Navegando por Palavras-chave "Protocols"
Agora exibindo 1 - 11 de 11
Resultados por página
Opções de Ordenação
- ItemAcesso aberto (Open Access)Adesão a protocolo de atendimento do trauma pediátrico em um centro de trauma brasileiro(Universidade Federal de São Paulo (UNIFESP), 2020-06-25) Botelho Filho, Fabio Mendes [UNIFESP]; Abib, Simone de Campos Vieira [UNIFESP]; Universidade Federal de São PauloObjectives: this study aims to quantify the adherence of trauma assessment protocols among different types of frontline trauma providers. As a secondary objective, it was also evaluated if adherence is associated with improved clinical outcomes for children. Methods: A descriptive study of pediatric trauma care in Hospital João XXIII was conducted between October 2017 and March 2018. Trauma primary survey assessments were observed and adherence to each step of a standardized primary assessment protocol was recorded. Adherence to the assessment protocol was compared considering different types of providers, the time of presentation, and severity of injury. The relationship between protocol adherence and clinical outcomes including mortality, length of hospital stay, admission to pediatric intensive care unit, use of blood components, need of mechanical ventilation, and number of imaging exams performed were also assessed. Results: Emergency Department evaluations of 64 patients of 274 pediatric admissions were observed over a period of 6 months. The mean patient age was 7.3 years. 40.6% of patients presented due to fall injuries and a majority sustained injury categorized as severe (59.4%). 50% of the primary assessments were performed by general surgeons, 34.4% by residents in general surgery and 15.6% by pediatricians. There was an average adherence rate of 34.1% to the trauma primary assessment protocol. Adherence among each specific step included airway: 17.2%; Breathing: 59.4%; Circulation: 95.3%; Disability: 28.8%; Exposure: 18.8%. No differences between specialties or time of presentation (day vs night) were observed as an influencer in physical assessment. Therefore, adherence was lower in severe patients than non-severe patients. Patients with a more thorough primary assessment, independent of severity, underwent fewer CT scans (ROC curve area: 0.661; p:0.027). Finally, no other associations between adherence and outcomes were observed. Conclusions: Our study demonstrates that trauma assessment protocol adherence among trauma providers is low for both surgeons and nonsurgeons. Thorough initial assessment reduced the use of CT scans, suggesting that standardized pediatric trauma assessments may be a way to reduce unnecessary radiologic imaging among children. It suggests that a standardized assessment should be encouraged, because it could decrease number of unnecessary radiologic exams in a child patient.
- ItemSomente MetadadadosCorrelation between classification in risk categories and clinical aspects and outcomes(Wiley, 2016) Oliveira, Gabriella Novelli [UNIFESP]; Vancini-Campanharo, Cassia Regina [UNIFESP]; Lopes, Maria Carolina Barbosa Teixeira [UNIFESP]; Barbosa, Dulce Aparecida [UNIFESP]; Okuno, Meiry Fernanda Pinto [UNIFESP]; Batista, Ruth Ester Assayag [UNIFESP]Objective: to correlate classification in risk categories with the clinical profiles, outcomes and origins of patients. Method: analytical cross-sectional study conducted with 697 medical forms of adult patients. The variables included: age, sex, origin, signs and symptoms, exams, personal antecedents, classification in risk categories, medical specialties, and outcome. The Chi-square and likelihood ratio tests were used to associate classifications in risk categories with origin, signs and symptoms, exams, personal antecedents, medical specialty, and outcome. Results: most patients were women with an average age of 44.5 years. Pain and dyspnea were the symptoms most frequently reported while hypertension and diabetes mellitus were the most common comorbidities. Classifications in the green and yellow categories were the most frequent and hospital discharge the most common outcome. Patients classified in the red category presented the highest percentage of ambulance origin due to surgical reasons. Those classified in the orange and red categories also presented the highest percentage of hospitalization and death. Conclusion: correlation between clinical aspects and outcomes indicate there is a relationship between the complexity of components in the categories with greater severity, evidenced by the highest percentage of hospitalization and death.
