Systematic review and meta-analysis of the efficacy of Unna boot in the treatment of venous leg ulcers.

This systematic review determined the effectiveness of the Unna boot in the treatment of venous leg ulcers (VLUs) by assessing the quality of the available evidence. A systematic search of studies published between August 2019 and February 2020 was conducted using the PubMed, PubMed/PMC, BVS/BIREME, CINAHL, Web of Science, MEDLINE, Embase, Cochrane, ProQuest, BDTD, CAPES Thesis and Dissertation, OPEN THESIS, Centre for Reviews and Dissemination and SciELO databases. Studies were eligible if they reported primary studies, controlled clinical trials, quasi-experimental studies or observational studies (cross-sectional studies or cohort studies). We identified 302 articles. After screening and critical appraisal, eight articles were included in this review, while six articles were included in the meta-analysis. Four studies were included in the outcome of complete ulcer healing rate with a weighted estimate of the odds ratio of 0.43 (95% CI = 0.188-1.01). No evidence of the presence of considerable heterogeneity was observed (p = 0.35, I2 = 32%). Two studies were assigned to the outcome time to complete ulcer healing (days) with a weighted estimated mean difference of 41.3 days (95% CI = 21.62-61.04). Evidence of the presence of considerable heterogeneity was observed (p = 0.01, I2 = 85%). The results showed a moderate degree of evidence that there is no difference in the healing rates of VLUs with the use of the Unna boot. For the time to complete ulcer healing, the low number of studies and low classification impaired the reporting at any level of evidence.

Perception of nursing regarding patient safety climate in public and private institutions. / Percepção da enfermagem frente ao clima de segurança do paciente em instituições públicas e privadas.

Objective To evaluate the perception of nursing staff regarding the safety climate among healthcare professionals from public and private institutions. Method This is a cross-sectional, quantitative study conducted with 235 nursing professionals from a private hospital and a public hospital in Campinas, between October 2014 and October 2015. The Safety Attitudes Questionnaire - Short Form was used to collect data. Descriptive and inferential statistics were used for analysis, and the Mann-Whitney test was used to compare the institutions. Results The private institution had higher averages than the public institution, and significant differences in the areas of safety climate (p=0.00), unit management (p<0.0001), hospital management (p=<0.0001), working conditions (p=<0.0001), and teamwork (p=0.00). Conclusion Although the private institution performed better, the professionals perceived the safety climate as unsatisfactory in both institutions.

[Pediatric patient classification system: improvement of an instrument]. / Sistema de classificação de pacientes pediátricos: aperfeiçoamento de um instrumento.

OBJECTIVE: Improve the content validity of the instrument for classification of pediatric patients and evaluate its construct validity. METHOD: A descriptive exploratory study in the measurement of the content validity index, and correlational design for construct validation through exploratory factor analysis. RESULTS: The content validity index for indicators was 0.99 and it was 0.97 for graded situations. Three domains were extracted in the construct validation, namely: patient, family and therapeutic procedures, with 74.97% of explained variance. The instrument showed evidences of content and construct validity. CONCLUSION: The validation of the instrument occurred under the approach of family-centered care, and allowed incorporating some essential needs of childhood such as playing, interaction and affection in the content of the instrument.

Factors related to Nursing workload in the Oncology assistance provided to hospitalized women.

OBJECTIVE: to evaluate the Nursing workload and its related factors in the assistance provided to hospitalized women with gynecological and breast cancers, according to the Nursing Activities Scores adapted for cancer patients. METHOD: a cross-sectional and epidemiological study. The participants were women with gynecological and/or breast cancer, over 18 years of age, and hospitalized for a minimum period of 24 hours. The following was collected from the medical records: sociodemographic and clinical data, Karnofsky Performance Status and workload, according to the adapted Nursing Activities Score. The factors related to workload were analyzed by means of multiple linear regression. RESULTS: the mean Nursing Activities Scores was 29.3%, denoting seven hours of daily care per patient. The factors related to workload differed according to the breast or gynecological cancer diagnosis (ß=-0.01; p<0.001), clinical or surgical treatment (ß=-0.03; p<0.001) and functional capacity at admission (ß=0.07; p<0.001), as per the Karnofsky Performance Status. CONCLUSION: there was greater workload for the care of women with gynecological cancer undergoing clinical treatment and with lower functional capacity at admission. The findings reveal directions for optimization of resources and improvements in work processes and flows, in order to promote a favorable work environment and good quality assistance. BACKGROUND: (1) A pioneer study in using the NAS instrument, adapted for Hospital Oncology. BACKGROUND: (2) The clinical treatment of gynecological/breast cancer demands a greater workload. BACKGROUND: (3) Functional capacity at the admission of women with cancer influences workload. BACKGROUND: (4) Gynecological cancer demands a greater Nursing workload than breast cancer.

