ELABORACIÓN Y VALIDEZ DE CONTENIDO DEL INSTRUMENTO 5R-MEDSAFE: EVALUACIÓN DE LA ADHESIÓN A LOS “CINCO CORRECTOS” DE LA ADMINISTRACIÓN SEGURA DE MEDICAMENTOS

Andolhe, Rafaela; Padilha, Adriel; Guirardello, Edineis de Brito; Gallani, Maria Cecília Bueno Jayme; Rodrigues, Roberta Cunha Matheus

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Special Section • Texto contexto - enferm. 33 • 2024 • https://doi.org/10.1590/1980-265X-TCE-2023-0171en copiar

ELABORACIÓN Y VALIDEZ DE CONTENIDO DEL INSTRUMENTO 5R-MEDSAFE: EVALUACIÓN DE LA ADHESIÓN A LOS “CINCO CORRECTOS” DE LA ADMINISTRACIÓN SEGURA DE MEDICAMENTOS

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

presentar las etapas de creación y validez de contenido correspondientes a un cuestionario para evaluar los determinantes del nivel de adhesión a los “Cinco correctos” de la administración segura de medicamentos - “5R-MEDSAFE”, sobre la base del modelo integrador de la Teoría del Comportamiento Planificado.

Método:

estudio metodológico para crear y validar un instrumento de medición autoinformado de variables psicosociales. Se desarrolló en dos hospitales-escuela universitarios y públicos: uno situado en la región Sur y el otro en la región Sudeste de Brasil.

Resultados:

los resultados se organizaron conforme a cada etapa de la validación de contenido de 5R-MEDSAFE.

Conclusión:

los resultados obtenidos en este estudio de creación y validación del contenido del instrumento 5R-MEDSAFE indicaron que la herramienta presentó diversa evidencia de validez de contenido. Su aplicación puede resultar útil en diferentes contextos como una forma de evaluar el nivel de adhesión a estas conductas entre trabajadores de Enfermería. Eso permitirá identificar los elementos de los comportamiento que son pasibles de intervención, al igual que implementar la intervención más adecuada, conforme a los constructos de la Teoría del Comportamiento Planificado.

DESCRIPTORES:
Seguridad del paciente; Administración de medicamentos; Comportamiento; Creencias de Enfermería

Items	^* P	E1	E2	E3	E4	E5	CVI-I	CVI-Total	Consensus version
1. Intention
1.1 I intend to adhere to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks.	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
1.2 I plan to adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
1.3 I intend to adhere to safe drug administration behaviors...	^†C	4	4	4	3	4	1.0	-	Unchanged
	^‡R	4	4	4	3	4	1.0	-	Unchanged
1.4 I want to adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0		Unchanged
1.5 I will strive to adhere to safe drug administration behaviors	^†C	4	4	4	4	3	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
1.6 The probability of me adhering to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks is...	^†C	4	4	4	4	3	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
Items - Intention	^§S	4	4	4	4	4	1.0	1.0
2. Attitude
For me, adhering to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks is: 2.1 Very bad; bad; no opinion or neutral; good; very good	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
2.2 Very unnecessary; unnecessary; no opinion or neutral; necessary; very necessary	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
2.3 Very useless; useless; no opinion or neutral; useful; very useful	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
2.4 Very relevant; relevant; no opinion or neutral; irrelevant; very irrelevant	^†C	4	4	4	4	2	0.8	-	Very irrelevant; irrelevant; no opinion or neutral; relevant; very relevant
	^‡R	4	4	4	4	4	1.0
2.5 Very disadvantageous; disadvantageous; no opinion or neutral; advantageous; very advantageous	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
2.6 Very difficult; difficult; no opinion or neutral; easy; very easy	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	3	4	1.0	-	Unchanged
2.7 Very time-consuming; time-consuming; no opinion or neutral; fast; very fast.	^†C	4	4	4	2	4	0.8	-	Unchanged
	^‡R	4	4	4	2	4	0.8	-	Unchanged
2.8 Very repetitive; repetitive; no opinion or neutral; not very repetitive; not repetitive at all	^†C	4	4	4	3	4	1.0	-	Unchanged
	^‡R	4	4	3	3	4	1.0	-	Unchanged
Items - Attitude	^§S	4	3	4	4	4	1.0	1.0
3. Perceived Norm
3.1 People whose opinions are important to me would approve of me adhering to safe drug administration behaviors... (doing all 5 “rights”) over the next two weeks.	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
3.2 People whose opinions are important to me want me to adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
3.3 Most of my coworkers who are important to me will adhere to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks.	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
3.4 Among the coworkers I know: ( ) None of them ( ) Less than half ( ) Half ( ) More than half ( ) All of them ...adhere(s) to safe drug administration behaviors...	^†C	4	4	4	4	3	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
3.5 As a Nursing worker, I am expected to adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
Items - Perceived Norm	^§S	4	3	4	4	4	1.0	1.0	Unchanged
4. Perceived Behavior Control
4.1 It is only up to me to adhere to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks.	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
4.2 It is within my control to adhere to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks.	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
4.3 I am sure that I can adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
4.4 I am confident about my ability to adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
4.5 I am able to adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
4.6 It is only up to me to adhere to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks.	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
4.7 It is within my control to adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
4.8 I am sure that I can adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
4.9 I am confident about my ability to adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
Items - Perceived Behavior Control	^§S	4	4	4	4	4	1.0	1.0

