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Silva TL, dos Santos LM, Kusahara DM, Burciaga LVB, Biazus Dalcin C, de Souza S, Bitencourt ADS, Rocha PK. Factors associated with the disinfection of devices attached to peripheral intravenous catheters performed by the nursing team in pediatric units. J Infect Prev 2024; 25:66-72. [PMID: 38584710 PMCID: PMC10998550 DOI: 10.1177/17571774241231675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/21/2024] [Indexed: 04/09/2024] Open
Abstract
Background Peripheral intravenous catheterization, as well as drug administration through it, represents one of the most performed procedures by the Nursing team and, for that, precautions need to be adopted to offer harm-free care. Objective To verify the association of Nursing professionals' work shift and training time with proper disinfection of intravenous catheter devices in pediatric units. Methods A cross-sectional and analytical study conducted between June and August 2021 in three hospitalization units of a Pediatric Hospital. The inclusion criterion was drug administration via peripheral intravenous catheters performed by Nursing professionals. The data were analyzed according to inferential statistics, adopting p ≤ .05 as significance level. Results There were a total of 385 observations of drug administration procedures. The device was not disinfected in 60.3% of the cases, there was no friction at the suitable time in 86.3%, and the disinfectant was not allowed to dry in 72.5%. The work shift exerted no influence on performance of the disinfection procedure (p = .376). However, longer training time was associated with a lower rate in performing such procedure (p < .001). Conclusion Performing friction below the recommended time can cause a false sense of prevention of catheter-associated bloodstream infection; therefore, training sessions and strategies for adherence to the disinfection procedures should be considered, mainly for professionals with more training time.
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Affiliation(s)
- Thiago Lopes Silva
- Postgraduate Program in Nursing, Nursing Department, Health Sciences Centre, Universidade Federal de Santa Catarina, Florianopolis, Brazil
| | - Luciano Marques dos Santos
- Postgraduate Program in Nursing, Health Department, Universidade Estadual de Feira de Santana, Feira de Santana, Brazil
| | - Denise Miyuki Kusahara
- Postgraduate Program in Nursing, Sao Paulo School of Nursing, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | | | | | - Sabrina de Souza
- Postgraduate Program in Nursing, Nursing Department, Health Sciences Centre, Universidade Federal de Santa Catarina, Florianopolis, Brazil
| | - Aline de Souza Bitencourt
- Postgraduate Program in Nursing, Nursing Department, Health Sciences Centre, Universidade Federal de Santa Catarina, Florianopolis, Brazil
| | - Patrícia Kuerten Rocha
- Postgraduate Program in Nursing, Nursing Department, Health Sciences Centre, Universidade Federal de Santa Catarina, Florianopolis, Brazil
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Favre G, Richardson JL, Moore A, Geissbühler Y, Jehl V, Oliver A, Shechtman S, Diav-Citrin O, Berlin M, De Haan T, Baud D, Panchaud A, Mor A, Sabidó M, de Souza S, Chambers C, van Rijt-Weetink YRJ, van Puijenbroek EP, Yates LM, Girardin F, Stellfeld M, Winterfeld U. Improving Data Collection in Pregnancy Safety Studies: Towards Standardisation of Data Elements in Pregnancy Reports from Public and Private Partners, A Contribution from the ConcePTION Project. Drug Saf 2024; 47:227-236. [PMID: 38114757 PMCID: PMC10874316 DOI: 10.1007/s40264-023-01384-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION AND OBJECTIVE The ConcePTION project aims to improve the way medication use during pregnancy is studied. This includes exploring the possibility of developing a distributed data processing and analysis infrastructure using a common data model that could form a foundational platform for future surveillance and research. A prerequisite would be that data from various data access providers (DAPs) can be harmonised according to an agreed set