- ItemAcesso aberto (Open Access)Development and validation of an algorithm for laser application in wound treatment(Univ Sao Paulo, Escola De Enfermagem De Ribeirao Preto, 2017) da Cunha, Diequison Rite; Salome, Geraldo Magela; Massahud Junior, Marcelo Renato; Mendes, Bruno; Ferreira, Lydia Masako [UNIFESP]Objective: To develop and validate an algorithm for laser wound therapy. Method: Methodological study and literature review. For the development of the algorithm, a review was performed in the Health Sciences databases of the past ten years. The algorithm evaluation was performed by 24 participants, nurses, physiotherapists, and physicians. For data analysis, the Cronbach's alpha coefficient and the chi-square test for independence was used. The level of significance of the statistical test was established at 5% (p<0.05). Results: The professionals' responses regarding the facility to read the algorithm indicated: 41.70%, great
- ItemSomente MetadadadosEfficiency and Cutoff Values of Self-Assessment Instruments on the Impact of a Voice Problem(Mosby-Elsevier, 2016) Behlau, Mara; Madazio, Glaucya; Moreti, Felipe [UNIFESP]; Oliveira, Gisele; Alves dos Santos, Luciana de Moraes; Paulinelli, Bruna Rabelo; Couto Junior, Euro de BarrosObjectives. To evaluate the efficiency of four self-assessment questionnaires that rate the impact of a voice problem on the individual's life: Voice-Related Quality of Life (V-RQOL), the original and reduced versions of the Voice Handicap Index (VHI) and VHI-10, Vocal Performance Questionnaire (VPQ), and Voice Symptom Scale (VoiSS). Methods. Data from 975 subjects, 486 with a diagnosis of dysphonia and 489 vocally healthy individuals, were submitted to the receiver operating characteristic (ROC) curve analysis to obtain the cutoff values that determine the discriminating power of these instruments (presence of dysphonia vs healthy voice). Results. The ROC curve analysis showed that the most efficient questionnaires were the VoiSS and the VHI. Results showed that they presented as a perfect classification based on their efficiency, specificity, and sensitivity values (all three of them = 1). The VHI-10 and the V-RQOL showed excellent classification (VHI-10: efficiency = 0.991
- ItemEmbargoMedicamentos recomendados em protocolos clínicos e diretrizes terapêuticas para doenças raras(Universidade Federal de São Paulo, 2024-08-21) Ramalho, Anna Carolina dos Santos [UNIFESP]; Melo, Daniela Oliveira de [UNIFESP]; Dourado, Andréa da Silva [UNIFESP]; http://lattes.cnpq.br/5052823551616937Introdução: Para abordar a temática de tratamento de Doenças Raras é necessário considerar a especificidade das doenças, a individualidade dos pacientes e o funcionamento do sistema de saúde em sua totalidade. Nesse contexto, uma das respostas a movimentação social e institucional por mais atenção e cuidado integrado para pacientes com essas condições são os Protocolos Clínicos e Diretrizes Terapêuticas (PCDT) para Doenças Raras. Para além da disponibilização dos medicamentos, o cuidado aos pacientes com doenças raras precisa considerar a complexidade do tratamento e as necessidades integrais de cada um, principalmente no que diz respeito ao manejo e acompanhamento de medicamentos, exigindo clareza na descrição do tratamento indicado. Objetivo: Identificar os medicamentos recomendados nos PCDTs de Doenças Raras, bem como a situação regulatória de cada especialidade indicada, a disponibilidade de bula, a presença ou ausência dos princípios ativos recomendados na Lista de Medicamentos Referência da Anvisa bem como determinar se há padronização na nomenclatura, de acordo com as normas exigidas para descrição de Formas Farmacêuticas e Vias de Administração. Métodos: Foi realizada uma busca em dois sites oficiais (Conitec e Ministério da Saúde) para identificar apenas PCDTs com uma lista formal de medicamentos, conforme a Portaria N° 375/2009. Usou-se a plataforma RedCap® para criar um formulário de extração padronizado e coletar dados sobre PCDTs, incluindo a portaria e ano de publicação, fármacos recomendados, posologia, esquema de administração e forma farmacêutica. Após a coleta, verificou-se o status de referência dos medicamentos e informações de bulas em sites da Anvisa para confirmar registros, concentração e forma farmacêutica. Com esses dados, foram identificados os PCDTs voltados para Doenças Raras, conforme informações do Ministério da Saúde. Resultados e Discussão: Representando 42,6% (43) de todos os PCDTs publicados pelo Ministério da Saúde até o período considerado, os PCDTs de Doenças Raras são documentos que preconizam o uso de 104 princípios ativos, descrevendo-os de acordo com as orientações e diretrizes estabelecidas e com poucos erros no que tange a presença de informação de via de administração (28; 26%) e descrição da forma farmacêutica (22; 14%) que impactam no entendimento do corpo multidisciplinar que acompanha esses pacientes. Além disso, entre as 180 especialidades farmacêuticas recomendadas nos PCDTs, 16 (8,8%) apresentam situação regulatória irregular na Anvisa e 82 (45,5%) constam na Lista de Medicamentos Referência da Anvisa. Conclusão: A maioria das especialidades farmacêuticas citadas nos PCDTs de Doenças Raras contém a informação correta de via de administração e Forma Farmacêutica, de acordo com o Vocabulário Controlado elaborado pela Anvisa e isso sugere um esforço contínuo para atualização e publicação de PCDTs, especialmente para doenças raras, que apresentaram representatividade significativa de 42,6% dos PCDTs analisados, indicando atenção considerável a essas condições, considerando a escassez de informações e tratamentos específicos.