Items	^* P	E1	E2	E3	E4	E5	CVI-Item	CVI-Total	Consensus version
5 Behavioral Beliefs
Adhering to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks: 5.1 would prevent me from making mistakes when administering medications.	^†C	4	4	4	4	4	1.0	-	...would help me avoid making mistakes when administering medications.
	^‡R	4	4	4	4	4	1.0	-
5.2 would contribute to patient safety.	^†C	4	4	4	4	4	1.0	-	...would contribute to patient safety.
5.2 would contribute to patient safety.	^‡R	4	4	4	4	4	1.0	-	...would contribute to patient safety.
5.3 would enable me to act in accordance with Nursing professionals' ethics	^†C	4	4	4	4	4	1.0	-	...would increase the time I need to administer medications.
	^‡R	4	4	4	4	4	1.0	-
5.4 would increase the time I need to administer medications.	^†C	4	4	4	4	4	1.0	-	Excluded
	^‡R	4	4	4	4	4	1.0	-	Excluded
5.5 would give me a sense of accomplishment.	^†C	4	4	4	4	3	1.0	-	...would give me a sense of accomplishment.
5.5 would give me a sense of accomplishment.	^‡R	4	4	4	4	4	1.0	-	...would give me a sense of accomplishment.
Items - Behavioral Beliefs	^§S	4	4	3	4	4	1.0	1.0
6 Control Beliefs
6.1 Having knowledge would make it easier for me to adhere to safe drug administration behaviors...	^†C	4	4	4	4	3	1.0	-	Over the next two weeks, the following factors would ease my adherence to safe drug administration behaviors (doing all 5 “rights”): My knowledge level
	^‡R	4	4	4	4	4	1.0	-
6.2 Attending regular training sessions would make it easier for me to adhere to safe drug administration behaviors.	^†C	4	4	4	4	4	1.0	-	My participation in previous periodic training sessions
	^‡R	4	4	4	4	4	1.0	-	My participation in previous periodic training sessions
6.3 Having professional experience would make it easier for me to adhere to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks.	^†C	4	4	4	4	3	1.0	-	My level of professional experience
	^‡R	4	4	4	4	4	1.0	-	My level of professional experience
6.4 Supporting the safety culture in the workplace would make it easier for me to adhere to safe drug administration behaviors...	^†C	4	2	2	4	3	0.6	-	The institution's support for the safety culture in my work environment
	^‡R	4	4	4	4	4	1.0	-
6.5 Insufficient Nursing staffing would hinder my adherence to safe drug administration behaviors...	^†C	4	4	4	4	3	1.0	-	Appropriate Nursing staffing in my work environment
	^‡R	4	4	4	4	4	1.0	-	Appropriate Nursing staffing in my work environment
6.6 Resistance to changes in the work routine would hinder my adherence to safe drug administration behaviors...	^†C	2	2	4	4	2	0.4	-	Being open to changes in the work routine
	^‡R	4	3	4	4	3	1.0	-	Being open to changes in the work routine
