Construção e validação de instrumento para a transição do cuidado de crianças e adolescentes de Unidade de Terapia Intensiva Pediátrica

Abstract

Transition of care refers to the transfer of responsibility and information about patient care, from discharge planning, medication monitoring, social support, symptom management after discharge to outpatient follow-up. To carry it out, the SBAR tool - Situation, Background, Assessment and Recommendation - can be used, a mnemonic widely used in health institutions, with the purpose of ensuring the safe transmission of information between professionals. This study aims to build and validate an instrument for the transition of care for children and adolescents in Pediatric Intensive Care Units, based on SBAR. This is a methodological study, with a quantitative approach, based on Pasquali's framework. It was developed in three poles or stages: theoretical pole through the scoping review, according to the PRISMA-ScR guidelines, to identify scientific evidence and structure the instrument items; empirical pole with the evaluation of content and appearance validity by 15 nursing specialists, using a Likert scale and the analytical pole that used statistical analysis by the Content Validity Index (CVI) and Kappa coefficient (k); and semantic analysis carried out by three first-year nursing residents, through the brainstorming technique and evaluation of the understanding of the items with a Likert scale. This study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, via Plataforma Brasil, with opinion number: 6.945.195, CAEE: 80940024.0.0000.5537. The scoping review resulted in the inclusion of six studies that supported the construction of the instrument, structured in five domains and 41 items. Validation by experts, through the Delphi technique, indicated high agreement in the clarity and representativeness of the items, with k and IVC values greater than 0.70 for all items. Semantic analysis, in the brainstorming, confirmed adequate understanding by the residents, without the need for adjustments with IVC above the cutoff point (>0.70). The developed and validated instrument is applicable and relevant for clinical practice in Pediatric Intensive Care Units and will have a significant social impact, since it seeks to reduce communication errors, standardize transmitted information, strengthen teamwork, optimize time and resources, and encourage an organizational culture more committed to ethics, transparency, and harm prevention. However, future studies are suggested to test its effectiveness in care practice and its applicability in different hospital contexts.