Browsing by Author "Santos-Costa, Paulo"
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- Baropodometric assessment of the podiatric profile of nursing students in clinical settings: a study protocolPublication . Bernardes, Rafael A.; Caldeira, Silvia; Parreira, Pedro; Sousa, Liliana B.; Almeida, Inês F.; Santos-Costa, Paulo; Paiva-Santos, Filipe; Cruz, Arménio GuardadoIntroduction: Nursing students are exposed to increased risks of developing foot and ankle disorders due to prolonged standing and walking positions during clinical settings. This can lead to high dropout rates from nursing degree, thus contributing to a future shortage in nursing professionals. This protocol aims to develop a study to understand the influence of prolonged standing and walking positions on nursing students' foot health, and specifically to study the relationship between the podiatric profile (regional force and pressure exerted on the foot) and related signs and symptoms. Methods and Analysis: A prospective observational cohort study will be conducted with 194 nursing students. Participants will be asked to walk through a baropodometric platform before and after a 5-month clinical training session. Assessment will focus on the change in podiatric profile, namely foot posture and foot function, at 5 months, and changes in foot health at 5 months. The study will start in January 2022 and it's expected to end by June 2022. Discussion: The study aims to perform an innovative assessment of nursing students' podiatric profile, which will allow for a comprehensive description of foot/ankle changes and their relationship with prolonged standing and walking contexts. Ethics and Dissemination: The study was approved by The Ethical Committee of the Health Sciences Research Unit: Nursing (UICISA: E), of the Nursing School of Coimbra (ESEnfC), with the approval code nr. P799_07_2021. The study was also recorded in ClinicalTrials.gov on the number NCT05197166. Findings will be used to publish articles in peer-review scientific journals and oral communications and posters at scientific meetings.
- Brief report on double-chamber syringes patents and implications for infusion therapy safety and efficiencyPublication . Sousa, Liliana B.; Santos-Costa, Paulo; Marques, Inês A.; Cruz, Arménio; Salgueiro-Oliveira, Anabela; Parreira, PedroThis review aimed to map the existing patents of double-chamber syringes that can be used for intravenous drug administration and catheter flush. A search was conducted in the Google patents database for records published prior to 28 October 2020, using several search terms related to double-chamber syringes (DCS). Study eligibility and data extraction were performed by two independent reviewers. Of the initial 26,110 patents found, 24 were included in this review. The 24 DCS that were found display two or more independent chambers that allow for the administration of multiple solutions. While some of the DCS have designated one of the chambers as the flushing chamber, most patents only allow for the sequential use of the flushing chamber after intravenous drug administration. Most DCS were developed for drug reconstitution, usually with a freeze-dried drug in one chamber. Some patents were designed for safety purposes, with a parallel post-injection safety sheath chamber for enclosing a sharpened needle tip. None of the DCS found allow for a preand post-intravenous drug administration flush. Given the current standards of care in infusion therapy, future devices must allow for the sequential use of the flushing chamber to promote a pre-administration patency assessment and a post-administration device flush.
- Effectiveness of reminiscence therapy versus cognitive stimulation therapy in older adults with cognitive decline: a quasi-experimental pilot studyPublication . Gil, Isabel; Santos-Costa, Paulo; Bobrowicz-Campos, Elzbieta; Silva, Rosa; Almeida, Maria de Lurdes; Apóstolo, JoãoCognitive impairment can represent a predecessor to neuro-degenerative processes; however, evidence suggests that non-pharmacologic interventions such as reminiscence therapy (RT) and cognitive stimulation therapy (CST) can potentially stabilize or reverse this trend. Community-based settings are widely regarded as the key area of intervention by healthcare professionals in this field. Thus, this study aimed to assess the effects of an RT and a CST program in the cognition, depressive symptomatology, and quality of life (QoL) of older adults with cognitive decline who attend community support structures (CSS) in central Portugal. A quasi-experimental study with two arms (RT and CST program) was conducted for seven weeks. Participants were allocated to each arm based on the CSS they attended. Of the 109 older adults initially screened, 76 completed the intervention (50 in the RT program and 26 in the CST program). A pre- and post-intervention analysis showed statistically significant differences in older adults' cognition, especially in their delayed recall ability, in both groups. Older adults in the RT program evidence improved QoL scores post-intervention. Both the RT and CST programs implemented throughout the study are beneficial to older adults' cognitive performance, although results are more pronounced in the earlier stages of cognitive decline. Participation in the RT program was associated with improvements in older adults' QoL scores.
