Percorrer por autor "Pinto, Maria do Rosário"
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- Adherence to peripheral venous catheters’ guidelines by emergency nurses: A systematic reviewPublication . Teixeira, Joana; Bastos, Celeste; Pinto, Maria do RosárioBackground: Peripheral intravenous catheters are widely used in emergency departments for intravenous treatment. However, peripheral intravenous catheter practices supported by the latest evidence remain suboptimal, negatively affecting patient outcomes. Objective: To identify the determinants influencing adherence to peripheral intravenous catheter guidelines in the emergency department (the insertion technique, maintenance protocols, and timely removal) and to analyse strategies for improving adherence. Methods: A systematic review was conducted from August to September 2025, in the Cochrane Central Register of Controlled Trials, CINAHL Complete, MEDLINE Complete databases (via EBSCOhost), and SCOPUS and included eligible papers published from 2018, according to eligibility criteria: studies involving emergency department nurses or clinicians, focusing on peripheral intravenous catheter adherence determinants and related strategies. This approach followed the methodological guidelines of the Joanna Briggs Institute and the PRISMA Statement reporting guidelines for Systematic Reviews. Results: The six studies included in this review identified individual, organisational, and clinical decision-making determinants that influence emergency nurses' adherence to peripheral intravenous catheter infection prevention guidelines, including limited knowledge, training gaps, lack of institutional support, and inconsistent practices. Effective strategies included ongoing education, ultrasound-guided training, the involvement of vascular access teams, and quality improvement approaches like the Plan-Do-Study-Act cycle. Conclusions: This review identified key determinants and strategies that influence and enhance emergency nurses' adherence to infection prevention guidelines for peripheral intravenous catheter care. The importance of integrating technical training with supportive environments and effective clinical leadership is emphasised throughout multimodal intervention programs. Future interventions should prioritise team empowerment, alignment with institutional goals, and promoting nurses' motivation and self-efficacy, ideally through participatory approaches.
- Effective nursing interventions for infection prevention and control in acute and critically ill patients with a peripherally inserted venous catheter: an umbrella reviewPublication . Costa, José; Teixeira, Joana; Sousa, Eliana; Pinto, Maria do RosárioIntroduction: Infections related to peripherally inserted venous catheters are among the most serious and frequent complications in acute and critical care. If unaddressed, these infections markedly escalate morbidity, mortality, and healthcare expenditures. Objective: To synthesize scientific evidence about effective nursing interventions that prevent and control infections in acute and critically ill patients with peripherally inserted venous catheters. Methods: This umbrella review followed Joanna Briggs Institute guidelines and the PRISMA statement for reporting systematic reviews. A systematic search was carried out in CINAHL, MEDLINE, JBI Evidence Synthesis, Cochrane Database of Systematic Reviews, Web of Science, and SCOPUS. Rayyan software supported study extraction and selection. Each study was assessed for methodological quality, grade of recommendation, and level of evidence. Results: Six systematic reviews were included, allowing the identification of nursing-led interventions that demonstrably reduce catheter-related infection. Evidence supports infection risk reduction through chlorhexidine gluconate for skin preparation, insertion and maintenance bundles, and strategies to support bundle implementation. Additional effective interventions include in-line filters, limiting device dwell time, minimizing continuous antibiotic infusions, and avoiding using Teflon cannulas, instead of polyethylene or Vialon cannulas. For patients with peripherally inserted central catheters (PICCs), quantified grip exercises improved circulation and reduced infection and thrombosis risk. Integrated short peripheral catheters were associated with significantly fewer complications than non-integrated ones. Conclusions: Nurses are pivotal in preventing peripherally inserted venous catheter-related infection through specific evidence-based interventions. Nurse leaders should also prioritize selecting lower-risk devices to enhance patient outcomes and reduce complications.
- Specialized nursing intervention on critically ill patient in the prevention of intubation-associated pneumonia: an integrative literature reviewPublication . Almeida, Daniela Fradinho; Pinto, Maria do Rosário; Durao, Maria Candida; Henriques, Helga Rafael; Teixeira, Joana FerreiraHealthcare-associated infections are adverse events that affect people in critical condition, especially when hospitalized in an intensive care unit. The most prevalent is intubation-associated pneumonia (IAP), a nursing-care-sensitive area. This review aims to identify and analyze nursing interventions for preventing IAP. An integrative literature review was done using the Medline, CINAHL, Scopus and PubMed databases. After checking the eligibility of the studies and using Rayyan software, ten final documents were obtained for extraction and analysis. The results obtained suggest that the nursing interventions identified for the prevention of IAP are elevating the headboard to 30º; washing the teeth, mouth and mucous membranes with a toothbrush and then instilling chlorohexidine 0.12%-0.2% every 8/8 hr; monitoring the cuff pressure of the endotracheal tube (ETT) between 20-30 mm Hg; daily assessment of the need for sedation and ventilatory weaning and the use of ETT with drainage of subglottic secretions. The multimodal nursing interventions identified enable health gains to be made in preventing or reducing IAP. This area is sensitive to nursing care, positively impacting the patient, family, and organizations. Future research is suggested into the effectiveness of chlorohexidine compared to other oral hygiene products, as well as studies into the mortality rate associated with IAP, with and without ETT for subglottic aspiration.
- Targeted temperature management to minimise secondary brain injury after cardiac arrest: A systematic reviewPublication . Seixas, Joana Costa; Oliveira, Mariana; Monteiro, Mariana; Pinto, Maria do Rosário; Durão, Cândida; Teixeira, Gisela; Henriques, Helga Rafael; Teixeira, Joana FerreiraBackground: A patient recovering from an in-hospital or out-of-hospital cardiac arrest (CA) requires interventions for recovery, particularly for minimising secondary brain injury. Targeted temperature management (TTM) is the intervention with the greatest impact on neurological recovery. Aim: The aim of this systematic review was to describe current TTM in adult CA patients and its impact on functional outcomes. Methods: This systematic review was developed between March and May 2024 according to the Joanna Briggs Institute guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for reporting. Eligibility criteria were established. We systematically reviewed studies enrolling adult CA patients who received TTM and reported functional outcomes. The search strategy was applied in the following databases: Medline and CINAHL Ultimate, the Cochrane Central Register of Controlled Trials, through EBSCO, and Scopus. The Rayyan software was used for the final extraction and selection. Results: The studies retrieved highlight the following interventions for neuroprotection: the use of a continuous temperature feedback system (continuous temperature monitoring with vesical, oesophageal, or parenthetic probes) for temperature induction; conducting a preinduction time between 390 min (6.5 h) and 12 h and an induction time greater than 440 min (7.3 h); setting the target temperature between 32 °C and 37.5 °C according to the patient's characteristics for a maintenance period between 24 and 48 h; the administration of sedatives, antipyretics, and neuromuscular blockers; and the assessment of neurological prognosis only after the rewarming phase, using scales such as the Cerebral Performance Category and the Modified Rankin Score. Conclusions: Continuous research and investment in this area of knowledge are highly encouraged, particularly in terms of refining accurate neurological prognostic tools and assessment scales.