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Volume 12, Issue 1 (2023)                   J Police Med 2023, 12(1) | Back to browse issues page

Ethics code: IR.IUMS.REC.1401.125


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Gholamzadeh M, Saei A, Sedigh Maroufi S, khobbin Khoshnazar T A, Rajabzadeh R. The Psychometry and Localization of the Patient Assessment and Discharge Checklist in the Post-Anesthesia Care Unit (SAMPE Checklist). J Police Med 2023; 12 (1) : e2
URL: http://jpmed.ir/article-1-1132-en.html
1- Department of Anesthesiology, Faculty of Paramedicine, Iran University of Medical Sciences, Tehran, Iran
2- Department of Anesthesiology, Faculty of Paramedicine, Iran University of Medical Sciences, Tehran, Iran , saei.a@iums.ac.ir
3- Department of Nursing, Faculty of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran
4- Department of Epidemiology, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnord, Iran
English Extended Abstract:   (1172 Views)
Aims: The correct transition in postoperative care, from the post-anesthesia care unit (PACU) to the general ward or even home discharge, is an essential step in the discharge of surgical patients. The present study was conducted with the aim of psychometrics and localization of the Persian version of the patient evaluation and discharge checklist in the post-anesthesia care unit.
Materials and Methods: This cross-sectional study was conducted in the paramedical faculty of Iran University of Medical Sciences in 2022. In this study, the psychometrics and localization of the Persian version of the patient assessment and discharge checklist in the post-anesthesia care unit (SAMPE checklist) were evaluated. The translation tool was implemented using the forward-backward method, and the clinical validation of the tool was done by determining face validity (qualitative) and content validity (content validity index). Also, to check the tool's reliability, the inter-rater reliability method was performed using the Kappa coefficient. SPSS version 26 software was used for statistical analysis.
Findings: The present research was conducted on 80 patients of the PACU with a mean age of 45 years (minimum = 18 years, maximum = 89 years). Patients were selected non-randomly (convenience samples) from the PACU and participated in the study after informing their consent. Demographic and anesthesia-surgery characteristics are provided in Table 1.
Content validity was reported as 0.94 using CVI (Table 2). For eight items of the checklist, a CVI over 0.79 was reported, indicating the favorable content validity of all items (Table 2). The face validity of the SAMPE checklist was assessed qualitatively using the recovery nurses’ comments. The recovery nurses approved all the items regarding the items’ level of difficulty, appropriateness, and ambiguity; thus, no change was made to the items. In order to assess the reliability, the kappa coefficient was calculated, the value of which was 0.31-1, indicating the appropriateness of the tool’s reliability (Table 3).
Conclusion: The research findings show the tool's face validity, content validity, and appropriate reliability. Based on this, the psychometric and localized patient evaluation and discharge checklist in the post-anesthesia care unit (SAMPE checklist) in this research can be used to determine the readiness of patients for discharge from the PACU.
CLINICAL & PRACTICAL TIPS in POLICE MEDICINE: The Persian version of the SAMPE checklist is a simple and practical tool for safely discharging patients from the post-anesthesia care unit. A medical staff of military and police forces can use this checklist as a quick and safe method to evaluate and discharge patients in the post-anesthesia care unit.
ACKNOWLEDGMENTS: The treatment staff of the operating room and PACU of Rasoul Akram Hospital in Tehran, Iran, were appreciated.
CONFLICT of INTEREST: The authors stated that there is no conflict of interest.
AUTHORS CONTRIBUTION: Mohammad Gholamzadeh in data collection; Azam Saei in the presentation of the idea and design of the study; Shahnam Sedigh Maroufi in presenting the idea and design of the study; Tahereh Sadat Khoobbin Khoshnazar in data interpretation; Rezvaneh Rajabzadeh in statistical data analysis; All the authors participated in the initial writing of the article and its revision, and all of them accept the responsibility for the accuracy and correctness of the contents of this article with the final approval of this article.
FUNDING SOURCES: The research vice-chancellor of the Paramedical Faculty of Iran, University of Medical Sciences, was the financial support of this research.