Validation of an instrument for patient classification to support obstetric nursing care.

OBJECTIVES: to develop and validate an instrument for the classification of pregnant and postpartum women according to the demand for nursing care. METHODS: a methodological study conducted in three stages: 1) construction of the instrument based on literature review; 2) content validation using the Delphi technique with 12 experts; and 3) Evaluation of the convergent construct validity through the correlation between the scores of the constructed instrument and the Fugulin instrument. RESULTS: an instrument with ten indicators of specific care for pregnant and postpartum women was developed. A content validity index higher than 0.9 was obtained, requiring only one round of the Delphi technique. The Spearman coefficient was 0.64 between the instruments, indicating a strong correlation. CONCLUSIONS: the classification instrument specifically constructed for pregnant and postpartum women showed evidence of content validity and convergent construct validity with a widely used instrument in the national territory.

Construction and validation of an instrument for event-related sterility of processed healthcare products.

OBJECTIVE: To construct and validate an instrument to assess events related to maintaining the sterility of processed healthcare products. METHODS: This methodological study developed the instrument through analysis by a panel of experts, focusing on the integrity of commonly used packaging: spunbond-meltblown-spunbond and medical-grade paper. The instrument was analyzed using the Content Validity Index and Content Validity Ratio (≥ 0.80) and modified Kappa (≥ 0.74). The instrument underwent pre-testing. RESULTS: Six experienced professionals participated in the expert panel. After two rounds, the final version of the instrument contained five dimensions. In the pre-test, 30 nursing professionals participated, of whom 86.67% considered the instrument good, and 90% found it understandable. CONCLUSION: The construction and validation followed literature recommendations. The instrument is available, aiding in the safe use of processed healthcare products.

Content validation of an instrument for medical record audits.

OBJECTIVE: To build and validate the content of an instrument to conduct medical record audits; to conduct a pre-test. METHODS: Methodological study conducted from May/2020 to May/2021 in three stages: 1) development of the instrument by bibliographic survey and benchmarking; 2) content validation using the Delphi technique; 3) application of the instrument and descriptive analysis in a sample of 200 medical records. RESULTS: An instrument was constructed with 11 domains containing sub-items that characterize the quality of care. Two stages of the Delphi technique were necessary to reach a content validity index higher than 0.90. For each domain, a graduated scale with a numerical value from 1 to 4 points was attributed, reflecting the quality of its completion. The average time of application was 35 minutes per record. CONCLUSIONS: The tool proved to be viable to support clinical audits to identify the level of excellence and reveal opportunities for improvement in care processes.

Implementation of a monitoring and contact tracing program to manage COVID-19 by a multinational chemical company.

Introduction: During the SARS-CoV-2 pandemic, uninterrupted manufacture of products for domestic or health care purposes presupposed initiatives to control transmission in the work environment. Objectives: This study analyzed data collected in a multinational chemical company between 2020 and 2022 through its COVID-19 contact tracing system, determining the association between work variables, personal protective equipment use, emotional distress symptoms, and diagnostic confirmation of COVID-19. Methods: This correlational, cross-sectional study analyzed a company database of reports of suspected cases between June 2020 and January 2022. Descriptive analysis was performed, and the chi-square test was used to study the associations between the variables, with a significance level of 5%. Results: Of the 4206 total reports, 1190 diagnoses of COVID-19 were confirmed. The following variables were associated with infection: age over 40 years, being symptomatic, being a remote worker, and reporting difficulties with emotional control. Conclusions: The results identified the potential of on-the-job education activities, as well as that control and prevention measures protected worker health, and that worker mental health should be monitored.

