAIN OUTCOME MEASURES: Changes in the delivery of diagnostics (diagnostic endoscopy), imaging for staging, therapeutics and surgical technique in the management of colorectal cancer. Predictors of change included increased hospital bed stress, critical care bed stress, mortality and world region. RESULTS: 191 responses were included from surgeons in 159 centers across 46 countries, demonstrating widespread service reduction with global variation. Diagnostic endoscopy was reduced in 93% of responses, even with low hospital stress and mortality; whilst rising critical care bed stress triggered complete cessation (p = 0.02). Availability of CT and MRI fell by 40-41%, with MRI significantly reduced with high hospital stress. Neoadjuvant therapy use in rectal cancer changed in 48% of responses, where centers which had ceased surgery increased its use (62 vs 30%, p = 0.04) as did those with extended delays to surgery (p<0.001). High hospital and critical care bed stresses were associated with surgeons forming more stomas (p<0.04), using more experienced operators (p<0.003) and decreased laparoscopy use (critical care bed stress only, p<0.001). Patients were also more actively prioritized for resection, with increased importance of co-morbidities and ICU need. CONCLUSIONS: The COVID-19 pandemic was associated with severe restrictions in the availability of colorectal cancer services on a global scale, with significant variation in behaviours which cannot be fully accounted for by hospital burden or mortality.


Assuntos
Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/terapia , Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos Eletivos , Alocação de Recursos para a Atenção à Saúde , Pneumonia Viral/epidemiologia , Betacoronavirus/fisiologia , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Feminino , Gastroenterologia/organização & administração , Gastroenterologia/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Pandemias , Segurança do Paciente
9.
Med Hypotheses ; 143: 110110, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33017904

RESUMO

Current formulations and dose regimens of hydroxychloroquine (HCQ) put patients at risk of harm. An analysis of clinical trials registered on ClinicalTrials.gov revealed that this may continue as many studies combine HCQ with agents that prolong the QT interval. Further, almost all of the trials registered do not consider dosage adjustment in the elderly, a patient population most likely to require HCQ treatment. Here we describe an inhaled formulation of HCQ which has passed safety studies in clinical trials for the treatment of asthma and discuss how this approach may reduce side-effects and improve efficacy. As this simple formulation progressed to phase II studies, safety data can be used to immediately enable phase II trials in COVID-19.


Assuntos
Infecções por Coronavirus/tratamento farmacológico , Hidroxicloroquina/administração & dosagem , Pulmão/efeitos dos fármacos , Pneumonia Viral/tratamento farmacológico , Administração por Inalação , Adolescente , Adulto , Idoso , Asma/tratamento farmacológico , Betacoronavirus , Ensaios Clínicos Fase I como Assunto , Ensaios Clínicos Fase II como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Segurança do Paciente , Resultado do Tratamento , Adulto Jovem
11.
Ital J Pediatr ; 46(1): 149, 2020 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-33032650

RESUMO

The rapid spread of the COVID-19 outbreak in Italy has dramatically impacted the National Healthcare System, causing the sudden congestion of hospitals, especially in Northern Italy, thus imposing drastic restriction of almost all routine medical care. This exceptional adaptation of the Italian National Healthcare System has also been felt by non-frontline settings such as Pediatric Orthopaedic Units, where the limitation or temporary suspension of most routine care activities met with a need to maintain continuity of care and avoid secondary issues due to the delay or suspension of the routine clinical practice. The Italian Society of Pediatric Orthopaedics and Traumatology formulated general and specific recommendations to face the COVID-19 outbreak, aiming to provide essential care for children needing orthopaedic treatments during the pandemic and early post-peak period, ensure safety of children, caregivers and healthcare providers and limit the spread of contagion.


Assuntos
Infecção Hospitalar/prevenção & controle , Assistência à Saúde/organização & administração , Procedimentos Ortopédicos/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde , Guias de Prática Clínica como Assunto/normas , Criança , Pré-Escolar , Tomada de Decisão Clínica , Feminino , Humanos , Itália , Masculino , Saúde do Trabalhador/estatística & dados numéricos , Procedimentos Ortopédicos/métodos , Ortopedia/normas , Segurança do Paciente , Pediatria/normas , Sociedades Médicas/normas , Traumatologia/normas
12.
World J Gastroenterol ; 26(36): 5387-5394, 2020 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-33024391

