Abstract:1Ústav ošetřovatelství a porodní asistence, Lékařská fakulta, Ostravská Univerzita v Ostravě, Česká republika 2 Ústav ošetrovateľstva, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Slovenská republika ABSTRAKT Východiská: V súčasnosti existuje na svete takmer 40 škál na posúdenie rizika vzniku dekubitu. Napriek ich množstvu boli psychometrické vlastnosti testované len u niektorých. Cieľ: Zistiť stupeň inter-rater reliability jednotlivých položiek vybraných škál na posúdenie rizika … Show more
“…With low inter-rater reliability values, one general nurse may indicate the patient as at high risk while the second nurse may assign the patient to the no risk group. In the psychometric testing the inter-rater reliability KontAKt / Journal of nursing and social sciences related to health and illness n u r s I n g Ševčíková et al / KONTAKT 21 of the total measuring instrument score, as well as their individual items, may be evaluated (Šáteková and Žiaková, 2016;Urbánek et al, 2011). Foreign research studies have demonstrated the inter-rater reliability values for Nu-DESC to be κ = 0.47 -0.83 (κ, ICC).…”
Objective: Determine the results for inter-rater reliability for items in two delirium screening measuring instruments (Delirium Observation Scale, Nursing Delirium Screening Scale). Design: Prospective comparative study of measuring instruments. Methods: Data were collected between August 2018 and August 2019 at the Trauma Clinic, Teaching Hospital, Olomouc, Czech Republic. Study sample included 50 patients with locomotive apparatus trauma, assessed by two raters -general nurses. To assess the inter-rater reliability the study used Cohen's kappa (κ) method. Results: For the Delirium Observation Scale, the agreement between the two raters for two of the items was 98% (κ = 0.790); for all other items the agreement was 100% (κ = 1.0). The percentage rate of agreement between both raters using the Nursing Delirium Screening Scale was 100% (κ = 1.0) for all five items. Conclusions: For both screening measuring instruments a high level of reliability has been established. Nevertheless, the highest agreement between the raters has been achieved for the Nursing Delirium Screening Scale. The recommendation is to further test the screening delirium measuring instruments in a Czech clinical setting.
“…With low inter-rater reliability values, one general nurse may indicate the patient as at high risk while the second nurse may assign the patient to the no risk group. In the psychometric testing the inter-rater reliability KontAKt / Journal of nursing and social sciences related to health and illness n u r s I n g Ševčíková et al / KONTAKT 21 of the total measuring instrument score, as well as their individual items, may be evaluated (Šáteková and Žiaková, 2016;Urbánek et al, 2011). Foreign research studies have demonstrated the inter-rater reliability values for Nu-DESC to be κ = 0.47 -0.83 (κ, ICC).…”
Objective: Determine the results for inter-rater reliability for items in two delirium screening measuring instruments (Delirium Observation Scale, Nursing Delirium Screening Scale). Design: Prospective comparative study of measuring instruments. Methods: Data were collected between August 2018 and August 2019 at the Trauma Clinic, Teaching Hospital, Olomouc, Czech Republic. Study sample included 50 patients with locomotive apparatus trauma, assessed by two raters -general nurses. To assess the inter-rater reliability the study used Cohen's kappa (κ) method. Results: For the Delirium Observation Scale, the agreement between the two raters for two of the items was 98% (κ = 0.790); for all other items the agreement was 100% (κ = 1.0). The percentage rate of agreement between both raters using the Nursing Delirium Screening Scale was 100% (κ = 1.0) for all five items. Conclusions: For both screening measuring instruments a high level of reliability has been established. Nevertheless, the highest agreement between the raters has been achieved for the Nursing Delirium Screening Scale. The recommendation is to further test the screening delirium measuring instruments in a Czech clinical setting.
PurposeAssessment of pressure ulcers is an indicator of nursing care quality. In physically handicapped patients, the risk is elevated, due to the neuropathy and incontinence that frequently accompany paresis and paralysis. We conducted a systematic review of 4 assessment scales to assess their use and usefulness for these patients.Materials/methodsWe searched 5 databases for articles published between 2016 and 2018 that included terms related to the risk of pressure ulcers in physically handicapped patients, including the names of 4 assessment scales (Norton, Braden, Waterlow and Spinal Cord Injury Pressure Ulcer Scale). One hundred and three sources were returned, from which we selected 10. We also selected an earlier source, for a total of 11.ResultsThe Braden and Waterlow scales are popular in clinical practice. The Norton scale is used for scientific comparisons and in clinical practice only sporadically. Expert opinion suggests that acceptance of the Spinal Cord Injury Pressure Ulcer Scale could reduce the incidence of pressure ulcers in physically handicapped patients.ConclusionsIntroduction of a scale designed for handicapped patients, combined with better preventive measures, could result in the bedsore reduction of pressure ulcers. Research testing the effectiveness of the Spinal Cord Injury Pressure Ulcer Scale in the Czech population is needed to validate its use in clinical practice.
Tlakové léze představují významné riziko a následně komplikaci pro pacienty, kterým je v rámci léčby přiložena fixace (sádra, sádrové dlahy, krční límce, ortézy). Cíl: Vytvořit přehled odborných informací popisujících tlakové léze vzniklých v důsledku přiložení fixace (sádra, sádrové dlahy, krční límce, ortézy). Metody: Pro tvorbu přehledu bylo zvoleno jednoduché vyhledávání ve dvou licencovaných a elektronických databázích a jednom nakladatelství (EBSCO, PROQUEST, SOLEN). Vyhledávání probíhalo v měsíci lednu a únoru 2019. Zařazovací kritéria splňovalo sedmnáct odborných publikací. Výsledky: Tlakové léze jsou způsobeny zejména vysokým působením tlaku, zevními a vnitřními faktory. Nesprávné a nedostatečné umístění fixace, která intenzivně tlačí na kůži, má za následek nedostatečný arteriální průtok krve. Dochází ke tkáňové perfuzi a následně vzniku tlakové léze. V horším případě může dojít k tvorbě trombu. Závěry: Monitorování kůže patří mezi základní činnosti ošetřovatelského personálu během přijetí a následné péče o pacienta v nemocnici. Vzdělávání ošetřovatelského personálu o správném přikládání kompenzačních pomůcek a péče o kůži, by měla být prioritou. Klíčová slova dekubit, fixace, ošetřovatelství, tlakový vřed, všeobecná sestra 1 Ústav ošetřovatelství, Fakulta zdravotnických věd, Univerzita Palackého v Olomouci
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