Protocolo de avaliação e classificação de risco de pacientes de uma unidade de emergência / Triage protocol of an emergency unit

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

29/07/2010

RESUMO

Introduction: The design and implementation of a protocol for assessing risks in emergency care prioritizes according to the patient severity evenly between all professionals. Thus, the waiting time is decreased for critical patients, improving quality of care. Therefor, you must know demand and profile of the Unit, using a compatible protocol with these features. Objectives: Identify the socio-demographic profile and the main complaints of the adult population at the Emergency Unit of a Hospital of University. Validate the contents of the protocol for assessment and risk classification of patients and verify its reliability. Method: A descriptive / retrospective and methodology developed in the Emergency Unit of a Hospital of University of São Paulo State. Comprised five steps: assessment of demand and the profile of the Unit; assessment of protocols of risk classification in the literature; development; content validation; and verification of the reliability of the protocol. The used instrument to characterize the profile has been struct ured based on data from the Bulletin of Emergency Room(BER) and the protocol of risk classification on the basis of the literature. The sample profile of the population consisted of 3424 BER from January to December 2008. The content validation was performed by six judges individually and a meeting of the committee of judges, the reliability of the researcher and four observers, the latter by applying the protocol in 40 patients. Results: The spontaneous demand for unity was made predominantly by young women aged 14 to 54 years in neighborhoods close to the unit during the week and on schedule from seven to nineteen hours. The most frequent complaints were headache, abdominal pain, chest pain, back pain, cough, fever, vomiting, dyspnea, pain in lower limbs, nausea, dizziness, sore throat, diarrhea, myalgia, dysuria, pain in neck and upper limbs. There predominance of risk classification in the priority green (67%), and the average waiting time for the classification of 33.6 min and for the medical care of 79.4 min. In the content validation were obtained the following percentages of agreement among the judges: the organization -100% in 31 items and 83.3% in four, in the coverage - 32 of 35 items had equal or greater concordance to 66.6%; objectivity - 24 items had equal or greater concordance to 66.6% and the relevance-30 items had equal or greater concordance to 66.6%. After individual assessment, the protocol was amended at the meeting of the committee of judges. The degree of reliability achieved excellent agreement (weighted kappa = 0.81). Conclusion: The profile of the sample answered in the adult unit were young adults of working age, female, coming from the municipality itself, spontaneous, during the daytime on weekdays. The consultations pointed to complaints of low complexity, predominantly green priority. The protocol for assessment and classification of risk demonstrated content validity and test of agreement between observers showed excellent reliability. This Master Dissertation is of the Processes in Health Care and Nursing research line.

ASSUNTO(S)

triagem serviços medicos de emergencia enfermagem em emergencia triage emergency medical services emergency nursing

ACESSO AO ARTIGO

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