- Evidence-informed development of a bundle for peripheral intravenous catheterization in Portugal: a delphi consensus studyPublication . Santos-Costa, Paulo; Paiva-Santos, Filipe; Sousa, Liliana B.; Bernardes, Rafael A.; Ventura, Filipa; Salgueiro-Oliveira, Anabela; Parreira, Pedro; Vieira, Margarida; Graveto, JoãoContrary to many international settings, there are no clinical guidelines for peripheral intravenous catheter (PIVC) insertion and maintenance in Portugal. We sought to derive an international consensus on a PIVC bundle that could guide Portuguese nurses’ clinical decision-making in this scope. Methods: Two international vascular access specialist groups participated in an online Delphi panel. During the first round, specialists (n = 7) were sent a summary report from a previous observational study conducted in a surgical ward in Portugal. Based on the report findings, specialists were asked to provide five to eight PIVC insertion and maintenance interventions. Then, another set of specialists (n = 7) scored and revised the recommendations until a consensus was reached (≥70% agreement). The PIVC bundle was made available and discussed with the surgical ward’s nurses. Results: After three rounds, a consensus was achieved for five evidence-informed interventions: (i) involve the person and assess the peripheral venous network; (ii) maintain an aseptic no-touch technique; (iii) ensure proper catheter dressing and fixation; (iv) perform catheter flush & lock; (v) test the peripheral venous catheter’s functionality and performance at each shift. Conclusion: The final version of the PIVC bundle achieved consensus among international experts. Despite the positive feedback provided by the ward nurses, future studies are warranted to assess its effectiveness in standardizing PIVC care delivery and its potential implications for care outcomes in Portuguese clinical settings.
- Foot and ankle disorders in nurses exposed to prolonged standing environments: a scoping reviewPublication . Bernardes, Rafael A.; Caldeira, Sílvia; Parreira, Pedro; Sousa, Liliana B.; Apóstolo, João; Almeida, Inês F.; Santos-Costa, Paulo; Stolt, Minna; Guardado Cruz, ArménioBackground: Prolonged standing environments constitute an occupational risk factor for nurses, particularly for developing foot and ankle disorders. The definitions and potential relationship to hours spent walking or standing are poorly understood. This scoping review aimed to synthesize the main disorders found on nurses’ ankles and feet, their prevalence, the influence of hours spent walking or standing, and gender differences. Methods: This review followed a previously published protocol. Primary and secondary studies were retrieved from relevant databases from December 2020 to March 2021. Potential articles were collated to Mendeley, and two independent reviewers assessed the title and abstracts. Studies meeting inclusion criteria were included. Two researchers retrieved and reviewed the full text of these studies independently. A predetermined extraction tool was used to retrieve relevant data, summarized in a tabular and narrative format. Findings: The most common disorder was pain, followed by numbness, burning feet, bunions, structural deformities, and calluses. Prevalence differed among studies, depending on settings and specific local policies. Discussion: Various foot and ankle disorders and related variables have been found, with clear gaps that may be addressed in the future. Conclusion/Applications to Practice:: Few studies have focused on nurses’ foot and ankle disorders. Mapping signs and symptoms may contribute to the future development of preventive interventions for nurses’ workplaces.
- Improving peripheral venous catheterization-related outcomes in oncology patients: an action research study in PortugalPublication . Santos-Costa, Paulo; Sousa, Liliana B.; Costeira, Cristina; Santos, Filipe; Salgueiro-Oliveira, Anabela; Parreira, Pedro; Vieira, Margarida; Graveto, João
- Nurses' involvement in the development and usability assessment of an innovative peripheral intravenous catheterisation pack: a mix-method studyPublication . Santos-Costa, Paulo; Alves, Mariana; Sousa, Carolina; Sousa, Liliana B.; Paiva-Santos, Filipe; Bernardes, Rafael A.; Ventura, Filipa; Salgueiro-Oliveira, Anabela; Parreira, Pedro; Vieira, Margarida; Graveto, JoãoGuaranteeing peripheral venous access is one of the cornerstones of modern healthcare. Recent evidence shows that the lack of adequate clinical devices can result in the provision of substandard care to patients who require peripheral intravenous catheterization (PIVC). To address this challenge, we aimed to develop a PIVC pack for adult patients and assess the usability of this new device. Methods: Following a mix-method design, the PIVC pack development and usability assessment were performed in two phases with the involvement of its potential end-users (nurses). In phase one (concept and semi-functional prototype assessment), focus group rounds were conducted, and a usability assessment questionnaire was applied at each stage. In phase two (pre-clinical usability assessment), a two-arm crossover randomised controlled trial (PIVC pack versus traditional material) was conducted with nurses in a simulated setting. Final interviews were conducted to further explore the PIVC pack applicability in a real-life clinical setting. Results: High average usability scores were identified in each study phase. During the pre-clinical usability assessment, the PIVC pack significantly reduced procedural time (Z = −2.482, p = 0.013) and avoided omissions while preparing the required material (Z = −1.977, p = 0.048). The participating nurses emphasised the pack’s potential to standardise practices among professionals, improve adherence to infection control recommendations, and enhance stock management. Conclusions: The developed pack appears to be a promising device that can assist healthcare professionals in providing efficient and safe care to patients requiring a PIVC. Future studies in real clinical settings are warranted to test its cost-effectiveness.
