Emergency Nursing, Critical Care Nursing, Safety, Risk, Reliability and Quality
67
Scopus Publications
Scopus Publications
Performance of the Quick Sequential Organ Failure Assessment in an emergency department Michelle Hillig Schmidt, Karen Patrícia Pena Trannin, Luiz Humberto Vieri Piacezzi, Karina Aparecida Lopes da Costa, Ruth Ester Assayag Batista, Taynara Valério dos Santos, Maria Carolina Barbosa Teixeira Lopes, Cássia Regina Vancini Campanharo Acta Paulista De Enfermagem, 2026 Objective To assess the performance of qSOFA for identifying sepsis in an emergency department. Methods This retrospective cohort study was conducted at a private hospital in São Paulo, Brazil, between 2018 and 2019. Data were extracted from the medical records of all individuals treated with suspected sepsis and assessed using the qSOFA tool, according to demographic, clinical, and outcome variables. Statistical analysis was performed using Student’s t-test, chi-square test, and McNemar’s test. Results A total of 5,017 patients with suspected sepsis were assessed using qSOFA, of which 88% had a negative qSOFA score and 12% a positive qSOFA. Individuals with a positive qSOFA (score>2) had a higher percentage of sepsis diagnosis, with a statistically significant association. Patients with a positive qSOFA were 49% men and 37.3% women, with a mean age of 74.28 years. It was observed that there was a similarity in the percentages between the scored variables of the qSOFA scale (systolic blood pressure (SBP) ≤ 100 mmHg or MAP < 65 mmHg, respiratory rate (RR) ≥ 22 rpm and level of consciousness). The most prevalent site of infection was the respiratory (55.7%). In relation to the outcome, 6.8% of sepsis cases progressed to death. Conclusion In this study, the qSOFA score showed good specificity (94%) and low sensitivity (32%) for detecting sepsis in an emergency department, demonstrating its effectiveness. This tool can be considered, due to its ease of application and worldwide knowledge, in the identification of sepsis.
Quick Sequential Organ Failure Assessment para identificar el deterioro clínico en adultos con COVID-19: cohorte retrospectiva Luiz Felipe Sales Mauricio, Cassia Regina Vancini Campanharo, Luiz Humberto Vieri Piacezzi, Maria Carolina Barbosa Teixeira Lopes, Ruth Ester Assayag Batista Revista Latino Americana De Enfermagem, 2025 Objetivo: evaluar el desempeño del qSOFA en la identificación de deterioro en pacientes con COVID-19. Método: cohorte retrospectiva, realizada entre febrero y agosto de 2020, en el Departamento de Emergencias de un hospital privado, con 813 adultos. Se estudiaron las siguientes variables: sociodemográficas, clínicas, de deterioro, qSOFA al ingreso y antes del evento, y desenlaces. El desempeño del qSOFA en ambos momentos se analizó utilizando el área bajo la curva ROC. Resultados: la edad promedio fue de 69 años. Predominaron los hombres (61,5%), blancos (97,2%), católicos (73,7%), casados (89,6%) y asalariados (66%). El 69,7% presentó comorbilidades y el 58,8% fueron clasificados como “urgentes” al ingreso. El deterioro más frecuente fue la insuficiencia respiratoria (16,7%), y el desenlace fue el alta (68%). Los pacientes con qSOFA positivo al ingreso tuvieron mayor porcentaje de insuficiencia respiratoria, paro cardiorrespiratorio y clasificación de riesgo “muy urgente”, y aquellos con qSOFA negativo tuvieron mayor porcentaje de alta (p< 0,0001). Al ingreso, el qSOFA tenía una sensibilidad del 66% y una especificidad del 55%, y antes del evento, una sensibilidad del 48% y una especificidad del 88% para identificar el deterioro. Los pacientes con qSOFA positivo al ingreso tenían 350 veces más probabilidades de deterioro. Conclusión: el qSOFA mostró baja sensibilidad para identificar el deterioro en ambos momentos y alta especificidad antes del evento.
