1
|
Leal MDC, Esteves-Pereira AP, Bittencourt SA, Domingues RMSM, Theme Filha MM, Leite TH, Ayres BVDS, Baldisserotto ML, Nakamura-Pereira M, Moreira MEL, Gomes MADSM, Dias MAB, Takemoto MLS, Pacagnella RDC, Gama SGND. Protocol of Birth in Brazil II: National Research on Abortion, Labor and Childbirth. CAD SAUDE PUBLICA 2024; 40:e00036223. [PMID: 38695459 PMCID: PMC11057480 DOI: 10.1590/0102-311xpt036223] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/26/2023] [Accepted: 08/07/2023] [Indexed: 05/06/2024] Open
Abstract
Brazil has made advances in obstetric care in public and private hospitals; however, weaknesses in this system still require attention. The Brazilian Ministry of Health, aware of this need, funded the second version of the Birth in Brazil survey. This study aimed to evaluate: prenatal, labor and birth, postpartum, and abortion care, comparing the results with those of Birth in Brazil I; and analyze the main determinants of perinatal morbidity and mortality; evaluate the care structure and processes of obstetrics and neonatology services in maternity hospitals; analyze the knowledge, practices, and attitudes of health professionals who provide birth and abortion care; and identify the main barriers and facilitators related to care of this nature in Brazil. With a national scope and a 2-stage probability sample: 1-hospitals and 2-women, stratified into 59 strata, 465 hospitals were selected with a total planned sample of around 24,255 women - 2,205 for abortion reasons and 22,050 for labor reasons. Data collection was conducted using six electronic instruments during hospital admission for labor or abortion, with two follow-up waves, at two and four months. In order to expand the number of cases of severe maternal morbidity, maternal and perinatal mortality, three case control studies were incorporated into Birth in Brazil II. The fieldwork began in November 2021 and is scheduled to end in 2023. It will allow a comparison between current labor and birth care results and those obtained in the first study and will evaluate the advances achieved in 10 years.
Collapse
Affiliation(s)
- Maria do Carmo Leal
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | | | | | | | | | | | | | - Marcos Nakamura-Pereira
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Maria Elisabeth Lopes Moreira
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | - Marcos Augusto Bastos Dias
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | | | | |
Collapse
|
2
|
Leal CRV, Rezende KP, Macedo EDCPD, Rezende GDC, Corrêa Júnior MD. Comparison between Protocols for Management of Fetal Growth Restriction. Rev Bras Ginecol Obstet 2023; 45:96-103. [PMID: 36977407 PMCID: PMC10078887 DOI: 10.1055/s-0043-1764493] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/17/2022] [Indexed: 03/30/2023] Open
Abstract
This comprehensive review compares clinical protocols of important entities regarding the management of fetal growth restriction (FGR), published since 2015. Five protocols were chosen for data extraction. There were no relevant differences regarding the diagnosis and classification of FGR between the protocols. In general, all protocols suggest that the assessment of fetal vitality must be performed in a multimodally, associating biophysical parameters (such as cardiotocography and fetal biophysical profile) with the Doppler velocimetry parameters of the umbilical artery, middle cerebral artery, and ductus venosus. All protocols reinforce that the more severe the fetal condition, the more frequent this assessment should be made. The timely gestational age and mode of delivery to terminate the pregnancy in these cases can vary much between the protocols. Therefore, this paper presents, in a didactic way, the particularities of different protocols for monitoring FGR, in order to help obstetricians to better manage the cases.
Collapse
|
3
|
Miranda MEDQ, Rosa MR, Castro MCNE, Fontes CMB, Bocchi SCM. Nursing protocols to reduce urinary tract infection caused by indwelling catheters: an integrative review. Rev Bras Enferm 2023; 76:e20220067. [PMID: 36888796 PMCID: PMC9987455 DOI: 10.1590/0034-7167-2022-0067] [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: 03/08/2022] [Accepted: 10/14/2022] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVES to analyze the production of knowledge in research articles about the effectiveness of nursing protocols for reducing indwelling urinary catheter dwell time and catheter-associated urinary tract infection rate in hospitalized adult and older patients. METHODS an integrative review of three full articles, available in the MEDLINE Complete - EBSCO, Scopus and Web of Science databases, from 01/01/2015 to 04/26/2021. RESULTS the three protocols reduced infection rates, and from the review/synthesis of their knowledge, a level IV body of evidence emerged to compose the nursing care process aimed at reducing indwelling urinary catheter dwell time and catheter-associated urinary tract infection. FINAL CONSIDERATIONS this process gathers scientific evidence to support the elaboration of nursing protocols and, consequently, the conduction of clinical trials on its effectiveness in reducing urinary tract infection by indwelling urinary catheter.
