Construção e validação de checklist para transfusão sanguínea em crianças

Abstract

Blood transfusion is commonly performed in hospitals, particularly in surgical and intensive care units, often occurring in the pediatric population. It is a process with several interconnected stages that involve health professionals of varied categories, among them the nurse who stands out favoring the safety and transfusion success of their patients. The objective was to build and validate a checklist for blood transfusion in children. Methodological study carried out between November/2016 and May/2017 developed in two stages. The first one consisted of an integrative review guided by the guiding question: "What nursing care for blood performance in children?" The data collection of this phase occurred in the period from November/2016 to January/2017 in the databases LILACS, Cochrane, CINAHL, PubMED Portal and Scopus through the cross-referencing of the descriptors blood transfusion AND nursing care AND child, in the English language and blood transfusion databases, nursing and child care, in the Portuguese language, resulting in 9 articles after application Inclusion and exclusion criteria. Data from the review identified the items that composed the checklist divided into pre-transfusion, transfusion, and post- transfusion nursing care. In the second stage, corresponding to content validation among specialist nurses, fourteen judges participated. The data were evaluated according to the Content Validity Index (CVI) and discussed according to the literature, organized in Excel using descriptive statistics. This study was approved by the Research Ethics Committee of the Federal University of Ceará under opinion 1.615.716. The checklist consisted of 17 items and 61 sub-items, in the first version of the instrument. After the validation stage and through the judges' suggestions, the content was modified, and the final version consisted of 14 items and 55 sub-items: pre-transfusional stage with four items (pre-transfusion nursing guidelines, blood component conference , child identification and pre-medication); transfusion stage remained with the same six items of the initial version; post-transfusion stage with four items (vital signs check, vital signs check one hour after the end of the transfusion, records and monitoring of the child for 24 hours after the end of the transfusion). It should be noted that 58.82% of the individually evaluated items were considered adequate with IVC greater than or equal to 0.8, demonstrating adequate content for nursing care for children undergoing blood transfusion. In the evaluation of the items regarding the clarity, pertinence and relevance of nursing care to the transfused child, a high degree of agreement between the judges was observed. About the overall evaluation the content was considered valid with IVC of 0.87 with modifications. Among the modifications suggested, there was the exclusion, substitution and addition of terms. Thus, the checklist for blood transfusion in children was considered a technology with valid content to be used in the transfusional act performed by nurses. It is concluded that, with the checklist, nurses can contribute to transfusion safety at the time of transfusion in children, but other types of validation need to be performed before it can be used in clinical practice.