VALIDATION OF A CHECKLIST FOR RESPONSIBLE HOSPITAL DISCHARGE IN A NEONATAL INTENSIVE CARE UNIT

Uema, Roberta Tognollo Borotta; Rodrigues, Thamires Fernandes Cardoso da Silva; Back, Ivi Ribeiro; Zulin, Aline; Santos, Fernanda Gatez Trevisan dos; Bernal, Suelen Cristina Zandonadi; Plantier, Gabriel Mendes; Radovanovic, Cremilde Aparecida Trindade

doi:10.1590/1980-265X-TCE-2023-0103en

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Original Article • Texto contexto - enferm. 32 • 2023 • https://doi.org/10.1590/1980-265X-TCE-2023-0103en copy

VALIDATION OF A CHECKLIST FOR RESPONSIBLE HOSPITAL DISCHARGE IN A NEONATAL INTENSIVE CARE UNIT

VALIDACIÓN DE UNA LISTA DE VERIFIACIÓN PARA EL ALTA HOSPITALARIA RESPONSABLE EN UNA UNIDAD DE CUIDADOS INTENSIVOS NEONATALES

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to create and validate a checklist for responsible hospital discharge processes in a neonatal intensive care unit.

Method:

a methodological study conducted from March to June 2022, in four phases: 1) Selection of topics relevant to the health of newborns discharged from the intensive care unit; 2) Elaboration of the first version of the checklist; 3) Content validation with expert judges by applying the Content Validity Index (CVI), accepting values > 0.8 per item; and 4) Correction and reformulation of the final version. The assessment instrument was structured by means of a Likert-type scale. The validation process was performed in electronic and printed means by approaching the evaluators within the neonatal unit, totaling 16 participants. Descriptive statistics was used for data analysis.

Results:

the checklist was validated with an overall Content Validity Index of 0.87. Analyzing the items individually, the following Content Validity Index values were found: 0.92 in the objectives, 0.89 for language, 0.84 for the content, 0.79 for relevance, 0.90 for layout, 0.94 for motivation and 0.88 for culture.

Conclusion:

the checklist presented favorable Content Validity Index values in the vast majority of the evaluation criteria, with the exception of relevance. However, it is noted that it can be implemented and tends to contribute to a responsible discharge process.

DESCRIPTORS:
Validation studies; Neonatal nursing; Patient care continuity; Discharge planning; Premature newborn

NEONATAL DISCHARGE CHECKLIST
Newborn identification:	Date of birth:	Discharge date:
Family members instructed on the discharge process:
DISCHARGE PROCESS
Discharge guidelines	Guided	Assisted	Able
Breastfeeding (latch and suction, breast care).
Avoid use of artificial nipples (silicone pacifier and mid-piece).
Offering expressed milk or infant formula in an open cup or bottle (newborn positioning during and after feedings).
Newborn's bath (water temperature, suitable place, where to start).
Hygiene and diaper exchange (necessary materials, how to do it, main care measures to be observed).
Urinary and bowel eliminations (frequency, color, volume. Indicate that the expected is 6 urine diapers/day and that, if the newborn is exclusively receiving breast milk, it can go up to 1 week without bowel movements).
Administration of medications or multivitamins.
Care with the newborn's temperature and clothes.
Identification of warning signs: cyanosis, pallor, bleeding, food refusal, hypotonia (“wet and unresponsive newborn”).
Exposure to the sun: until 10 am or after 4 pm.
Newborn's sleep: sleep on its back, especially in the same environment as the mother until the sixth month of life.
Screening tests: chest, ear, heart.
Return visits with specialists if necessary.
Return visits to the hospital outpatient service for monitoring.
Maintain follow-up in the reference Basic Health Unit.
Vaccination booklet: weight, growth, developmental milestones and vaccines.
Support visits and network
Process applied by:	Date:

	Totally adequate	Adequate	Partially adequate	Inadequate	CVI
Objectives					0.92
The objectives are consistent with the target population's needs.	9	8	0	0	1.00
The instrument assists in the care to be provided to premature newborns that will be discharged from the hospital and their families.	8	8	1	0	0.94
The instrument can circulate in the scientific community of the area.	7	7	3	0	0.82
The instrument can promote behavioral and attitudinal changes in the family members in relation to care of the newborn.	9	6	2	0	0.88
Content					0.84
The instrument is appropriate to assist in the care of the premature newborn that will be discharged from the hospital.	8	7	2	0	0.88
The instrument is clear and objective.	6	7	4	0	0.76
The instrument is scientifically correct.	7	5	3	2	0.70
The instrument has a logical sequence.	8	7	2	0	0.88
The instrument highlights the importance of care.	7	8	2	0	0.88
The instrument's title and subtitle are pertinent.	7	9	1	0	0.94
Language					0.89
All the information presented is clear and understandable, considering the target audience experience level.	5	10	2	0	0.88
The writing style corresponds to the target audience level of knowledge.	8	8	1	0	0.94
All the information is well structured in terms of spelling.	7	9	1	0	0.94
The writing style used is appealing.	5	9	2	0	0.82
Relevance					0.79
The topics presented describe key aspects that should be reinforced in the care of premature newborns that will be discharged from the hospital environment.	8	6	3	0	0.82
The instrument contributes diverse knowledge that encourages the care to be provided to premature newborns discharged from the hospital environment.	7	8	2	0	0.88
The instrument addresses the necessary subject matters for the care of discharged premature newborns in their homes.	5	7	5	0	0.70
The instrument is adequate and can be used as a tool to promote health education in the family caregivers of premature newborns.	8	5	4	0	0.76
Layout					0.90
Presentation of the instrument is appealing and well-organized.	2	13	2	0	0.88
The content is presented with fonts of suitable size.	6	9	2	0	0.88
The type of font used eases reading of the material.	7	10	0	0	1.00
The colors are suitable and ease reading.	5	10	2	0	0.88
The information layout is adequate.	6	8	3	0	0.82
The instrument is adequate in terms of length.	6	10	1	0	0.94
Motivation					0.94
The instrument's content generates interest for its application.	7	9	1	0	0.94
The content is motivating and encourages researchers to continue applying it.	7	9	1	0	0.94
Culture					0.88
The material is appropriate to the sociocultural level of the proposed target audience.	7	8	2	0	0.88

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
Roberta Tognollo Borotta Uema robertaborotta@hotmail.com