Collapse
Affiliation(s)
| | - Marcelo Ricardo Rosa
- Universidade Estadual Paulista Júlio de Mesquita Filho. São Paulo, São Paulo, Brazil
| | | | | | | |
Collapse
|
4
|
Krepker FF, Arreguy-Sena C, Braga LM, Krempser P, Santos JDC, Dutra HS. Nursing protocol in chronic kidney disease prevention in older adults in primary care. Rev Bras Enferm 2022; 76:e20220052. [PMID: 36449972 PMCID: PMC9728820 DOI: 10.1590/0034-7167-2022-0052] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/09/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES to develop a protocol for Nursing Process operationalization in approaching older adults with vulnerability to chronic kidney disease in Primary Health Care, based on Neuman's stressors. METHODS a methodological study, carried out in two stages: 1) synthesis of evidence using an inductive strategy (mixed method study) and 2) protocol development to support the nursing process operationalization with older adults enrolled in a Basic Health Unit, using a deductive strategy (Neuman's stressor concepts, NANDA, NIC, and NOC taxonomies, Risner's line of reasoning, and cross-mapping), described according to A Step-by-Step Guide to Developing Protocols. RESULTS 102 older adults participated, and 17 diagnoses, 34 interventions and 26 nursing outcomes were identified. CONCLUSIONS the protocol developed is a technology that makes it possible to operationalize the Nursing Process, based on Neuman's stressors and on taxonomy, conceptual and care frameworks, guiding care and nursing records.
Collapse
Affiliation(s)
| | | | | | - Paula Krempser
- Universidade Federal de Juiz de Fora. Juiz de Fora, Minas Gerais, Brazil
| | | | - Herica Silva Dutra
- Universidade Federal de Juiz de Fora. Juiz de Fora, Minas Gerais, Brazil
| |
Collapse
|
5
|
Marques MA, Fiorelli SKA, Barros BCS, Ribeiro AJA, Ristow AVON, Fiorelli RKA. Protocol for prophylaxis of venous thromboembolism in varicose vein surgery of the lower limbs. Rev Col Bras Cir 2022; 49:e20223326. [PMID: 36000685 PMCID: PMC10578810 DOI: 10.1590/0100-6991e-20223326-en] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/03/2022] [Indexed: 12/23/2022] Open
Abstract
Pulmonary embolism is the most feared complication of venous thromboembolism (VTE) and the third leading cause of cardiovascular mortality in the world, after acute myocardial infarction and stroke. The risk of VTE is virtually universal in hospitalized patients, especially those with reduced mobility. Although variable in incidence between clinical and surgical patients, up to 66.6% of events related to hospitalizations can occur after discharge, with this risk remaining for up to 90 days. Despite all the investment made in VTE prophylaxis in recent decades, there is still no consensus or specific guidelines for its prevention in patients undergoing conventional surgery for varicose veins of lower limbs. The adoption of a validated risk assessment model for VTE prophylaxis, based on the current literature, may help in the implementation and standardization of VTE prophylaxis in conventional lower limb varicose vein surgery, in addition to this benefit, it may lead to a reduction in the length of hospital stay and the number of readmissions.
