Cristiane Schmitt
University of São Paulo
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Publication
Featured researches published by Cristiane Schmitt.
Revista Da Escola De Enfermagem Da Usp | 2009
Kazuko Uchikawa Graziano; Rúbia Aparecida Lacerda; Ruth Teresa Natália Turrini; Camila Quartim de Moraes Bruna; Cristiane Pavanello Rodrigues Silva; Cristiane Schmitt; Giovana Abrahão de Araújo Moriya; Lilian Machado Torres
Methodological study to elaborate and validate measures of evaluation in health contributing to an evaluation system of practices related to the control and prevention of hospital infection. It was elaborated eight dental-medical-hospital supply reprocessing conformity indicators. Indicators are described using items of the structure, process and outcomes that permitted the elaboration of conformity indicators related to the best practices (gold pattern). It was performed the content validity of the attributes of applicability and representativeness by a consensus expert judgment process using a psychometric scale. All the indicators showed to have content validity. Expert judgments, including comments and suggestions, evidenced the importance of perform validity of the evaluation processes, independently of the existence of golden pattern criteria and/or relevancies to the nursing practice.Estudio de desenvolvimiento metodologico para la elaboracion y validacion de medidas de evaluacion en salud, con la finalidad de contribuir con los sistemas de evaluacion de practicas para el control y prevencion de las infecciones hospitalarias, por la elaboracion y validacion de ocho indicadores de evaluacion del procesamiento de instrumentos odonto-medico-hospitalarios. A partir de la fundamentacion teorico cientifico, tales indicadores contemplan evaluaciones de estructura, proceso y resultado asi como permiten la elaboracion de indices de conformidad con relacion a las mejores practicas esperadas (padron-oro). La evaluacion se refirio a la validez del contenido, por la tecnica de consenso de especialistas para el juzgamiento de representatividad y aplicabilidad. Todos los indicadores fueron aprobados. Los juzgamientos efectuados, incluyendo comentarios y sugestiones, demostraron la importancia de realizar la validacion de procesos de evaluacion, independiente da existencia de criterios padron-oro y/o a la relevancia de su repercusion en la practica asistencial.* Extracted from project “Indicadores de Avaliação de Práticas de Controle de Infecção Hospitalar”, School of Nursing at University of São Paulo, 2006. 1 Full Professor of Medical-Surgery Nursing Department at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. kugrazia@usp 2 Associate Professor of Medical-Surgery Nursing Department at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 3 Doctorate Professor of Medical-Surgery Nursing Department at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 4 Student. PostGraduation Program PROESA at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 5 Student. Post-Graduation Program PROESA at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 6 Student. Post-Graduation Program PROESA at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 7 Student. Post-Graduation Program PROESA at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 8 Student. Post-Graduation Program PROESA at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] O R IG IN A L A R IC LE
American Journal of Infection Control | 2012
Cristiane Schmitt; Rúbia Aparecida Lacerda; Maria Clara Padoveze; Ruth Natalia Teresa Turrini
BACKGROUND Compliance with the best surgical antibiotic prophylaxis practice is usually low despite many published guidelines. OBJECTIVE This study investigated compliance with the Hospital Infection Control Committee guideline for antibiotic prophylaxis in a Brazilian hospital using quality indicators. METHODS A retrospective study was carried out from November 2009 to March 2010. Medical records from adult inpatients undergoing cardiac, neurologic, and orthopedic clean surgeries were included. The full compliance index was considered 100% when the antibiotic prophylaxis showed adequacy in all evaluated attributes. Analyses were conducted with 5% significance. RESULTS Medical records from 101 cardiac, 128 neurologic, and 519 orthopedic surgical patients were evaluated. The compliance index was 4.9%, and the compliance index according to specialty was 5.8%, 3.1%, and 3.0%, respectively, for orthopedic, neurologic, and cardiac surgeries. The attribute route of administration produced the best outcomes, whereas the attribute duration of antibiotic prophylaxis produced the worst. No association was identified between compliance to the attributes and patient characteristics. CONCLUSION This study showed a low level of adherence to Hospital Infection Control Committee guidelines for antibiotic prophylaxis. This suggests that different strategies should be implemented to promote the best possible practice in the field of antibiotic prophylaxis with greater surgeon engagement.
