Elaboração e validação de checklist de cuidados do enfermeiro ao paciente no pós-operatório imediato de cirurgia cardíaca

Abstract

Introduction: Cardiovascular diseases (CVD) represent an expressive number of deaths in Brazil, mainly with the impact of acute coronary syndromes (ACS) and heart failure (HF). There is an arsenal of treatments for CVD, highlighting clinical and surgical treatments. The characteristics of cardiac surgeries such as coronary artery closure, atrial and ventricular septal defect, and reconstructive surgery (myocardial revascularization, aortic valve, mitral or tricuspid valve replacement) and the substitutive ones (valve replacement and transplantation ). To this end, it is assumed that health professionals working in the perioperative period of cardiovascular surgeries need to be up-to-date, trained and qualified in order to provide a qualified and safe patient care. Objectives: Elaborate and validate a checklist for the care of the nurse to the patient in the immediate postoperative period of cardiac surgery. Method: This is a methodological study, with a quantitative approach, that followed two steps: preparation of the instrument (checklist) and validation of the contents of the checklist. The content validation process was performed using the Delphi technique in three rounds. The first round referred to the "Relevance / Presentation" of the items of the instrument that had the participation of 14 experts who composed the bank of judges; the second round corresponded to the "Analysis" of the items of the instrument, with the participation of 12 experts for the judgment regarding the comprehensiveness and clarity of each topic; and in the third round the "Refinement of the Instrument" was carried out with the participation of nine experts. The experts were selected from the Lattes Platform search, being considered as inclusion criterion, being a nurse specialized in intensive care and / or cardiology and / or surgical center; master and / or doctor; with a minimum of 1 year of experience in the postoperative period of cardiovascular surgery. The study was approved by the Research Ethics Committee. Results: In the first round, the instrument was adjusted as to the relevance and presentation of each topic with their respective contents. In the second round we obtained a mean IVC of 92,6% and a universal agreement (UA-IVC) of 93,8%. In the third round, the mean IVC for each criterion was: Objectivity (95,8%), Simplicity (97,9%) Clarity (91,0%), Relevance (93,1%), Variety (96,5%), showed an adequate degree of agreement between the judges in these criteria. Thus, in relation to UA-IVC, it was reached: Objectivity (93,8%), Simplicity (100,0%), Clarity (75,0%), Relevance (87,5%), Variety (93,8%). Conclusion: Checklist for the care of the nurse to the patient in the immediate postoperative period of cardiac surgery was validated with three topics, four categories, sixteen items and eighty-six sub-items of assistance assignments for applicability in clinical practice, aiming to be a guide / referential to receive the patient, in an agile, safe, with a care free of intercurrences and failures.