Infecção em sítio cirúrgico pós-cirurgia cesariana em um hospital de referência: desenvolvimento e validação de vídeo educativo

Abstract

Introduction: Healthcare-associated infections consist of adverse events, increase hospitalization and morbidity and mortality in healthcare services, therefore, prevention measures are necessary to reduce infections. Objectives: To identify the rate of surgical site infection after cesarean section surgery in a reference hospital; build and validate, with experts in the field, the educational video content, regarding guidance to postpartum women on the necessary post-discharge care to prevent infections at the surgical site after cesarean section surgery. Method: Retrospective, observational, cross-sectional and methodological study, carried out in two stages: identification of surgical site infection after cesarean surgery and preparation and validation of an educational video by expert judges. Part of the research were postpartum women undergoing cesarean section surgery in the study maternity hospital, who had surgical site infections after cesarean surgery, from May 1, 2021 to December 31, 2021, a period chosen due to the beginning of the active voice search for infections. surgical site of cesarean section in the study maternity ward. Data were collected using a structured form, through analysis of investigation forms and active surveillance notifications from the Hospital Infection Control Center and electronic medical records from a reference hospital. In the first stage, the results of the investigation of post-cesarean section infection were divided into descriptive analyzes with associations and correlations. The second stage was carried out through the process of construction and validation of the educational video, which included four moments: planning, production, implementation and evaluation, which were subdivided and comprised more specific stages, namely: Analysis and diagnosis, Instructional planning, Didactic design, Media production, Review and Validation. The video was validated by 11 expert health judges, with each evaluation item analyzed by completing a script, observing the following aspects: objectives, structure and presentation and relevance, in which the concepts of health validation index were applied. content and intraclass correlation coefficient, which evaluates the agreement between more than two sets of data or more than two evaluators. Statistical analyzes of data at all stages were carried out using Excel (Microsoft Office Professional Plus, 2013) and IBM SPSS (Statistical Package for the Social Sciences) 23, 2015, presented in descriptive form with frequencies and percentages. The significance level used in the entire study was 5%; In the descriptive analysis, qualitative variables were presented as frequency (n) and percentage (%). Results: 1383 cesarean surgeries were performed during the period, with 55 patients diagnosed with surgical site infection, classification of surgical site infection as superficial incisional, followed by deep incisional, the majority of women were mixed race, with an education level of up to nine years, and the patients had an average age of 29.33 years. Regarding the validation of the educational video, the answers were considered satisfactory: only “totally adequate” and “adequate”, with a value of 1 being assigned to them in each situation. For judges considering satisfactory results for “adequate” or “totally adequate” responses: CVI = 0.936, and for the results of the content validity index (I-CVI) of each item and the general content validity index of the entire questionnaire (S-CVI/Ave), considering the “adequate” or “totally adequate” responses, the values were: 0.957 (95% I.C. 0.908 – 0.986) for Cronbach’s alpha, and 0.958 (95% I.C. 0.911 – 0.987) for the ICC, indicating that the questionnaire answered by experts in the field showed very high internal consistency, with high agreement between judges (experts). Three scientific articles were also included as results. Products developed: 1. Article entitled Surgical site infection after cesarean surgery in a reference hospital, submitted to the magazine Comunicação em Ciências da Saúde (ISSN online 1980-0584 / ISSN 1980-5101), classified by the Capes program unified in Qualis B1; 2. Article entitled Surgical site infection after cesarean surgery, length of stay and surgical time, submitted to the journal Interfaces: Saúde, Humanas e Tecnologia (ISSN online 2317-434X), classified by the Capes program unified into Qualis A3; 3. Article entitled Development of an educational video on the prevention of surgical site infections after cesarean surgery, submitted to the magazine Ensino, Educação e Ciências Humanas (ISSN online 2447- 8733), classified by the Capes program unified in Qualis A3; 4. Educational video titled How to care for a cesarean section scar. Conclusion: There were 55 patients diagnosed with surgical site infection, the majority of women were mixed race, with an education level of up to nine years, an average age of 29.33 years and the predominance was Surgical site infection of the superficial incisional type, followed by deep incisional. This study allowed the development and validation of an educational video with a specific theme on prevention guidelines for surgical site infections after cesarean surgery, material validated and approved in terms of appearance and content, whose evaluated items had high agreement among expert judges, content judges and technical judges, demonstrating that the constructed material is reliable and approved to be applie parturient women during postpartum care, aiming to prevent infection at the surgical site after cesarean surgery.