- ItemAcesso aberto (Open Access)Nursing care protocol for patients with a ventricular assist device(Assoc Brasileira Enfermagem, 2017) Machado, Regimar Carla; Girones, Purificacion; Souza, Andressa Rodrigues de; Moreira, Rita Simone Lopes [UNIFESP]; von Jakitsch, Camila Bomfim; Branco, João Nelson Rodrigues [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: to develop and validate a nursing care protocol for patients with a ventricular assist device (VAD). Method: descriptive study, with a quantitative approach, for an instrument's methodological validation. Three stages were conducted: development of the instrument; protocol content validation according to the Delphi technique, and agreement among experts and the scientific literature. Results: based on the content validation, a care protocol for patients with a VAD was created and assessed by Spanish experts. Of the 15 items evaluated by means of the content validity index (CVI), 10 presented solid evidence of validation, with Kappa ranging between 0.87 and 1. Conclusion: the method enabled the validation of interventions that will contribute to qualified and standardized care for patients with a VAD.
- ItemAcesso aberto (Open Access)Percepção de fala em crianças escolares do 3º ao 5º ano do Ensino Fundamental: proposta de avaliação(Universidade Federal de São Paulo (UNIFESP), 2017-02-21) Appezzato, Mariana Martins [UNIFESP]; Avila, Clara Regina Brandao de [UNIFESP]; http://lattes.cnpq.br/4265004102490366; http://lattes.cnpq.br/1114212941572013; Universidade Federal de São Paulo (UNIFESP)To elaborate an protocol for assessment of speech perception, investigate its internal consistency, describe speech perception and phonological representation skills in typical school children, and investigate the presence of correlations between the studied variables. Method: Sixty typical children (60% female), regularly enrolled in the 3rd, (N=14), 4th (N=24) and 5th (N=22) grade of the Elementary School, with ages ranging between 08 years, 02 months to 11 years, 08 months old (99 to 136 months; M=120,05; DP = 10,26) were evaluated. A protocol included 06 tasks to assess reception skills of speech stimulus: (A) speech perception of verbal and non-verbal sounds; (B) discrimination of non-words with the structure of the Portuguese Language; (C) discrimination between the syllabic structure of the Portuguese Language and of the syllabic structure of another language; (D) perception of phonetic features that distinguishes words in Portuguese; (E) correlation between image and the pronunciation of the word in Portuguese; (F) reception of alliteration and rhymes; and (G) feedback. The evaluations occurred within the period comprised of the end of the 1st school semester and the beginning of the 2nd school semester of 2016. The data were analysed by Cronbach’s Alpha Coefficient, Spearman and Pearson’s Correlation Coefficient with significance level of 0,05. Results: The items of tasks (B) and (C) showed good internal consistency (α=0,84; α =0,80); the items of task (C) in the answers Portuguese/Non-Portuguese showed acceptable internal consistency (α=0,76). The other tasks showed poor and unacceptable consistency. It was observed the effect of the school year in the answers of children only in tasks (C), in the Portuguese/Non-Portuguese answers, in the equal/different (E/D) and in task (D). Conclusion: Considerable part of the proposed items to the speech perception evaluation showed internal consistency. The task of discrimination of non-words with the structure of the Portuguese Language and the task of discrimination between the syllabus structure of Portuguese Language and another language showed reliable to evaluate typical children’s skills. On the other hand, for other tasks it will be necessary some substitutions of excluded items, in order to adequate the protocol’s reliability. The older the children, or the more advanced the school grade, the better the auditory perception capacity and discrimination capacity for syllabic structure. Some items from the questionnaire predicted auditory perception skills and discrimination capacity for Portuguese syllabic structure.
- ItemAcesso aberto (Open Access)Protocolo de um banco de tecidos neoplásicos(Sociedade Brasileira de Ortopedia e Traumatologia, 2008-03-01) Alimena, Luiz José Moura [UNIFESP]; Garcia Filho, Reynaldo Jesus [UNIFESP]; Toledo, Silvia Regina Caminada de [UNIFESP]; Alves, Maria Teresa de Seixas [UNIFESP]; Petrilli, Antonio Sergio [UNIFESP]; De Luca Junior, Giuseppe; Jacobus, Lucas Senger [UNIFESP]; Romani, Ricardo Filipe; Spader, Daniel Lunardi; Universidade Federal de São Paulo (UNIFESP); Santa Casa de Porto Alegre Setor de Ortopedia Oncológica; Instituto de Oncologia Pediátrica; Fundação Faculdade de Ciências Médicas de Porto Alegre; Universidade Federal do Rio Grande do SulA Tumor Bank with systematic organization of data allows for the carrying out of cancer research with sound and scientific conclusions. The need thus arises for a specific protocol whose main advantage would be that of adding qualified donor information to tumor samples used in research. The purpose of this study was to develop a simple, reliable, and replicable procedures protocol to acquire and store samples of musculoskeletal tumors. The basis for the planning of this protocol comprises the information gathered in the literature relating to tumor tissue banks from 1969 to 2005. The paper describes the capture, storage, and donor background. The tumor bank with an efficient protocol allows to store both healthy and neoplastic tissue, and to record information relating to patients with neoplastic lesions. Furthermore, it enables supplying tissue samples in ideal research conditions.