Quick Sequential Organ Failure Assessment to identify clinical deterioration in adults with COVID-19: a retrospective cohort Luiz Felipe Sales Mauricio, Cassia Regina Vancini Campanharo, Luiz Humberto Vieri Piacezzi, Maria Carolina Barbosa Teixeira Lopes, Ruth Ester Assayag Batista Revista Latino Americana De Enfermagem, 2025 Objective: to evaluate the performance of qSOFA in identifying deterioration in patients with COVID-19. Method: retrospective cohort study conducted between February and August 2020 in the Emergency Department of a private hospital, involving 813 adults. The variables studied included sociodemographic data, clinical characteristics, deterioration, qSOFA on admission and before the event, and outcomes. The performance of qSOFA at both moments was analyzed using the area under the ROC curve. Results: the average age was 69 years. There was a predominance of men (61.5%), white (97.2%), catholic (73.7%), married (89.6%) and employed (66%). Comorbidities were present in 69.7%, and 58.8% were classified as “urgent” upon admission. The most frequent deterioration was respiratory failure (16.7%), and the outcome was discharge (68%). Patients with positive qSOFA on admission had a higher percentage of respiratory failure, cardiopulmonary arrest, and “very urgent” risk classification, and those with negative qSOFA showed a higher percentage of discharge (p< 0.0001). Upon admission, qSOFA showed 66% sensitivity and 55% specificity, and prior to the event it showed 48% sensitivity and 88% specificity for identifying clinical deterioration. Patients with positive qSOFA on admission were 350 times more likely to experience deterioration. Conclusion: qSOFA showed low sensitivity for identifying deterioration at both moments and high specificity before the event.
Clinical simulation and deliberate practice in rapid-cycle deliberate practice: a randomized clinical trial Gisele Cabral da Silva, Cássia Regina Vancini Campanharo, Maria Carolina Barbosa Teixeira Lopes, Meiry Fernanda Pinto Okuno, Carla Roberta Monteiro Miura, Ruth Ester Assayag Batista Revista Brasileira De Enfermagem, 2025 Objectives: to compare clinical simulation with a standardized patient with rapid-cycle deliberate practice in knowledge acquisition, perception of experience and scenario design in the care of patients with suspected stroke. Methods: a randomized clinical trial conducted between 2022 and 2023 involving 134 undergraduate nursing students. After a theoretical class, participants were randomly assigned to one group. A questionnaire was administered before and after the practical sessions to assess knowledge, in addition to the Educational Practices Questionnaire and the Simulation Design Scale. Results: the groups showed significant improvement in knowledge (p<0.001), with no difference between them (p=1.0). Rapid-cycle deliberate practice obtained a better assessment regarding design (p=0.03). Conclusions: the strategies are effective and recommended in nursing education, although rapid-cycle deliberate practice showed advantages in student engagement. Universal Trial Number: U1111-1295-1246.
COVID-19: association of the National Early Warning Score with triage categories, severity and outcomes Luiz Humberto Vieri Piacezzi, Jaine Novaes da Silva, Rui Carlos Negrão Baptista, Karina Aparecida Lopes da Costa, Maria Carolina Barbosa Teixeira Lopes, Ruth Ester Assayag Batista, Cássia Regina Vancini Campanharo Revista Brasileira De Enfermagem, 2025 Objectives: to identify the association of the National Early Warning Score (NEWS2) and NEWS Age with risk categories, severity markers and outcomes in the emergency department. Methods: retrospective cohort study, conducted in a high-complexity hospital, with 356 hospitalized patients (mean age 59.4; ±14.4 years) with COVID-19, from April to August 2020. To verify the association between risk categories and alert scores, the chi-square, Kruskal-Wallis and likelihood ratio tests (p<0.05) were used. Results: patients stratified in the red category had higher NEWS2 and NEWS Age (<0.0001) than the others. Clinical risk categorized by scores was associated with clinical deterioration (p<0.0001), orotracheal intubation (p<0.0001) and death (NEWS - p=0.0098/NEWS Age - p<0.0001). Conclusions: scores ≥ 7 were associated with red/orange risk stratification, clinical deterioration and occurrence of death.
