Instrument for assessing the quality of initial care for critical patients in the emergency

Abstract

OBJECTIVE: to develop a tool for evaluating care for critically ill patients suffering from severe trauma at the entrance to the emergency room, using specific indicators related to the trauma, the patients clinical condition and the organization and response time of the procedures carried out by the professionals involved in the care.
METHOD: methodological research carried out in three stages: 1) theoretical procedure - formulation of instrument items; 2) experimental procedure - a working group was organized to analyze the items from the initial instrument prepared in the first stage; and 3) analytical procedure - testing the instrument by emergency nurses, on patients suffering from severe trauma.
RESULTS: the items of the initial instrument were created from a literature review, which was analyzed and approved by the evaluating group. Around 75% of the nursing workforce responded to the questionnaire. In the analysis of the responses, three of the items (questions 1, 16 and 17) obtained an agreement rate of less than 80%, which led to changes in the instrument, totaling 29 items. Suggestions were made by the participants and, after a new evaluation by the working group, relevant modifications were made, without changing the number of variables.
CONCLUSION: the instrument developed has specific items for evaluating the patients clinical condition upon arrival and at the end of the patients stabilization period in the emergency room, as well as response time indicators in the procedures performed by the professionals involved in the care, being validates for use on service.

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