Introdução: O trabalho ininterrupto de profissionais que atuaram na produção de insumos para uso doméstico ou para a assistência à saúde pressupôs ações para o controle da transmissão do SARS-CoV-2 no ambiente de trabalho e, assim, prevenir o adoecimento dos trabalhadores. Objetivos: Descrever os dados resultantes do rastreamento de contatos para covid-19; identificar condições de sofrimento emocional no período de 2020-2022; e verificar a associação entre variáveis laborais, uso de equipamento de proteção individual, sintomas de sofrimento emocional e a confirmação diagnóstica de covid-19 em trabalhadores de uma indústria química multinacional. Métodos: Estudo correlacional, de corte transversal. Foi analisado um banco de dados composto pelos registros de casos suspeitos entre junho de 2020 e janeiro de 2022 de uma empresa multinacional. Foi realizada análise descritiva e, para estudar as associações entre as variáveis, foram aplicados os testes qui-quadrado, sendo considerado um nível de significância igual a 5%. Resultados: Dos 4.206 registros realizados, 1.190 respostas apresentaram resultado positivo de covid-19. Profissionais maiores de 40 anos, sintomáticos, em atividade remota e que declaram dificuldades para controlar sentimentos apresentaram maior positividade para covid-19. Conclusões: Identificou-se a potencialidade das atividades de educação em serviço presencial e que a fiscalização de medidas de controle e prevenção protegeu a saúde do trabalhador. Em relação à saúde mental, os resultados indicaram a necessidade de acompanhamento dos trabalhadores para identificar potenciais agravos e sofrimentos mentais decorrentes da pandemia.

Adaptation and validation of an adult patient classification instrument with emphasis on the family dimension.

OBJECTIVES: to adapt and validate an instrument for classifying adult patients that emphasizes the family support network in the demand for nursing care. METHODS: methodological study, carried out in three phases: adaptation of an instrument considering the reality of adult patients; content validation with seven experts and assessment of measurement properties (construct validity and internal consistency) with 781 hospitalized patients. RESULTS: in content validation, the indicators reached the values established for the Content Validity Index (0.85-1.00). In the confirmatory factor analysis, the 11 indicators were distributed in three domains and presented average variance extracted and factor loading greater than 0.5. Composite reliability was greater than 0.7. CONCLUSIONS: the present study adapted and made available, with evidence of validity and reliability, an instrument for classifying adult patients that considers the family support network in the demand for nursing care.

[Pediatric Patient Classification System: construction and validation of care categories]. / Sistema de Classificação de Pacientes Pediátricos: construção e validação de categorias de cuidados.

Patient classification is essential for managing a hospital unit. Literature, however, does not present conceptualizations of pediatric patient categories. The objectives of this study were to define and validate pediatric patient care categories, according to the level of dependency of the nursing team. The care categories were defined based on a literature review, and the content of the proposed categories was validated by a group of judges involved in managing and providing care in a pediatric unit, and by judges involved in pediatric education and research as well as in the construction of patient instruments. Five care categories were established and validated: Minimal, Intermediate, High dependency, Semi-intensive and Intensive. The validation of the care categories were the basis for constructing a system for the classification of pediatric patients, that may contribute with the decision making process of nurses working in management and health care.

Adaptation of an instrument to classify neonatal patients into care categories.

OBJECTIVE: To adapt and validate a patient classification instrument for neonatal units. METHOD: Methodological study, with adaptation of the Pediatric Patients Classification Instrument for neonatal patients. After content validation by judges, the instrument was tested for reliability, applied to 33 neonates by two nurses, simultaneously. To assess the agreement among nurses regarding the scores of each patient on the classification scale, an intraclass agreement coefficient was applied. To assess the agreement regarding the classification in care categories, the weighted Kappa coefficient was calculated. RESULTS: The adapted instrument consisted of a total of nine indicators, with three care categories: high dependence on care, semi-intensive care and intensive care. The Content Validity Index varied between 0.85 and 0.92 for items of the instrument. The intraclass agreement was 0.87 and the weighted Kappa for care categories was 0.56. CONCLUSION: An instrument that allows neonatal patients to be classified into care categories, with satisfactory reliability was validated to support the dimensioning of the nursing team.

The Effect of Plantago major on Wound Healing in Preclinical Studies: A Systematic Review.