Nursing workload and severity of COVID-19 patients in the Intensive Care Unit Wesley Cajaiba Santos, Maria Carolina Barbosa Teixeira Lopes, Cassia Regina Vancini-Campanharo, Daniela Boschetti, Sirlei Oliveira da Silva Dias, Meire Cristina Novelli e Castro, Luis Humberto Vieri Piacezzi, Ruth Ester Assayag Batista Journal of the American Mosquito Control Association, 2025 Objective: To evaluate the workload and severity of patients in the Intensive Care Unit (ICU) with COVID-19. Method: Cross-sectional, analytical study carried out in the ICU of a private hospital. All patients over the age of 18 with a diagnosis of COVID-19 admitted from September 2020 to June 2021 were included. Workload assessed by the Nursing Activities Score (NAS), and severity by the Sequential Organ Failure Assessment. Descriptive and inferential analyses were performed. Results: 217 patients were included, mostly men, mean age 62.41 years, white, obese, non-smokers and sedentary. The average NAS was 84.79. Staffing was in line with legislation and NAS. NAS was not associated with severity. Severity was associated with higher age, gender, comorbidities, sedentary lifestyle, time on mechanical ventilation, hospitalization and death. Conclusion: Workload was high and not associated with severity or outcomes. Severity was associated with demographic and clinical conditions. This study shows the importance of staff sizing, with a view to promoting safety and quality of care.
Nursing workload and severity of COVID-19 patients in the Intensive Care Unit Wesley Cajaiba Santos, Maria Carolina Barbosa Teixeira Lopes, Cassia Regina Vancini-Campanharo, Daniela Boschetti, Sirlei Oliveira da Silva Dias, Meire Cristina Novelli e Castro, Luis Humberto Vieri Piacezzi, Ruth Ester Assayag Batista Revista Da Escola De Enfermagem Da USP, 2024 Objective: To evaluate the workload and severity of patients in the Intensive Care Unit (ICU) with COVID-19. Method: Cross-sectional, analytical study carried out in the ICU of a private hospital. All patients over the age of 18 with a diagnosis of COVID-19 admitted from September 2020 to June 2021 were included. Workload assessed by the Nursing Activities Score (NAS), and severity by the Sequential Organ Failure Assessment. Descriptive and inferential analyses were performed. Results: 217 patients were included, mostly men, mean age 62.41 years, white, obese, non-smokers and sedentary. The average NAS was 84.79. Staffing was in line with legislation and NAS. NAS was not associated with severity. Severity was associated with higher age, gender, comorbidities, sedentary lifestyle, time on mechanical ventilation, hospitalization and death. Conclusion: Workload was high and not associated with severity or outcomes. Severity was associated with demographic and clinical conditions. This study shows the importance of staff sizing, with a view to promoting safety and quality of care.
Factors associated with functional capacity in older adults in emergency services Lidia Ferreira de Souza, Eilane Souza Marques dos Santos, Cássia Regina Vancini Campanharo, Maria Carolina Barbosa Teixeira Lopes, Meiry Fernanda Pinto Okuno, Gilson de Vasconcelos Torres, Vilani Medeiros de Araújo Nunes, Ruth Ester Assayag Batista Acta Paulista De Enfermagem, 2024 Objective To relate sociodemographic, economic and clinical variables and having or not having a caregiver, risk for falls and perception of the risk for falls with the functional capacity of older adults in an Emergency Department. Methods Analytical cross-sectional study of 197 older adults conducted in the Emergency Department between September 2019 and March 2020. A questionnaire with sociodemographic, economic and clinical information was applied, as well as the instruments: Falls Risk Awareness Questionnaire, Morse Falls Scale, Katz Index and Lawton Scale. The Kruskal Wallis test was used to compare the Katz Index and the Lawton Scale, and the Spearman correlation coefficient was used to associate the Morse Falls Scale with continuous variables. The Mann-Whitney test and the Kruskal Wallis test were used to associate the Falls Risk Awareness Questionnaire with the categorical variables. Results Illiterate patients (p<0.0001) with lower income (p=0.0446) had a lower score on the Katz Index, that is, they presented a higher percentage of totally dependent people. Divorced older adults (p=0.0004) without a caregiver (p<0.0001) had a higher score on the Lawton Scale, that is, a greater degree of independence. The greater perception of risk for falls (p=0.0403) was associated with less independence for instrumental activities of daily living. The low risk for falls (p<0.0001) was associated with greater independence for instrumental activities of daily living. There was no association between perceived risk for falls (p=0.2693) and risk for falls (p=0.4984) with the Katz Index. Conclusion Lower education and income were associated with dependence for activities of daily living. Being divorced and not having a caregiver were associated with independence in instrumental activities of daily living. There was no association between the perception of risk for falls and the risk for falls with activities of daily living. The greater perception of risk for falls was associated with less independence, and the low risk for falls was associated with greater independence for instrumental activities of daily living.