of standard rules concerning the structure and content of the data. To do so, a reference framework of core data elements (CDEs) recommended for primary data studies on drug safety during pregnancy was previously developed. The aim of this study was to assess the ability of several public and private DAPs using different primary data sources focusing on multiple sclerosis, as a pilot, to map their respective data variables and definitions with the CDE recommendations framework. METHODS Four pregnancy registries (Gilenya, Novartis; Aubagio, Sanofi; the Organization of Teratology Information Specialists [OTIS]; Aubagio, Sanofi; the Dutch Pregnancy Drug Register, Lareb), two enhanced pharmacovigilance programmes (Gilenya PRIM, Novartis; MAPLE-MS, Merck Healthcare KGaA) and four Teratology Information Services (UK TIS, Jerusalem TIS, Zerifin TIS, Swiss TIS) participated in the study. The ConcePTION primary data source CDE includes 51 items covering administrative functions, the description of pregnancy, maternal medical history, maternal illnesses arising in pregnancy, delivery details, and pregnancy and infant outcomes. For each variable in the CDE, the DAPs identified whether their variables were: identical to the one mentioned in the CDE; derived; similar but with a divergent definition; or not available. RESULTS The majority of the DAP data variables were either directly taken (85%, n = 305/357, range 73-94% between DAPs) or derived by combining different variables (12%, n = 42/357, range 0-24% between DAPs) to conform to the CDE variables and definitions. For very few of the DAP variables, alignment with the CDE items was not possible, either because of divergent definitions (1%, n = 3/357, range 0-2% between DAPs) or because the variables were not available (2%, n = 7/357, range 0-4% between DAPs). CONCLUSIONS Data access providers participating in this study presented a very high proportion of variables matching the CDE items, indicating that alignment of definitions and harmonisation of data analysis by different stakeholders to accelerate and strengthen pregnancy pharmacovigilance safety data analyses could be feasible.
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Affiliation(s)
- Guillaume Favre
- Swiss Teratology Information Service and Clinical Pharmacology Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Materno-fetal and Obstetrics Research Unit, Department "Femme-Mère-Enfant", Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jonathan L Richardson
- UK Teratology Information Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Institute of Health and Society, Newcastle upon Tyne, UK
| | | | | | | | - Alison Oliver
- UK Teratology Information Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Svetlana Shechtman
- The Israeli Teratology Information Service, Ministry of Health, Jerusalem, Israel
| | - Orna Diav-Citrin
- The Israeli Teratology Information Service, Ministry of Health, Jerusalem, Israel
| | - Maya Berlin
- Clinical Pharmacology and Toxicology Unit, Drug Consultation Center, Shamir Medical Center (Assaf Harofeh), Affiliated with the Sackler Faculty of Medicine, Zerifin TIS, Tel Aviv University, Tel Aviv, Israel
| | - Tal De Haan
- Clinical Pharmacology and Toxicology Unit, Drug Consultation Center, Shamir Medical Center (Assaf Harofeh), Affiliated with the Sackler Faculty of Medicine, Zerifin TIS, Tel Aviv University, Tel Aviv, Israel
| | - David Baud
- Materno-fetal and Obstetrics Research Unit, Department "Femme-Mère-Enfant", Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Alice Panchaud
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Service of Pharmacy, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Anil Mor
- Epidemiology and Benefit Risk, Sanofi, North York, ON, Canada
| | | | | | - Christina Chambers
- Organization of Teratology Information Specialists (OTIS), University of California San Diego, San Diego, CA, USA
| | | | | | - Laura M Yates
- Northern Genetics Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- KRISP, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - François Girardin