BACKGROUND: Plantago major is a medicinal plant that has been used for centuries to treat various health conditions including wounds. PURPOSE: To investigate the effectiveness of the topical use of P major in healing skin wounds in animal models. METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review was conducted. Seven (7) electronic databases (Virtual Health Library, Public/Publisher MEDLINE, Scopus, Web of Science, Embase, Cumulative Index of Nursing and Allied Health Literature, and CAB Direct) were searched for controlled studies published in English from January 2006 to March 2020. The Collaborative Approach to Meta Analysis and Review of Animal Data from Experimental Studies tools guided the evaluation of the studies and determined their quality. The Systematic Review Center for Laboratory Animal Experimentation was used to assess the risk of bias. RESULTS: Of the 176 publications identified, 4 met the inclusion criteria. Studies included 20 to 100 animals and varying concentrations of P major. There were no reports of losses during research. Wound healing was assessed between 17 and 21 days following wounding. The best response in terms of wound contraction rate occurred with 10%, 20%, and 50% concentrations when compared with control groups. One (1) study did not have an animal ethics committee review. All studies had a high risk of bias and a lack of methodological rigor. CONCLUSION: The results of this review did not find evidence about the in vivo effectiveness of P major for wound healing. More rigorous preclinical studies with adequate sample sizes are required to identify the best concentrations and formulations as well as increase understanding about the mechanisms of action of P major in wound healing.

Risk of falls in people with chronic kidney disease and related factors.

OBJECTIVE: to identify the risk and prevalence of falls in the last year in chronic renal failure patients on hemodialysis; to associate the risk of falls with the fear of falling and socio-demographic-clinical variables. METHOD: association study. 131 individuals participated in the study. The Morse Falls Scale, the Fall Efficacy Scale and the Tilburg Frailty Indicator were used. The data were analyzed by linear regression, the level of significance adopted was 0.05. RESULTS: 97.7% were at risk for falls and 37.4% had at least one fall per year, with a mean of 2.02. Extreme concern about falling was presented by women, patients with less education, amputees, and frail individuals. Diabetes, as a comorbidity, and people with difficulty or need for assistance for ambulance showed a significant increase in the occurrence of falls. CONCLUSION: high risk and high prevalence of falls were found in hemodialysis patients, greater in those with diabetes or mobility limitations. Fear of falling was identified especially in women and in people with less education. These findings challenge the role of preventing falls, both in hemodialysis sessions and in the adoption of strategies for activities of daily living that involve patients and their families.

Psychological empowerment of health professionals.

OBJECTIVE: To assess whether there are differences in psychological empowerment between different health professionals working in a teaching hospital. METHOD: A comparative, quantitative, and cross-sectional study carried out with 165 professionals selected at random and who worked in a teaching hospital in the inland of the state of São Paulo. The participants were divided into three groups: 1) nurses, 2) physicians, and 3) other professionals (physiotherapists, psychologists, pharmacists, speech therapists, social workers, and nutritionists). For data collection, a form was used to characterize the sample, as well as the Brazilian version of the Psychological Empowerment Instrument. To compare the scores between the three groups, the Kruskal-Wallis test was used, followed by Dunn' post-test. RESULTS: Nurses, physicians, and other professionals scored 71.4; 69.3, and 71.1 points (p=0.5959), respectively, in the total score of the instrument. CONCLUSION: There are no statistically significant differences in the perception of psychological empowerment of different health professionals. CONCLUSION: There are no statistically significant differences in the perception of psychological empowerment of different health professionals.

Validation of an Instrument to guide Nursing Staffing in Obstetric Rooming in.

OBJECTIVES: to construct and validate an instrument for the classification of mother-baby binomials that subsidizes personnel Staffing in in-rooming units. METHOD: methodological study. The construction was based on theoretical and legal references. Content validity was performed by experts through the content validity index measurement. Then, the instrument was applied to a sample of 122 binomials, and exploratory factor analysis was performed using the principal components analysis. RESULTS: the instrument consisted of seven care indicators: Birth route; Maternal morbidity; Neonatal morbidity; Breastfeeding; Social aggravating factors; Care guidance; and interaction and bonding. All with content validity index of 1. The construct was composed of 3 domains, with Cronbach's alpha of 0.62, 0.85 and 0.89. CONCLUSIONS: the classification instrument of mother-baby binomials allows the classification of mother-baby binomials and may support personnel Staffing in in-rooming units.