Effect of video on satisfaction and self-confidence in simulation training: A randomized clinical trial Lissette Lucrecia Monge Abarca, Alba Lúcia Bottura Leite de Barros, Rui Carlos Negrão Baptista, Ruth Ester Assayag Batista, Juliana de Lima Lopes Revista Brasileira De Enfermagem, 2023 Objectives: to identify the effect on satisfaction and self-confidence of undergraduate nursing students after using a validated bed bath video during the simulation. Methods: blinded parallel randomized clinical trial. Participants were allocated to the control group (simulation with tutor) or intervention (simulation with video). After the interventions, the Student Satisfaction and Self Confidence with Learning Scale was used to assess satisfaction and self-confidence. The study was approved by the Ethics Committee and Brazilian Registry of Clinical Trials. Mann Whitney, Fisher Exact and Student t statistical tests were used. A significance level of 5% was adopted. Results: fifty eight students (30, control; and 28, intervention) were evaluated. There was no significant difference between the groups regarding satisfaction (p=0.832) and self-confidence (p>0.999). Conclusions: satisfaction and self-confidence were similar between the groups, and the two strategies could be used in the simulated practice of bed bathing.
Quality of life and burden of caregivers of elderly people Andréa Fachini da Costa, Maria Carolina Barbosa Teixeira Lopes, Cássia Regina Vancini Campanharo, Ruth Ester Assayag Batista, Meiry Fernanda Pinto Okuno Texto E Contexto Enfermagem, 2020
Evaluation of triage quality in the emergency department: A scoping review protocol Ana Paula Santos de Jesus, Vanessa Cordeiro Vilanova, Alyne Henri Motta Coifman, Bruna Roberta Siqueira Moura, Fernanda Ayache Nishi, Larissa Chaves Pedreira, Ruth Ester Assayag Batista, Diná de Almeida Lopes Monteiro da Cruz Jbi Database of Systematic Reviews and Implementation Reports, 2019
Quality of life of hospitalized octogenarians Meiry Fernanda Pinto Okuno, Anderson da Silva Rosa, Maria Carolina Barbosa Teixeira Lopes, Cássia Regina Vancini Campanharo, Ruth Ester Assayag Batista, Angélica Gonçalves Silva Belasco Texto E Contexto Enfermagem, 2019
Functional capacity and quality of life of hospitalized octogenarians Michelle Cardoso Billett, Cássia Regina Vancini Campanharo, Maria Carolina Barbosa Teixeira Lopes, Ruth Ester Assayag Batista, Angélica Gonçalves Silva Belasco, Meiry Fernanda Pinto Okuno Revista Brasileira De Enfermagem, 2019
Evaluation of delirium in aged patients assisted at emergency hospital service Isabella Cristina Barduchi Ohl, Suzel Regina Ribeiro Chavaglia, Rosali Isabel Barduchi Ohl, Maria Carolina Barbosa Teixeira Lopes, Cássia Regina Vancini Campanharo, Meiry Fernanda Pinto Okuno, Ruth Ester Assayag Batista Revista Brasileira De Enfermagem, 2019
Advantages of a cohort study on cardiac arrest conducted by nurses Cássia Regina Vancini Campanharo, Rodrigo Luiz Vancini, Maria Carolina Barbosa Teixeira Lopes, Meiry Fernanda Pinto Okuno, Ruth Ester Assayag Batista, Álvaro Nagib Atallah, Aécio Flávio Teixeira de Góis Revista Da Escola De Enfermagem, 2015
Functional capacity and severity of trauma in the elderly Flávia Lie Maeshiro, Maria Carolina Barbosa Teixeira Lopes, Meiry Fernanda Pinto Okuno, Cássia Regina Vancini Camapanharo, Ruth Ester Assayag Batista Acta Paulista De Enfermagem, 2013
Ethics and legality in the era of digital imaging Acta Paulista De Enfermagem, 2012
