Validation of manual to complement the transition of care at discharge from intensive care

Zucchetti, Martina; Severo, Isis Marques; Echer, Isabel Cristina; Borba, Daniela dos Santos Marona; Nectoux, Carmen Lucia Silva; Azzolin, Karina de Oliveira

doi:10.1590/1983-1447.2022.20220142.en

Martina Zucchetti

Hospital Nossa Senhora da Conceição (HNSC). Porto Alegre, Rio Grande do Sul, Brasil.

https://orcid.org/0000-0001-8412-1886

Isis Marques Severo

Hospital de Clínicas de Porto Alegre (HCPA). Porto Alegre, Rio Grande do Sul, Brasil.

https://orcid.org/0000-0002-9288-0708

Isabel Cristina Echer

Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil.

https://orcid.org/0000-0001-5425-205X

Daniela dos Santos Marona Borba

Hospital de Clínicas de Porto Alegre (HCPA). Porto Alegre, Rio Grande do Sul, Brasil.

https://orcid.org/0000-0002-0559-1466

Carmen Lucia Silva Nectoux

Hospital de Clínicas de Porto Alegre (HCPA). Porto Alegre, Rio Grande do Sul, Brasil.

https://orcid.org/0000-0003-0119-1737

Karina de Oliveira Azzolin

Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil.

https://orcid.org/0000-0002-2363-2858

Corresponding author
Isis Marques Severo E-mail: isismsevero@gmail.com

Associate editor

Graziella Badin Aliti

Editor-in-chief

João Lucas Campos de Oliveira

Authorship contribution

Project administration: Isis Marques Severo, Karina de OliveiraAzzolin. Formal analysis: Martina Zucchetti, Isis Marques Severo, Isabel Cristina Echer, Carmen Lucia Silva Nectoux, Karina de Oliveira Azzolin. Funding acquisition: Isabel Cristina Echer, Karina de Oliveira Azzolin. Conceptualization: Martina Zucchetti, Isis Marques Severo, Isabel Cristina Echer, Daniela dos Santos Marona Borba, Karina de Oliveira Azzolin. Data curation: Martina Zucchetti, Isis Marques Severo, Isabel Cristina Echer, Karina de Oliveira Azzolin. Writing-original draft: Martina Zucchetti, Isis Marques Severo, Isabel Cristina Echer, Daniela dos Santos Marona Borba, Carmen Lucia Silva Nectoux, Karina de Oliveira Azzolin. Writing-review & editing: Isis Marques Severo, Isabel Cristina Echer, Daniela dos Santos Marona Borba, Karina de Oliveira Azzolin. Investigation: Martina Zucchetti, Isis Marques Severo, Karina de Oliveira Azzolin. Methodology: Martina Zucchetti, Isis Marques Severo, Isabel Cristina Echer, Daniela dos Santos Marona Borba, Carmen Lucia Silva Nectoux, Karina de Oliveira Azzolin. Resources: Isis Marques Severo, Isabel Cristina Echer, Daniela dos Santos Marona Borba, Carmen Lucia Silva Nectoux, Karina de Oliveira Azzolin. Supervision: Isis Marques Severo, Karina de Oliveira Azzolin. Validation: Martina Zucchetti, Isis Marques Severo, Daniela dos Santos Marona Borba, Carmen Lucia Silva Nectoux, Karina de Oliveira Azzolin. Visualization: Isis Marques Severo, Isabel Cristina Echer, Daniela dos Santos Marona Borba, Carmen Lucia Silva Nectoux, Karina de Oliveira Azzolin.

The authors declare that there is no conflict of interest.

