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1.
Front Med (Lausanne) ; 11: 1281199, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38975055

RESUMO

Background: Metrology plays a crucial role in small healthcare service businesses to ensure the quality of products and services. While legal metrology in healthcare exists in some regions, it lacks harmonization. In other countries, there is limited presence of metrology in medical and biomedical engineering. We aimed to evaluate the implementation of metrological assurance systems for medical devices in Latin America. Methods: A systematic review was conducted following PRISMA 2020 guidelines and registered with PROSPERO (CRD42022359284). Searches were performed across 13 databases from October 30th to November 3rd, 2022. The search equation was "(((quality assurance) AND (metrology)) AND (medical devices))." A total of 7,789 documents were identified, of which only 16 met the inclusion criteria. Results: The majority of studies (75%) were conducted in Colombia, with a significant portion being undergraduate theses. The primary normative references used in the analyzed studies were ISO 10012 and ISO 17025, with the majority (68.75%) relying on national legislation for their approach. One study in Colombia referenced eight standards, and one in Brazil analyzed user involvement in medical device management. Among the included studies, 56.25% were conducted in healthcare institutions, mainly clinics. Most studies provided implementation guidelines, with ISO 10012 being prominent, alongside ISO 17025, which implicitly addresses ISO 9001 elements. Global bias was low across all studies. Conclusion: Our results underscore the importance of metrological assurance in managing medical devices in Latin America. The utilization of international standards and national legislation illustrates the diverse approaches adopted by different institutions. Future research should focus on optimizing metrological practices to enhance quality and safety in healthcare.

2.
Abdom Radiol (NY) ; 2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-38940911

RESUMO

Prostate magnetic resonance imaging (MRI) stands as the cornerstone in diagnosing prostate cancer (PCa), offering superior detection capabilities while minimizing unnecessary biopsies. Despite its critical role, global disparities in MRI diagnostic performance persist, stemming from variations in image quality and radiologist expertise. This manuscript reviews the challenges and strategies for enhancing image quality in prostate MRI, spanning patient preparation, MRI unit optimization, and radiology team engagement. Quality assurance (QA) and quality control (QC) processes are pivotal, emphasizing standardized protocols, meticulous patient evaluation, MRI unit workflow, and radiology team performance. Additionally, artificial intelligence (AI) advancements offer promising avenues for improving image quality and reducing acquisition times. The Prostate-Imaging Quality (PI-QUAL) scoring system emerges as a valuable tool for assessing MRI image quality. A comprehensive approach addressing technical, procedural, and interpretative aspects is essential to ensure consistent and reliable prostate MRI outcomes.

3.
Fam Pract ; 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38831566

RESUMO

BACKGROUND: Clinical practice guidelines (CPGs) are statements to assist practitioners and stakeholders in decisions about healthcare. Low methodological quality guidelines may prejudice decision-making and negatively affect clinical outcomes in non-communicable diseases, such as cardiovascular diseases worsted by poor lipid management. We appraised the quality of CPGs on dyslipidemia management and synthesized the most updated pharmacological recommendations. METHODS: A systematic review following international recommendations was performed. Searches to retrieve CPG on pharmacological treatments in adults with dyslipidaemia were conducted in PubMed, Scopus, and Trip databases. Eligible articles were assessed using AGREE II (methodological quality) and AGREE-REX (recommendation excellence) tools. Descriptive statistics were used to summarize data. The most updated guidelines (published after 2019) had their recommendations qualitatively synthesized in an exploratory analysis. RESULTS: Overall, 66 guidelines authored by professional societies (75%) and targeting clinicians as primary users were selected. The AGREE II domains Scope and Purpose (89%) and Clarity of Presentation (97%), and the AGREE-REX item Clinical Applicability (77.0%) obtained the highest values. Conversely, guidelines were methodologically poorly performed/documented (46%) and scarcely provided data on the implementability of practical recommendations (38%). Recommendations on pharmacological treatments are overall similar, with slight differences concerning the use of supplements and the availability of drugs. CONCLUSION: High-quality dyslipidaemia CPG, especially outside North America and Europe, and strictly addressing evidence synthesis, appraisal, and recommendations are needed, especially to guide primary care decisions. CPG developers should consider stakeholders' values and preferences and adapt existing statements to individual populations and healthcare systems to ensure successful implementation interventions.