- Swiss Teratology Information Service and Clinical Pharmacology Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Ursula Winterfeld
- Swiss Teratology Information Service and Clinical Pharmacology Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
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de Souza S, Rosario Claudio J, Sim J, Inyang KE, Dagenais A, Monahan K, Lee B, Ramakrishnan H, Parmar V, Geron M, Scherrer G, Folger JK, Laumet G. Interleukin-10 signaling in somatosensory neurons controls CCL2 release and inflammatory response. Brain Behav Immun 2024; 116:193-202. [PMID: 38081433 PMCID: PMC10843623 DOI: 10.1016/j.bbi.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 11/29/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023] Open
Abstract
Appropriate regulation of the inflammatory response is essential for survival. Interleukin-10 (IL-10), a well-known anti-inflammatory cytokine, plays a major role in controlling inflammation. In addition to immune cells, we previously demonstrated that the IL-10 receptor (IL-10R1) is expressed in dorsal root ganglion sensory neurons. There is emerging evidence that these sensory neurons contribute to immunoregulation, and we hypothesized that IL-10 signaling in dorsal root ganglion (DRG) neurons facilitates the regulation of the inflammatory response. We showed that mice that lack IL-10R1 specifically on advillin-positive neurons have exaggerated blood nitric oxide levels, spinal microglia activation, and cytokine upregulation in the spinal cord, liver, and gut compared to wild-type (WT) counterparts in response to systemic lipopolysaccharide (LPS) injection. Lack of IL-10R1 in DRG and trigeminal ganglion (TG) neurons also increased circulating and DRG levels of proinflammatory C-C motif chemokine ligand 2 (CCL2). Interestingly, analysis of published scRNA-seq data revealed that Ccl2 and Il10ra are expressed by similar types of DRG neurons; nonpeptidergic P2X purinoceptor (P2X3R + ) neurons. In primary cultures of DRG neurons, we demonstrated that IL-10R1 inhibits the production of CCL2, but not that of the neuropeptides substance P and calcitonin-gene related peptide (CGRP). Furthermore, our data indicate that ablation of Transient receptor potential vanilloid (TRPV)1 + neurons does not impact the regulation of CCL2 production by IL-10. In conclusion, we showed that IL-10 binds to its receptor on sensory neurons to downregulate CCL2 and contribute to immunoregulation by reducing the attraction of immune cells by DRG neuron-derived CCL2. This is the first evidence that anti-inflammatory cytokines limit inflammation through direct binding to receptors on sensory neurons. Our data also add to the growing literature that sensory neurons have immunomodulatory functions.
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Affiliation(s)
- Sabrina de Souza
- Department of Physiology, Michigan State University, East Lansing, MI, USA
| | | | - Jaewon Sim
- Department of Physiology, Michigan State University, East Lansing, MI, USA
| | | | - Andrew Dagenais
- Department of Physiology, Michigan State University, East Lansing, MI, USA
| | - Karli Monahan
- Department of Physiology, Michigan State University, East Lansing, MI, USA
| | - Beenhwa Lee
- Department of Physiology, Michigan State University, East Lansing, MI, USA
| | | | - Visha Parmar
- Department of Physiology, Michigan State University, East Lansing, MI, USA
| | - Matan Geron
- Department of Cell Biology and Physiology, Department of Pharmacology, UNC Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA
| | - Grégory Scherrer
- Department of Cell Biology and Physiology, Department of Pharmacology, UNC Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA; New York Stem Cell Foundation - Robertson Investigator, University of North Carolina, Chapel Hill, NC, USA
| | - Joseph K Folger
- Department of Physiology, Michigan State University, East Lansing, MI, USA
| | - Geoffroy Laumet
- Department of Physiology, Michigan State University, East Lansing, MI, USA; Department of Physiology, Michigan State University, Interdisciplinary Science and Technology Building, 766 Service Rd, East Lansing, MI 48826, USA.
