Grado de concordancia interevaluador de la escala «Nursing Activities Score» en cuidados intensivos / Inter-rater concordance of the «Nursing Activities Score» in intensive care

OBJETIVO: Determinar la concordancia entre evaluadores de la escala «Nursing Activities Score». MÉTODO: Estudio descriptivo transversal realizado desde diciembre del 2012 a junio del 2013, en una unidad de cuidados intensivos polivalente de 12 camas. Tres enfermeras evaluadoras con diferentes años de experiencia profesional, de manera simultánea e independiente puntuaron, a través de la gráfica diaria del paciente, el trabajo enfermero utilizando la «Nursing Activities Score» en todos los pacientes ingresados mayores de 18 años. RESULTADOS: Se recogieron un total de 339 registros. El coeficiente de correlación intraclase (CCI) entre los evaluadores fue del 0,92 (0,89-0,94). El 39,1% de los ítems tuvo una concordancia perfecta, el 52,2% alta y el 8,7% baja, correspondiendo a 2 de los ítems con varias opciones de puntuación. Se encontraron diferencias significativas de la puntuación obtenida en 2 de los evaluadores (p = 0,049). CONCLUSIONES: A pesar de que la concordancia interevaluadores de la escala es alta, serían necesarios unos registros enfermeros más precisos para reducir la variabilidad de los ítems con varias opciones de puntuación, y permitir una mayor precisión en la interpretación y medición de los datos sobre la carga de trabajo enfermera

OBJECTIVE: To evaluate inter-rater concordance in the valuation of the «Nursing Activities Score». METHOD: Cross-sectional descriptive study conducted from December 2012 until June 2013 in a general intensive care unit with twelve beds. Three evaluator nurses, simultaneously and independently, through the patient daily charts, scored the nursing workload using Nursing Activities Score scale in all patients admitted over 18 years old. RESULTS: Three hundreds and thirty-nine records were collected. The intra-class correlation coefficient (ICC) between evaluators was 0.92 (0.89-0.94). A perfect concordance was obtained in 39.1% of the items, with 52.2% having a high, and 8.7% having lower concordance, corresponding to two of the items with multiple scoring options. Significant differences between two of the evaluators (P=.049) were found. CONCLUSIONS: Although the inter-rater concordance was high, more accurate records are needed to reduce the variability of the items with multiple options and to allow more accuracy in the interpretation and measurement of the data regarding nursing workload

[Inter-rater concordance of the "Nursing Activities Score" in intensive care]. / Grado de concordancia interevaluador de la escala "Nursing Activities Score" en cuidados intensivos.

OBJECTIVE: To evaluate inter-rater concordance in the valuation of the "Nursing Activities Score". METHOD: Cross-sectional descriptive study conducted from December 2012 until June 2013 in a general intensive care unit with twelve beds. Three evaluator nurses, simultaneously and independently, through the patient daily charts, scored the nursing workload using Nursing Activities Score scale in all patients admitted over 18 years old. RESULTS: Three hundreds and thirty-nine records were collected. The intra-class correlation coefficient (ICC) between evaluators was 0.92 (0.89-0.94). A perfect concordance was obtained in 39.1% of the items, with 52.2% having a high, and 8.7% having lower concordance, corresponding to two of the items with multiple scoring options. Significant differences between two of the evaluators (P=.049) were found. CONCLUSIONS: Although the inter-rater concordance was high, more accurate records are needed to reduce the variability of the items with multiple options and to allow more accuracy in the interpretation and measurement of the data regarding nursing workload.