Sistema de classificação de pacientes cirúrgicos em hospitais especializado: construção e validação de um instrumento
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Data
2008-07-25
Autores
Tristão, Maria Tereza Cazal [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O sistema de classificação de pacientes, como ferramenta na prática administrativa de enfermagem, proporciona a formação de um banco de dados indispensável ao processo de tomada de decisão em áreas relacionadas com o dimensionamento e alocação de recursos humanos, a garantia da qualidade da assistência e o monitoramento da produtividade e custos dos serviços de enfermagem.(²²) Vários sistemas têm sido desenvolvidos, mas não existem estudos que abordem instrumentos específicos para classificar pacientes cirúrgicos em hospital especializado. Desse modo, faz-se necessária a construção e a validação de um instrumento específico para essa clientela. O presente estudo foi conduzido com intuito de elaborar um instrumento de classificação de pacientes cirúrgicos em relação ao grau de dependência de enfermagem na Unidade de Internação do Hospital de Reabilitação de Anomalias Craniofaciais (HRAC) – USP – Bauru/SP, assim como verificar a confiabilidade e a validade desse instrumento. A construção do instrumento fundamentou-se em levantamento bibliográfico sobre a implementação de modelos operacionais de instrumento de classificação de pacientes. Foram consideradas dez áreas de cuidados e as três situações de dependência de cuidados, graduadas de um a quatro pontos, seguindo uma intensidade crescente de complexidade assistencial. Na validade de conteúdo do instrumento, utilizou-se a técnica Delphi, formada por juízes que avaliaram o instrumento proposto. A confiabilidade entre avaliadores foi aplicada pela pesquisadora e outra enfermeira lotada na unidade cirúrgica da Unidade de Internação do HRAC, em 20 pacientes acima de quatro anos de idade, escolhidos aleatoriamente. A validade de construto foi aplicada pela pesquisadora na clínica cirúrgica da unidade de Internação do HRAC, em 52 pacientes acima de quatro anos de idade...
As a tool in nursing management, the patient classification system enables the compilation of an essential database to the decision-making process in areas related to the dimensioning and allocation of human resources, the guarantee of health care provision quality and productivity and cost control in nursing services(²²). Various systems have been developed, but no studies have been reported which approach specific instruments to classify surgery patients in specialized hospitals. Hence, the construction and validation of a specific instrument for such clientele are necessary. This study was conducted with the purposes to design an instrument for classifying surgery patients in relation to their level of dependence on the nursing staff at an inpatient unit of the Craniofacial Anomaly Rehabilitation Hospital (CARH) – USP in Bauru/SP and to evaluate the reliability and validity of such instrument. The instrument’s design was based on a literature review on the implementation of operational models for patient classification instruments. Ten care provision areas and the three care dependence situations were taken into account and graded from one to four points according to an increasing intensity of care provision complexity. As regards the instrument’s content validity, the Delphi technique was used, consisting of three referees who evaluated the proposed instrument. The reliability among evaluators was applied by the researcher and another nurse allotted to the surgery unit of the inpatient ward of CARH to 20 over-four-year-old randomly selected patients. The validity of the construct was applied by the researcher at the surgery unit of the inpatient ward of CARH to 52 over-four-year-old randomly selected patients. Reliability evaluated the level of consistency in the instrument’s Abstract application for each care provision area, and the construct’s validity evaluated... (Complete abstract click electronic access below)
As a tool in nursing management, the patient classification system enables the compilation of an essential database to the decision-making process in areas related to the dimensioning and allocation of human resources, the guarantee of health care provision quality and productivity and cost control in nursing services(²²). Various systems have been developed, but no studies have been reported which approach specific instruments to classify surgery patients in specialized hospitals. Hence, the construction and validation of a specific instrument for such clientele are necessary. This study was conducted with the purposes to design an instrument for classifying surgery patients in relation to their level of dependence on the nursing staff at an inpatient unit of the Craniofacial Anomaly Rehabilitation Hospital (CARH) – USP in Bauru/SP and to evaluate the reliability and validity of such instrument. The instrument’s design was based on a literature review on the implementation of operational models for patient classification instruments. Ten care provision areas and the three care dependence situations were taken into account and graded from one to four points according to an increasing intensity of care provision complexity. As regards the instrument’s content validity, the Delphi technique was used, consisting of three referees who evaluated the proposed instrument. The reliability among evaluators was applied by the researcher and another nurse allotted to the surgery unit of the inpatient ward of CARH to 20 over-four-year-old randomly selected patients. The validity of the construct was applied by the researcher at the surgery unit of the inpatient ward of CARH to 52 over-four-year-old randomly selected patients. Reliability evaluated the level of consistency in the instrument’s Abstract application for each care provision area, and the construct’s validity evaluated... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Serviços de enfermagem - Avaliação, Enfermagem e pacientes, Enfermagem cirúrgica
Como citar
TRISTÃO, Maria Tereza Cazal. Sistema de classificação de pacientes cirúrgicos em hospitais especializado: construção e validação de um instrumento. 2008. 107 f. Dissertacao (mestrado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2008.