The purpose of this study was to reconstruct Perroca's patient classification instrument; and to assess the content validity of the new version. A group of experts comprising ten nurses appraised the instrument, using the Delphi technique. Data collection took place from March The new version contained nine nursing care areas. Agreement levels on the instrument structure amounted to ≥ 90%, and ranged between 80 and 96% in the nursing care areas. Desarrollo y validación de contenido de la nueva versión de un instrumento para clasificación de pacientesEste estudio tuvo como propósito reconstruir el instrumento de clasificación de pacientes propuesto por Perroca y evaluar la validez de contenido de la nueva versión. La apreciación del instrumento fue realizada por un grupo de expertos constituidos por diez enfermeros mediante aplicación de la Técnica Delphi. La recolección de datos ocurrió en el período de marzo de 2008 a febrero de 2009 a través de cuestionarios estructurados enviados por correo electrónico. La nueva versión pasó a ser constituida por nueve áreas de cuidados. Hubo concordancia ≥ 90% en relación a la estructura del instrumento y de 80 a 96% en las áreas de cuidados. El refinamiento de instrumentos de clasificación es de fundamental importancia para generación de datos válidos y confiables en los cuales se puede basar la toma de decisiones de administración relativa a la planificación de la asistencia y mensuración de carga de trabajo del equipo de enfermería.

P E R R O C A M . G . ( 2 0 1 3 ) The new version of a patient classification instrument: assessment of psychometric properties. AbstractAims. This paper assessed the reliability and construct validity of the new version of a patient classification instrument. Background. In the development of patient classification instruments, monitoring validity and reliability is essential to assure that patient care requirements and nursing staff workload are appropriately measured. Design method. The sample included 194 patients (construct validity test) and 60 patients (inter-rater reliability test) at medical, surgical, and specialized wards of a teaching hospital in the south east of Brazil. The study was conducted in 2009-2010. For analysis purposes, Spearman's correlation and Cronbach's alpha (internal consistency) were used, and weighted kappa (inter-rater reliability), factor analysis with principal axis factoring extraction method (construct validity) and ordinal regression (instrument's predictive ability). Results. A high level of inter-rater agreement was found. The importance of all care areas and their contribution to distinguish patient care needs and category in the new instrument were demonstrated. Results also showed the instrument's high predictive ability (99Á6%). Conclusion. The findings give the evidence that the new scale is a reliable and valid tool to assess patient care needs and care category and that it can be used to guide nursing management practice in determining the nursing staff workload.

This study had in its aim the construction and the validation of a patient classification instrument which has been based on the patient's individual necessities that require the nursing care. It was considered in the instrument 13 critical indicators: Mental State and Level of Consciousness. Breathing, Vital Signs, Nutrition and Hydration, Movement, Locomotion, Corporeal Hygiene, Eliminations, Therapy, Health Teaching, Behavior, Communication and Skin Integrety. Each one of these indicators has a 1 to 5 gradation denoting an increasing level in the nursing care complexity. The patient is classified in all the indicators in one of the five levels, in the option that better describes his/her situation. The content validation of the instrument was done by the Delphi Technique application through 2 rounds. A team of 15 nursing experts who attend patients or teach in the Medical School in São José do Rio Preto were participants in this research. The obtained results have showed the experts' agreement concerned to: the maintenance of the 13 critical indicators in the instrument; property and intelligibility of the critical indicator contents and the presence of an increasing level in the nursing care complexity.

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This study discusses the problem of surgery cancellation on the economic-financial perspective. It was carried out in the Surgical Center Unit of a school hospital with the objective to identify and analyze the direct costs (human resources, medications and materials) and the opportunity costs that result from the cancellation of elective surgeries. Data were collected during three consecutive months through institutional documents and a form elaborated by the researchers. Only 58 (23.3%) of the 249 cancelled scheduled surgeries represented costs for the institution. The cancellations direct total cost was R$ 1.713.66 (average cost per patient R$ 29.54); distributed as follows: expenses with consumption materials R$ 333.05; sterilization process R$201.22; medications R$149.77 and human resources R$1,029.62. The human resources costs represented the greatest percentile in relation to the total cost (60.40%). It was observed that most of the cancellations could be partially avoided. Planning on management; redesigning work processes, training the staff and making early clinical evaluation can be strategies to minimize this occurrence.