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ORIGINAL ARTICLE
Interobserver agreement in Reception and Risk Stratification in Obstetrics implementation
- Manuela Beatriz Velho
, - Luciana Santos Pimentel ,
- Fernanda Amâncio Soares da Silva ,
- Alberto Trapani Junior ,
- Thayná Ventura , [ ... ],
- Roxana Knobel
12-13-2024
Resumo
ORIGINAL ARTICLEInterobserver agreement in Reception and Risk Stratification in Obstetrics implementation
Revista Brasileira de Enfermagem. 2024;77(5):e20230361
12-13-2024DOI 10.1590/0034-7167-2023-0361
- Manuela Beatriz Velho ,
- Luciana Santos Pimentel ,
- Fernanda Amâncio Soares da Silva ,
- Alberto Trapani Junior ,
- Thayná Ventura ,
- Adaiana Fátima Almeida ,
- Roberta Costa ,
- Roxana Knobel
Visualizações0Ver maisABSTRACT
Objectives:
to analyze interobserver agreement in the Reception and Risk Stratification in Obstetrics protocol implementation.
Methods:
a cross-sectional study carried out during Reception and Risk Stratification in Obstetrics implementation, conducted in a tertiary hospital in southern Brazil with 891 participants in January 2020. Descriptive and interobserver agreement analysis was carried out using the Kappa coefficient in the risk stratification assigned by the triage nurse and reviewed by the researcher.
Results:
around half of the calls (55.6%) were stratified as not very urgent (green), followed by urgent (yellow) (31.8%), very urgent (orange) (9.3%), not urgent (blue) (3.4%) and no emerging stratification (red). Agreement analysis of revised stratification found Kappa values of 0.20 (blue), 0.54 (green), 0.77 (yellow) and 0.80 (orange).
Conclusions:
most appointments were non-urgent. The agreement analysis between the revised and assigned risk stratification revealed greater interobserver agreement as the priority level increased.
Visualizações0
Resumo
ORIGINAL ARTICLEInterobserver agreement in Reception and Risk Stratification in Obstetrics implementation
Revista Brasileira de Enfermagem. 2024;77(5):e20230361
12-13-2024DOI 10.1590/0034-7167-2023-0361
- Manuela Beatriz Velho ,
- Luciana Santos Pimentel ,
- Fernanda Amâncio Soares da Silva ,
- Alberto Trapani Junior ,
- Thayná Ventura ,
- Adaiana Fátima Almeida ,
- Roberta Costa ,
- Roxana Knobel
Visualizações0Ver maisABSTRACT
Objectives:
to analyze interobserver agreement in the Reception and Risk Stratification in Obstetrics protocol implementation.
Methods:
a cross-sectional study carried out during Reception and Risk Stratification in Obstetrics implementation, conducted in a tertiary hospital in southern Brazil with 891 participants in January 2020. Descriptive and interobserver agreement analysis was carried out using the Kappa coefficient in the risk stratification assigned by the triage nurse and reviewed by the researcher.
Results:
around half of the calls (55.6%) were stratified as not very urgent (green), followed by urgent (yellow) (31.8%), very urgent (orange) (9.3%), not urgent (blue) (3.4%) and no emerging stratification (red). Agreement analysis of revised stratification found Kappa values of 0.20 (blue), 0.54 (green), 0.77 (yellow) and 0.80 (orange).
Conclusions:
most appointments were non-urgent. The agreement analysis between the revised and assigned risk stratification revealed greater interobserver agreement as the priority level increased.
- Manuela Beatriz Velho
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ORIGINAL ARTICLE
Risk assessment for postoperative complications in patients undergoing cardiac surgical procedures
- Carolina Larrosa de Almeida ,
- Jones Sidnei Barbosa de Oliveira ,
- Cláudia Geovana da Silva Pires ,
- Cláudia Silva Marinho
09-20-2024
Resumo
ORIGINAL ARTICLERisk assessment for postoperative complications in patients undergoing cardiac surgical procedures
Revista Brasileira de Enfermagem. 2024;77(4):e20230127
09-20-2024DOI 10.1590/0034-7167-2023-0127
- Carolina Larrosa de Almeida ,
- Jones Sidnei Barbosa de Oliveira ,
- Cláudia Geovana da Silva Pires ,
- Cláudia Silva Marinho
Visualizações0ABSTRACT
Objectives:
to evaluate the risk of postoperative complications in cardiac patients.
Methods:
an evaluative study using the Tuman Score on medical records of 70 adult patients who underwent cardiac surgery at a University Hospital. The R for Windows software was used for the analyses. Descriptive statistics and bivariate analysis were employed to verify the association between the risk score and complications. The relative risk between the Tuman Score and postoperative complications was obtained through Quasi-Poisson regression, with a 95% confidence interval.