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Dalcin CB, Souza SD, Anders JC, Pina JC, Carmo ACFD, Manzo BF, Rocha PK. Desinfecção de hubs e conectores de cateteres intravenosos. REME Rev Min Enferm 2022. [DOI: 10.35699/2316-9389.2022.38490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Objetivo: identificar métodos de desinfecção de hubs e conectores sem agulha dos cateteres intravenosos em pacientes hospitalizados e verificar a efetividade das intervenções para a prevenção de infecções de corrente sanguínea associada a cateter intravenoso. Método: revisão de escopo seguindo as recomendações de Joanna Briggs Institute. Busca realizada em bases de dados eletrônicas Pubmed, Embase, Cochrane Library, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Base de Dados Enfermagem e Bibliografía Nacional en Ciencias de la Salud Argentina, e estudos indicados por experts. A busca foi atemporal até setembro de 2020. Protocolo registrado na Open Science Framework. Resultados: foram incluídos 27 estudos, sendo que cinco foram Guidelines e 22 foram artigos publicados em periódicos. Existe grande variedade de métodos de desinfecção de hubs e de conectores. Para a desinfecção ativa, foram indicados Gluconato de Clorexedina, Isopropanol e Iodopovedina; para a desinfecção passiva, Gluconato de Clorexedina e Isopropanol. A quantidade do agente desinfetante variou de 0,25 mL a 0,6 mL. O tempo de fricção na desinfecção ativa variou de cinco segundos a 30 segundos, e o tempo de contato na desinfecção passiva variou de três minutos a sete dias. O tempo de secagem de agentes desinfetantes foi superior a cinco segundos. Conclusão: verifica-se variedade de métodos de desinfecção; no entanto, não há consenso sobre a melhor indicação. Necessita-se de estudos que evidenciem a quantidade de desinfetante, a pressão e o tempo de fricção e o tempo de secagem. Pesquisas com práticas de desinfecção utilizadas no Brasil e ensaios clínicos randomizados são necessários.
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Muro S, Suzuki M, Nakamura S, Wang JR, Garry EM, Sakamoto W, de Souza S. Real-world effectiveness of early intervention with fixed-dose tiotropium/olodaterol vs tiotropium in Japanese patients with COPD: a high-dimensional propensity score-matched cohort analysis. Respir Res 2021; 22:180. [PMID: 34140019 PMCID: PMC8212527 DOI: 10.1186/s12931-021-01776-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/10/2021] [Indexed: 11/18/2022] Open
Abstract
Background Escalation to triple therapy (long-acting muscarinic antagonist/β2-agonist, inhaled corticosteroid [ICS]) in chronic obstructive pulmonary disorder (COPD) is recommended for patients on LAMA/LABA combinations with frequent exacerbations and severe symptoms. An extended time-to-escalation to triple therapy suggests patients are in a stable condition and is an indicator of treatment effectiveness. No studies in Japanese clinical practice have compared the effectiveness of LAMA/LABA fixed-dose combination therapies with LAMA monotherapy in terms of time-to-escalation to triple therapy. The primary objective of this real-world study in Japan was to compare time-to-escalation to triple therapy among new users of tiotropium/olodaterol or tiotropium monotherapy for COPD without asthma. Methods In this active-comparator cohort study, new users of tiotropium/olodaterol (n = 1436) and tiotropium monotherapy (n = 5352) were identified from a large Japanese hospital-based database (Medical Data Vision Co., Ltd., Tokyo; prespecified study period: 1 April 2015 to 31 March 2019); patients in each group were matched 1:1 using high-dimensional propensity scores (hdPS). The primary outcome was time-to-escalation to triple therapy. Results For the prespecified study period in the hdPS-matched cohort, escalation to triple therapy was infrequent among new users of tiotropium/olodaterol (n = 1302, 7 escalation events) and tiotropium monotherapy (n = 1302, 8 escalation events). The difference in time-to-escalation to triple therapy between groups was not statistically significant (median [interquartile range]: 28 days [15.0–139.2] for tiotropium monotherapy vs 193 days [94.5–302.0] for tiotropium/olodaterol; hazard ratio: 0.89; 95% CI: 0.32–2.46). Similar findings (hazard ratio: 0.71; 95% Cl: 0.36–1.40) were observed in a post hoc analysis, which extended the study period by 1 year to 31 March 2020. Risks of first moderate and/or severe COPD exacerbation were lower for tiotropium/olodaterol than tiotropium monotherapy (between-group differences not significant). There were no significant between-group differences for the risks of all-cause inpatient mortality, major adverse cardiovascular events, and first use of home oxygen therapy. Conclusions ICS monotherapy or ICS/LABA added to tiotropium or tiotropium/olodaterol is limited in Japanese clinical settings. The number of escalations to triple therapy was very limited in the dataset and there was insufficient power to detect differences between the treatment groups in the primary hdPS-matched cohort. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-021-01776-y.
