Pediatric patient classification system: improvement of an instrument

Abstract

RESUmo Este estudo teve como objetivos avaliar a reprodutibilidade interavaliadores do ins-trumento para a classificação de pacientes pediátricos portadores de câncer; verificar se o instrumento de classificação de pa-cientes é adequado a pacientes pediátri-cos portadores de câncer e elaborar uma proposta de modificação do instrumento, permitindo a adaptação para pacientes pediátricos oncológicos. Foram avaliados, na unidade de internação pediátrica de um Hospital de câncer, 34 pacientes pe-las equipes de médicos, enfermeiros e técnicos de enfermagem. Para a avaliação do grau de concordância entre os escores obtidos pelos avaliadores foi utilizado o coeficiente Kappa, que revelou um valor intermediário/alto nas classificações ob-jetivas, e um valor baixo nas subjetivas. Conclui-se que o instrumento é confiável e reprodutível, porém, para classificação do paciente pediátrico oncológico, sugere-se a complementação de itens para atingir um resultado mais compatível com a realidade dessa população. dEScRiToRES Criança Neoplasias Classificação Enfermagem pediátrica AbSTRAcT The objectives of this study were to assess the interrater reproducibility of the instrument to classify pediatric patients with cancer; verify the adequacy of the patient classification instrument for pediatric patients with cancer; and make a proposal for changing the instrument, thus allowing for the necessary adjustments for pediatric oncology patients. A total of 34 pediatric inpatients of a Cancer Hospital were evaluated by the teams of physicians, nurses and nursing technicians. The Kappa coefficient was used to rate the agreement between the scores, which revealed a moderate to high value in the objective classifications, and a low value in the subjective. In conclusion , the instrument is reliable and reproducible , however, it is suggested that to classify pediatric oncology patients, some items should be complemented in order to reach an outcome that is more compatible with the reality of this specific population. dEScRiPToRS Child Neoplasms Classification Pediatric nursing RESUmEn Estudio que objetivó estimar la reproduc-tibilidad inter-evaluadores del instrumento para la clasificación de pacientes pediá-tricos portadores de cáncer; verificar si el instrumento de clasificación de pacientes es adecuado para pacientes pediátricos portadores de cáncer y elaborar una pro-puesta de modificación del instrumento, permitiendo su adaptación para pacientes pediátricos oncológicos. Fueron evaluados 34 pacientes en la unidad de internación pediátrica de un Hospital oncológico por parte de los equipos de médicos, enferme-ros y técnicos de enfermería. Para estimar el grado de concordancia entre los punta-jes obtenidos por los evaluadores, se utilizó el coeficiente Kappa, que expresó un valor entre intermedio y alto en las clasificacio-nes objetivas, y un valor bajo en las sub-jetivas. Se concluye en que el instrumento es confiable y reproducible, aunque para la clasificación del paciente pediátrico on-cológico se sugiere la implementación de ítems p...

The qualitative dimension of Nursing workload: a measurement proposal

“…To reach the proposed objectives, four measurement instruments were applied: APROCENF scale ( 15 ) ; Two Patient Classification Instruments (PCIs) (one for adult ( 13 ) and another pediatric ( 17 ) ) and the Nursing Activities Score (NAS) ( 18 ) . It is noteworthy that the first three instruments ( 13 , 15 , 17 ) were constructed and had their psychometric properties tested in Brazil, respectively in 2017, 2013 and 2014, and the last ( 18 ) , was validated for Brazilian culture in 2009.…”

“…It is noteworthy that the first three instruments ( 13 , 15 , 17 ) were constructed and had their psychometric properties tested in Brazil, respectively in 2017, 2013 and 2014, and the last ( 18 ) , was validated for Brazilian culture in 2009.…”

“…The values are summed and the type of care, classified as: Minimum (MC) (9-12 points), Intermediate (IC) (13 to 18 points), Semi-intensive (SI) (19 to 24 points) or Intensive (In) (25 to 36 points). Similarly, pediatric PCI ( 17 ) directs evaluation for family, patient and therapeutic procedures with 11 care areas, classifying them into MC (11 to 17 points), IC (18 to 23), High Dependency (HD) (24 to 30), SI (31 36), and In (37 to 44).…”

“…This classification has been instituted for more than five years in the practice of nurses of this service and is performed daily at night, using a PCI for the Adult IU ( 13 ) and another for the Pediatric unit ( 17 ) and the NAS in the ICUs. …”

Water balance in pediatric nephrology: construction of a Standard Operating Procedure

“…Due to the lack of consensus in the literature about the number of people needed to compose the expert panel, we chose to use the sample of nine people, the highest number among the studies found (16)(17)(18)(19) .…”