GILCERIA TOCHIKA SHIMODA
Projetos de Pesquisa
Unidades Organizacionais
2 resultados
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- 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.
- 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.