Avaliação do efeito de uma intervenção educativa sobre o cuidado seguro ao paciente renal crônico submetido à hemodiálise

Abstract

The objective of this study was to evaluate the effect of an educational intervention on the safety of nursing care for patients in hemodialysis units. This is an evaluative study with a quantitative approach carried out in four hemodialysis units in the metropolitan region of Natal/RN. The data collection procedure was organized into: Evaluation 1: carried out in the selected units using a previously validated instrument; Intervention: an extension course with an educational character about safe care in dialysis units aimed at nurses and nursing technicians from each of the units evaluated. Evaluation 2: occurred in the same way as evaluation 1 in order to evaluate the effects related to the improvement of safe care in hemodialysis units, after the intervention. The data collection instrument was the graphic protocol for evaluating safe nursing care for chronic kidney patients on hemodialysis, in which the level of compliance was verified through items related to structure, process and result, which allows classifying the care as safe, partially safe or unsafe. The data were stored in Microsoft Excel® 2010 spreadsheets and subsequently analyzed using inferential descriptive statistics using the Statistical Package for Social Science® (SPSS) software. The Kappa coefficient was measured to determine the level of agreement between evaluators. The results for the classification of care were organized using the scores listed in the graphic protocol checklist. The Pareto Diagram was used to evaluate nonconformities. According to the evaluation, it was possible to observe that in the first evaluation, three clinics obtained scores between 7 and 11, referring to partially safe care, while in the second evaluation, all clinics obtained scores between 14 and 16, considered as safe care. The Kappa coefficient indicated substantial agreement, with values between 0.61 and 0.80 for clinic 1, 2, and 4. Clinic 3 presented perfect agreement between evaluators. It is concluded that after the intervention there was an improvement in all dimensions evaluated, which confirms that the intervention had a positive effect on all items, evidenced by the reduction of non-conformities in the dimensions studied in the four clinics.