Revista Da Escola De Enfermagem Da Usp | 2009
Kazuko Uchikawa Graziano; Rúbia Aparecida Lacerda; Ruth Teresa Natália Turrini; Camila Quartim de Moraes Bruna; Cristiane Pavanello Rodrigues Silva; Cristiane Schmitt; Giovana Abrahão de Araújo Moriya; Lilian Machado Torres
Methodological study to elaborate and validate measures of evaluation in health contributing to an evaluation system of practices related to the control and prevention of hospital infection. It was elaborated eight dental-medical-hospital supply reprocessing conformity indicators. Indicators are described using items of the structure, process and outcomes that permitted the elaboration of conformity indicators related to the best practices (gold pattern). It was performed the content validity of the attributes of applicability and representativeness by a consensus expert judgment process using a psychometric scale. All the indicators showed to have content validity. Expert judgments, including comments and suggestions, evidenced the importance of perform validity of the evaluation processes, independently of the existence of golden pattern criteria and/or relevancies to the nursing practice.Estudio de desenvolvimiento metodologico para la elaboracion y validacion de medidas de evaluacion en salud, con la finalidad de contribuir con los sistemas de evaluacion de practicas para el control y prevencion de las infecciones hospitalarias, por la elaboracion y validacion de ocho indicadores de evaluacion del procesamiento de instrumentos odonto-medico-hospitalarios. A partir de la fundamentacion teorico cientifico, tales indicadores contemplan evaluaciones de estructura, proceso y resultado asi como permiten la elaboracion de indices de conformidad con relacion a las mejores practicas esperadas (padron-oro). La evaluacion se refirio a la validez del contenido, por la tecnica de consenso de especialistas para el juzgamiento de representatividad y aplicabilidad. Todos los indicadores fueron aprobados. Los juzgamientos efectuados, incluyendo comentarios y sugestiones, demostraron la importancia de realizar la validacion de procesos de evaluacion, independiente da existencia de criterios padron-oro y/o a la relevancia de su repercusion en la practica asistencial.* Extracted from project “Indicadores de Avaliação de Práticas de Controle de Infecção Hospitalar”, School of Nursing at University of São Paulo, 2006. 1 Full Professor of Medical-Surgery Nursing Department at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. kugrazia@usp 2 Associate Professor of Medical-Surgery Nursing Department at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 3 Doctorate Professor of Medical-Surgery Nursing Department at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 4 Student. PostGraduation Program PROESA at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 5 Student. Post-Graduation Program PROESA at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 6 Student. Post-Graduation Program PROESA at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 7 Student. Post-Graduation Program PROESA at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 8 Student. Post-Graduation Program PROESA at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] O R IG IN A L A R IC LE
American Journal of Infection Control | 2017
Cristiane Schmitt; Rúbia Aparecida Lacerda; Ruth Natalia Teresa Turrini; Maria Clara Padoveze
HighlightsCompliance with surgical antibiotic prophylaxis (SAP) was associated with weekly hours of infection control personnel per intensive care unit bed, hospital‐wide dissemination of SAP guidelines, monitoring, and feedback of compliance rates.Daytime procedures had greater compliance regarding drug dose and initial time.Monitoring and feedback and closer interaction between the infection control personnel and the surgical team are key factors for better compliance rates of SAP.An innovative stewardship approach is needed to improve adherence to SAP guidelines and targeted training programs to ensure dissemination of guidelines among surgeons. Background: Improving surgical antibiotic prophylaxis (SAP) use is an important element in the control of antimicrobial resistance. However, compliance with SAP guidelines is unsatisfactory. This study investigated the level of compliance with SAP guidelines in neurosurgery, and institutional characteristics associated with compliance. Methods: This study assessed surgeries in 9 Brazilian hospitals. Medical record reviews and a structured questionnaire were used to assess compliance and to describe institutional characteristics. Six attributes of compliance with SAP guidelines were evaluated; full compliance was defined whenever all these attributes were met. Logistic and linear regressions were used to investigate the association between compliance, patients, and hospital characteristics. Results: Full compliance was 10% and was associated with weekly hours of infection control personnel per intensive care unit bed (95% CI, 0.2–0.1), hospital‐wide dissemination of SAP guidelines (95% CI, 1.2–25.1), monitoring (95% CI, 1.2–25.1), and feedback of compliance rates (95% CI, 3.8–25.2). Daytime procedures had greater compliance regarding drug dose (odds ratio [OR], 3.38; 95% confidence interval [CI], 1.72‐6.65) and initial time (OR, 2.30; 95% CI, 1.24‐4.25). Spinal procedures achieved greater compliance with initial time (OR, 1.83; 95% CI, 1.12‐3.01) and duration (OR, 1.59; 95% CI, 1.7‐2.16). Conclusions: A low level of compliance was identified, which pointed out the need for an innovative stewardship approach to improve adherence to SAP guidelines. Targeted training programs need to be developed to ensure dissemination of guidelines among surgeons. Monitoring, feedback, and closer interaction between the infection control personnel and the surgical team are key factors for better compliance rates of SAP.