Topics addressed	Description/Content
Presenting the manual	Explains who developed the manual and its main objective. It also features a character - an illustrated infusion pump in - to serve as a “guide” while reading the manual.
Knowing the scenario	Guides the patient and/or their caregivers about what an ICC is; its human and material resources, introducing the team and equipment; practices and routines of the place, highlighting the importance of hand hygiene, the different patient identification wristbands, the shift change, the multiprofessional rounds, visiting hours, medical and health information1515. Donovan AL, Aldrich JM, Gross AK, Barchas DM, Thornton KC, Schell-ChapleHM, et al. Interprofessional care and teamwork in the ICU. Crit Care Med. 2018;46(6):980-90. doi: https://doi.org/10.1097/CCM.0000000000003067. https://doi.org/10.1097/CCM.000000000000... .
Transfer of care	Clarifies the transfer of patient care from the ICC to the inpatient units, addressing77. Gallo VCL, Khalaf DK, Hammerschmidt KSA, Santiago ML, Vendruscolo C. Transition strategies for hospital discharge used by nurses: integrative review. Rev Enferm UFSM. 2021;11:e79. doi: https://doi.org/10.5902/2179769264383. https://doi.org/10.5902/2179769264383... ^,88. Shahsavari H, Zarei M, Mamaghani JA. Transitional care: concept analysis using Rodgers’ evolutionary approach. IntJNurs Stud. 2019;99:103387. doi: https://doi.org/10.1016/j.ijnurstu.2019.103387. https://doi.org/10.1016/j.ijnurstu.2019.... : What is this transfer of care? How does it happen? What are inpatient units?
Information and important care for discharge from the ICC	Guides the patient and/or their caregivers about information and general care, which need attention in the transition between the ICC and the inpatient units: Clinical signs that deserve attention: unrest or abnormal sleepiness, significant differences in blood pressure and heart rate, signs of respiratory effort, difference between pupils, pale, cold, sticky skin. Devices: tubes, oxygen catheter, vascular access. Food: types of diet, routes of administration, proper placement, and maintenance of fasting. Care in drug administration. Care with patient mobilization. Possible effects of hospitalization: delirium, swelling, difficulty speaking and swallowing, weakness, difficulty in mobilization and weight loss. Care in airway aspiration1111. Rocha GS, Oliveira APP, Teixeira E, Nemer CRB. Validation of care manual for the elderly after brain surgery. J Nurs UFPE on line. 2019;13:e243025. doi: https://doi.org/10.5205/1981-8963.2019.243025. https://doi.org/10.5205/1981-8963.2019.2... ^,1515. Donovan AL, Aldrich JM, Gross AK, Barchas DM, Thornton KC, Schell-ChapleHM, et al. Interprofessional care and teamwork in the ICU. Crit Care Med. 2018;46(6):980-90. doi: https://doi.org/10.1097/CCM.0000000000003067. https://doi.org/10.1097/CCM.000000000000... .
Customization of care	Space for registering doubts of patients and/or their caregivers33. Ghorbanzadeh K, Ebadi A, Hosseini M, Maddah SSB, Khankeh H, Pishkhani MK, et al. Factors influencing the decision-making of healthcare providers regarding the transition of patients from the Intensive Care Unit to the general ward in Iran: a qualitative study. Indian J Crit Care Med. 2022;26(5):568-73. doi: https://doi.org/10.5005/jp-journals-10071-24211. https://doi.org/10.5005/jp-journals-1007... ^,1919. Tominaga LBL, Bernardino E, Lacerda MR, Martins MM, Lapierre J, et al. Proposta de transição e continuidade de cuidados da Unidade de Terapia Intensiva para enfermaria. Res Soc Dev. 2021;10(15):e478101522974. doi: http://doi.org/10.33448/rsd-v10i15.22974. http://doi.org/10.33448/rsd-v10i15.22974... regarding the reading of the manual or that may arise during hospitalization in the ICC and/or inpatient unit.
Deserve attention	Space for team professionals to record with which devices the patient is being discharged33. Ghorbanzadeh K, Ebadi A, Hosseini M, Maddah SSB, Khankeh H, Pishkhani MK, et al. Factors influencing the decision-making of healthcare providers regarding the transition of patients from the Intensive Care Unit to the general ward in Iran: a qualitative study. Indian J Crit Care Med. 2022;26(5):568-73. doi: https://doi.org/10.5005/jp-journals-10071-24211. https://doi.org/10.5005/jp-journals-1007... , in case he/she has any pressure ulcer, allergy, colonized by a multidrug-resistant organism or in respiratory isolation.
Descriptive space	Extra space for care team records33. Ghorbanzadeh K, Ebadi A, Hosseini M, Maddah SSB, Khankeh H, Pishkhani MK, et al. Factors influencing the decision-making of healthcare providers regarding the transition of patients from the Intensive Care Unit to the general ward in Iran: a qualitative study. Indian J Crit Care Med. 2022;26(5):568-73. doi: https://doi.org/10.5005/jp-journals-10071-24211. https://doi.org/10.5005/jp-journals-1007... .

Questions	CVI
1. Are the guidance contained in the manual relevant?	1
2. Is the language of the manual accessible to the target audience?	0.9
3. Will the content of this manual contribute to clarify doubts of patients and caregivers?	0.9
4. Is the amount of information adequate?	1
5. Does the information favor the performance of patient care?	1
6. Is the manual applicable in team work practice?	1
7. Is the font size and style adequate?	0.9
8. Do the illustrations used in the manual contribute to a better understanding by the reader?	1
9. Is the layout and organization of information adequate?	0.9
10. Is the information easily located?	1
11. Is the main title consistent with the manual’s proposal?	0.9
12. Are the internal titles and subtitles consistent with the manual’s proposal?	1

Questions	Arithmetic mean of each answer
1. Are the guidance contained in the manual important?	3.7
2. Is the writing of the manual easy to understand?	4.0
3. Will the content of this manual help to clarify your doubts?	3.7
4. Is the amount of information adequate?	3.9
5. Will the information help you or your family member?	4.0
6. Did reading this manual help to reduce your doubts?	3.7
7. Is the font size and style adequate?	3.5
8. Do the illustrations used in the manual help to better understand the text?	4.0
9. Is the information easily located in the manual?	3.7
Total	3.8

[1] Corresponding author
Isis Marques Severo E-mail: isismsevero@gmail.com

Brasil

Brasil

Validation of manual to complement the transition of care at discharge from intensive care

Validación del manual para complementar la transición de cuidados al alta de cuidados intensivos

ABSTRACT

Objective

Method

Results

Final considerations