5.
Int J Clin Pharm ; 46(3): 602-613, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38570475

RESUMO

BACKGROUND: Key performance indicators (KPIs) are quantifiable measures used to monitor the quality of health services. Implementation guidelines for clinical pharmacy services (CPS) do not specify KPIs. AIM: To assess the quality of the studies that have developed KPIs for CPS in inpatient hospital settings. METHOD: A systematic review was conducted by searching in Web of Science, Scopus, and PubMed, supplemented with citation analyses and grey literature searches, to retrieve studies addressing the development of KPIs in CPS for hospital inpatients. Exclusions comprised drug- or disease-specific studies and those not written in English, French, Portuguese, or Spanish. The Appraisal of Indicators through Research and Evaluation (AIRE) instrument assessed methodological quality. Domain scores and an overall score were calculated using an equal-weight principle. KPIs were classified into structure, process, and outcome categories. The protocol is available at https://doi.org/10.17605/OSF.IO/KS2G3 . RESULTS: We included thirteen studies that collectively developed 225 KPIs. Merely five studies scored over 50% on the AIRE instrument, with domains #3 (scientific evidence) and #4 (formulation and usage) displaying low scores. Among the KPIs, 8.4% were classified as structure, 85.8% as process, and 5.8% as outcome indicators. The overall methodological quality did not exhibit a clear association with a major focus on outcomes. None of the studies provided benchmarking reference values. CONCLUSION: The KPIs formulated for evaluating CPS in hospital settings primarily comprised process measures, predominantly suggested by pharmacists, with inadequate evidence support, lacked piloting or validation, and consequently, were devoid of benchmarking reference values.


Assuntos
Pacientes Internados , Serviço de Farmácia Hospitalar , Indicadores de Qualidade em Assistência à Saúde , Serviço de Farmácia Hospitalar/normas , Humanos , Indicadores de Qualidade em Assistência à Saúde/normas
6.
Environ Sci Pollut Res Int ; 31(23): 33623-33637, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38684615

RESUMO

We present an analytical method to detect and quantify residues of currently used pesticides (CUPs), which include 31 active ingredients (ai) and seven transformation products (TPs) in tropical and agricultural soils of Cuba. Ten isotopically labeled analogous compounds served as internal standards (IL-IS). The novelty of this research is the inclusion of different tropical soils type scarcely studied for CUPs and TPs, based on the QuEChERS (quick, easy, cheap, effective, rugged and safe) method, followed by chromatography tandem mass spectrometry. All figures of merit proved to be satisfactory according to SANTE guidelines 2020 and 2021. Matrix effects (ME) calculated by the external standard method were significant (|ME| > 20% for almost all compounds; grand mean ± standard deviation (STD) 104 ± 108%) in all soils. The internal standard method compensated ME to non-significant levels (8 ± 50%), even for analytes with a non-structure identical IL-IS (STD, 13 ± 57%). Repeatability (relative standard deviation, RSDr) and reproducibility (RSDR) for skeletic regosol (SR) were 7.5 ± 2.8% and 11.7 ± 4.7%, respectively. Absolute (quantified for 11 analytes with structure identical IL-IS) and relative recovery from SR was 92 ± 13% (mean ± STD) and 90 ± 12%, respectively. Limits of quantification for SR ranged from 0.1 to 10 ng/g, except metalaxyl and oxyfluorfen (25 ng/g each). Linearity of matrix-matched (MM) calibration curves (5 to 100 ng/g) had an R2 of ≥ 0.99 for all soils and almost all analytes. The method was successfully applied to 30 real soil samples.