Validation of an instrument for patient classification to support obstetric nursing care / Validación de instrumento para clasificación de pacientes a fin de basar cuidados de enfermería obstétrica / Validação de instrumento para classificação de pacientes a fim de embasar cuidados de enfermagem obstétrica

ABSTRACT Objectives: to develop and validate an instrument for the classification of pregnant and postpartum women according to the demand for nursing care. Methods: a methodological study conducted in three stages: 1) construction of the instrument based on literature review; 2) content validation using the Delphi technique with 12 experts; and 3) Evaluation of the convergent construct validity through the correlation between the scores of the constructed instrument and the Fugulin instrument. Results: an instrument with ten indicators of specific care for pregnant and postpartum women was developed. A content validity index higher than 0.9 was obtained, requiring only one round of the Delphi technique. The Spearman coefficient was 0.64 between the instruments, indicating a strong correlation. Conclusions: the classification instrument specifically constructed for pregnant and postpartum women showed evidence of content validity and convergent construct validity with a widely used instrument in the national territory.

RESUMEN Objetivos: construir y validar un instrumento para clasificación de gestantes y puérperas segundo la demanda de cuidado de enfermería. Métodos: estudio metodológico realizado en tres etapas: 1) construcción del instrumento basado en la revisión bibliográfica; 2) validación de contenido aplicando la técnica Delphi con 12 especialistas; y 3) Evaluación de la validez de constructo convergente mediante la correlación entre los escores del instrumento construido y del instrumento de Fugulin. Resultados: fue construido un instrumento con diez indicadores de cuidados específicos para gestantes y puérperas. Obtenido el índice de validez de contenido superior a 0,9, siendo necesaria sólo una rodada de la técnica Delphi. El coeficiente de Spearman fue de 0,64 entre los instrumentos, indicando una correlación fuerte. Conclusiones: el instrumento de clasificación construido específicamente para gestantes y puérperas presentó evidencias de validez de contenido y validez de constructo convergente con instrumento ampliamente utilizado en territorio nacional.

RESUMO Objetivos: construir e validar um instrumento para classificação de gestantes e puérperas segundo a demanda de cuidado de enfermagem. Métodos: estudo metodológico realizado em três etapas: 1) construção do instrumento com base na revisão bibliográfica; 2) validação de conteúdo aplicando a técnica Delphi com 12 especialistas; e 3) Avaliação da validade de construto convergente mediante a correlação entre os escores do instrumento construído e do instrumento de Fugulin. Resultados: foi construído um instrumento com dez indicadores de cuidados específicos para gestantes e puérperas. Obteve-se o índice de validade de conteúdo superior a 0,9, sendo necessária apenas uma rodada da técnica Delphi. O coeficiente de Spearman foi de 0,64 entre os instrumentos, indicando uma correlação forte. Conclusões: o instrumento de classificação construído especificamente para gestantes e puérperas apresentou evidências de validade de conteúdo e validade de construto convergente com instrumento amplamente utilizado em território nacional.

Factors related to Nursing workload in the Oncology assistance provided to hospitalized women / Factores relacionados con la carga de trabajo de enfermería en la atención oncológica de mujeres hospitalizadas / Fatores relacionados à carga de trabalho da enfermagem na assistência oncológica de mulheres hospitalizadas

Objective: to evaluate the Nursing workload and its related factors in the assistance provided to hospitalized women with gynecological and breast cancers, according to the Nursing Activities Scores adapted for cancer patients. Method: a cross-sectional and epidemiological study. The participants were women with gynecological and/or breast cancer, over 18 years of age, and hospitalized for a minimum period of 24 hours. The following was collected from the medical records: sociodemographic and clinical data, Karnofsky Performance Status and workload, according to the adapted Nursing Activities Score. The factors related to workload were analyzed by means of multiple linear regression. Results: the mean Nursing Activities Scores was 29.3%, denoting seven hours of daily care per patient. The factors related to workload differed according to the breast or gynecological cancer diagnosis (β=-0.01; p<0.001), clinical or surgical treatment (β=-0.03; p<0.001) and functional capacity at admission (β=0.07; p<0.001), as per the Karnofsky Performance Status. Conclusion: there was greater workload for the care of women with gynecological cancer undergoing clinical treatment and with lower functional capacity at admission. The findings reveal directions for optimization of resources and improvements in work processes and flows, in order to promote a favorable work environment and good quality assistance.