- Nurses’ practices in the peripheral intravenous catheterization of adult oncology patients: a mix-method studyPublication . Santos-Costa, Paulo; Paiva-Santos, Filipe; Sousa, Liliana B.; Bernardes, Rafael A.; Ventura, Filipa; Fearnley, William David; Salgueiro-Oliveira, Anabela; Parreira, Pedro; Vieira, Margarida; Graveto, JoãoA significant number of adult oncology patients require at least one peripheral intravenous catheter to fulfill their therapeutic plan. Recent evidence indicates that catheter failure rates are high in this cohort, impacting care outcomes and patient experience during cancer treatment. This reality represents a challenge to nurses worldwide since in most international settings they are responsible for delivering quality care during the insertion and maintenance of such devices. This study aims to explore current nursing practices regarding the insertion, maintenance, and surveillance of peripheral intravenous catheters in oncology patients. A two-phase mix-method study was conducted with the nursing team from the surgical ward of a large oncology hospital in Portugal. In phase one (observational prospective study), nurses’ practices during catheter insertion and maintenance were observed by the research team and recorded using standardized instruments and validated scales. In phase two, three online focus groups were conducted with the nursing team to present the results observed in phase one and explore their perceptions of current practices. All ethical principles were assured throughout the study. Significant divergent practices were observed and identified by the nurses, especially concerning patient involvement, nurses’ adherence to the aseptic, non-touch technique, catheter stabilization and dressing, and catheter flushing and locking. Such practices may partially explain the high complication rate found (26%) and substantiate the need for future intervention in this field.
- Peripheral venipuncture in elderly patients: is near-infrared light technology an option to avoid vein depletion?Publication . Santos-Costa, Paulo; Sousa, Liliana B.; Serambeque, Beatriz; Bernardes, Rafael; Parreira, Pedro; Salgueiro-Oliveira, Anabela; Vieira, Margarida; Graveto, JoãoBackground: Peripheral venipuncture is the minimal invasive procedure most commonly performed in acute settings. However, several publications report that health professionals perform multiple puncture attempts until a successful catheterization or blood draw is achieved. Among the patients most affected by this reality are the elderly patients, who often display a number of factors that increase difficulty. In recent years, several recent technological aids, such as the Near-Infrared Light, have emerged in the medical devices market as potential facilitators of vein selection and puncture. However, while Near-Infrared Light devices are widely studied in pediatric settings, there are no known reviews of its use and applicability with elderly patients. Methods: A scoping review of the literature was conducted following the Joanna Briggs Institute method. Study relevance, data extraction, and synthesis were performed by two independent reviewers. Results: Three studies were included in this review. The use of NIR technology may improve the number of peripheral veins located in elderly patients, as well as reduce hematoma development and patient anxiety before, during and after the procedure. Moreover, one study briefly explored health professionals’ usability and technology acceptance related outcomes. Conclusions: While peripheral venipuncture of elderly patients assisted by NIR devices is still an understudied area, the studies found indicated results favorable to its clinical application. However, such results should be carefully analyzed, since potential bias and lack of larger study samples may prevent the generalization of the results.
- Rehabilitation strategies and footwear recommendations for nurses in standing environments: a narrative reviewPublication . Alves Bernardes, Rafael; Caldeira, Sílvia; Stolt, Minna; Santos-Costa, Paulo; Cruz, ArménioIntroduction: Prolonged standing can lead to tendon and ligament damage, particularly in the feet and ankles, if preventive measures are not taken. Ill-fitting shoes are associated with increased foot pain and disorders, especially among nurses. This narrative review aims to comprehensively synthesize existing literature on footwear recommendations for nurses in prolonged standing positions, emphasizing healthcare strategies and rehabilitation benefits. It seeks to provide a comprehensive overview while identifying gaps for future research. Methodology: A narrative literature review was conducted using databases such as MEDLINE, CI-NAHL, Web of Science, and ScienceDirect. Studies were included if they described footwear characteristics and therapeutic indications for workers in prolonged standing contexts, following the PRISMA guideline. Results: Twenty-three studies published between 1998 and 2021 were reviewed, revealing recommendations to reduce gastrocnemius fatigue levels with viscoelastic insoles and arch support. Personalized footwear with cushioning is recommended to decrease peak pressure and alleviate issues like calluses and blisters. Soft shoes help reduce edema formation, while optimizing shoe climate is crucial. The combination of antifatigue mats and sports shoes enhances comfort. Discussion: Current research primarily focuses on insole impact, leaving areas like psychological comfort and footwear design acceptance largely unexplored. Future research should investigate the influence of standing environments and footwear, considering variations in foot health among worker cohorts. Conclusion: Few studies address nurses’ footwear needs. Future research should provide detailed information on footwear characteristics and their podiatric benefits for nurses.