Abstract:
Background/Objectives: Patient handover is the process by which the responsibility for care is transferred from one health care professional to another. Given the lack of validated scales to assess the handover of critically ill patients, our aim was to evaluate the reliability and validity of the Instrumento de Evaluación de la Transferencia de Enfermos Críticos (IETEC) (English: Instrument for the Evaluation of Handovers in Critically Ill Patients). Methods: Psychometric analysis of the reliability and validity (construct, convergent, and discriminant) of the IETEC. This single-center study included professionals (nurses, physicians, and emergency medical technicians) involved in the care of the critically ill in urgent care and emergency situations. Results: We evaluated 147 handovers of critically ill patients. The KR-20 score was 0.87, indicting good internal consistency. Of the 147 handovers, 117 (79.6%) were classified as unsafe and 30 (20.4%) as safe. The model fit showed an acceptable construct validity (24 items and four factors: Identification, Communication, Quality, and Family). The Communication domain had the strongest correlation with the total scale (r = 0.876) while Family had the weakest (r = 0.706). The Communication and Family domains were closely correlated (r = 0.599). The IETEC reliably differentiated between safe and unsafe handovers, with a mean (SD) score of 26.3 (1.2) versus 19.0 (4.8), respectively. No significant differences (p = 0.521) in mean IETEC scores were observed between the physicians and nurses. Conclusions: These results show that the IETEC presents adequate psychometric properties and is, therefore, a valid, reliable tool to evaluate handovers in critically ill patients in urgent care and emergency settings.
摘要:
背景/目标:患者移交是将护理责任从一个医疗保健专业人员转移到另一个专业人员的过程。鉴于缺乏经过验证的量表来评估危重患者的交接情况,我们的目的是评估重症患者移交评估工具(IETEC)(英文:重症患者移交评估工具)的信度和效度.方法:信度和效度的心理测量学分析(结构,convergent,和判别式)的IETEC。这项单中心研究包括专业人士(护士,医师,和紧急医疗技术人员)参与紧急护理和紧急情况下的重症患者的护理。结果:我们评估了147例重症患者的交接。KR-20得分为0.87,内部一致性良好。在147次切换中,117(79.6%)被归类为不安全,30(20.4%)被归类为安全。模型拟合显示出可接受的结构效度(24个项目和四个因素:识别,Communication,质量,和家庭)。沟通域与总量表的相关性最强(r=0.876),而家庭最弱(r=0.706)。沟通域和家族域密切相关(r=0.599)。IETEC可靠地区分了安全和不安全的切换,平均(SD)得分为26.3(1.2)和19.0(4.8),分别。医生和护士之间的平均IETEC评分没有显着差异(p=0.521)。结论:这些结果表明,IETEC具有足够的心理测量特性,因此,一个有效的,在紧急护理和急诊环境中评估危重患者交接的可靠工具。