Alta hospitalaria responsable: validación de contenido de las actividades del enfermero

Zanetoni, Tatiane Cristina; Cucolo, Danielle Fabiana; Perroca, Marcia Galan

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Revista Gaúcha de Enfermagem

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Sumário

Original Article • Rev. Gaúcha Enferm. 43 • 2022 • https://doi.org/10.1590/1983-1447.2022.20210044.en copiar

Alta hospitalaria responsable: validación de contenido de las actividades del enfermero

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Ejecutar y validar un listado de actividades que deben realizar los enfermeros en el alta hospitalaria responsable.

Método:

Estudio de validación de contenido. Los 14 ítems producidos fueron organizados en una escala Likert y sometidos a apreciación de jueces, mediante la Técnica Delphi. Se evaluó relevancia, claridad de los enunciados y orden secuencial de ejecución. El consenso para las respuestas fue preestablecido en 0,80 y calculado el índice de validación de contenido. Resultados: Ocho profesionales participaron en la validación de la lista construida. En Delphi 1, el índice de validación de contenido varió de 0,7 (contacto post-alta y programación de visita domiciliaria) a 1,0 y en Delphi 2, se encontró variación de 0,60 (contacto telefónico post-alta) a 1,0.

Conclusión:

Fueron validadas 13 de las 14 actividades propuestas. El listado de actividades obtenido puede contribuir con el proceso de alta segura, con la continuidad e integralidad del cuidado y, también, con la reducción de reingresos en los hospitales.

Palabras clave:
Alta del paciente; Continuidad de la atención al paciente; Evaluación de procesos, atención de salud; Evaluación en enfermería; Estudio de validación

Activities	M	SD	Md	Q1	Q3
1. Eligibility Criteria	4.0	0.0	4.0	4.0	4.0
2. Medical contact and discharge forecast	3.9	0.3	4.0	4.0	4.0
3. Therapeutic project	3.9	0.3	4.0	4.0	4.0
4. Information collection	4.0	0.0	4.0	4.0	4.0
5. Elaboration of discharge plan	3.6	0.7	4.0	3.5	4.0
6. Patient/family communication	4.0	0.0	4.0	4.0	4.0
7. Professional team coordination	3.7	0.5	4.0	3.5	4.0
8. Documentation and referrals	3.7	0.5	4.0	3.5	4.0
9. Information sharing	3.7	0.5	4.0	3.5	4.0
10. Patient/family guidance	3.9	0.3	4.0	4.0	4.0
11. Teaching of equipment handling	4.0	0.0	4.0	4.0	4.0
12. Post-discharge contact	3.2	0.9	3.5	2.5	4.0
13. Scheduling home visit	3.2	1.2	4.0	2.5	4.0
14. Discharge Plan Effectiveness	3.6	0.7	4.0	3.5	4.0

Activities	pc	I-CVI	K^*
1. Eligibility criteria	0.004	1.00	1.00
2. Medical contact and discharge forecast	0.004	1.00	1.00
3. Therapeutic project	0.004	1.00	1.00
4. Information collection	0.004	1.00	1.00
5. Elaboration of discharge plan	0.031	0.87	0.87
6. Patient/family communication	0.004	1.00	1.00
7. Professional team coordination	0.004	1.00	1.00
8. Documentation and referrals	0.004	1.00	1.00
9. Information sharing	0.004	1.00	1.00
10. Patient/family guidance	0.004	1.00	1.00
11. Teaching of equipment handling	0.004	1.00	1.00
12. Post-discharge contact	0.109	0.75	0.72
13. Scheduling home visit	0.109	0.75	0.72
14. Discharge Plan Effectiveness	0.031	0.87	0.87

Activities	M	SD	Md	Q1	Q3
1. Eligibility criteria	3.8	0.4	4.0	4.0	4.0
2. Medical contact and discharge forecast	4.0	0.0	4.0	4.0	4.0
3. Therapeutic project	4.0	0.0	4.0	4.0	4.0
4. Information collection	3.6	0.5	4.0	3.0	4.0
5. Patient/family communication	4.0	0.0	4.0	4.0	4.0
6. Elaboration of discharge plan	3.8	0.4	4.0	4.0	4.0
7. Professional team coordination	4.0	0.0	4.0	4.0	4.0
8. Documentation and referrals	3.8	0.4	4.0	4.0	4.0
9. Information sharing	3.6	0.5	4.0	3.0	4.0
10. Patient/family guidance	4.0	0.0	4.0	4.0	4.0
11. Teaching of equipment handling	3.8	0.4	4.0	4.0	4.0
12. Telephone contact after discharge (up to 7 days)	2.8	0.8	3.0	2.0	3.0
13. Scheduling home visit ^*	4.0	0.0	4.0	4.0	4.0
14. Identification/solving post-discharge problems	3.8	0.4	4.0	4.0	4.0

Activities	pc	I-CVI	K^*
1. Eligibility criteria	0.031	1.00	1.00
2. Medical contact and discharge forecast	0.031	1.00	1.00
3. Therapeutic project	0.031	1.00	1.00
4. Information collection	0.031	1.00	1.00
5. Patient/family communication	0.031	1.00	1.00
6. Elaboration of discharge plan	0.031	1.00	1.00
7. Professional team coordination	0.031	1.00	1.00
8. Documentation and referrals	0.031	1.00	1.00
9. Information sharing	0.031	1.00	1.00
10. Patient/family guidance	0.031	1.00	1.00
11. Teaching of equipment handling	0.031	1.00	1.00
12. Telephone contact after discharge (up to 7 days)	0.313	0.60	0.42
13. Scheduling home visit ^*	0.031	1.00	1.00
14. Identification/solving post-discharge problems	0.031	1.00	1.00

ACTIVITIES
1	To identify eligibility criteria for responsible discharge of the patient through active bedside search.
2	To discuss with the physician the hospital discharge forecast.
3	To establish the therapeutic project and the discharge plan with the multidisciplinary team.
4	To collect information from the patient (main caregiver, health care network in the municipality, clinical conditions, family composition, and necessary care at home, among others), facilitating and restricting factors for continuing care at home.
5	To communicate and involve the patient and/or family member/caregiver in the discharge plan.
6	To elaborate the discharge plan and its documentation in medical records or electronically.
7	To align the communication process and coordinate actions between the multidisciplinary team.
8	To document the necessary referrals, reference and counter-reference guide, home oxygen process and others for the social worker.
9	To share information with the city of origin related to clinical conditions, care, family nucleus, among other information relevant to the process.
10	To guide the patient and family/caregiver about the necessary care and measures after hospital discharge, verbally and/or in writing.
11	To teach the patient and family member/caregiver how to handle equipment and/or special materials for the necessary care at home, reviewing and certifying their understanding.
12	To schedule and conduct home visits for patients with greater demand for care needs (use of equipment/devices or care with greater technical complexity).
13	To identify problems after hospital discharge, by telephone or on a home visit, and establish a care plan to resolve them, involving the primary care unit of reference, when necessary.

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
E-mail: revista@enf.ufrgs.br

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[1] Corresponding author:
Marcia Galan Perroca E-mail: marcia.perroca@gmail.com