Sistema de classificação de risco em urgência e emergência: um aplicativo móvel para enfermeiros

Abstract

Introduction: Overcrowding in urgency and emergency services is a worldwide phenomenon. One of the proposals for the reorganization of these services is the Reception with Risk Classification of users, through a triage process. The triage aims to identify the most serious patients and those at greatest risk of death, ensuring fast care with minimum time. The act of Risk Classification is an exclusive competence of the Nurse, being an intuitive element of the clinical practice of nurses who work in urgency and emergency services. There are several triage systems, among which the Manchester Triage System (MTS), where there is the use of flowcharts representing the patient's main complaint, classifying them through a color system. Information and Communication Technologies have had an impact on social, business, and institutional relationships, creating a new, constantly evolving information and knowledge society. By the incorporation of these technologies in society, especially with the use of mobile devices and applications, we propose the use of a tool to aid in decision making through a mobile application. Objectives: To idealize, develop and evaluate a mobile application for use on smartphones, for nurses to be used in the activities of Reception and Risk Classification of patients, guided by the MTS. Method: methodological research applied to technological production with the development of a prototype application for mobile devices, through the Evolutionary Prototyping process. The content was validated with the use of a Likert-type questionnaire and through the Content Validation Index (CVI) by expert judges, obeying inclusion criteria and respecting ethical aspects. Results and Discussion: A literature review on the production of apps in Portuguese resulted in 23 articles. The analysis of the papers allowed us to evaluate the national production on the theme and to verify that there is a gap in relation to studies of this nature. Next, a mobile application called Triage Now App was developed, divided into four sections: Risk Classification Reception, Manchester Protocol - Original, Triage, and About the app. The triage section was divided into three sections: Pregnant, Adult, and Pediatrics, where each of the options presents specific problem situations aimed at these target audiences, involving a total of 59 possible scenarios. A total of 21 judges participated in the evaluation, predominantly female (76%), working in public institutions (90%), with more than ten years of professional experience (95%) and in the urgency and emergency area (81%). The average response was 4.45 out of 5 points. The CVI of nine of the ten proposed statements was higher than 0.85, showing the agreement between the evaluators. The CVI of the data collection instrument was 0.90, corroborating the results found. Conclusions: The application developed proved to be functional after the judges' evaluation, presenting satisfactory results. We reiterate the importance of carrying out new studies, aiming at the development of new tools that help health professionals in their daily activities.