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Affiliation(s)
- Shigeo Muro
- Department of Respiratory Medicine, Nara Medical University, 840, Shijo-cho, Kashihara-shi, Nara, 634-8522, Japan.
| | - Masaru Suzuki
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
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Souza SD, Rocha PK, Avelar AFM, Tomazoni A, Anders JC, Ullman A. PICCPED® MOBILE APPLICATION: PREVENTION OF ADVERSE EVENTS IN A PERIPHERALLY INSERTED CENTRAL CATHETER IN PEDIATRICS. Texto contexto - enferm 2021. [DOI: 10.1590/1980-265x-tce-2020-0627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to construct a mobile application in the mobile-learning format that favors learning, offering support to the nurse's clinical reasoning and decision-making in the prevention of adverse events related to the peripherally inserted central catheter in pediatrics. Method: the construction of the mobile-learning technological production took place between 2016 and 2020, following seven steps that included the Contextualized Instructional Designer. The content of the application was based on current scientific evidence, with the inclusion of guidelines, international and national directives; and was elaborated grounded on Problem-Based Learning. The project team involved the participation of two content experts, a programmer, and two graphic designers. Results: the application consists of a pediatric clinical case, which gives rise to six other cases, exploring six catheter maintenance procedure. When presenting the cases, the user is encouraged to perform a clinical evaluation and make a decision about the problem raised. So, when the user correctly chooses the clinical issue, there is a message of congratulations and they are encouraged to continue their learning. In opposition, when the user answers incorrectly, the software shows the adverse event that can affect the patient and a new evaluation and decision-making are encouraged. At the end of each procedure, there is an animation of the correct technique for better assimilation of the constructed knowledge. Conclusion: this type of mobile-learning application allows for knowledge dissemination and assists safe care to children using the peripherally inserted central catheters.
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Silva MFD, Rocha PK, Echevarria-Guanilo ME, Bertoncello KCG, Souza SD, Schneider KLK. CONSTRUCTION OF THE INSTRUMENT FOR CARE TRANSITION IN PEDIATRIC UNITS. Texto contexto - enferm 2021. [DOI: 10.1590/1980-265x-tce-2018-0206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to build and semantically validate a safe communication tool to systematize care transition in pediatric clinical and emergency units. Method: a methodological study, based on the Classic Theory of Psychometric Tests and on the Instrument Development Model, proposed by Pasquali, which included seven professionals, five nurses and two physicians, experts in pediatrics and/or patient safety, who followed specific criteria for inclusion. Data collection was carried out between November and December 2016 and took place with the application of a form made available to the experts via the Google Drive/Microsoft® tool in two validation rounds, conducted by the Delphi Technique, being organized into two domains with 19 items. Data analysis was performed by calculating the Content Validity Index. Results: in order to validate the content, it was necessary to reach a Content Validity Index ≥ 0.80; thus, in the first round, five items underwent changes and were adjusted according to the experts' recommendations. These were validated in the second round, maintaining two domains and nineteen items. Conclusion: the construction and content validation of the instrument can enhance and qualify the clinical practice and contribute to minimize failures in pediatric patient safety associated with effective communication.