Assuntos
Agricultura , Poluentes do Solo , Solo , Espectrometria de Massas em Tandem , Cuba , Poluentes do Solo/análise , Solo/química , Espectrometria de Massas em Tandem/métodos , Resíduos de Praguicidas/análise , Praguicidas/análise , Cromatografia Gasosa-Espectrometria de Massas , Reprodutibilidade dos Testes , Monitoramento Ambiental/métodos
7.
Rev. Col. Bras. Cir ; 51: e20243750EDIT01, 2024. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1559008

RESUMO

ABSTRACT Medical societies must maintain high standards of competence and quality when awarding specialist titles, defining the certification criteria, taking into account the needs and realities of the health system and medical practice.


RESUMO As Sociedades Médicas devem manter padrões elevados de competência e qualidade na concessão dos Títulos de Especialista, com definição dos critérios de certificação, considerando as necessidades e realidades do sistema de saúde e da prática médica.

8.
Rev. bras. enferm ; 77(3): e20230374, 2024. graf
Artigo em Inglês | LILACS-Express | LILACS, BDENF - Enfermagem | ID: biblio-1569673

RESUMO

ABSTRACT Objectives: To analyze nurses' perspectives on nurses' work methods in the hospital context. Methods: A descriptive study with a qualitative approach was conducted in a hospital in northern Portugal, involving 17 nurses. Semi-structured interviews were used for data collection. Data collected between May and June 2023 underwent content analysis, supported by Atlas.ti software. Results: Three thematic areas emerged: "Nurses' work methods in a hospital context," highlighting the conception and components of work methods and the methods in use; "Implementation of nurses' work methods," emphasizing influencing factors and challenges to implementation; and "Impact of nurses' work methods on patients, nurses, and institutions." Final Considerations: Nurses' work methods constitute the structure of nursing care. Some factors influence and some challenges arise in the implementation of these methods, producing impacts on patients, nurses, and institutions.


RESUMEN Objetivos: Analizar percepción de enfermeros sobre métodos de trabajo en enfermería en contexto hospitalario. Métodos: Estudio descriptivo con abordaje cualitativa, realizado en un hospital del norte de Portugal, con participación de 17 enfermeros. Como instrumento de recolecta de datos, recorrido a la entrevista semiestructurada. Datos recolectados entre mayo e junio de 2023, pasaron por análisis de contenido, con suporte del software Atlas.ti. Resultados: Emergieron tres áreas temáticas: "Métodos de trabajo de enfermeros en contexto hospitalario", destacándose la concepción y componentes de métodos de trabajo y en uso; "Implementación de métodos de trabajo", señalándose factores influenciadores y desafíos a la implementación; e "Impacto de métodos de trabajo de enfermeros para los pacientes, enfermeros e instituciones". Consideraciones Finales: Los métodos de trabajo constituidos como la estructura de asistencia de enfermería. Hay factores que influencian y desafíos que se quedan a la implementación de esos métodos, produciendo impacto en pacientes, enfermeros e instituciones.


RESUMO Objetivos: Analisar a percepção dos enfermeiros sobre os métodos de trabalho em enfermagem no contexto hospitalar. Métodos: Estudo descritivo com abordagem qualitativa, realizado num hospital do norte de Portugal, com participação de 17 enfermeiros. Como instrumento de coleta de dados, recorreu se à entrevista semiestruturada. Os dados, recolhidos entre maio e junho de 2023, passaram por análise de conteúdo, com suporte do software Atlas.ti. Resultados: Emergiram três áreas temáticas: "Métodos de trabalho dos enfermeiros em contexto hospitalar", destacando-se a concepção e componentes dos métodos de trabalho e os métodos em uso; "Implementação dos métodos de trabalho", salientando-se fatores influenciadores e desafios à implementação; e "Impacto dos métodos de trabalho dos enfermeiros para os pacientes, enfermeiros e instituições". Considerações Finais: Os métodos de trabalho constituem-se como a estrutura da assistência de enfermagem. Existem fatores que influenciam e desafios que se colocam à implementação desses métodos, produzindo impacto nos pacientes, enfermeiros e instituições.

