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Analysis of uterine evacuation methods in postabortion care after implementation of a surveillance network (CLAP MUSA-Network) at a university hospital

by Nelio N. Veiga-Junior, Caroline Eugeni, Beatriz D. Kajiura, Priscilla B. F. Dantas, Caroline B. Trabach, Aline A. Junqueira, Carina C. Nunes, Luiz F. Baccaro

Background

Management of uterine evacuation is essential for increasing safe abortion care. Monitoring through surveillance systems tracks changes in clinical practice and provides information to improve equity in abortion care quality.

Objective

This study aimed to evaluate the frequency of manual vacuum aspiration (MVA) and medical abortion (MA), and identify the factors associated with each uterine evacuation method after surveillance network installation at a Brazilian hospital.

Methods

This cross-sectional study included women admitted for abortion or miscarriage to the University of Campinas Women’s Hospital, Brazil, between July 2017 and November 2020. The dependent variables were the use of MVA and MA with misoprostol. The independent variables were the patients’ clinical and sociodemographic data. The Cochran–Armitage, chi-square, and Mann–Whitney U tests, as well as multiple logistic regression analysis, were used to compare uterine evacuation methods.

Results

We enrolled 474 women in the study, 91.35% of whom underwent uterine evacuation via uterine curettage (78.75%), MVA (9.46%), or MA (11.54%). MVA use increased during the study period (Z = 9.85, p Conclusion

MVA use increased following the installation of a surveillance network for good clinical practice. Being part of a network that encourages the use of evidence-based methods provides an opportunity for healthcare facilities to increase access to safe abortions.

Application of ventilator-associated events (VAE) in ventilator-associated pneumonia (VAP) notified in Brazil (IMPACTO MR-PAV): a protocol for a cohort study

Por: Nascimento · G. M. · Gomes Rodrigues · D. L. · Mangas Catarino · D. G. · Piastrelli · F. T. · Cheno · M. Y. · Braz · K. C. C. · Oliveira Alves · L. B. · Avezum · A. · Veiga · V. C. · Zavascki · A. P. · Tomazini · B. · Besen · B. · Pereira · A. J. · Marques de Pinho · A. P. N. · De
Introduction

Certain criteria for ventilator-associated events (VAE) definition might influence the type of an event, its detection rate and consequently the resource expenditure in intensive care unit. The Impact of Infections by Antimicrobial-Resistant Microorganisms - Ventilator-Associated Pneumonia (IMPACTO MR-PAV) aims to evaluate the incidence and diagnostic accuracy of ventilator-associated pneumonia (VAP) using the current criteria for VAP surveillance in Brazil versus the VAE criteria defined by the US National Healthcare Safety Network-Center for Diseases Control and Prevention (CDC) criteria.

Methods and analysis

The study will be conducted in around 15 centres across Brazil from October 2022 to December 2023. Trained healthcare professionals will collect data and compare the incidence of VAP using both the current criteria for VAP surveillance in Brazil and the VAE criteria defined by the CDC. The accuracy of the two criteria for identifying VAP will also be analysed. It will also characterise other events associated with mechanical ventilation (ventilator-associated condition, infection-related ventilator-associated complication) and adjudicate VAP reported to the Brazilian Health Regulatory Agency (ANVISA) using current epidemiological diagnostic criteria.

Ethics and dissemination

This study was approved by the Institutional Review Board under the number 52354721.0.1001.0070. The study’s primary outcome measure will be the incidence of VAP using the two different surveillance criteria, and the secondary outcome measures will be the accuracy of the two criteria for identifying VAP and the adjudication of VAP reported to ANVISA. The results will contribute to the improvement of VAP surveillance in Brazil and may have implications for other countries that use similar criteria.

Trial registration number

NCT05589727; Clinicaltrials.gov.

Aplicación web como estrategia para la enseñanza de la presión arterial en enfermería

Objetivo: analizar el proceso de enseñanza-aprendizaje de la medición de la presión arterial, a través de una aplicación web, desde la perspectiva de los estudiantes de enfermería. Método: estudio cualitativo con 19 estudiantes de enfermería. Los datos se recopilaron en 2017, en dos etapas: presentación y uso de la aplicación web y realización del grupo focal. Se utilizó el análisis del benchmark de Análisis Temático. Resultados: a partir del análisis de los datos, se elaboró un tema central: la construcción del conocimiento sobre la medición de la presión arterial a través de una aplicación web y dos subtemas, La mirada en la tecnología y La mirada en diferentes formas de aprendizaje. Conclusión: la educación mediada por el uso de la aplicación web contribuyó al proceso de enseñanza del aprendizaje, tanto en relación con el contenido teórico como práctico sobre la medición de la presión arterial. La aplicación web se consideró dinámica, innovadora y favoreció la incautación del conocimiento y la actualización a una práctica clínica más segura.

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