Results:
the majority of the patients were male (58.57%), aged between 41-64 years (50%), who underwent myocardial revascularization (50%). These patients were associated with a lower risk of postoperative complications (p=0.003), (p=0.008), and (p=0.000), respectively. High-risk patients had pulmonary complications (RR=1.32, p=0.002) and neurological complications (RR=1.20, p=0.047).
Conclusions:
preoperative risk assessment promotes qualified care to reduce postoperative complications.
Palavras-chave: Cardiac Surgical ProceduresCardiovascular DiseasesCardiovascular NursingPostoperative ComplicationsRisk AssessmentVer maisVisualizações0Resumo
ORIGINAL ARTICLERisk assessment for postoperative complications in patients undergoing cardiac surgical procedures
Revista Brasileira de Enfermagem. 2024;77(4):e20230127
09-20-2024DOI 10.1590/0034-7167-2023-0127
- Carolina Larrosa de Almeida ,
- Jones Sidnei Barbosa de Oliveira ,
- Cláudia Geovana da Silva Pires ,
- Cláudia Silva Marinho
Visualizações0ABSTRACT
Objectives:
to evaluate the risk of postoperative complications in cardiac patients.
Methods:
an evaluative study using the Tuman Score on medical records of 70 adult patients who underwent cardiac surgery at a University Hospital. The R for Windows software was used for the analyses. Descriptive statistics and bivariate analysis were employed to verify the association between the risk score and complications. The relative risk between the Tuman Score and postoperative complications was obtained through Quasi-Poisson regression, with a 95% confidence interval.
Results:
the majority of the patients were male (58.57%), aged between 41-64 years (50%), who underwent myocardial revascularization (50%). These patients were associated with a lower risk of postoperative complications (p=0.003), (p=0.008), and (p=0.000), respectively. High-risk patients had pulmonary complications (RR=1.32, p=0.002) and neurological complications (RR=1.20, p=0.047).
Conclusions:
preoperative risk assessment promotes qualified care to reduce postoperative complications.
Palavras-chave: Cardiac Surgical ProceduresCardiovascular DiseasesCardiovascular NursingPostoperative ComplicationsRisk AssessmentVer mais - Carolina Larrosa de Almeida
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ORIGINAL ARTICLE
Breast cancer screening program for risk groups: facts and perspectives
Revista Brasileira de Enfermagem. 2022;75(3):e20210050
10-18-2022
Resumo
ORIGINAL ARTICLEBreast cancer screening program for risk groups: facts and perspectives
Revista Brasileira de Enfermagem. 2022;75(3):e20210050
10-18-2022DOI 10.1590/0034-7167-2021-0050
Visualizações0ABSTRACT
Objectives:
to measure the frequency and compliance of breast cancer screening, according to the risk for this disease.
Methods:
a cross-sectional study with 950 female users of 38 public Primary Health Care services in São Paulo, between October and December 2013. According to UHS criteria, participants were grouped into high risk and standard risk, and frequency, association (p≤0.05), and screening compliance were measured.
Results:
6.7% had high risk and 93.3% standard risk, respectively; in these groups, the frequency and compliance of clinical breast examination were 40.3% and 37.1%, and 43.5% and 43.0% (frequency p=0.631, compliance p=0.290). Mammograms were 67.7% and 35.5% for participants at high risk, and 57.4% and 25.4% for those at standard risk (frequency p=0.090, compliance p=0.000).
Conclusions:
in the groups, attendance and conformity of the clinical breast exam were similar; for mammography, it was higher in those at high risk, with assertiveness lower than the 70% set in UHS.
Palavras-chave: Breast NeoplasmsMass ScreeningPrimary PreventionProcess and Outcome Evaluation in Health CareRisk AssessmentVer maisVisualizações0Resumo
ORIGINAL ARTICLEBreast cancer screening program for risk groups: facts and perspectives
Revista Brasileira de Enfermagem. 2022;75(3):e20210050
10-18-2022DOI 10.1590/0034-7167-2021-0050
Visualizações0ABSTRACT
Objectives:
to measure the frequency and compliance of breast cancer screening, according to the risk for this disease.
Methods:
a cross-sectional study with 950 female users of 38 public Primary Health Care services in São Paulo, between October and December 2013. According to UHS criteria, participants were grouped into high risk and standard risk, and frequency, association (p≤0.05), and screening compliance were measured.
Results:
6.7% had high risk and 93.3% standard risk, respectively; in these groups, the frequency and compliance of clinical breast examination were 40.3% and 37.1%, and 43.5% and 43.0% (frequency p=0.631, compliance p=0.290). Mammograms were 67.7% and 35.5% for participants at high risk, and 57.4% and 25.4% for those at standard risk (frequency p=0.090, compliance p=0.000).
