Tradução, adaptação transcultural e validação do instrumento segurança do paciente na administração de medicamentos na pediatria

Abstract

Patient safety is an important indicator of the quality of care and should be a priority in health services. Had as objective translate and cross-culturally adapt the Patient Safety instrument in pediatric Medication Administration (PSPMA) from Portuguese to Spanish in the Peruvian context. Methodological study with a quantitative approach, developed in two phases: 1) translation and cross-cultural adaptation of the PSPAM instrument into Spanish, generating the SPAMP-vE instrument, with 28 items; 2) evaluation of the psychometric properties of the SPAMP-vE instrument, according to content validity and reliability. Upon completion of the instrument PSPAM-vE 25 nurses self-filled it and the researcher performed 183 Observations of the preparation and administration of medicines in the pediatrics of a Lambayeque-Peru hospital. Data were analyzed using SPSS version 20.0 using Wilcoxon test, with a 95% confidence interval. To evaluate the performance of professionals in the execution of each action, the Positivity Index (PI) was determined, classified as: desirable (PI = 100%), adequate (90% ≤PI≤99%), safe (80%≤PI≤89%), borderline (71% ≤PI≤79%) and suffering (PI≤70%). Study approved by the Research Ethics Committee in Brazil and Peru. As a result, the committee of nine experts made the SPAMP-vE cross-cultural adaptation of the semantic, idiomatic, conceptual and cultural equivalences, whose experts considered the items comprehensible, with clear and easily eligible response options, obtaining the pre-SPAMP-vE. In the analysis of psychometric properties, the Total Content Validity Coefficient (CVCT) of the criteria of practical relevance, language clarity and theoretical relevance, respectively, were 0.97; 0.97 and 0.96. The committee of seven judges made suggestions on 28 items to maintain (10 items), change (16 items) and / or group (2 items), which were accepted, leaving 26 items. Reliability in the homogeneity category was calculated by Cronbach's alpha (0.921), presenting high internal consistency, maintaining the 26 items, in the final version, distributed in nine domains: right patient, right medication, right route, right time, right dose, right record, right orientation, right form and right answer. The self-fill test-retest stability was calculated by Cronbach's alpha ranging from 0.792 to 0.821, in the retest, considered as an acceptable parameter. The domains of the SPAMP-vE instrument showed, by self-completion, in the test, mean and standard deviation of 68.0 + 25.5 to 99.5 + 2.5; and in the retest from 86.0 + 14.8 to 96 + 11.8. Six domains showed no significant difference (p> 0.05) between test and retest, according to Wilcoxon test. When comparing the actions of the self-filled SPAMP-vE instrument, in the test and retest, seven items showed significant difference (1, 7, 8, 15, 19, 22 and 23). The performance of nurses obtained by observation, according to the instrument SPAMP-vE. No action showed the desired positivity index. It is concluded that the SPAMP-vE instrument is reliable, valid and able to evaluate the actions of nursing professionals in the preparation and administration of medicines in pediatrics.