Validação de um instrumento multiprofissional para decanulação traqueal em adultos

Abstract

Introduction: Tracheostomy is indicated when there is a failure in ventilatory weaning, deficient neurological status, inability to handle tracheal secretions and upper airway obstructions. Usually, its indication is not definitive and it is necessary to plan its early withdrawal when possible. Tracheal decannulation requires the assessment of a multiprofessional team observing criteria that predict success. A validated instrument can increase the safety of the procedure, reduce the length of stay in the Intensive Care Unit and ensure greater care security and quality of life for the patient. Objective: To validate in content a multiprofessional instrument for tracheal decannulation in adults. Methodology: Descriptive cross-sectional study, with the participation of 24 judges: doctors, physiotherapists, speech therapists and nurses. After a literature review, criteria were developed for the development of the instrument and, subsequently, it was presented through an electronic form where the judges made their notes and the adjustments they deemed necessary. After the return, calculations of the Content Validity Index by Item (CVI-I) and Total (CVI -T) were performed, to verify evidence of validation. For not validated items, adjustments were made based on the suggestions made by the judges and submitted to the new evaluation phase in order to obtain a value of CVI -I that enabled the complete validation of the instrument. Results: In the first evaluation phase, the items: Identification, Ventilatory History, Vital Signs, Consciousness / Collaboration, Ventilatory Data, Opinion and Legend obtained CVI -I> 0.78, therefore they were considered validated. The Muscular Performance and Phonation and Swallowing items did not obtain adequate CVI-I, CVI -I = 0.67 and 0.17, respectively. Therefore, they were submitted to the second evaluation phase. In this, these items were validated by obtaining CVI -I = 0.83 in the item Muscular Performance and CVI -I = 1.0 in the item Phonation and Swallowing. From the average IVC-I, the CVI -T = 0.9 was obtained, validating this instrument in its entirety. Conclusion: Based on current scientific literature, a multiprofessional instrument was developed that can assist in the process of tracheal decannulation in adults and that was validated in content after two phases of evaluation by a group of experts in the field.