Objetivo: evaluar la carga de trabajo de enfermería y los factores relacionados con la atención de mujeres hospitalizadas con cáncer ginecológico y de mama, según el Nursing Activities Scores adaptado para pacientes oncológicos. Método: estudio epidemiológico y transversal. Participaron mujeres con cáncer ginecológico y/o de mama, mayores de 18 años, hospitalizadas por un período mínimo de 24 horas. De las historias clínicas se recolectaron datos sociodemográficos y clínicos, Karnofsky Performance Status y carga de trabajo, según el Nursing Activity Score adaptado. Los factores relacionados con la carga de trabajo se analizaron mediante regresión lineal múltiple. Resultados: el puntaje promedio del Nursing Activity Scores fue del 29,3%, lo que indica que se brindan siete horas diarias de atención por paciente. Los factores relacionados con la carga de trabajo difirieron según diagnóstico de cáncer de mama o ginecológico (β=-0,01; p<0,001), tratamiento clínico o quirúrgico (β=-0,03; p<0,001) y capacidad funcional al momento del ingreso (β=0,07; p< 0,001), conforme a la escala Karnofsky Performance Status . Conclusión: hubo una mayor carga de trabajo en la atención a mujeres con cáncer ginecológico en tratamiento clínico y con menor capacidad funcional al momento del ingreso. Los hallazgos revelan información útil para optimizar recursos, mejorar procesos y flujos de trabajo, con el fin de promover un ambiente de trabajo favorable y una atención de calidad.

Objetivo: avaliar a carga de trabalho da enfermagem e seus fatores relacionados na assistência às mulheres hospitalizadas com cânceres ginecológicos e mamários, segundo o Nursing Activities Scores , adaptado a pacientes oncológicos. Método: estudo epidemiológico de corte transversal. Participaram mulheres com câncer ginecológico e/ou mamário, maiores de 18 anos, hospitalizadas por período mínimo de 24 horas. Coletados, do prontuário, dados sociodemográficos, clínicos, Karnofsky Performance Status e carga de trabalho, segundo Nursing Activities Score adaptado. Os fatores relacionados à carga de trabalho foram analisados por regressão linear múltipla. Resultados: pontuação média do Nursing Activities Scores foi 29,3%, denotando sete horas de assistência diária por paciente. Os fatores relacionados à carga de trabalho diferiram conforme diagnóstico de câncer de mama ou ginecológico (β= - 0,01; p<0,001), tratamento clínico ou cirúrgico (β= - 0,03; p<0,001) e capacidade funcional na admissão (β= 0,07; p<0,001), pelo Karnofsky Performance Status . Conclusão: evidenciou-se maior carga de trabalho para atendimento de mulheres com câncer ginecológico sob tratamento clínico e com menor capacidade funcional na admissão. Os achados revelam direcionamentos para otimização de recursos, melhorias em processos e fluxos de trabalho, a fim de promover ambiente laboral favorável e assistência de qualidade.

Construction and validation of an instrument for event-related sterility of processed healthcare products / Construcción y validación de instrumento para esterilidad relacionada a eventos de productos para salud procesados / Construção e validação de instrumento para esterilidade relacionada a eventos de produtos para saúde processados

ABSTRACT Objective: To construct and validate an instrument to assess events related to maintaining the sterility of processed healthcare products. Methods: This methodological study developed the instrument through analysis by a panel of experts, focusing on the integrity of commonly used packaging: spunbond-meltblown-spunbond and medical-grade paper. The instrument was analyzed using the Content Validity Index and Content Validity Ratio (≥ 0.80) and modified Kappa (≥ 0.74). The instrument underwent pre-testing. Results: Six experienced professionals participated in the expert panel. After two rounds, the final version of the instrument contained five dimensions. In the pre-test, 30 nursing professionals participated, of whom 86.67% considered the instrument good, and 90% found it understandable. Conclusion: The construction and validation followed literature recommendations. The instrument is available, aiding in the safe use of processed healthcare products.

RESUMEN Objetivo: Construir y validar instrumento para evaluar evento relacionado a manutención de la esterilidad de productos para salud procesados. Métodos: Estudio metodológico para desarrollar instrumento mediante análisis por comité de jueces. Considerado como aspecto rector la integridad de envases más utilizados en la práctica: de no tejido y de papel grado quírurgico. Realizado análisis por Índice de Validez de Contenido y Razón de Validez de Contenido ≥ 0,80 y Kappa modificado ≥ 0,74. Sometido el instrumento a pre-prueba. Resultados: Participaron del comité de jueces seis profesionales experientes en la temática. Trás dos rondas, fue constituída la versión final del instrumento, conteniendo cinco dimensiones. En la pre-prueba, participaron 30 profesionales de enfermería, en que 86,67% consideraron el instrumento bueno; y 90%, comprensible. Conclusion: La construcción y validación siguió las recomendaciones de la literatura. El instrumento está disponible para ser utilizado, auxiliando el uso seguro del producto para salud.

