GILCERIA TOCHIKA SHIMODA
Projetos de Pesquisa
Unidades Organizacionais
3 resultados
Resultados de Busca
Agora exibindo 1 - 3 de 3
- 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.
- 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.
- Nonpharmacological analgesic interventions among newborn infants in the University Hospital of the University of Sao Paulo: a best practice implementation project(2020) BRITO, Ana P. A.; SHIMODA, Gilceria T.; ARAGAKI, Ilva M. M.; SICHIERI, Karina; CIRICO, Michelli O. V.; FREITAS, Patricia de; MCARTHUR, AlexaIntroduction: Despite evidence from studies on nonpharmacological pain management among newborns, many health professionals still don't apply evidence from scientific knowledge in their clinical practice. Objectives: To promote evidence-based practice for nonpharmacological analgesic interventions among newborns in the Maternity Ward of the University Hospital of the University of Sao Paulo, improving pain management and promoting healthy newborn growth and development, and better use of resources. Method: The current evidence implementation project used the JBI Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tool. The JBI Practical Application of Clinical Evidence System and Getting Research into Practice framework for promoting evidence-based healthcare involve three phases of activity: conducting a baseline audit, implementing strategies to address areas of noncompliance and conducting a follow-up audit to assess the outcomes of the interventions implemented to improve practice. Ten evidence-based criteria on nonpharmacological pain management among newborns were audited, by direct observation of the nursing staff activities involving single skin-breaking procedures in the newborn. Results: The baseline audit indicated poor compliance with evidence in current practice inmost of the evidence-based criteria audited. Discussion with the implementation team identified barriers to best practice, with interventions including a nursing protocol and educational program for all nursing staff on nonpharmacological analgesic approaches to reduce pain in the newborn (breastfeeding, skin-to-skin contact with the mother, nonnutritive sucking and glucose 25%), and a leaflet to inform the best available evidence on newborn pain management. In the follow-up audit, compliance increased in eight of nine audit criteria, with criterion 7 remaining at 100% compliance to best practice. Conclusion: The current best practice implementation project contributed to establishing evidence-based practice and enhancing neonatal pain management during skin-breaking painful procedures in the University Hospital. However, to achieve 100% compliance with all the evidence-based audit criteria, we will need to invest in continuing education and extend this implementation project to other related settings of the hospital. Moreover, it is necessary to perform follow-up cyclical audits to assess compliance and address barriers to best practice, enhancing the quality of nursing care, ensuring better results on pain management of the newborn and ongoing sustainability of this project.