Adaptação dos instrumentos de avaliação de eventos adversos para uso em hospitais brasileiros

Abstract

Objective: To adapt assessment forms and triggers of the Canadian Adverse Events Study (CAES), aiming at the assessment of Adverse Events (AEs) in Brazilian hospitals. Method: Adjustment followed a four-step process: (I) translation from Portuguese into English; (II) expert' panel to judge triggers in the context of Brazilian hospitals and translation of the assessment form (III) pretest and (IV) back-translation. Results: The expert panel changed the definition of AEs in Portuguese by introducing the terms harm and dysfunction in "unintended harm or injury resulting in death, temporary or permanent disability or dysfunction, and/ or prolonged hospital stay resulting from health care management". The Panel also modified the list of triggers in the CAES form. Pre-test results detected problems in the quality of assessment in the tracking phase. The frequency of potential AEs obtained by a senior physician was similar to the one obtained by CAES. This indicates that information available in medical records was adequate for using retrospective record review methods, but that nurse reviewers needed to be retrained. Conclusions: Adapted CAES tools and triggers are feasible to be used in hospitals in Brazil. Retrospective chart review requires a well structured training process and assessment of reviewers' performance previously to their acceptance as reviewers.