9.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1535404

RESUMO

Introducción: La calidad de los datos facilita garantizar la fiabilidad de los estudios observacionales. Objetivo: Describir el aseguramiento y el control de calidad para mantener la fiabilidad y la validez del dato en un estudio de cohorte. Métodos: Presentar el manejo de datos implementado dentro de un seguimiento de enfermos renales crónicos cuya exposición fue un programa de protección renal comparado con el tratamiento convencional y su asociación con desenlaces clínicos. Se evaluó el cambio en la frecuencia de errores después de implementar el plan y la reproducibilidad del ingreso de registros a las bases de datos. Resultados: Se documentó una disminución progresiva en los errores cometidos en la captación de datos. El valor de Kappa entre los recolectores de la información para las variables clínicas más importantes fue 0,960 para la depuración de creatinina 150 mg/dL; 0,730 para la alteración del sedimento urinario; 0,956 para la asignación de estadio al ingreso. Los coeficientes de correlación intraclase para la identificación de las cifras de presión arterial sistólica fue 0,996; para la de presión arterial diastólica 0,993 y para los niveles de creatinina sérica al diagnóstico 0,995. Discusión: La calidad de los datos comienza con el reconocimiento de los retos y dificultades que implica su responsable captación, de ahí el aporte de la estandarización de los procesos y el personal que los lleve a cabo en forma idónea. Estudios evidencian que muchos procesos de mejora surgen en el desarrollo de la investigación sin protocolos preestablecidos. Conclusión: La reducción en la proporción y el tipo de error durante el proceso de captación de datos se debe a su identificación temprana y la corrección de instructivos, del instrumento de control de diligenciamiento y de la capacitación continua del personal. El análisis mostró una buena concordancia interevaluador.


Introduction: Data quality makes it easier to ensure that observational studies are reliable. Objective: To describe assurance and quality control to maintain data reliability and validity in a cohort study. Methodology: We present the data management strategies implemented in a study that followed patients of chronic kidney disease who were in a renal protection program and compared them with those undergoing conventional treatment to observe its association with clinical outcomes. We assessed the changes in error frequency after implementing the plan along with the reproducibility of the strategies for entering records into the databases. Results: We documented a progressive decrease of data collection errors. The Kappa values among data collectors for the most important variables were: 0.960 for creatinine clearance 150 mg/dl; 0.730 for urinary sediment alteration and 0.956 for stage allocation upon admission. The intraclass correlation coefficient for the identification of systolic blood pressure was 0.996; for diastolic blood pressure, the coefficient was 0.993 and for serum creatinine levels at diagnosis, the value was 0.995. Discussion: Data quality begins with the recognition of the challenges and difficulties involved in responsible data collection, hence the contribution of standardized processes and personnel to carry them out in a suitable manner. Studies show that many improvement processes arise in the development of research without pre-established protocols. Conclusion: The reduction in error ratio and type during the data collection process are the result of the early identification of erroneously entered or missing data, the correction of the guidelines for completing forms as well as of the instruments for detecting errors and continuous training of the staff. The analysis showed good inter-rater reliability.

10.
Micromachines (Basel) ; 14(10)2023 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-37893256

RESUMO

This study presents a comprehensive literature review that investigates the distinctions between true and false cinnamon. Given the intricate compositions of essential oils (EOs), various discrimination approaches were explored to ensure quality, safety, and authenticity, thereby establishing consumer confidence. Through the utilization of physical-chemical and instrumental analyses, the purity of EOs was evaluated via qualitative and quantitative assessments, enabling the identification of constituents or compounds within the oils. Consequently, a diverse array of techniques has been documented, encompassing organoleptic, physical, chemical, and instrumental methodologies, such as spectroscopic and chromatographic methods. Electronic noses (e-noses) exhibit significant potential for identifying cinnamon adulteration, presenting a rapid, non-destructive, and cost-effective approach. Leveraging their capability to detect and analyze volatile organic compound (VOC) profiles, e-noses can contribute to ensuring authenticity and quality in the food and fragrance industries. Continued research and development efforts in this domain will assuredly augment the capacities of this promising avenue, which is the utilization of Artificial Intelligence (AI) and Machine Learning (ML) algorithms in conjunction with spectroscopic data to combat cinnamon adulteration.

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