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Tomazoni A, Rocha PK, Ribeiro MB, Serapião LS, Souza SD, Manzo BF. Perception of nursing and medical professionals on patient safety in neonatal intensive care units. ACTA ACUST UNITED AC 2017; 38:e64996. [PMID: 28658397 DOI: 10.1590/1983-1447.2017.01.64996] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 02/14/2017] [Indexed: 11/22/2022]
Abstract
Objective To describe patient safety in the perception of nursing and medical professionals of neonatal intensive care units. Method Exploratory and descriptive study with a qualitative approach, using the instrument Hospital Survey on Patient Safety Culture for data collection. Twenty-eight nursing and medical professionals of three neonatal intensive care units in the city of Florianópolis, state of Santa Catarina, participated in the study, from 2013 to 2015. Content thematic analysis was used for data analysis. Results The following categories emerged: perception and strategies for patient safety; risk factors that interfere with patient safety; challenges in the communication of errors associated with health care. Conclusions Patient safety in the perception of professionals reflected the importance of safe care and the identification of risk factors in work conditions, predisposing to errors. Communication of risk situations, development of safety culture, and qualification are of utmost importance.
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Affiliation(s)
- Andreia Tomazoni
- Universidade Federal de Santa Catarina (UFSC), Departamento de Enfermagem, Programa de Pós-graduação em Enfermagem. Florianópolis, Santa Catarina, Brasil
| | - Patrícia Kuerten Rocha
- Universidade Federal de Santa Catarina (UFSC), Departamento de Enfermagem, Programa de Pós-graduação em Enfermagem. Florianópolis, Santa Catarina, Brasil
| | - Mariana Batista Ribeiro
- Universidade Federal de Santa Catarina (UFSC), Departamento de Enfermagem, Programa de Pós-graduação em Enfermagem. Florianópolis, Santa Catarina, Brasil
| | - Leonardo S Serapião
- Universidade Federal de Santa Catarina (UFSC), Departamento de Enfermagem, Programa de Pós-graduação em Enfermagem. Florianópolis, Santa Catarina, Brasil
| | - Sabrina de Souza
- Universidade Federal de Santa Catarina (UFSC), Departamento de Enfermagem, Programa de Pós-graduação em Enfermagem. Florianópolis, Santa Catarina, Brasil
| | - Bruna Figueiredo Manzo
- Universidade Federal de Minas Gerais (UFMG), Escola de Enfermagem da UFMG, Departamento de Enfermagem Materno Infantil e Saúde Pública. Belo Horizonte, Minas Gerais, Brasil
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Macedo TR, Rocha PK, Tomazoni A, Souza SD, Anders JC, Davis K. The culture of patient safety from the perspective of the pediatric emergency nursing team. Rev Esc Enferm USP 2017; 50:756-762. [PMID: 27982393 DOI: 10.1590/s0080-623420160000600007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 08/31/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify the patient safety culture in pediatric emergencies from the perspective of the nursing team. METHOD A quantitative, cross-sectional survey research study with a sample composed of 75 professionals of the nursing team. Data was collected between September and November 2014 in three Pediatric Emergency units by applying the Hospital Survey on Patient Safety Culture instrument. Data were submitted to descriptive analysis. RESULTS Strong areas for patient safety were not found, with areas identified having potential being: Expectations and actions from supervisors/management to promote patient safety and teamwork. Areas identified as critical were: Non-punitive response to error and support from hospital management for patient safety. The study found a gap between the safety culture and pediatric emergencies, but it found possibilities of transformation that will contribute to the safety of pediatric patients. CONCLUSION Nursing professionals need to become protagonists in the process of replacing the current paradigm for a culture focused on safety. The replication of this study in other institutions is suggested in order to improve the current health care scenario. OBJETIVO Identificar a cultura de segurança do paciente em emergências pediátricas, na perspectiva da equipe de enfermagem. MÉTODO Pesquisa quantitativa, tipo survey transversal. Amostra composta por 75 profissionais da equipe de enfermagem. Dados coletados entre setembro e novembro de 2014, em três Emergências Pediátricas, aplicando o instrumento Hospital Survey on Patient Safety Culture. Dados submetidos à análise descritiva. RESULTADOS Não foram encontradas áreas de força para a segurança do paciente, sendo identificadas áreas com potencial de assim se tornarem: Expectativas e ações do supervisor/chefia para promoção da segurança do paciente e Trabalho em equipe. Como área crítica identificaram-se: Resposta não punitiva ao erro e Apoio da gestão hospitalar para segurança do paciente. O estudo apontou distanciamento entre a cultura de segurança e as emergências pediátricas, porém vislumbrou possibilidades de transformação, que contribuirão para segurança do paciente pediátrico. CONCLUSÃO Os profissionais de enfermagem precisam se tornar protagonistas no processo de substituição do atual paradigma para uma cultura focada na segurança. Sugere-se replicação deste estudo em outras instituições a fim de aprimorar o atual cenário de assistência à saúde.
