Avaliação da segurança no cuidado com vacinas: construção e validação de protocolo

COVID-19: Protocol and Checklist for Nursing Care Management at Urgent Care Units

BACKGROUND

The 24 h urgent care units (24 h UCU) in Brazil are the main pre-admission hospital process of the public healthcare system and constitute an intermediate modality between primary care and hospital care. These units also provide care in cases of less severity that are not considered urgent. This study aimed to create and validate the content of a graphic protocol and checklist for the nursing care management of patients with a suspicion or confirmation of infection by COVID-19 at urgent care units.

METHODS

A methodological study was carried out in three phases: construct of items and dimensions of the checklist; evaluation of the checklist by specialists for content validation; and construct and content validation of the graphic protocol.

RESULTS

The checklist was evaluated by nine specialists. Eight items received suggestions for changes. Items with a content validity index ≥0.83 were maintained. With regard to content validity, despite the satisfactory level of agreement, the specialists suggested some changes in the writing of eight items. The graphic protocol was evaluated by six specialists and had an overall content validity of 0.97.

CONCLUSION

The checklist with 44 items and three dimensions (Management, Biosafety and Care) and the protocol achieved a satisfactory standard of content validity for use at 24 h urgent care units. This protocol can contribute to the standardization and guidance of nursing actions in suspected and confirmed cases of COVID-19 at urgent care units, ensuring safe care based on scientific evidence.

Validity of an instrument to evaluate the immunobiological cold chain

Objective: To develop and to test the validity of content and layout of a multidimensional tool to evaluate maintenance of the cold chain for immunobiological conservation.Method: A methodological study carried out in three steps: integrative review; development of theoretical and logical model for the development of the tool; implementation of the Delphi Technique to test the validity of content and layout. The Content Validity Index (CVI) and Content Validity Ratio (CVR) were calculated considering appropriate those values greater than or equal to 75% and 0.4, respectively.Results: The instrument consisted of 7 questions about structure and 20 about process, subdivided into three components: Transportation/Reception (n=3); Storage/Handling (n=13); Supervision/Permanent education (n=4). The CVI value was 87.4%, with values equal to 85.7% and 89% in the structure and process dimensions, respectively. The process components obtained CVI values equal to 88.9, 88.9 and 89.2%, respectively. The CVR was 0.8, with values equal to 0.7 and 0.8 in the structure and process dimensions. As for the layout validation, the questionnaire was considered intelligible.Conclusion: The study provides an instrument with validity of content and layout for health professionals in charge of the supervision of activities of immunobiological conservation, ensuring the maintenance of the immunogenic quality of the products offered to the population.