RESUMO

The current coronavirus pandemic is imposing unpreceded challenges to the practice of pediatric gastroenterology. These are highlighted in their impact on performing aerosol-generating endoscopy procedures and the need to accommodate longer room turnaround time for disinfection, ensuring appropriate and consistent safety measures for patients, staff and providers, and emphasizing the importance for screening patients for active coronavirus disease (COVID) infection before endoscopy when possible. Pediatric patients are less likely to exhibit severe COVID-related symptoms so survey-based screening would not be a sensitive measure to identify patients with active infections. To address the restrictions of patients coming for face to face clinic encounters, there has been rapid expansion of telehealth services in a very short time period with several difficulties encountered. To survive these challenges, pediatric gastroenterology practices need to adapt and accept flexibility in clinical operations with ongoing commitment to safety for patients and healthcare workers.


Assuntos
Infecções por Coronavirus , Gastroenterologia/métodos , Controle de Infecções/métodos , Pandemias , Segurança do Paciente , Pediatria/métodos , Pneumonia Viral , Betacoronavirus , Humanos , Telemedicina/tendências
13.
ScientificWorldJournal ; 2020: 7945309, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33029109

RESUMO

As early as December 2019 in the province of Hubei, China, contamination of patients with pneumonia of an unknown etiology occurred. These patients presented with symptoms such as coughing, sore throat, malaise, diarrhea, high fever, and dyspnea. This emerging disease was named COVID-19 due to being part of the group of coronaviruses (CoVs) belonging to the subfamily Orthocoronavirinae, in the Coronaviridae family and in the Nidovirales order. COVID-19 is most commonly transmitted through speech, coughing, sneezing, and salivary sputum. Because dental professionals work closely with the oral cavity, it is imperative that infection prevention controls are strictly adhered to. It is important that the dental profession treats patients while also limiting the possible contamination through the production of aerosol in the dental environment. Furthermore, the dental professional also has a key role in raising awareness and guidance amongst the population concerning COVID-19 related biosafety measures. This literature review aims to inform dental professionals about the COVID-19 pandemic and to present the implications of the virus to the dentist. Dental professionals are considered to be at high risk for contracting SARS-CoV-2.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Odontólogos , Procedimentos Cirúrgicos Bucais , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Papel Profissional , Segurança , Infecções por Coronavirus/epidemiologia , Humanos , Segurança do Paciente , Pneumonia Viral/epidemiologia , Medição de Risco
14.
Comput Math Methods Med ; 2020: 1391583, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33029193

RESUMO

Purpose: We aimed to analyze and evaluate the safety signals of ribavirin-interferon combination through data mining of the US Food and Drug Administration Adverse Event Reporting System (FAERS), so as to provide reference for the rationale use of these agents in the management of relevant toxicities emerging in patients with novel coronavirus pneumonia (COVID-19). Methods: Reports to the FAERS from 1 January 2004 to 8 March 2020 were analyzed. The proportion of report ratio (PRR), reporting odds ratio (ROR), and Bayesian confidence interval progressive neural network (BCPNN) method were used to detect the safety signals. Results: A total of 55 safety signals were detected from the top 250 adverse event reactions in 2200 reports, but 19 signals were not included in the drug labels. All the detected adverse event reactions were associated with 13 System Organ Classes (SOC), such as gastrointestinal, blood and lymph, hepatobiliary, endocrine, and various nervous systems. The most frequent adverse events were analyzed, and the results showed that females were more likely to suffer from anemia, vomiting, neutropenia, diarrhea, and insomnia. Conclusion: The ADE (adverse drug event) signal detection based on FAERS is helpful to clarify the potential adverse events related to ribavirin-interferon combination for novel coronavirus therapy; clinicians should pay attention to the adverse reactions of gastrointestinal and blood systems, closely monitor the fluctuations of the platelet count, and carry out necessary mental health interventions to avoid serious adverse events.