6.7 Noise in the medication preparation room would hinder my adherence to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks.	^†C	4	4	4	4	2	0.8	-	Over the next two weeks, the following factors would hinder my adherence to safe drug administration behaviors (doing all 5 “rights”): Noise in the medication preparation environment
	^‡R	4	4	4	4	3	1.0	-
6.8 Absence of an exclusive place for preparing medications would hinder my adherence to safe drug administration behaviors...	^†C	4	4	4	4	2	0.8	-	Absence of an exclusive area for preparing medications.
	^‡R	4	4	4	4	3	1.0	-	Absence of an exclusive area for preparing medications.
6.9 Work overload would hinder my adherence to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Work overload
	^‡R	4	4	4	4	4	1.0	-	Work overload
6.10 Performing too many activities at the same time would hinder my adherence to adhere to safe drug administration behaviors...	^†C	4	3	4	4	3	1.0	-	Performing several activities at the same time
	^‡R	4	3	4	4	4	1	-	Performing several activities at the same time
Items - Control Beliefs	^§S	4	3	4	4	4	1	1.0
7 Normative Beliefs
7.1 Most of the patients think that I should adhere to safe drug administration behaviors...	^†C	4	3	4	4	4	1.0	-	Unchanged
	^‡R	4	3	4	4	4	1.0	-	Unchanged
7.2 Most of the patients' relatives would expect me to adhere to safe drug administration behaviors...	^†C	4	3	4	4	4	1.0	-	Unchanged
	^‡R	4	3	4	4	4	1.0	-	Unchanged
7.3 My immediate manager and/or supervisors would expect me to adhere to safe drug administration behaviors...	^†C	4	3	4	4	4	1.0	-	Unchanged
	^‡R	4	3	4	4	4	1.0	-	Unchanged
7.4 All Nursing professionals think that I should adhere to safe drug administration behaviors...	^†C	4	3	4	4	4	1.0	-	Unchanged
	^‡R	4	3	4	4	4	1.0	-	Unchanged
7.5 Adhering to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks would mean doing the right thing.	^†C	4	4	4	4	3	1.0	-	Excluded
	^‡R	2	4	4	4	4	0.8	-	Excluded
7.6 Adhering to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks would mean acting in accordance with professional ethics.	^†C	4	4	4	4	4	1.0	-	Adhering to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks: 8.1...would mean acting in accordance with professional ethics
	^‡R	2	4	4	4	3	0.8	-
7.7 Adhering to the safe drug administration behaviors (doing all 5 “rights”) over the next two weeks is Nursing professionals' duty.	^†C	4	4	4	4	4	1.0	-	8.2 ...is Nursing professionals' duty.
	^‡R	2	4	4	4	3	0.8	-	8.2 ...is Nursing professionals' duty.
7.8 Adhering to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks is Nursing professionals' responsibility.	^†C	4	4	4	4	4	1.0	-	8.3 ...is Nursing professionals' responsibility.
	^‡R	4	4	4	2	3	0.8	-	8.3 ...is Nursing professionals' responsibility.
Items - Normative Beliefs	^§S	4	3	4	2	4	0.8	1.0

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] CORRESPONDING AUTHOR
Rafaela Andolhe rafaela.andolhe@ufsm.br