GILCERIA TOCHIKA SHIMODA
Projetos de Pesquisa
Unidades Organizacionais
12 resultados
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- Implementation of evidence-based practices in normal delivery care(2018) CORTES, Clodoaldo Tentes; OLIVEIRA, Sonia Maria Junqueira Vasconcellos de; SANTOS, Rafael Cleison Silva dos; FRANCISCO, Adriana Amorim; RIESCO, Maria Luiza Gonzalez; SHIMODA, Gilceria TochikaObjective: to evaluate the impact of the implementation of evidence-based practices on normal delivery care. Method: quasi-experimental, before-and-after intervention study conducted in a public maternity hospital, Amapa. Forty-two professionals and 280 puerperal women were interviewed and data from 555 medical records were analyzed. The study was developed in three phases: baseline audit (phase 1), educational intervention (phase 2) and post-intervention audit (phase 3). Results: after the intervention, there was an increase of 5.3 percentage points (p.p.) in the normal delivery rate. Interviews with the women revealed a significant increase of the presence of companions during labor (10.0 p.p.) and of adoption of the upright or squatting position (31.4 p.p.); significant reduction of amniotomy (16.8 p.p.), lithotomy position (24.3 p.p.), and intravenous oxytocin (17.1 p.p.). From the professionals' perspective, there was a statistical reduction in the prescription/administration of oxytocin (29.6 p.p.). In the analysis of medical records, a significant reduction in the rate of amniotomy (29.5 p.p.) and lithotomy position (1.5 p.p.) was observed; the rate of adoption of the upright or squatting position presented a statistical increase of 2.2 p.p. Conclusions: there was a positive impact of the educational intervention on the improvement of parturition assistance, but the implementation process was not completely successful in the adoption of scientific evidence in normal delivery care in this institution.
- Effectiveness of photobiomodulation therapy for nipple pain or nipple trauma in lactating women: a systematic review protocol(2021) CIRICO, Michelli Oliveira Vani; SHIMODA, Gilceria Tochika; SILVA, Isilia Aparecida; SOUSA, Marcelo Victor Pires de; CASTRO, Renata de; MCARTHUR, AlexaObjective: The objective of this protocol is to evaluate the effectiveness of photobiomodulation therapy for the treatment of nipple pain or nipple trauma in women during the breastfeeding period. Introduction: One approach that has been reported on the management of nipple pain or nipple trauma in lactating women is the use photobiomodulation therapy to heal the injury or to decrease pain intensity. However, studies have achieved different results, due to variations in the treatment protocol, such as the source of light used, the application mode, the irradiation, or the light dose parameters, leading to varying outcomes. Inclusion criteria: This review will consider studies that evaluate photobiomodulation therapy for the treatment of nipple pain or nipple trauma in lactating women in the postpartum period that compare the intervention to standard care, placebo, or other type of treatment. The following outcomes will be considered: intensity of nipple pain, healing of nipple trauma, exclusive breastfeeding rate, quality of life, and satisfaction of the women with treatment. There will be no publication time limit, and studies published in any language will be considered for inclusion. Methods: This review will be conducted in accordance with JBI methodology for systematic reviews of effectiveness. The search strategy will search both published and unpublished studies, and the process of study selection, critical appraisal, data extraction, and data synthesis will be performed in accordance to the JBI approach. Systematic review registration number: PROSPERO CRD42019147401
- Avaliação da cicatrização da episiotomia: confiabilidade da escala REEDA (Redness, Oedema, Ecchymosis, Discharge, Approximation)(2015) ALVARENGA, Marina Barreto; FRANCISCO, Adriana Amorim; OLIVEIRA, Sonia Maria unqueira Vasconcellos de; SILVA, Flora Maria Barbosa da; SHIMODA, Gilceria Tochika; DAMIANI, Lucas PetriObjective: to analyse the Redness, Oedema, Ecchymosis, Discharge, Approximation (REEDA) scale reliability when evaluating perineal healing after a normal delivery with a right mediolateral episiotomy. Method: observational study based on data from a clinical trial conducted with 54 randomly selected women, who had their perineal healing assessed at four time points, from 6 hours to 10 days after delivery, by nurses trained in the use of this scale. The kappa coefficient was used in the reliability analysis of the REEDA scale. Results: the results indicate good agreement in the evaluation of the discharge item (0.75< Kappa >= 0.88), marginal and good agreement in the first three assessments of oedema (0.16< Kappa >= 0.46), marginal agreement in the evaluation of ecchymosis (0.25< Kappa >= 0.42) and good agreement regarding redness (0.46< Kappa >= 0.66). For the item coaptation, the agreement decreased from excellent in the first assessment to good in the last assessment. In the fourth evaluation, the assessment of all items displayed excellent or good agreement among the evaluators. Conclusion: the difference in the scores among the evaluators when applying the scale indicates that this tool must be improved to allow an accurate assessment of the episiotomy healing process.