Assuntos
Infecções por Coronavirus/tratamento farmacológico , Interferons/efeitos adversos , Pneumonia Viral/tratamento farmacológico , Ribavirina/efeitos adversos , Adolescente , Adulto , Sistemas de Notificação de Reações Adversas a Medicamentos , Idoso , Algoritmos , Teorema de Bayes , Mineração de Dados , Esquema de Medicação , Quimioterapia Combinada/efeitos adversos , Feminino , Humanos , Interferons/administração & dosagem , Masculino , Pessoa de Meia-Idade , Redes Neurais de Computação , Razão de Chances , Pandemias , Segurança do Paciente , Ribavirina/administração & dosagem , Adulto Jovem
15.
Rev Lat Am Enfermagem ; 28: e3379, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33027407

RESUMO

OBJECTIVE: to understand how professional interaction takes place in the hospital organizational structure for the management of Permanent Education in Health, to guarantee patient safety and the quality of nursing care. METHOD: this is a qualitative study, which used the structuralist aspect of the Grounded Theory as a methodological framework. 27 interviewers participated in the study, who made up four sample groups. RESULTS: six categories and 13 subcategories were presented, representing the studied phenomenon and highlighting particularities of the public health system and the influence of the manager's support and management priority, the disposition of the organizational structure, the institutional culture, the external encouragement to institution, and the nurses' initiative and leadership in the professional interaction for the management of the Permanent Education in Health, patient safety, and quality of care triad, revealing the need for cultural change through interdisciplinarity. CONCLUSION: the professional interaction in the hospital organizational structure requires the creation of new management models with an emphasis on more participative management, in order to improve the care processes in hospital institutions.


Assuntos
Liderança , Segurança do Paciente , Hospitais , Humanos , Pesquisa Qualitativa
16.
Drugs Today (Barc) ; 56(9): 609-614, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: covidwho-804881

RESUMO

The Drug Information Association (DIA) Europe 2020 brought together multiple stakeholders from around the world including regulatory agencies, industry, patients and academia, to discuss the most innovative topics in healthcare. Main subjects covered were regulatory science, data and data standards, clinical safety and pharmacovigilance, translational medicines and science, patient engagement in clinical development, value and access, medical affairs and scientific communication, health policy, and public affairs and legal issues. The meeting, which was initially intended to take place in Brussels, was finally held virtually due to the COVID-19 situation. This report covers some of the sessions held on these 5 days of state-of-the-art topic discussions.


Assuntos
Participação do Paciente , Farmacovigilância , Pesquisa Médica Translacional , Congressos como Assunto , Infecções por Coronavirus , Europa (Continente) , Humanos , Pandemias , Segurança do Paciente , Pneumonia Viral
17.
World J Gastroenterol ; 26(36): 5387-5394, 2020 Sep 28.
Artigo em Inglês | MEDLINE | ID: covidwho-835896

RESUMO

The current coronavirus pandemic is imposing unpreceded challenges to the practice of pediatric gastroenterology. These are highlighted in their impact on performing aerosol-generating endoscopy procedures and the need to accommodate longer room turnaround time for disinfection, ensuring appropriate and consistent safety measures for patients, staff and providers, and emphasizing the importance for screening patients for active coronavirus disease (COVID) infection before endoscopy when possible. Pediatric patients are less likely to exhibit severe COVID-related symptoms so survey-based screening would not be a sensitive measure to identify patients with active infections. To address the restrictions of patients coming for face to face clinic encounters, there has been rapid expansion of telehealth services in a very short time period with several difficulties encountered. To survive these challenges, pediatric gastroenterology practices need to adapt and accept flexibility in clinical operations with ongoing commitment to safety for patients and healthcare workers.


Assuntos
Infecções por Coronavirus , Gastroenterologia/métodos , Controle de Infecções/métodos , Pandemias , Segurança do Paciente , Pediatria/métodos , Pneumonia Viral , Betacoronavirus , Humanos , Telemedicina/tendências
18.
Drugs Today (Barc) ; 56(9): 609-614, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: covidwho-834918

RESUMO

The Drug Information Association (DIA) Europe 2020 brought together multiple stakeholders from around the world including regulatory agencies, industry, patients and academia, to discuss the most innovative topics in healthcare. Main subjects covered were regulatory science, data and data standards, clinical safety and pharmacovigilance, translational medicines and science, patient engagement in clinical development, value and access, medical affairs and scientific communication, health policy, and public affairs and legal issues. The meeting, which was initially intended to take place in Brussels, was finally held virtually due to the COVID-19 situation. This report covers some of the sessions held on these 5 days of state-of-the-art topic discussions.