RESUMO Objetivo: Construir e validar instrumento para avaliar evento relacionado à manutenção da esterilidade de produtos para saúde processados. Métodos: Estudo metodológico para desenvolver instrumento mediante análise por comitê de juízes. Considerou-se como aspecto norteador a integridade das embalagens mais utilizadas na prática: a de não tecido e a de papel grau cirúrgico. A análise foi realizada pelo Índice de Validade de Conteúdo, Razão de Validade de Conteúdo ≥ 0,80 e Kappa modificado ≥ 0,74. Submeteu-se o instrumento ao pré-teste. Resultados: Participaram do comitê de juízes seis profissionais experientes na temática. Após duas rodadas, chegou-se à versão final do instrumento, contendo cinco dimensões. No pré-teste, participaram 30 profissionais de enfermagem, dos quais 86,67% consideraram o instrumento bom; e 90%, compreensível. Conclusões: A construção e validação seguiu as recomendações da literatura. O instrumento está disponível para ser utilizado, auxiliando no uso seguro do produto para saúde.

Desempenho do Escore Pediátrico de Alerta (EPA) no rastreio da sepse / Desempeño del Puntaje Pediátrico de Alerta (EPA) para el rastreo de la sepsis / Pediatric Alert Score (EPA) performance in sepsis screening

Resumo Objetivo Avaliar o desempenho do Escore Pediátrico de Alerta (EPA) no rastreio de casos de sepse em um contexto hospitalar. Métodos Estudo de teste diagnóstico guiado pelas recomendações do Standards for the Reporting of Diagnostic Accuracy Studies (STARD). A amostra foi de 190 crianças e adolescentes internados em um hospital do interior da Bahia, Brasil. A coleta foi realizada em banco de dados de um projeto guarda-chuva, em prontuários e sistema de registros do hospital. O processamento e análise foram realizados no SPSS® version 25.0 for Windows e MedCalc® version 20.00. O desempenho do EPA no rastreio da sepse quando comparado aos critérios do padrão de referência foi mensurado através da Sensibilidade, Especificidade, Valores Preditivos e curva ROC. Resultados Dentre os participantes, 53,2% eram do sexo masculino, com média da idade de 4,39 anos (DP: 4,28) e mediana 3 anos (IIQ: 1 - 8). A prevalência da sepse identificada pelo padrão de referência foi de 10% e pelo EPA 23.1%. A sensibilidade, especificidade e valores preditivos positivo e negativo do EPA no rastreio de sepse foram de 73,7%, 82,5%, 31,8% e 96,6%, respectivamente. A área sob a curva ROC foi de 0,794. Conclusão O estudo apresenta evidências sobre o desempenho do EPA no rastreio da sepse, demonstrando boa acurácia na discriminação de pacientes pediátricos com e sem sepse na amostra estudada.

Resumen Objetivo Evaluar el desempeño del Puntaje Pediátrico de Alerta (EPA, por sus siglas en portugués) para el rastreo de casos de sepsis en un contexto hospitalario. Métodos Estudio de prueba diagnóstica guiado por las recomendaciones del Standards for the Reporting of Diagnostic Accuracy Studies (STARD). La muestra estuvo compuesta por 190 infantes y adolescentes internados en un hospital del interior del estado de Bahia, Brasil. La recopilación se realizó en un banco de datos de un proyecto paraguas, en historias clínicas y en el sistema de registros del hospital. El procesamiento y el análisis se realizaron en el SPSS® version 25.0 for Windows y MedCalc® version 20.00. El desempeño del EPA para el rastreo de la sepsis, cuando se lo compara con los criterios del modelo de referencia, se midió a través de la sensibilidad, especificidad, valores predictivos y curva ROC. Resultados Entre los participantes, el 53,2 % era de sexo masculino, con edad promedio de 4,39 años (DP: 4,28) y mediana de 3 años (IIQ: 1 - 8). La prevalencia de la sepsis identificada por el modelo de referencia fue del 10 % y por el EPA del 23,1 %. La sensibilidad, la especificidad y los valores predictivos positivo y negativo del EPA para el rastreo de la sepsis fue del 73,7 %, 82,5 %, 31,8 % y 96,6 %, respectivamente. El área bajo la curva ROC fue de 0,794. Conclusión El estudio presenta evidencias sobre el desempeño del EPA para el rastreo de la sepsis y demuestra una buena precisión en la discriminación de pacientes pediátricos con y sin sepsis en la muestra estudiada.