- Necessidades de saúde de nutrizes e qualidade de vida(2013) SHIMODA, Gilceria Tochika; ARAGAKI, Ilva Marico Mizumoto; SOUSA, Clovis Arlindo de; SILVA, Isilia AparecidaObjective: Establish a relationship between nursing mothers' health needs and their quality of life. Methods: Cross-sectional study with 219 nursing mothers selected by consecutive convenience sampling. The assessment instrument WHOQOL-bref was used in this study. Results: A significant statistical difference was found between the non-satisfaction of the nursing mothers' health needs and a lower mean quality of life score as follows: in the physical domain, for women who needed sleep and rest, family support and time for themselves; in the social relationships domain, for women who needed family support; in the environment domain, for those who needed access to health services, an appropriate environment to breastfeed and professional support; in the psychological domain, for mothers who needed good mental health. Conclusion: Nursing mothers with unsatisfied health needs presented a lower mean quality of life score.
- Central line bundle maintenance among adults in a university hospital intensive care unit in São Paulo, Brazil: A best practice implementation project(2018) SICHIERI, K.; IIDA, L. I. S.; MENEZES, I. R. D. S. C. De; GARCIA, P. Carlos; SANTOS, T. R.; PERES, E.; SHIMODA, G. T.; MAIA, F. De Oliveira Motta; SECOLI, S. R.; PüSCHEL, V. A. De AraújoObjectives: This implementation project aimed to identify the current practice in regards to central venous catheters (CVCs) maintenance to improve knowledge amongst nursing staff and to assess increased compliance with evidence-based best practice. Introduction: Central venous catheters are considered an important therapeutic resource for the administration of fluids, drugs, blood, collection of blood samples and hemodynamic monitoring. Despite the benefits, catheter use is associated with complications such as primary infection of the catheter-related bloodstream. Methods: This project utilized the audit and feedback model using the Joanna Briggs Institute Practical Application of Clinical Evidence System. Nine of 10 criteria were audited through direct observation of nursing professionals or patient records in relation to CVC maintenance, and one criterion involved direct questioning of nursing staff. Baseline and follow-up audits were conducted in a 12-bed adult intensive care unit in a university hospital. Results: The baseline audit revealed deficits between current practice and best practice in some criteria. Barriers to implementation of CVC maintenance best practice criteria were identified, and the strategies were implemented. The post-implementation (follow-up) audit showed improvement in compliance to best practice guidelines in all of the audit criteria, except in one criterion: the use of sterile gloves or surgical tweezers during the execution of the dressing. Conclusions: Best practice in CVC care was achieved in the hospital, strengthening and guiding nursing care, as well as highlighting the importance of nursing records throughout the care process. However, this project highlighted the need to improve compliance through follow-up audits and periodic training to support best practice. © 2018 THE JOANNA BRIGGS INSTITUTE.
- Interventions to reduce patient identification errors in the hospital setting: a systematic review protocol(2019) REZENDE, H.A. De; MELLEIRO, M.M.; SHIMODA, G.T.REVIEW QUESTION: The question of this review is: how effective are the interventions that may prevent or reduce patient identification errors in the hospital setting?
- Surgical counts in open abdominal and pelvic surgeries in a university hospital: a best practice implementation project(2021) GOMES, Eduardo T.; GALVAO, Mayana C. B.; SHIMODA, Gilceria T.; OLIVEIRA, Larissa B. de; PUSCHEL, Vilanice A. de AraujoIntroduction: Counting of accountable items used during surgery, frequently called 'the count', is a fundamental practice to ensure that items such as surgical instruments, sponges and sharps are not forgotten within patients. Although inadvertently leaving behind a sponge or instrument at the end of an operation is a rare event, it is an error that may have serious implications. Objectives: The aim of this evidence implementation project was to contribute to promoting evidence-based practice in surgical counts in open abdominal and pelvic surgeries and thereby improving the outcomes of the surgical patients at a surgical centre of a university hospital. Methods: The current evidence implementation project used the JBI Practical Application of Clinical Evidence System and Getting Research into Practice (GRiP) audit and feedback tool. The JBI Practical Application of Clinical Evidence System and GRiP framework for promoting evidence-based healthcare involves three phases of activity: first, establishing a project team and undertaking a baseline audit based on evidence-informed criteria; second, reflecting on the results of the baseline audit and designing and implementing strategies to address non-compliance found in the baseline audit informed by the JBI GRiP framework; third, conducting a follow-up audit to assess the outcomes of the interventions implemented to improve practice, and identify future practice issues to be addressed in subsequent audits. These three phases were performed over a period of 6 months, from August 2017 to March 2018. Results: The baseline audit revealed deficits between old and best practice in all criteria. Barriers for implementation of a protocol for surgical counts were identified, and strategies were implemented. The postimplementation (follow-up) audit showed improvement in compliance with best practice in six of the audit criteria selected except two, a multidisciplinary team approach to decrease retained surgical items, and limited staff hand-offs during surgical procedures to ensure the same team is present in all counting episodes. Conclusion: The main achievements of the study included substantial increases in compliance with best practice. However, registration and report and commitment of all members of surgical team to apply the entire protocol, avoiding to skip any step, persist as challenges.
