Navegando por Palavras-chave "Dispositivos De Acesso Vascular"

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    Eficácia de cobertura estéril de cateteres intravenosos periféricos na prevenção de flebite: estudo clínico pragmático, randômico e controlado com cegamento
    (Universidade Federal de São Paulo (UNIFESP), 2020-08-27) Enes, Sandra Maria Sampaio [UNIFESP]; Pedreira, Mavilde Da Luz Goncalves [UNIFESP]; Universidade Federal de São Paulo
    Introduction: Peripheral venous catheterization is the most commonly performed invasive procedure in healthcare. Care practices and the use of technologies may influence the results of the use peripheral intravenous catheters (PIC), contributing to the reduction of complications and adverse events. Phlebitis is characterized as one of the most serious complication related to the use of PIC and this study has as hypothesis to analyze if the occurrence of phlebitis associated with PIC is influenced by the use of sterile dressing. Objectives: To verify the effect of using sterile dressing and sterile adhesive tape compared to non-sterile adhesive tape in PIC on the occurrence of phlebitis in adult patients attended at a hospital from the Western Brazilian Amazon. Methods: Pragmatic, randomized, controlled and single-blinded clinical study conducted in Rio Branco, Acre. The sample was calculated in 330 patients, aged 18 years or older and who met the inclusion criteria. Data collection took place between June 2018 and September 2019, after approval of ethical merit. To identify the type of sterile transparent dressing to be studied, was carried out an implementation study with a final sample of 71 patients, focusing analysis from the perspective of the patient, professional and clinics. The patients of the clinical study were randomly allocated to one of the study groups: Experimental group (sterile transparent dressing) or Standard Group (nonsterile adhesive tape). Phlebitis was diagnosed by the bedside nurse, according to presence and severity. If present, the nurse removed the CIP and an external evaluator was called to perform a diagnose of phlebitis with blindness regarding the intervention. Variables related to patient characterization, intravenous therapy, peripheral venipuncture, reasons for withdrawal and length of PIC stay, reasons for removal and length of coverage, and associated complications were investigated. For the statistical analysis, Chi-square, Fisher's Exact, student t test, and Mann-Whitney U tests were used. The multiple analysis was performed using the logistic regression model to estimate the Relative Risk (RR) and the Kaplan-Meier model, Cox regression, for survival analysis. RR calculation for 95% Confidence Interval (IC) was applied to estimate the degree of association between variables. In all tests, the significance level of 5% was considered. Result: In the implementation study, the IV3000TM ported dressing obtained the best result of the satisfaction indicators of professional and patient (p <0.0001). The average survival rate of PIC with IV3000TM ported dressing was 3.096 greater than Tegaderm3MTM Basic (p=0.006). The clinical study was carried out with 306 patients, 153 in each study group (24 follow-up losses), the majority being female (52.3%), with an average of 47.22(±16.1) years of age, with brown skin color (68.3%) and 51% had chronic diseases. Phlebitis was identified in 24.2% of the patients, with a difference between the study groups (p<0.0001). Using non-sterile tapes increased the chance of developing phlebitis by 5.958 times compared to patients who received sterile dressing (p=0.0001; 95% CI; 13.09-10.78). The average survival rate for PICs using sterile dressing was 5.387 times greater than catheters with non-sterile adhesive tape for stabilization (p = 0.0001). Conclusion: The use of sterile dressing was significantly effective in reducing phlebitis and other complications related to PIC, and longer catheter dwell time, when compared to the use of non-sterile adhesive tape.
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    Escala de avaliação da rede venosa Venous International Assessment (VIA): tradução para a língua portuguesa do Brasil, adaptação transcultural e proposta de revisão (VIA-R)
    (Universidade Federal de São Paulo (UNIFESP), 2021) Lopes, Mayara [UNIFESP]; Pedreira, Mavilde Da Luz Goncalves [UNIFESP]; Universidade Federal de São Paulo
    Objective: Validate the translation and cross-cultural adaptation to Brazilian Portuguese of the Venous International Assessment Scale (VIA-Scale). Methods: This is a study of methodological design, for which permission was obtained from the authors of the original scale and approval by the ethics committee. Translation processes and back translation of the instruments, synthesis of the versions and approval of the authors of the proposed versions in the back translation were outlined. For the validation of the translation into Brazilian Portuguese, using the Delphi technique, a committee of seven expert judges it. Consensus in the first round was analyzed through item score calculations (minimum of 21 points) and minimum indices of 0.8 for the item level content validity index. There was a suggestion to incorporate explanatory contents to the scale expressed in article of the original scale, but not incorporated into the instrument, being approved by the authors, deciding for the proposition of a reviewed version. In subsequent assessments by the committee of judges, a minimum of 18 points per item and content validation indices of 0.7 were established. To carry out the cross-cultural adaptation, 35 professional experts were invited, who performed the global assessment of the instrument (minimum indices of 0.75) through six attributes (understanding, simplicity, objectivity, typicality, relevance and credibility) and analysis of the scale ownership to support the professional's decision in peripheral catheterization. Results: Three rounds of the Delphi technique were necessary to reach consensus in the validation of the translation. In the first round 32 (86.5%) items were validated and the instrument had an average content validation index of 0.93 and universal agreement of 0.73. At the end of the three rounds, a content validation index of 0.96 and universal agreement of 0.78 were obtained. In the cross-cultural adaptation analysis stage, the scale has obtained an index of 0.77 and 90.5% of the participants judged positively the property of decision support for venipuncture. Conclusion: The process of translate validation and cross-cultural adaptation to the Brazilian-Portuguese language of the VIA Scale was carried out, with a revised proposal called the VIA-R Scale, which should be submitted to a clinical validation process.