Conclusions:
in the groups, attendance and conformity of the clinical breast exam were similar; for mammography, it was higher in those at high risk, with assertiveness lower than the 70% set in UHS.
Palavras-chave: Breast NeoplasmsMass ScreeningPrimary PreventionProcess and Outcome Evaluation in Health CareRisk AssessmentVer mais -
ORIGINAL ARTICLE
Risk classification in a pediatric service: evaluation of the structure, process, and outcome
- Karynne Borges Cabral ,
- Cristiane Chagas Teixeira ,
- Julianna Malagoni Cavalcante Oliveira ,
- Jacqueline Andreia Bernardes Leão Cordeiro ,
- Keila Cristianne Trindade da Cruz , [ ... ],
- Lizete Malagoni de Almeida Cavalcante Oliveira
09-24-2022
Resumo
ORIGINAL ARTICLERisk classification in a pediatric service: evaluation of the structure, process, and outcome
Revista Brasileira de Enfermagem. 2022;75(1):e20210022
09-24-2022DOI 10.1590/0034-7167-2021-0022
- Karynne Borges Cabral ,
- Cristiane Chagas Teixeira ,
- Julianna Malagoni Cavalcante Oliveira ,
- Jacqueline Andreia Bernardes Leão Cordeiro ,
- Keila Cristianne Trindade da Cruz ,
- Leidiene Ferreira Santos ,
- Virginia Visconde Brasil ,
- Lizete Malagoni de Almeida Cavalcante Oliveira
Visualizações0ABSTRACT
Objectives:
to evaluate a pediatric risk evaluation and classification service in the aspects of structure, process, and outcome.
Methods:
a cross-sectional, descriptive, and exploratory study in which qualitative data complement the results. Data collection by non-participant observation, interview, and consultation of medical records.
Results:
we observed two hundred and four visits. The service works in a makeshift room and without privacy. The nurses did not use various materials/equipment available for evaluation, rarely performed a physical examination, used the interview most of the time, and did not consult the protocol. Parents/companions received no information, and medical records showed incomplete records. Nurses classified 69.1% of the children as non-emergency. The most frequent outcome of the visits was discharge.
Conclusions:
the service showed weaknesses in the physical structure, in the risk classification process, and the outcomes, but it presents a good resolution in the assistance. We recommend a revision in the protocol used and sensitize nurses about the work process and communication with parents/companions.
Palavras-chave: Emergency Medical ServicesNursingPediatric Emergency MedicinePediatricsRisk AssessmentVer maisVisualizações0Resumo
ORIGINAL ARTICLERisk classification in a pediatric service: evaluation of the structure, process, and outcome
Revista Brasileira de Enfermagem. 2022;75(1):e20210022
09-24-2022DOI 10.1590/0034-7167-2021-0022
- Karynne Borges Cabral ,
- Cristiane Chagas Teixeira ,
- Julianna Malagoni Cavalcante Oliveira ,
- Jacqueline Andreia Bernardes Leão Cordeiro ,
- Keila Cristianne Trindade da Cruz ,
- Leidiene Ferreira Santos ,
- Virginia Visconde Brasil ,
- Lizete Malagoni de Almeida Cavalcante Oliveira
Visualizações0ABSTRACT
Objectives:
to evaluate a pediatric risk evaluation and classification service in the aspects of structure, process, and outcome.
Methods:
a cross-sectional, descriptive, and exploratory study in which qualitative data complement the results. Data collection by non-participant observation, interview, and consultation of medical records.
Results:
we observed two hundred and four visits. The service works in a makeshift room and without privacy. The nurses did not use various materials/equipment available for evaluation, rarely performed a physical examination, used the interview most of the time, and did not consult the protocol. Parents/companions received no information, and medical records showed incomplete records. Nurses classified 69.1% of the children as non-emergency. The most frequent outcome of the visits was discharge.
Conclusions:
the service showed weaknesses in the physical structure, in the risk classification process, and the outcomes, but it presents a good resolution in the assistance. We recommend a revision in the protocol used and sensitize nurses about the work process and communication with parents/companions.
Palavras-chave: Emergency Medical ServicesNursingPediatric Emergency MedicinePediatricsRisk AssessmentVer mais - Karynne Borges Cabral
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ORIGINAL ARTICLE
Classification of clinical risk in people with AIDS followed up in specialized care
Revista Brasileira de Enfermagem. 2019;72(5):1235-1242
09-16-2019
Resumo
ORIGINAL ARTICLEClassification of clinical risk in people with AIDS followed up in specialized care
Revista Brasileira de Enfermagem. 2019;72(5):1235-1242
09-16-2019DOI 10.1590/0034-7167-2017-0559
Visualizações0Ver maisABSTRACT
Aim:
To develop a clinical risk stratification score for people living with AIDS and to analyze its association with clinical and sociodemographic aspects.