- Falls prevention strategies for adult inpatients in a university hospital of São Paulo, Brazil: A best practice implementation project(2018) MAIA, F. D. O. M.; CRUZ, D. D. A. L. M. Da; SHIMODA, G. T.; SICHIERI, K.; IIDA, L. I. S.Objectives: The main objective of this project was to reduce the incidence and harm from falls that occur among patients admitted in the acute Internal Medicine Unit and Intensive Care Unit in a public teaching hospital in São Paulo, Brazil. Introduction: Falls are a challenge for health professionals and healthcare services as they may result in high-impact outcomes for patients, such as functional decline, increase in length of hospital stay, increase in the cost of healthcare services, and death. In an attempt to promote safe care the World Health Organization (WHO) launched the World Alliance for Patient Safety in 2004 that encourages the adoption of best practice to reduce adverse events in healthcare services. Methods: The project used the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI-PACES) and Getting Research into Practice (GRiP) audit tool for promoting change in health practice. A baseline audit was conducted measuring eight best practice criterias, followed by the implementation of target strategies and a followup audit. Results: The results of the baseline audit identified large gaps between current practice and overall compliance with best practice. The GRiP module helped identify strategies related to education programs for patients, families and nursing teams, and a falls risk assessment with an accurate tool to address the gaps in compliance. The follow-up audit cycle was satisfactory as all best practice audit criteria showed an improvement as an aggregated result. Conclusions: The project used the audit and feedback strategy to translate evidence into practice. Some of the measured criteria improved to moderate-high compliance with best practice. The results showed that implementation of evidence-based practice leads to an improvement in falls prevention. Future audits are required to sustain improvements. © 2018 The Joanna Briggs Institute.
- Nursing contributions to the development of the Brazilian Telehealth Lactation Support Program(2013) PRADO, Claudia; SILVA, Isilia Aparecida; SOARES, Alda Valeria Neves; ARAGAKI, Ilva Marico Mizumoto; SHIMODA, Gilceria Tochika; ZANIBONI, Vanessa Forte; PADULA, Camila Brolezzi; MULLER, Fabiana Swain; SALVE, Jeanine Maria; DARE JUNIOR, Sergio; WEN, Chao Lung; PERES, Heloisa Helena Ciqueto; LEITE, Maria Madalena JanuarioThe National Telehealth Program was founded by the Ministry of Health, in partnership with the Ministry of Education (Ministerio da Educacao - MEC) and the Ministry of Science and Technology (Ministerio da Ciencia e Tecnologia - MCT), to support the development of family healthcare teams throughout the country. The Sao Paulo Telehealth Center has developed the Telehealth Lactation Support program, which provides primary healthcare professionals with information on diverse aspects of breastfeeding. This paper reports the development of the Lactation Support program and the nursing contributions. Project methodology included the formation of a multidisciplinary group of pediatricians, nurses, speech and language therapists, nutritionists, and dentists. Multimedia teaching resources were prepared for inclusion in the Cybertutor platform. Telehealth Lactation Support is an innovative and promising addition to continuing education for healthcare professionals and provides a framework for the development of other programs.
- Prevention and management of primary postpartum hemorrhage among puerperae in a teaching hospital in São Paulo, Brazil: A best practice implementation project(2019) OGAWA, L.; SHIMODA, G.T.; WEI, C.Y.; PüSCHEL, V.A.D.A.Objectives:The aim of this project was to develop and implement strategies to promote standardization and formal documentation of increased bleeding within the first 24 h after birth, in compliance with best practice.Introduction:Official data from Brazil shows a maternal mortality rate of around 52 to 75 deaths per 100,000 live births, 8% of which are caused by hemorrhage. Early diagnosis is promoted through standardization and formal documentation of the first signs of hemorrhage.Methods:The current implementation project used the Joanna Briggs Institute Practical Application of Clinical Evidence System, a baseline audit was conducted on a sample size of 108 patients and 67 nursing staff. Based on the results of the baseline audit, strategies to address non-compliance were developed and implemented. A follow-up audit was conducted on a sample size of 110 patients and 68 nursing staff, using the same audit criteria.Results:The baseline audit showed poor compliance with evidence-based best practice in every criterion. The implemented protocol for postpartum hemorrhage was well received by the nursing staff, promoting early diagnosis of increased bleeding within 24 h after birth and providing support for further medical treatment. There were significant improvements in every best practice criterion in the follow-up audit.Conclusion:The current implementation project managed to improve the nursing staff professional practice, reducing the absence of records while promoting greater awareness of the first signs of primary postpartum hemorrhage. © 2019 THE JOANNA BRIGGS INSTITUTE.