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Affiliation(s)
- Taise Rocha Macedo
- Universidade Federal de Santa Catarina, Programa de Pós-Graduação em Enfermagem, Florianópolis, SC, Brazil
| | - Patricia Kuerten Rocha
- Universidade Federal de Santa Catarina, Departamento de Enfermagem, Florianópolis, SC, Brazil
| | - Andreia Tomazoni
- Universidade Federal de Santa Catarina, Hospital Universitário, Residência Multiprofissional na Área de Saúde da Mulher e da Criança, Florianópolis, SC, Brazil
| | - Sabrina de Souza
- Universidade Federal de Santa Catarina, Hospital Universitário, Residência Multiprofissional na Área de Saúde da Mulher e da Criança, Florianópolis, SC, Brazil
| | - Jane Cristina Anders
- Universidade Federal de Santa Catarina, Departamento de Enfermagem, Florianópolis, SC, Brazil
| | - Karri Davis
- Fairfield University, New Haven, Connecticut, United States
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Tomazoni A, Rocha PK, de Souza S, Anders JC, de Malfussi HFC. Patient safety culture at Neonatal Intensive Care Units: perspectives of the nursing and medical team. Rev Lat Am Enfermagem 2016; 22:755-63. [PMID: 25493670 PMCID: PMC4292682 DOI: 10.1590/0104-1169.3624.2477] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 08/29/2014] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE: to verify the assessment of the patient safety culture according to the function
and length of experience of the nursing and medical teams at Neonatal Intensive
Care Units. METHOD: quantitative survey undertaken at four Neonatal Intensive Care Units in
Florianópolis, Brazil. The sample totaled 141 subjects. The data were collected
between February and April 2013 through the application of the Hospital Survey on
Patient Safety Culture. For analysis, the Kruskal-Wallis and Chi-Square tests and
Cronbach's Alpha coefficient were used. Approval for the research project was
obtained from the Ethics Committee, CAAE: 05274612.7.0000.0121. RESULTS: differences in the number of positive answers to the Hospital Survey on Patient
Safety Culture, the safety grade and the number of reported events were found
according to the professional characteristics. A significant association was found
between a shorter Length of work at the hospital and Length of work at the unit
and a larger number of positive answers; longer length of experience in the
profession represented higher grades and less reported events. The physicians and
nursing technicians assessed the patient safety culture more positively.
Cronbach's alpha demonstrated the reliability of the instrument. CONCLUSION: the differences found reveal a possible relation between the assessment of the
safety culture and the subjects' professional characteristics at the Neonatal
Intensive Care Units.
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Affiliation(s)
- Andréia Tomazoni
- Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Patrícia Kuerten Rocha
- Departamento de Enfermagem, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Sabrina de Souza
- Hospital Universitário Polydoro Ernani de São Thiago, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Jane Cristina Anders
- Departamento de Enfermagem, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
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Marques EP, Garcia TMB, Anders JC, Luz JHD, Rocha PK, Souza SD. Playful activities in health care for children and adolescents with cancer: the perspectives of the nursing staff. Escola Anna Nery - Revista de Enfermagem 2016. [DOI: 10.5935/1414-8145.20160073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
OBJECTIVE: To understand the use of safety strategies in child identification for drug administration.METHODS: In this cross-sectional study at a pediatric unit, drugs were distributed in a centralized and unique manner. We conducted 373 observations of the process for preparing and distributing drugs carried out by 25 nursing professionals.RESULTS: The pharmacy had distributed 198 (53.1%) medicines without identifying the drugs' label, which, while in storage, was identified with the child's first name handwritten on adhesive tape. At the time of drug preparation, the professional transcribed the drug's name as described in the prescription to the drug label for 173 (90.6%) observations of injectable drug preparation and 161 (88.5%) observations of preparation of oral drugs. Information regarding the five rights of medication administration and preparation, such as the full name of the child, appeared on 10.7% of drug labels.CONCLUSION: No safety strategies to identify children during drug administration were found, nor were any standards for data identification observed.
