Identification of care needs of patients with and without the use of a classification instrument

Abstract

Rev Esc Enferm USP2014; 48(4):625-31 www.ee.usp.br/reeusp/ RESUmEn Objetivo: Analizar la concordancia y la discordancia entre las evaluaciones realizadas mediante la aplicación o no de un instrumento de clasificación de pacientes e investigar la asociación entre la concordancia y las características personales y profesionales de los evaluadores. Méto-do: Estudio descriptivo exploratorio. Se investigaron a 105 pacientes internados en hospital universitario del interior del Estado de São Paulo utilizándose la estadística kappa (ponderado) y el método Bootstrap. Resultados: La concordancia entre las evaluaciones reveló: kw 0,87 (instrumento x evaluador interno), kw 0,78 (instrumento x evaluador externo) y kw 0,76 (entre los evaluadores) y la influencia de algunas características personales y profesionales. Las evaluaciones conducidas mediante el empleo de instrumento contemplaron mayor número de áreas de cuidado en comparación a cuando no se aplicó el instrumento. Conclusión: Se recomienda el uso de este instrumento a fin de lograr una identificación más efectiva de las necesidades de cuidados a los pacientes. AbStRActObjective: To analyze the agreement and disagreement between the assessments by applying or not a patient classification instrument, and to investigate the association between the agreement and personal and professional characteristics of the evaluators. Method: This is a descriptive exploratory study. 105 patients were hospitalized in a teaching hospital in the state of Sao Paulo, using the kappa statistic (weighted) and the Bootstrap method. Results:The agreement between the assessments were: k w 0.87 (instrument x internal evaluator), k w 0.78 (instrument x external evaluator) and k w 0.76 (between evaluators) and the influence of some personal and professional characteristics. The assessments conducted through the use of an instrument contemplated a greater number of areas of care in relation to when the instrument was not applied. Conclusion: The use of this instrument is recommended in order to more effectively identify care needs of patients. dEScRIPtoRSNursing assessment Patients Classification Needs assessment

Conformity of nurse prescribing to care needs: nurses' understanding

“…Although the Patient Classification Instrument has been originally created to help calculate nursing personnel, it is a powerful tool to guide nurses' decisions when planning care (8)(9) . It was found that assessments conducted employing this instrument reached further areas of care when compared to those in which the instrument was not used (7) . These study's findings reveal that care involving health education for patients/families, walking and assessment of drug effectiveness is being rarely prescribed.…”

“…It might be asked, in this practice scenario, how it is possible for nurses to individually monitor patients for identification of needs and prescribing that is adequate for care. Knowledge of clinical conditions, establishment of bonds between patients/families and active participation in the planning and execution of the care process are all crucial to make the assessment process more efficient (7) . The low appreciation given to NP, although mentioned by few participants, is a worrying element.…”

“…Frequently, this lack of adequacy results from lack of personnel for serving patients, from limited infrastructure for nursing practice or lack of engagement and/or lack of appreciation by these professionals when conducting the nursing process (6) . Still, other interfering factors that have been reported are work overload (4) and lack of use of instruments capable of supporting the identification of care areas in need of greater nursing attention (7) . Although the incorporation of the Patient Classification Instrument happens slowly in the field of clinical and management practice (8) , it is of the utmost importance (8)(9)(10) .…”

The transcultural adaptation and the validity and reliability of the Turkish Version of Perroca's Patient Classification Instrument

“…(Perroca, , ). In a study conducted to measure nursing workloads in various areas of acute care (including infectious–parasitic diseases, obstetrics‐gynaecology, neurology units and adult intensive care units), Perroca, Jericó, and Paschoal () determined that when patients were classified with or without using an instrument, more accurate results were obtained when an instrument was used (Perroca et al, ).…”

Systematization of an Instrument for Patient Classification in a Teaching Hospital

“…Entende-se que os sistemas de classificação de pacientes convertem-se em uma ferramenta gerencial que pode contribuir para dar visibilidade às necessidades de cuidado dos pacientes, assim como da necessidade de profissionais de nove indicadores de cuidado que pontuam individualmente de um a quatro, em ordem crescente de complexidade. O somatório total classifica o cuidado em mínimo (9-12 pontos), intermediário (13-18 pontos), semi-intensivo (19)(20)(21)(22)(23)(24) pontos) e intensivo (25-36 pontos). 9 A escala foi aplicada por enfermeiros previamente capacitados, do próprio setor, respeitando diariamente o mesmo horário para coleta.…”