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Metas de Enfermería

Metas de Enfermería

ABRIL 2013 N° 3 Volumen 16

Interobserver concordance degrees in Norton and Braden scales for critical care

Section: Method

How to quote

Guardia Mesa MF, Cobos Vargas A, López Pérez F, Garófano Jerez JR. Niveles de concordancia interobservador de las escalas Norton y Braden en cuidados críticos. Metas Enferm 2013; 16(3):17-20.

Authors

1Manuel Fernando Guardia Mesa, 2Ángel Cobos Vargas, 1Francisca López Pérez, 3Juan Rafael Garófano Jerez, 2Celia Carrasco Muriel

Position

1Enfermero de Cuidados de Intensivos. Hospital Universitario Virgen de las Nieves de Granada. Servicio Andaluz de Salud.2Enfermero/a de Cuidados Intensivos. Hospital Universitario San Cecilio de Granada. Servicio Andaluz de Salud.3Enfermero de Cuidados Intensivos. Licenciado en Antropología. Hospital Universitario San Cecilio de Granada. Servicio Andaluz de Salud.

Contact address

Manuel Fernando Guardia Mesa. C/ Abeto, 5. Urbanización Huerta del Pilar, Belicena. 18193 Vegas del Genil (Granada).

Abstract

Objective: to analyze the interobserver reliability of each of the items included in the Norton and Braden Scales, when used in intensive care.
Materials and method: multicenter descriptive study in the Intensive Care Units (ICUs) of two hospitals in Granada, with two observers in the Hospital Universitario Virgen de las Nieves (HUVN), and three in the Hospital Universitario San Cecilio (HUSC) in Granada. There was a selection of 268 patients in HUSC and 215 in HUVN, taking into account an expected­ 0.65 proportion of agreement, and a 95% safety. The Kappa coefficient was used (two observers) in order to calculate interobserver reliability, as well as the Kappa Fleiss (three observers). Confidence intervals were calculated for 95% safety (CI 95%).
Results: total interobserver reliability was Very Good for both scales: k=0.8196 (CI 95%: 0.7350-0.901) for the Norton Scale and k=0.90 (CI 95%: 0.858-0.940) for Braden. Within the Norton Scale, the items Physi­cal Condition and Incontinence showed Moderate and Weak concordances, while the rest ranged between Good- Very Good. Within the Braden Scale, the item Risk of Lesions showed Poor (in HUVN) and Good concordance (in HUSC); the rest ranged between Moderate-Very Good.
Conclusions: in both centers, the item Physical Condition shows lower concordance for the Norton Scale. In terms of the Braden Scale, Poor concordance for Risk of Lesions is noticeable only in that health centre where it was not typically used (lower training level).The total interobserver reliability of scales is higher than per items, because there is risk stratification in scales.

Keywords:

Braden Scale; critical care; intensive care; interobserver reliability; Norton Scalepressure ulcers

Versión en Español

Título:

Niveles de concordancia interobservador de las escalas Norton y Braden en cuidados críticos