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13
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Souza SD, Sujata G. Malignant melanoma of the nose. Indian J Otolaryngol Head Neck Surg 2012; 53:138-40. [PMID: 23119777 DOI: 10.1007/bf02991509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Invasive tumors containing abnormal melanocvtes are termed ax malignant melanomas. Primary malignant melanomas of the nasal and paranasal cavities are extremely rare. A 65 years old female presented with bleeding from the nose and a gradually increasing mass in the left nostril. Histopathological examination of the specimen showed "poorly differentiated carcinoma" like features. But S-100 staining proved it to be a malignant melanoma. This case is reported here for its rarity. The literature on malignant melanoma is reviewed and the aetiology pathology, diagnostic and therapeutic problems are also discussed.
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Affiliation(s)
- S D Souza
- Jaslok Hospital and Research Centre, 15, Dr. G. Deshmukh Marg, 400 026 Bombay
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14
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Abstract
BACKGROUND The effects of vitamin C on anastomotic healing process are controversial. OBJECTIVE To compare the jejunal anastomotic tension and in the upright segment in different postoperative periods. METHOD Fifty male rats weighing 250 to 400 grams were submitted to laparotomy. The jejunum was transversally cut 10 cm from the duodenojejunal flexure, and subsequently anastomosed. The rats were divided into two groups (n = 25). Group I--control, Group II--oral administration of vitamin C (100 mg/kg). The anastomotic and the upright segment resistance was determined by using bursting pressure test on the 3rd, 5th, 7th, 21st and 28th postoperative days. RESULTS The rats submitted to oral administration of ascorbic acid show higher bursting pressure on the 5th, 7th and 28th postoperative days. The bursting resistances of the upright segment was higher on the rats submitted to vitamin C ingestion. CONCLUSIONS Vitamin C enhances the anastomotic and jejunal resistances. Moreover, the final resistance on the upright jejunal segment was significant higher than in the control group.
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Affiliation(s)
- A Petroianu
- Departamento de Cirurgia, Faculdade de Medicina Universidade Federal de Minas Gerais-FM-UFMG, Belo Horizonte, MG
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15
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Abstract
The effects of crotoxin, isolated from the venom of the South American rattlesnake, Crotalus durissus terrificus, were investigated on isolated guinea pig hearts, perfused with Locke solution, by the Langendorff method. The cardiac beats and the electrocardiogram were simultaneously registered and the creatine kinase (CK) activity of the perfusate measured. Crotoxin was infused (4.5 x 10(-8) M and 2.3 x 10(-7) M) into the heart during 90 min, and induced a remarkable decrease in the contractile force, without a significant reduction of heart rate, increased the P-R interval and displaced the S-T segment. The activity of CK only increased in the late phases of the experiments, when the force of contraction was below 25% of the control value. Arrhythmias were uncommon and no alterations of QRS duration or Q-Tc interval were observed. The reduction of the contractile force and the increase in CK activity were completely prevented by bovine serum albumin, whereas lanatoside C did not interfere with the toxin action. A bolus injection of crotoxin (11 +/- 2 nmoles) also induced a decrease of contractile force without reduction of heart rate. This decrease of force was partially prevented by indomethacin, but not by atropine. It is suggested that the reduction of contractile force evoked by crotoxin is due probably to release of free fatty acids and lysophospholipids (initial effect) and to a cellular lesion (late effect).
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Affiliation(s)
- P E Santos
- Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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