 
Table 1) Demographic characteristics and surgical anesthesia in the statistical sample (N=80)
Index Number (percent)
Sex Female
male
37(46.3)
43(53.7)
Type of anesthesia general anesthesia
Monitored care
Regional anesthesia
52(65)
12(15)
16(20)
Class ASA I
II
III
IV
28(35)
25(31.3)
25(31.3)
2(2.5)
Extent of surgery small and medium
big
48(60)
32(40)
Type of surgery Chest
rectum and colon
General
Obstetrics and Gynecology
Neurology
orthopedics
Plastic
urology
Artery
1(1.3)
1(1.3)
21(26.3)
21(26.3)
3(3.8)
18(22.5)
4(5)
2(2.5)
9(11.3)


Table 2) Content validity index (CVI) in SAMPLE checklist
Items CVI
Stable vital signs
The Cardiovascular system is stable. (Heart rate and blood pressure values are close to preoperative levels or systolic blood pressure is over 90 mmHg and less than180 mmHg).
1
Awake and conscious or with an early consciousness pattern
(The patient is conscious and aware of time and place, the effects of anesthetic drugs have recovered, or he is at his usual level of consciousness)
0.97
Spontaneous ventilation
(Spontaneous deep breathing and cough and swallowing reflexes are present. The patient's ventilation pattern is normal)
1
Arterial oxygen saturation (SpO2) above 90%
(Arterial oxygen saturation is over 90%. If necessary, supplemental oxygen is on the agenda to discharge the patient to the inpatient unit)
0.91
Controlled pain
(The patient's pain is controlled (verbal pain scale≤3) and an adequate analgesic drug regimen has been prescribed. If neuraxial anesthesia with opioids, epidural catheters or other advanced analgesia methods are used, a post-anesthesia care team visit has been performed)
0.88
lack of nausea and vomiting
(The patient's nausea and vomiting have been controlled and a multiple drug regimen has been prescribed).
0.85
lack of bleeding
(Any bleeding at the surgical other than the usual patterns that prevent discharge has been reported to the surgical team)
0.91
lack of movement block
(Patients who have neuraxial anesthesia and were admitted to the hospital have visible return of sensory and motor block. Outpatients who underwent neuraxial anesthesia can walk and urinate before discharge.)
1
mean 0.94


Table 3) Agreement between two evaluators by calculating Cohen's kappa coefficient in SAMPE checklist
Items kappa
Stable vital signs
(Cardiovascular system is stable. Heart rate and blood pressure values are close to preoperative levels or systolic blood pressure is above 90 mmHg and below 180 mmHg)
1
Awake and conscious or with an early consciousness pattern
(The patient is conscious and aware of time and place, the effects of anesthetic drugs have recovered or he is at his usual level of consciousness)
0.779
Spontaneous ventilation
(Spontaneous deep breathing and cough and swallowing reflexes are present. The patient's ventilation pattern is normal)
1
Arterial oxygen saturation (SpO2) above 90%
(Arterial oxygen saturation is over 90%. If necessary, supplemental oxygen is on the agenda to discharge the patient to the inpatient unit)
1
Controlled pain
(The patient's pain is controlled (verbal pain scale≤3) and an adequate analgesic drug regimen has been prescribed. If neuraxial anesthesia with opioids, epidural catheters or other advanced analgesia methods are used, a post-anesthesia care team visit has been performed)
0.635
lack of nausea and vomiting
(The patient's nausea and vomiting have been controlled and a multiple drug regimen has been prescribed).
0.310
lack of bleeding
(Any bleeding at the surgical other than the usual patterns that prevent discharge has been reported to the surgical team)
1
lack of motor block
(Patients who underwent neuraxial anesthesia and were admitted to the hospital have visible return of sensory and motor block. Outpatients who underwent neuraxial anesthesia canwalk and urinate before discharge).
1

 
Article number: e2
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Article Type: Original Research | Subject: Police Medicine Emergencies
Received: 2022/09/20 | Accepted: 2022/12/13 | Published: 2023/02/6

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