American Journal of Infection Control | 2018
Cristiane Schmitt; Amanda Luiz Pires Maciel; Icaro Boszczowski; Thaís Pereira da Silva; Eliane Aparecida Job Neves; Giulio Fabio Rossini; Camila Rizek; Silvia Figueiredo Costa; Rogério F. Lourenço; Michelle J. Alfa
HighlightsAdenosine triphosphate (ATP) test failed more than culture and protein tests.The inclusion of ATP testing after a single cleaning increased the length of time for the whole procedure (cleaning plus testing cleanliness) by 50%.First cleaning: 70.8% of gastroscopes failed the ATP test; 58.3% of gastroscopes had no microbial growth; and in 91.7% of gastroscopes the protein was undetectable.Second cleaning: 64.7% of gastroscopes still failed the ATP test. Two samples had bacterial growth, and none had protein detected.Poor correlation was found between ATP test and culture. Objective Using adenosine triphosphate (ATP) tests to assess manual cleaning of gastroscopes and to determine the associated workload in a busy endoscopy unit. Methods Patient‐used gastroscopes were sampled before and after cleaning to assess ATP levels, bioburden, and protein. Samples were collected by flushing 20 mL of sterile water through the biopsy port to the distal end. Time spent for reprocessing and performing the ATP test was recorded. Results Twenty‐four samples were collected from 10 gastroscopes. After manual cleaning, 14/24 (58.3%) samples had no microbial growth (mean, 21 colony‐forming units/cm2), and in 22/24 (91.7%) samples the protein was undetectable (mean, 0.04 &mgr;g/cm2). ATP test was above the cutoff (200 relative light units [RLU]) in 17/24 (70.8%) samples (mean, 498 RLU). After the second cleaning, 11/17 (64.7%) gastroscopes still failed the ATP test (mean, 321.2 RLU). The mean time spent to perform manual cleaning and ATP tests was 16 and 8 minutes, respectively. Hence, each test increased the length of time for cleaning plus testing cleanliness by 50%. Conclusion Further studies regarding the optimal cutoff for ATP tests are needed. ATP tests for cleaning monitoring are easy to perform and provide immediate feedback to the team. However, the increased workload needs to be considered.
BMC Proceedings | 2011
Cristiane Schmitt; Rúbia Aparecida Lacerda; Maria Clara Padoveze; Rnt Turrini
The preferred choice of the best surgical antibiotic prophylaxis practice is usually low despite many published guidelines. This study describes the application of quality indicators for antibiotic prophylaxis in a hospital in Sao Paulo, Brazil.
Revista Da Escola De Enfermagem Da Usp | 2009
Kazuko Uchikawa Graziano; Rúbia Aparecida Lacerda; Ruth Teresa Natália Turrini; Camila Quartim de Moraes Bruna; Cristiane Pavanello Rodrigues Silva; Cristiane Schmitt; Giovana Abrahão de Araújo Moriya; Lilian Machado Torres
Methodological study to elaborate and validate measures of evaluation in health contributing to an evaluation system of practices related to the control and prevention of hospital infection. It was elaborated eight dental-medical-hospital supply reprocessing conformity indicators. Indicators are described using items of the structure, process and outcomes that permitted the elaboration of conformity indicators related to the best practices (gold pattern). It was performed the content validity of the attributes of applicability and representativeness by a consensus expert judgment process using a psychometric scale. All the indicators showed to have content validity. Expert judgments, including comments and suggestions, evidenced the importance of perform validity of the evaluation processes, independently of the existence of golden pattern criteria and/or relevancies to the nursing practice.Estudio de desenvolvimiento metodologico para la elaboracion y validacion de medidas de evaluacion en salud, con la finalidad de contribuir con los sistemas de evaluacion de practicas para el control y prevencion de las infecciones hospitalarias, por la elaboracion y validacion de ocho indicadores de evaluacion del procesamiento de instrumentos odonto-medico-hospitalarios. A partir de la fundamentacion teorico cientifico, tales indicadores contemplan evaluaciones de estructura, proceso y resultado asi como permiten la elaboracion de indices de conformidad con relacion a las mejores practicas esperadas (padron-oro). La evaluacion se refirio a la validez del contenido, por la tecnica de consenso de especialistas para el juzgamiento de representatividad y aplicabilidad. Todos los indicadores fueron aprobados. Los juzgamientos efectuados, incluyendo comentarios y sugestiones, demostraron la importancia de realizar la validacion de procesos de evaluacion, independiente da existencia de criterios padron-oro y/o a la relevancia de su repercusion en la practica asistencial.* Extracted from project “Indicadores de Avaliação de Práticas de Controle de Infecção Hospitalar”, School of Nursing at University of São Paulo, 2006. 1 Full Professor of Medical-Surgery Nursing Department at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. kugrazia@usp 2 Associate Professor of Medical-Surgery Nursing Department at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 3 Doctorate Professor of Medical-Surgery Nursing Department at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 4 Student. PostGraduation Program PROESA at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 5 Student. Post-Graduation Program PROESA at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 6 Student. Post-Graduation Program PROESA at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 7 Student. Post-Graduation Program PROESA at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] 8 Student. Post-Graduation Program PROESA at School of Nursing at University of São Paulo. São Paulo, SP, Brazil. [email protected] O R IG IN A L A R IC LE
Revista Eletrônica de Enfermagem | 2015
Cristiane Schmitt; Rúbia Aparecida Lacerda
Ciência, Cuidado e Saúde | 2011
Rafael Queiroz de Souza; Cristiane Schmitt; Lilian Machado Torres; Kazuko Uchikawa Graziano; Rúbia Aparecida Lacerda; Ruth Natalia Teresa Turrini
American Journal of Infection Control | 2018
Cristiane Schmitt; Lais Silva; Icaro Boszczowski; Maria Clara Padoveze; Lígia Maria Abraão; Marcia Baraldi
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