- ItemAcesso aberto (Open Access)Qualidade das anotações de enfermagem relacionadas à ressuscitação cardiopulmonar comparadas ao modelo Utstein(Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2010-01-01) Fernandes, Ana Paula [UNIFESP]; Vancini, Cássia Regina [UNIFESP]; Cohrs, Frederico Molina [UNIFESP]; Moreira, Rita Simone Lopes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To assess the quality of nursing records related to cardiopulmonary resuscitation, comparing them to the validated Utstein protocol, in a university hospital. METHODS: Retrospective, exploratory and descriptive study, with quantitative approach, performed by means of consultation records of patients that suffered cardiorespiratory arrest (CRA) followed by death. The data collection was carried out in the period of May 1st to June 30th, in 2009. RESULTS: Of the 144 medical records surveyed, 74 were dismissed for not having any recorded information on the items to be studied and, 70 constituted the study sample. In these there were no entries on: the immediate cause of CRA (92%); the interventions seeking to recover the cardiorespiratoy arrest (RCA) (71%); on the initial rate of CRA (59%); on the time of events (16%); on drugs used (50%); and, on the professionals involved in RCA (88%). CONCLUSIONS: The notes were scarce and often not realized. The use of the Utstein model favors the annotation sequence of events, avoiding data loss.
- ItemAcesso aberto (Open Access)Sequência de Möbius: protocolo de anamnese e avaliação - relato de caso(Sociedade Brasileira de Fonoaudiologia, 2009-01-01) Albuquerque, Tatiana Cantarelli Andrade Lima De [UNIFESP]; Barreto, Renata Ramalho Da Silva [UNIFESP]; Costa, Thieza Christy Carregã Martins Da [UNIFESP]; Guedes, Zelita Caldeira Ferreira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Möbius Sequence (MS) was initially described by Von Graefe, in 1888. It is characterized by palsy of VI and VII cranial nerves, determining absence of facial expression accompanied by convergent strabismus. In the children assessed in this group all described characteristics are found. However, palsy caused by other cranial nerves may also occur, impairing soft palate and tongue mobility and thus making it difficult to produce phonemes and/or showing excessive nasalization during their emission. The present study had the aim to disclose the protocol used at our institution with MS patients and to report a case from this service, as mere example. The protocol consists of two parts: anamnesis and evaluation of stomatognathic structures and functions. The anamnesis is carried out using a questionnaire responded by the caregivers, with the aim to gather information about the patient's history, since birth. The evaluation investigates mobility, motricity, muscular tonus and posture of the phonoarticulatory organs, and activities of neurovegetative functions. The muscles responsible for facial expression are also individually assessed, in order to evaluate the real possibilities for these patients' expression. To exemplify both parts of the protocol, a 10-year-old male patient was evaluated, and the results are described in this study. He has been attending therapy at this institution since 2000. With this protocol, we had the aim to identify clinical symptoms of MS related to Speech-Language Pathology, as well as to describe the individual characteristics.
- ItemAcesso aberto (Open Access)Validation of a protocol to assist patients with intra-aortic balloon(Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2012-01-01) Machado, Regimar Carla [UNIFESP]; Guerra, Grazia Maria; Branco, João Nelson Rodrigues [UNIFESP]; University of Vale do Paraiba; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To develop a protocol of care for patients with Intra-Aortic Balloon and validate the content of this protocol. METHODS: Study of quantitative and descriptive approach. The methodology followed three steps: development of the instrument; content validity and reliability verification of the protocol for the analysis of agreement between specialists with greater experience. The study included 48 specialists, including physicians and nurses experienced in patient care in use of balloon. Items considered valid achieved at least 75% of consensus before the analysis of agreement between evaluators. RESULTS: We evaluated 36 items, of these, 20 were considered valid. The reliability was also verified, using consistency of the responses of more experienced evaluators. Among the items submitted to new statistical analysis by these evaluators, only two were considered valid. CONCLUSION: Based on the content validation, a protocol with 22 items concerning patient care without the use of intra-aortic balloon was developed.