Avaliação de sinais vitais segundo o sistema de triagem de Manchester: concordância de especialistas [Evaluation of vital signs by the Manchester triage system: expert agreement]
DOI:
https://doi.org/10.12957/reuerj.2017.7506Keywords:
Triagem, serviços médicos de emergência, reprodutibilidade dos testes, classificação.Abstract
Objetivo: avaliar a concordância de especialistas quanto à necessidade de mensuração de sinais vitais e dados adicionais, com base nos discriminadores do sistema de triagem de Manchester. Método: estudo transversal analítico realizado na Escola de Enfermagem da Universidade Federal de Minas Gerais, em 2012. Participaram três especialistas selecionados por critérios pré-definidos que analisaram os discriminadores do protocolo de Manchester. Os dados foram analisados no programa SPSS, versão 17.0, através do índice Kappa. Pesquisa aprovada pelo COEP-UFMG (CAAE 0430.0.203.000-11). Resultados: encontrou-se excelente concordância entre avaliadores e o padrão ouro quanto à necessidade de mensuração de pelo menos um dado vital (0,89-0,90). Em três (75%) dos quatro tipos de dados vitais, houve excelente concordância entre avaliadores (0,85-1,00), e no dado vital frequência respiratória, a concordância foi boa (0,72-0,79). Conclusão: as discordâncias quanto à necessidade de mensuração de sinais vitais estavam relacionadas a discriminadores para avaliação da função respiratória, apontando para a necessidade de revisão desses termos.
ABSTRACT
Objective: to assess expert agreement on the need to measure vital signs and additional data based on the discriminators of Manchester triage system. Method: analytical cross-sectional study conducted in 2012 at the School of Nursing of Minas Gerais Federal University. Participants were three experts selected on predefined criteria, who analyzed the discriminators of the Manchester protocol. Data were analyzed by SPSS (version 17.0) using the Kappa index. The study was approved by COEP-UFMG (CAAE 0430.0.203.000-11). Results: excellent agreement (0.89-0.90) was found between raters and gold standard with regard to the need to measure at least one critical datum. On three (75%) of the four types of vital sign data, agreement between raters was excellent (0.85-1.00) and, on respiratory frequency, agreement between raters was good (0.72-0.79). Conclusion: disagreements on the need to measure vital signs related to discriminators for assessment of respiratory function, which points to the need to review these terms.
RESUMEN
Objetivo: evaluar el acuerdo de expertos sobre la necesidad de medir los signos vitales y obtener datos adicionales basados en los discriminadores de sistema de triaje de Manchester. Método: Estudio transversal analítico realizado en 2012, en la Escuela de Enfermería de la Universidad Federal de Minas Gerais. Participaron tres expertos, seleccionados por criterios predeterminados, que analizaron los discriminadores del protocolo de Manchester. Los datos fueron analizados con el programa SPSS, versión 17.0, utilizando el índice Kappa. Investigación aprobada por el COEP-UFMG (CAAE 0430.0.203.000-11). Resultados: encontramos un excelente acuerdo entre evaluadores y el estándar oro en lo que respecta a la necesidad de medir al menos un dato vital (0,89 - 0,90). En tres (75%) de los cuatro tipos de datos vitales, el acuerdo entre los evaluadores fue excelente (0,85 - 1,00) y, en el dato vital ‘frecuencia respiratoria’, el acuerdo entre los evaluadores fue bueno (0,72 - 0,79). Conclusión: los desacuerdos sobre la necesidad de la medición de los signos vitales estaban relacionados con discriminadores para evaluación de la función respiratoria, lo que apunta a la necesidad de revisar estos términos.
DOI: http://dx.doi.org/10.12957/reuerj.2017.7506
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