FLAVIA DE OLIVEIRA MOTTA MAIA
Projetos de Pesquisa
Unidades Organizacionais
6 resultados
Resultados de Busca
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- Screening and detection of delirium in an adult critical care setting: a best practice implementation project(2021) SOUZA-TALARICO, Juliana N. de; SILVA, Fernanda C. da; MAIA, Flavia O. de Motta; SICHIERI, Karina; CARDOSO, Diley; GARCIA, Paulo; MATOS, Tatiane M.; NASCIMENTO, Tatiane S.Aim: To assess compliance with evidence-based practice regarding screening and detection of delirium in adult patients at the ICU from a university hospital. Methods: The compliance rates were evaluated using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tool. This strategy was designed in three phases: (1) establishing a team and conducting a baseline audit based on criteria informed by the evidence; (2) reflecting on the results of the baseline audit and designing and implementing strategies to address noncompliance found in the baseline audit informed by the JBI Getting Research into Practice framework; and (3) 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. The implementation protocol was designed based on the primary barriers and facilitators identified in the baseline audit, allied to a training program and electronic medical records changes. Nursing documentation available in medical records from patients admitted in the ICU was used to assess the baseline and follow-up audit compliance rates. Results: None of the medical records evaluated before the implementation protocol showed compliance with the following audit criteria: a valid and reliable instrument is accessible in the ward environment (0%), the nursing care documentation supports that the Confusion Assessment Method for the Intensive Care Unit instrument is being used (0%) and population assessed for delirium includes all adults over the age of 65, cognitive impairment, dementia, or both, current hip fracture and severe illness (0%). After the evidence-based practice implementation, the follow-up audit revealed up to 100% compliance rates with those criteria, showing that all patients under risk were screened and assessed for delirium. The only exception was the Confusion Assessment Method for the Intensive Care Unit use, whose compliance was observed in 80.95% of the medical records. Conclusion: These findings support that baseline and follow-up audits allied to a delirium training program, and changes in the electronic nursing records increase the compliance rates related to the evidence-based practice for screening patients under risk and assessing delirium.
- 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.
- Cross-Cultural Adaptation of the Vulnerable Elders Survey-13(VES-13): helping in the identification of vulnerable older people(2012) MAIA, Flavia de Oliveira Motta; DUARTE, Yeda Aparecida de Oliveira; SECOLI, Silvia Regina; SANTOS, Jair Licio Ferreira; LEBRAO, Maria LuciaTo use the VES-13 - a tool for identifying vulnerable older people - cultural adaptation was performed, a process that seeks the equivalence between the original instrument and its version in another culture. The evaluation of semantic, idiomatic, cultural and conceptual equivalence obtained a general average agreement of 78%, 78%, 97.0% and 94.0% respectively. Kappa coefficient was used to verify the agreement in test-retest reliability, where variables were significant. The analysis of internal consistency was measured by using Cronbach's alpha coefficient, where 70% of the phenomenon under study are represented in the VES-13. The VES-13, translated and adapted, is a reliable instrument with respect to stability and internal consistency of their measurements. Its simple structure and easy to use may therefore contribute to the identification of vulnerable older people, thus contributing to the prioritization of monitoring health services.
- 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.
- Strategies to support health professionals in the condition of second victim: scoping review(2021) QUADRADO, Ellen Regina Sevilla; TRONCHIN, Daisy Maria Rizatto; MAIA, Flavia de Oliveira MottaObjective: To map and analyze the knowledge produced about strategies aimed at promoting support to health professionals in the condition of second victim. Method: Scoping review, developed in portals, databases and academic websites, whose inclusion criteria were articles and materials indexed in the respective search sites, between January 2000 and December 2019, in Portuguese, English and Spanish. The findings were summarized and analyzed based on descriptive statistics and narrative synthesis. Results: A total of 64 studies were included, 100% international; 92.2% in English and 50% from secondary research. The support strategies were grouped into four categories and most of the studies referred to the use of the forYOU, Medically Induced Trauma Support Services and Resilience in Stressful Events programs and the interventions represented, through dialogue with peers, family, friends and managers. Conclusion: Support strategies for the second victim are pointed out in international mostly developed through programs/services and interventions. It is recommended to develop studies to learn about the phenomenon and to structure feasible support strategies in Brazilian health organizations.
- Pain evaluation scales for elderly patients with dementia(2015) CUSTÓDIA, Andressa Caio Eira da; MAIA, Flávia de Oliveira Motta; SILVA, Rita de Cassia Gengo eABSTRACT BACKGROUND AND OBJECTIVES: Elderly people with dementia are impaired in the way they interpret and communicate pain, being important the use of specific tools for accurate diagnosis. This study aimed at summarizing literature data on tools for pain evaluation in hospitalized elderly patients with dementia. CONTENTS: This is a literature review of the following databases: LILACS, Pubmed/Medline, CINAHL, SCOPUS, Cochrane, Web of Science and Joanna-Briggs Institute. Eligibility criteria were established for studies selection. A specific tool was used for critical evaluation. From 383 studies found, 4 were included in this review. Studies have evaluated the performance of 8 observational or self-report scales. CONCLUSION: Our study results suggest that observational and self-report scales may be used to evaluate pain in hospitalized elderly patients with dementia, provided the level of cognitive impairment is observed to select the scale, thus avoiding inadequate evaluations and consequently the undertreatment of pain.