Collapse
Affiliation(s)
- Marcos Arêas Marques
- - Universidade Federal do Estado do Rio de Janeiro, Departamento de Cirurgia Geral e Especializada - Rio de Janeiro - RJ - Brasil
- - Universidade do Estado do Rio de Janeiro, Unidade Docente Assistencial de Angiologia - Rio de Janeiro - RJ - Brasil
| | - Stênio Karlos Alvim Fiorelli
- - Universidade Federal do Estado do Rio de Janeiro, Departamento de Cirurgia Geral e Especializada - Rio de Janeiro - RJ - Brasil
| | - Bernardo Cunha Senra Barros
- - Universidade Federal do Estado do Rio de Janeiro, Departamento de Cirurgia Geral e Especializada - Rio de Janeiro - RJ - Brasil
| | | | - Arno VON Ristow
- - Academia Nacional de Medicina - Rio de Janeiro - RJ - Brasil
| | - Rossano Kepler Alvim Fiorelli
- - Universidade Federal do Estado do Rio de Janeiro, Departamento de Cirurgia Geral e Especializada - Rio de Janeiro - RJ - Brasil
- - Academia Nacional de Medicina - Rio de Janeiro - RJ - Brasil
| |
Collapse
|
6
|
da Silva JA, Emi AS, Leão ER, Lopes MCBT, Okuno MFP, Batista REA. Emergency Severity Index: accuracy in risk classification. Einstein (Sao Paulo) 2017; 15:421-427. [PMID: 29364364 PMCID: PMC5875154 DOI: 10.1590/s1679-45082017ao3964] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/10/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To verify agreement between estimative of predicted resources using the adapted Emergency Severity Index and the real amount of resources used by patients. To analyze the variables number of years since graduation, years of work experience and years of experience in emergency services especially with accurate anticipation of resources need. METHODS This retrospective analytical study with a quantitative approach included 538 medical records of patients assisted by 11 triage nurses. Data collected were related to assistances carried out from December 2012 to February 2013. RESULTS There was no significant association between the adequacy of the number of resources used, based on Emergency Severity Index score, number of years since graduation, year of work experience or years of experience in emergency services. Kappa agreement coefficient (0.34) showed that agreement was low between predicted and real used number of resources. CONCLUSION Nurses' accuracy index to predict resources for patients care from emergency room using the adapted Emergency Severity Index was lower than results reported in the studies in the literature that used the original scale. There was low agreement of diagnostic exams predicted by nurses and those really performed. There was no association among correct prediction of resources needed, number of years since graduation, years of experience in emergency services and years of work experience in the unit where the study was done.
Collapse
|
7
|
Saura-Llamas J, Saturno Hernández PJ, Romero Román JR, Gaona Ramón JM, Gascón Cánovas JJ. [Characteristics of primary care clinical guidelines associated with greater structural quality of the document]. Aten Primaria 2001; 28:525-34. [PMID: 11792269 PMCID: PMC7681688 DOI: 10.1016/s0212-6567(01)70442-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AIM To identify characteristics associated with greater structural quality of clinical guidelines. DESIGN Cross-sectional study. SETTING Health centers in the region of Murcia (southeastern Spain). MAIN OUTCOME MEASURES All clinical practice guidelines and protocols developed between January 1985 and January 1994 were reviewed. Of the 470 documents originally obtained, 462 were evaluated and 8 were excluded because of missing data. The quality of document design was evaluated in all materials. The rate of criteria compliance was calculated for each document. The characteristics that were associated with protocol quality were identified in two types of multivariate analysis: multiple regression (with compliance rate as the dependent variable) and logistic regression (with compliance rate referred to the mean as the dependent variable). RESULTS Both analyses showed that structural quality was associated with specific health care areas, multidisciplinary design (p < 0.001), reference to chronic health problems (p < 0.001), design of the document specifically as a clinical practice guideline (p < 0.001), and reference to the health services offered at a given center (p < 0.001). In some analyses, greater quality appeared to be associated with heath centers that were also teaching centers, reference in the document to health care, and womens health programs. CONCLUSIONS Document quality varied significantly in different health care areas, and certain characteristics (chronic health problems, multidisciplinary design and specific design, reference to specific health services offered) were associated with greater document quality. Reference to acute health problems, design by only one type of professional (physicians or nurses), inclusion as part of a larger program, and lack of reference to specific health services offered at a given center were characteristics with a greater risk for low document quality.
Collapse
Affiliation(s)
- J Saura-Llamas
- Especialista en Medicina Familiar y Comunitaria, Centro de Salud Barrio del Carmen, Murcia, Spain.
| | | | | | | | | |
Collapse
|