Reprodutibilidade e confiabilidade de um indicador processual de avaliação da adesão à higiene bucal em pacientes com intubação orotraqueal

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

A higiene bucal tem sido reconhecida como medida direta e relevante na prevenção de pneumonia em pacientes críticos. Considerando a avaliação da qualidade dos cuidados através de indicadores de processo como uma etapa importante para melhorar a assistência, o objetivo do estudo foi medir a intensidade de concordância do "Indicador de avaliação da adesão à higiene bucal (IRHB)", junto a pacientes críticos submetidos a intubação orotraqueal, por meio do teste estatístico Kappa. Tal teste recomenda que as avaliações sejam realizadas em duplas de observadores, o que totalizou 104 duplas-observações. Resultados mostraram um grau de concordância perfeita entre três das quatro duplas de observadores (74%; k=1,00) e quase perfeita em uma dupla (26%; k=0,90). Das 27 avaliações realizadas por esta última, apenas o item relacionado à categoria profissional apresentou discordância. Tais resultados indicam que há redução do erro aleatório, além sugerir que o instrumento é passível de ser aplicado em outras instituições que assistam pacientes críticos, desde que seja realizado o teste de Kappa para se garantir a precisão dos dados obtidos.

Translated abstract

The oral hygiene has been recognized as direct and relevant measure to prevent pneumonia in critically ill patients. Considering the assessment of quality of care through processual indicators as an important step to improve care, this study aimed to measure the intensity of agreement of "indicator to evaluate adherence to oral hygiene (IRHB)", in critically ill patients with orotracheal intubation, through the Kappa test. This test recommends that assessments must be done by pairs of observers, which totaled 104 double-observations. Results showed a perfect agreement among three of four pairs of observers (74% k = 1.00) and almost perfect in a pair (26% k = 0.90). Of the 27 observations performed by this last pair, only the item related to the profession did not agree. These results indicate that there is a reduction of aleatory error, and suggest that the instrument could be applied at other institutions that assist critically ill patients, since the Kappa test is made to ensure the accuracy of the data.

Related collections

Most cited references 22

Record: found
Abstract: not found
Article: not found

The Measurement of Observer Agreement for Categorical Data

J Landis, Gary G. Koch (1977)

0 comments Cited 7317 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

A comparison of the ability of foam swabs and toothbrushes to remove dental plaque: implications for nursing practice.

L S Pearson (1996)

This study aimed to assess the impact which the use of a toothbrush and the use of foam swabs had on the removal of dental plaque over a 6-day period. Three experiments were completed and duplicated using the author's mouth and one of these experiments was completed a third time on a volunteer's mouth. A plaque scoring system which quantified the amount of plaque on teeth in areas adjacent to periodontal tissue, and therefore capable of initiating inflammation, was used after plaque had been disclosed. Plaque at the gum/tooth margin (gingival crevice plaque) and plaque between teeth (approximal plaque) was measured. At the end of each 6-day period, which commenced with all tooth surfaces clean, the ability of the toothbrush to remove plaque was consistently better than that of swabs, and usually achieved complete visible plaque removal from all sites. In contrast, plaque remained in all sites which had been cleaned using foam swabs (after using a 'swabbing' or 'scrubbing' technique). However, it was possible to remove plaque from a number of gingival crevice sites with a swab when a varied 'any technique' was used on the visible disclosed plaque. The plaque in all approximal sites still remained after this technique. An experiment to measure the effect of using foam swabs on plaque which had been allowed to accumulate over a 6 day period produced similar results. The results from this study suggest that the success of a toothbrush in removing plaque is affected by user technique (total visible plaque removal was not achievable), and that foam swabs are not able to remove plaque from some 'sheltered' areas of teeth (total visible plaque removal was not achievable). The implications of these findings to nursing practice are discussed.