Name: Juliana Mitre da Silva
Type: MSc dissertation
Publication date: 13/02/2020

Namesort descending Role
Mirian Fioresi Advisor *
Walckiria Garcia Romero Sipolatti Co-advisor *

Examining board:

Namesort descending Role
Bruno Henrique Fiorin External Examiner *
Cândida Caniçali Primo Internal Examiner *
Karolini Zuqui Nunes External Alternate *
Maria Edla de Oliveira Bringuente Internal Alternate *
Mirian Fioresi Advisor *
Walckiria Garcia Romero Sipolatti Co advisor *

Summary: Introduction: The concept of decreased cardiac output is found mainly in the nursing and medical fields and is centered on the pumping capacity of the heart. However, due to the similarity of signs and symptoms involving this phenomenon with those of other diseases, its early identification may be impaired, which culminates in a serious risk to the patient. Nurses are the professionals who stay the longest in direct care of people, so they commonly identify clinical changes and signs of deterioration of patients´ health at all levels of health care. Considering the phenomenon of decreased cardiac output and its severity, it is possible to establish a noninvasive assistive technology in the form of a scale for predicting risk in adults and to facilitate clinical thinking and nursing care for patients with this disease. Objective: To develop a scale to classify the risk of decreased cardiac output in adult. Methods: This is a methodological study developed in three stages: literature scope review, pilot instrument construction and validation by judges. The scale was constructed following the principles of Pasquali´s elaboration of scales, in the dimension of its theoretical pole. Content and face validation was based on content validity index (CVI) and was considered as inclusion criteria CVI greater than or equal to 0.8. The judging population consisted of nurses with a minimum degree of specialist and minimum experience of two years in the field of nursing cardiology. The items that made up the scale were evaluated as: 1- Adequate, 2- Needs adequacy and 3- Inadequate, within the criteria of clarity, relevance or representativeness and comprehensiveness. Results: After the validation process, the scale was composed of the following nine items, called clinical indicators: consciousness status, respiratory status, activity tolerance, fluid volume, gastric status, sensory alteration of cardiac origin, heart rate and rhythm, blood pressure and tissue perfusion. Each item can be scored from 1 to 3 in ascending order of severity and by summing the total points the patient risk can be stratified into: minimum risk (9 to 12 points), intermediate risk (13 to 18 points) and high risk (19 to 27 points). If the patient is tired with minor exertion (eating) and/or presents with chest pain that does not cease at rest and therapy, he/she should be classified as high risk even if the patient has a score below 19 points. Conclusion: A scale-based assistive technology was developed and validated to classify the risk of decreased cardiac output in adults that can direct nursing care and favor the clinical reasoning of nurses in the nursing process to patients who present signs and symptoms of this phenomenon.

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