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Instrument for classifying dependency in neonatal intensive care: analysis of agreement and reliability* * Paper extracted from master’s thesis “Validação do instrumento para classificação de recém-nascido de acordo com o grau de dependência dos cuidados de enfermagem em unidade de terapia intensiva neonatal”, presented to Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, PR, Brazil. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) - Finance Code 001, Brazil.

Abstract

Objective:

to analyze the reliability of the items that compose the instrument for classifying newborns according to the degree of dependence on nursing care in a neonatal intensive care unit.

Method:

methodological study that analyzed the agreement and reliability of the instrument in a neonatal intensive care unit. Six care nurses and a research nurse assessed 35 newborns and completed the instrument, which was made up of 15 areas of care. The weighted Kappa coefficient and the Intraclass Correlation Coefficient were used for analysis.

Results:

the areas of: weight (92%), oxygenation (93%) and catheter control (95%) had almost perfect agreement and the area of reaction to stimuli (50%) had poor agreement. The areas of elimination and vital signs showed low reliability, due to the low variability of responses. The Intraclass Correlation Coefficient was 0.94.

Conclusion:

there are variations in the evaluations of some areas of care due to the imprecise description of items to which scores are assigned, however the instrument is reliable for categorizing the type of care (minimal, intermediate and intensive). Its use can contribute to measuring the quality and safety of newborn care.

Descriptors:
Health Assessment; Neonatal Nursing; Validation Studies; Neonatal Intensive Care Units; Nursing Care; Patient Care Planning

Highlights:

(1) The instrument is reliable for categorizing the type of newborn care.

(2) The use of a manual can minimize the subjectivity of the instrument.

(3) There is almost perfect agreement in less subjective areas of the instrument.


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