Abstract Objective To assess Pediatric Alert Score (EPA) performance in screening cases of sepsis in a hospital context. Methods This is a diagnostic test study guided by the Standards for the Reporting of Diagnostic Accuracy Studies (STARD) recommendations. The sample consisted of 190 children and adolescents admitted to a hospital in the countryside of Bahia, Brazil. Data collection was carried out in the database of an umbrella project in medical records and the hospital's records system. Processing and analysis were performed in SPSS® version 25.0 for Windows and MedCalc® version 20.00. EPA performance in sepsis screening when compared to the reference standard criteria was measured through sensitivity, specificity, predictive values and ROC curve. Results Among the participants, 53.2% were male, with a mean age of 4.39 years (SD: 4.28) and a median of 3 years (IQR: 1 - 8). The prevalence of sepsis identified by the reference standard was 10% and by EPA (23.1%). The sensitivity, specificity and positive and negative predictive values of EPA in sepsis screening were 73.7%, 82.5%, 31.8% and 96.6%, respectively. The area under the ROC curve was 0.794. Conclusion The study presents evidence on EPA performance in sepsis screening, demonstrating good accuracy in discriminating pediatric patients with and without sepsis in the studied sample.

Content validation of an instrument for medical record audits / Validación de contenido de un instrumento para auditoría clínica de registros médicos / Validação de conteúdo de um instrumento para auditoria clínica de prontuários

ABSTRACT Objective: To build and validate the content of an instrument to conduct medical record audits; to conduct a pre-test. Methods: Methodological study conducted from May/2020 to May/2021 in three stages: 1) development of the instrument by bibliographic survey and benchmarking; 2) content validation using the Delphi technique; 3) application of the instrument and descriptive analysis in a sample of 200 medical records. Results: An instrument was constructed with 11 domains containing sub-items that characterize the quality of care. Two stages of the Delphi technique were necessary to reach a content validity index higher than 0.90. For each domain, a graduated scale with a numerical value from 1 to 4 points was attributed, reflecting the quality of its completion. The average time of application was 35 minutes per record. Conclusions: The tool proved to be viable to support clinical audits to identify the level of excellence and reveal opportunities for improvement in care processes.

RESUMEN Objetivo: Construir y validar contenido de un instrumento para realización de auditoría clínica de prontuarios; realizar pre-test. Métodos: Estudio metodológico, realizado de mayo/2020 a mayo/2021 en tres etapas: 1) construcción del instrumento por análisis bibliográfico y benchmarking; 2) validación de contenido por la técnica Delphi; 3) aplicación del instrumento y análisis descriptivo en una muestra de 200 prontuarios. Resultados: Construido un instrumento con 11 dominios conteniendo subitems que caracterizan la calidad de la asistencia. Para llegar al índice de validez de contenido superior a 0,90, fueron necesarias dos etapas de la técnica Delphi. Para cada dominio, atribuido una escala graduada con valor numérico de 1 a 4 puntos, reflejando la calidad del relleno. El tiempo mediano de aplicación fue de 35 minutos por prontuario. Conclusiones: El instrumento construido se demostró viable para basar la auditoría clínica en la identificación del nivel de excelencia o oportunidades de mejoría en procesos asistenciales.

RESUMO Objetivo: Construir e validar conteúdo de um instrumento para realização de auditoria clínica de prontuários; realizar pré-teste. Métodos: Estudo metodológico, realizado de maio/2020 a maio/2021 em três etapas: 1) construção do instrumento por levantamento bibliográfico e benchmarking; 2) validação de conteúdo pela técnica Delphi; 3) aplicação do instrumento e análise descritiva em uma amostra de 200 prontuários. Resultados: Construiu-se um instrumento com 11 domínios contendo subitens que caracterizam a qualidade da assistência. Para chegar ao índice de validade de conteúdo superior a 0,90, foram necessárias duas etapas da técnica Delphi. Para cada domínio, atribuiu-se uma escala graduada com valor numérico de 1 a 4 pontos, refletindo a qualidade do preenchimento. O tempo médio de aplicação foi de 35 minutos por prontuário. Conclusões: O instrumento construído demonstrou-se viável para embasar a auditoria clínica na identificação do nível de excelência ou oportunidades de melhoria em processos assistenciais.