CONSTRUCTION AND VALIDATION OF PROTOCOL FOR POLYTRAUMATED PATIENTS IN MOBILE EMERGENCY CARE SERVICE
Nursing. Patient Safety.. Check List. Clinical Protocol.
Clinical Protocols and Therapeutic Guidelines are documents that provide recommendations aimed at optimizing patient care, which can be called clinical practice guides, manuals, guidelines, notebooks, protocols, among others that must be adopted to improve this process. Considering the relevance of monitoring risks and standardizing the care process for polytraumatized patients in practice scenarios. From this context, the present study aimed to build and validate a protocol for multiple trauma patients in a Mobile Emergency Care Service in Rio Grande do Norte. This was applied research for the development of a technological product with a quantitative approach, focused on the construction and validation of content and appearance of the Standard Operating Procedure (SOP). The product was built through the following steps: 1) scoping review on the theme 2) construction of the instrument based on the characterization of the checklist items with the mapping of the scoping review and 3) content and appearance validation process using the Delphi technique composed of a panel of judges (nurses). The judges were invited via email. The study complied with the ethical precepts in research with human beings described in Resolution 466/2012 of the National Health Council and is in accordance with the guidelines for research procedures at any stage in a face-to-face environment, with approval from the University's Research Ethics Committee. Federal Government of Rio Grande do Norte, authenticated by opinion no. 6,046,885. In the results, items with a Content Validity Index ≥ 0.90 and checklist reliability based on Kappa agreement ≥ 0.83 were considered valid. After the construction and structuring of the POP, the Delphi stage was carried out with the responses of 6 judges, to validate the content and appearance, containing a form organized using a Likert scale (1. I completely disagree, 2. I partially disagree , 3. partially agree and 4. completely agree). The checklist categorized into 5 items. The 1st round evaluated the individual content of the items, the 2nd round evaluated the attributes of the instrument and the 3rd round evaluated the appearance and general evaluation (comparison between the immobilization performed before and currently). The level of agreement between the judges and the validation of content and appearance reached final values of 1.00. These professionals (100%) have worked at SAMU 192 for between five and ten years. This work revealed the need to standardize, through a protocol, nursing care for victims of accidents with forearm injuries, in order to contribute to the standardization of the immobilization procedure for the affected segment, optimize knowledge of the technical condition, and maintain up-to-date professional in the treatment of orthopedic trauma in different scenarios. The product of this study consisted of the standard operational protocol to guide the immobilization procedure of the upper limbs (forearm), drawn up based on the improvement strategies collectively raised in the interviews, with a view to standardizing the aforementioned process of immobilization of the upper limbs of the polytraumatized person, which is fragile and out of alignment.