Segurança do paciente: construção e validação de checklist para Cirurgia de Alta Frequência - CAF

Abstract

Patient safety is a fundamental part of ensuring quality health, being a current, relevant and widely discussed topic, since it involves actions promoted to reduce the risk of unnecessary damage associated with health care to an acceptable minimum. This work deals with the safety of patients undergoing High Frequency Surgery (CAF), performed at the Lower Genital Tract Pathology (PTGI) outpatient clinic of the Januário Cicco Maternity School (MEJC), linked to the Federal University of Rio Grande do Norte. Considering the complications that culminate in the exposure of patients to adverse events (AE) both during the CAF and after care, the need arose to develop a standardizing instrument for nursing care, in order to standardize the care provided. Thus, the general objective was to build and validate a safety checklist for highfrequency surgeries based on the systematization of information that would allow the elaboration, validation of the content and appearance, and the assessment of the instrument's reliability index. The method for developing the study was methodological research with a mixed approach. Data collection was performed using an instrument composed of objective and subjective questions related to the procedures and the technique used to determine the sample was the “snowball” and also the intentional technique. Twenty professionals, called judges, were invited, among nurses, professors and nursing technicians working in the MEJC, obtaining the participation of eight of them. To measure the agreement regarding the relevance of the items, the Content Validity Index (CVI) was used. Cronbach's alpha was used to assess the internal consistency (reliability) of the instrument developed. The checklist was submitted to a single validation round using the Delphi technique, and the contents that reached the minimum score of 0.80 or more were considered validated. The results indicate that, in terms of content, the CVI's achieved were, for the most part, equal to 1.00, with the total CVI's equal to 0.99 in the four evaluated perspectives (clarity, relevance, objectivity and wording of the items) . Regarding the scope, the indices obtained were all equal to 1.00, even with the suggestion of small changes. As for general reliability, the instrument showed almost perfect internal consistency (Cronbach's alpha of 0.94). Considering the results obtained, it is concluded that there was statistical agreement between the judges, indicating the suitability for use in the practice/clinical of the instrument called Checklist of High Frequency Surgery - CCAF, the final product of this research, which, it is hoped, will have an impact positive results among patients, the health team and the institution by minimizing the occurrence of adverse events before, during and after the surgery, contributing to an increasingly safe and humanized care.