title: Reliability and accuracy of the screening for adverse events in Brazilian hospitals.
abstract: OBJECTIVE
  To analyze the reliability and accuracy of the screening for adverse events (AEs) conducted by nurses taking the assessment by medical residents as the reference.
  
  
  METHODS
  A validation study of the screening phase of a previous retrospective cohort study based on the patient record review that estimated the incidence of AEs (base study).
  
  
  METHODS
  Three general teaching hospitals in the State of Rio de Janeiro, Brazil.
  
  
  METHODS
  A subsample of 242 medical records randomly selected from an original sample of 1103 previously evaluated records.
  
  
  METHODS
  A two-step approach was used for analysis: the identification of at least one screening criterion (first endpoint) and the validation of each identified criterion (second endpoint), taking the assessment by medical residents as the reference. Kappa coefficient; simple percentage agreement; sensitivity; specificity; positive and negative predictive values were calculated.
  
  
  RESULTS
  The total agreement between medical residents and nurses on the presence of screening criteria was moderate (78.9%, K = 0.55). Specificity (81.6%) was higher than sensitivity (74.4%). Nurses detected more screening criteria that were later confirmed as true AEs (179 vs. 171, respectively). Significant differences in the detection of the screening criteria: 'Other complications', 'Hospitalization injury' and 'Prior admission' were observed.
  
  
  CONCLUSIONS
  The results suggested a good performance of the nurses in the screening for detection of AE and showed significant differences in relation to detection of specific screening criteria among reviewers. A better understanding of the screening process and the performance of reviewers was provided.
authors.affiliation: Oswaldo Cruz Foundation, Rio de Janeiro, Manguinhos, Rio de Janeiro-RJ, Brazil.
authors.forename: Ana Luiza Braz
authors.initials: AL
authors.lastname: Pavão
authors.forename: Luiz Antônio Bastos
authors.initials: LA
authors.lastname: Camacho
authors.forename: Mônica
authors.initials: M
authors.lastname: Martins
authors.forename: Walter
authors.initials: W
authors.lastname: Mendes
authors.forename: Cláudia
authors.initials: C
authors.lastname: Travassos
mesh_terms: D001938:Brazil; D002985:Clinical Protocols; D006784:Hospitals, Teaching / Q000592:standards*; D006801:Humans; D019300:Medical Errors / Q000706:statistics & numerical data*; D008505:Medical Staff, Hospital / Q000592:standards*; D009741:Nursing Staff, Hospital / Q000592:standards*; D015203:Reproducibility of Results; D012189:Retrospective Studies