Method:
Cross-sectional study involving 150 adults with AIDS, in outpatient follow-up. A structured instrument was applied and, sequentially, inferential statistical techniques on the developed score.
Results:
45.3% of the participants were classified as in high clinical risk. TL-CD4+ <500cel/mm3 count, detectable viral load, presence of opportunistic diseases, chronic diseases and clinical manifestations were associated with high clinical risk. There was a significant difference in the mean risk between the categories of variables employment status (p = 0.003) and economic class (p = 0.035). There was a higher risk for brown people (OR = 5.55), unemployed status (OR = 16,51) and belonging to classes C (OR = 20.07) and D (OR = 53,32), and a lower risk for individuals with higher schooling (OR = 0.02).
Conclusion:
The proposed score quantifies clinical situations and points out sociodemographic aspects that predispose to instability and aggravation of AIDS, supporting the qualification of care.
Visualizações0Resumo
ORIGINAL ARTICLEClassification of clinical risk in people with AIDS followed up in specialized care
Revista Brasileira de Enfermagem. 2019;72(5):1235-1242
09-16-2019DOI 10.1590/0034-7167-2017-0559
Visualizações0Ver maisABSTRACT
Aim:
To develop a clinical risk stratification score for people living with AIDS and to analyze its association with clinical and sociodemographic aspects.
Method:
Cross-sectional study involving 150 adults with AIDS, in outpatient follow-up. A structured instrument was applied and, sequentially, inferential statistical techniques on the developed score.
Results:
45.3% of the participants were classified as in high clinical risk. TL-CD4+ <500cel/mm3 count, detectable viral load, presence of opportunistic diseases, chronic diseases and clinical manifestations were associated with high clinical risk. There was a significant difference in the mean risk between the categories of variables employment status (p = 0.003) and economic class (p = 0.035). There was a higher risk for brown people (OR = 5.55), unemployed status (OR = 16,51) and belonging to classes C (OR = 20.07) and D (OR = 53,32), and a lower risk for individuals with higher schooling (OR = 0.02).
Conclusion:
The proposed score quantifies clinical situations and points out sociodemographic aspects that predispose to instability and aggravation of AIDS, supporting the qualification of care.
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PESQUISA
Pressure ulcers in critically ill patients: incidence and associated factors
Revista Brasileira de Enfermagem. 2016;69(3):460-467
01-01-2016
Resumo
PESQUISAPressure ulcers in critically ill patients: incidence and associated factors
Revista Brasileira de Enfermagem. 2016;69(3):460-467
01-01-2016DOI 10.1590/0034-7167.2016690307i
Visualizações0Ver maisABSTRACT
Objective:
to identify the incidence and describe the associated factors for pressure ulcers in critically ill patients.
Method:
this was a prospective cohort study with 77 patients, using a clinical, metabolic assessment and the associated factors for pressure ulcer, applying the risk scales (Braden and Waterlow) and assigning ulcers to categories.
Results:
an incidence of 22% (95% CI 12.6 - 31.5), with 17 patients with 32 pressure ulcers in the sacral region (47%), and of Class I (72%). The length of stay was greater than ten days (71%), most admissions were surgical (53%) or for congestive heart failure (24%), and were high risk on the Braden Scale (59%).
Conclusion:
the study highlights the high incidence of pressure ulcers, clinical and metabolic characteristics and associated factors, as well as the outcome of death, requiring, therefore, preventive measures.
Visualizações0Resumo
PESQUISAPressure ulcers in critically ill patients: incidence and associated factors
Revista Brasileira de Enfermagem. 2016;69(3):460-467
01-01-2016DOI 10.1590/0034-7167.2016690307i
Visualizações0Ver maisABSTRACT
Objective:
to identify the incidence and describe the associated factors for pressure ulcers in critically ill patients.
Method:
this was a prospective cohort study with 77 patients, using a clinical, metabolic assessment and the associated factors for pressure ulcer, applying the risk scales (Braden and Waterlow) and assigning ulcers to categories.
Results:
an incidence of 22% (95% CI 12.6 - 31.5), with 17 patients with 32 pressure ulcers in the sacral region (47%), and of Class I (72%). The length of stay was greater than ten days (71%), most admissions were surgical (53%) or for congestive heart failure (24%), and were high risk on the Braden Scale (59%).
Conclusion:
the study highlights the high incidence of pressure ulcers, clinical and metabolic characteristics and associated factors, as well as the outcome of death, requiring, therefore, preventive measures.
Risk Assessment Archives - Revista Brasileira de Enfermagem