Assuntos
Participação do Paciente , Farmacovigilância , Pesquisa Médica Translacional , Congressos como Assunto , Infecções por Coronavirus , Europa (Continente) , Humanos , Pandemias , Segurança do Paciente , Pneumonia Viral
19.
Drugs Today (Barc) ; 56(9): 609-614, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33025954

RESUMO

The Drug Information Association (DIA) Europe 2020 brought together multiple stakeholders from around the world including regulatory agencies, industry, patients and academia, to discuss the most innovative topics in healthcare. Main subjects covered were regulatory science, data and data standards, clinical safety and pharmacovigilance, translational medicines and science, patient engagement in clinical development, value and access, medical affairs and scientific communication, health policy, and public affairs and legal issues. The meeting, which was initially intended to take place in Brussels, was finally held virtually due to the COVID-19 situation. This report covers some of the sessions held on these 5 days of state-of-the-art topic discussions.


Assuntos
Participação do Paciente , Farmacovigilância , Pesquisa Médica Translacional , Congressos como Assunto , Infecções por Coronavirus , Europa (Continente) , Humanos , Pandemias , Segurança do Paciente , Pneumonia Viral
20.
Rev. SOBECC ; 25(3): 128-135, 30-09-2020.
Artigo em Inglês | LILACS | ID: biblio-1122400

RESUMO

Objetivo: Analisar o processo de produção e execução do protocolo de cirurgia segura em dois hospitais terciários do município de Manaus. Método: Pesquisa guiada pelo design thinking, com ênfase na técnica do duplo diamante, realizada em dois hospitais públicos no município de Manaus, de julho de 2018 a março de 2019. Foi feita nas etapas: investigativa (observação e questionário) e interventiva (síntese, ideação e entrega). Resultados: Na primeira etapa, com 120 horas de observação, constatou-se que as três fases do protocolo não foram cumpridas; analisando-se as repostas a 63 questionários, reforçou-se a não adesão ao checklist. Com base nesses achados, na etapa de síntese, elegeu-se como foco a aplicação do checklist do protocolo; na etapa de ideação, realizou-se a proposição de solução e a testagem-piloto; a etapa de entrega da solução aos hospitais encerrou o ciclo. Conclusão: A análise do processo de execução do protocolo indicou seu descumprimento, o que sugere o comprometimento da segurança do paciente. A solução testada poderá, após entrega e implementação, contribuir para a execução efetiva do protocolo.


Objective: To analyze the process of elaboration and implementation of the surgical safety checklist in two tertiary hospitals in the city of Manaus. Method: This study was based on design thinking, focusing on the double diamond technique. It was conducted in two public hospitals in Manaus, from July 2018 to March 2019. The following stages were adopted for this research: investigation (observation and questionnaire) and intervention (synthesis, ideation, and delivery). Results: The first stage, consisting of 120 hours of observation, showed the non-fulfillment of the three phases of the process. After analyzing the answers to the 63 questionnaires, we confirmed the non-adherence to the checklist. Based on these findings, the synthesis phase focused on the use of the checklist; the ideation phase involved the proposal of solutions and the pilot testing; the delivery phase concluded the cycle by providing solutions to the hospitals. Conclusion: The analysis of the process of implementation of the checklist indicated non-compliance, suggesting risk to patient safety. After delivery and implementation, the tested solution may contribute to the effective execution of the checklist.


Objetivo: Analizar el proceso de producción y ejecución del Protocolo de Cirugía Segura en dos hospitales terciarios de la ciudad de Manaus. Método: Investigación guiada por Design Thinking, con énfasis en la técnica Double Diamond, llevada a cabo en dos hospitales públicos de la ciudad de Manaus, desde julio de 2018 hasta marzo de 2019. Se realizó por etapas: de investigación (observación y cuestionario) e intervencionista (síntesis, ideación y entrega). Resultados: En la primera etapa, con 120 horas de observación, se encontró que las tres fases del protocolo no se cumplieron; En base a las respuestas a 63 cuestionarios, se reforzó la no adhesión a la lista de verificación. Con base en estos hallazgos, en la etapa de síntesis, la aplicación de la lista de verificación del protocolo fue elegida como el foco; en la etapa de ideación, se llevaron a cabo la propuesta de solución y la prueba piloto;La etapa de entrega de la solución a los hospitales finalizó el ciclo. Conclusión: El análisis del proceso de ejecución del protocolo indicó incumplimiento, lo que sugiere comprometer la seguridad del paciente. La solución probada puede, después de la entrega y la implementación, contribuir a la ejecución efectiva del protocolo.


Assuntos
Humanos , Cirurgia Geral , Lista de Checagem , Segurança do Paciente , Protocolos , Hospitais , Hospitais Públicos
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