Assessment of the nursing care product (APROCENF): a reliability and construct validity study

Safe practices for bed bathing in the intensive care unit: validation of a checklist

OBJECTIVE

To validate a checklist for safe bathing in critically ill patients.

METHODS

This is a methodological and quantitative study. Researchers developed a checklist for safe bathing in critically ill patients consisting of 41 items, which were submitted to the apparent and content validation process, evaluated by eleven judges, and interobserver reliability. For reliability analysis, the instrument was applied in 54 bed bath procedures in the ICU; Kappa and CHF tests were used.

RESULTS

In the apparent and content validation, adjustments were made according to the judges' suggestions. Kappa values ranged from moderate to almost perfect (0.462 to 0.962), and, in some items, there was 100% agreement; the reliability of the instrument was excellent (ICC = 0.962).

CONCLUSION

The instrument proved to be dependable and easy to apply. Its use will contribute to safe bed bathing and subsidize interventions aimed at increasing the quality of care.

A systematic review of classifications systems to determine complexity of patient care needs in palliative care

BACKGROUND

Providing the right care for each individual patient is a key element of quality palliative care. Complexity is a relatively new concept, defined as the nature of patients' situations and the extent of resulting needs. Classifying patients according to the complexity of their care needs can guide integration of services, anticipatory discussions, health service planning, resource management and determination of needs for specialist or general palliative care. However, there is no consistent approach to interpreting and classifying complexity of patient needs.

AIM

The aim of this article is to identify and describe classification systems for complexity of patient care needs in palliative care.

DESIGN

Narrative systematic review (PROSPERO registration number CRD42020182102).

DATA SOURCES

MEDLINE, Embase, CINAHL and PsychINFO databases were searched without time limitations. Articles were included that described classification systems for complexity of care requirements in populations with palliative care needs.

RESULTS

In total, 4301 records were screened, with nine articles identified reporting the use of patient classification systems in populations with palliative care needs. These articles included the use of six classification systems: HexCom, Perroca Scale, AN-SNAP, Hui Major Criteria, IDC-Pal and PALCOM. These systems were heterogenous in the manner they determined complexity of care needs. The HexCom and IDC-Pal systems contained items that covered all domains of complexity as described by Hodiamont; personal, social support, health care team and environment.

CONCLUSION

Although six classification systems have been developed, they access differing aspects of care needs and their application has been limited. The HexCOM and IDC-Pal systems offer the broadest determinations of complexity from an individual perspective. Further research is needed to apply these systems to populations external to those in which they were developed, and to appreciate how they may integrate with, and impact, clinical care.

The qualitative dimension of Nursing workload: a measurement proposal

OBJECTIVE

construct and test a proposal to measure the qualitative dimension of nursing workload; identify the workload cut-off point and its indicator as predictors of the good and optimal nursing care product score.

METHOD

this is a descriptive study conducted in four inpatient units and four intensive care units of a Brazilian teaching hospital, considering 308 evaluations performed by 19 nurses. Four measurement instruments were used: three to assess the care demand in relation to nursing and the other to classify the care product delivered at the end of the shift. The workload was calculated and its indicator was constructed.

RESULTS

a weak and inverse correlation was found between the care product score, workload and the workload indicator and the workload indicator in the units and moderate and inverse between Nursing care planning and Care needs assistance with the number of hospitalized patients.

CONCLUSION

it is possible to associate workload and its indicator with the care product. Nursing workload ≤ 173 hours (24 hours) and indicator ≤ 12.3 hours / professional were associated with a higher probability of obtaining a "good" and "optimal" score in the care product in the inpatient units.

The continuity of hospital nursing care for Primary Health Care in Spain

OBJECTIVE

To learn the profile and activities carried out by the Hospital Nurse Liaison for the continuity of care in Primary Health Care in Spain.

METHOD

An exploratory study with a qualitative approach developed in five University Hospitals in Madrid and three in Barcelona, with Hospital Nurse Liaisons who work in Hospitals in Madrid (8) and Barcelona (11). An online questionnaire was applied with open and closed questions for data collection. The data were analyzed by the content analysis technique in the thematic modality.

RESULTS

Nineteen (19) Hospital Nurse Liaisons participated in the study. The liaisons' ages ranged from 26 to 64 years old, the majority were women (94.73%) with experience between 21 and 30 years (52.63%), and had worked in this job between 6 months and 26 years. The Nurse Liasion is required to perform a clinical assessment of the patient prior to discharge and to contact the Nurse in the patient's area of origin by telephone or e-mail. It is necessary to have experience as an educator, to work in a team and have motivation.

CONCLUSION

Nurses in Spain perform care continuity for Primary Health Care, in which their activities encompass the availability of resources and experience in managing the care of complex patients and their families.

Assessment of the product of nursing care in specialized hospitals

OBJECTIVE

To evaluate the product of care in units of specialized hospitals, identifying the items that most contributed to the score; to compare the product of care among hospitals, units, and shifts; to verify the association between demographic and professionals variables and the product of care.

METHOD

Descriptive study, conducted in eight units of two specialized hospitals in the State of São Paulo. The evaluation of the product of care was performed by applying an instrument to 44 nurses.

RESULTS

"Multidisciplinary interaction and performance" obtained the lowest median in both hospitals, and the "Meeting assistance needs" and "Nursing care planning" were the better assessed ones. "Dimensioning of nursing staff" was the item that most contributed to the total score. There was a weak correlation between socio-demographic variables and score.

CONCLUSION

The product of care, as found in both hospitals, was predominantly considered "good." The tool enabled the identification of critical aspects of the nursing work.