From: Validation of an instrument for the evaluation of exchange transfusion (INEXTUS) via an OSCE
Station | Fleiss’ kappa | 95% CI | p value |
---|---|---|---|
item | |||
Station 1. Clinical history and risk approach of the patient with neonatal jaundice | |||
Identifies background of pregnancy and childbirth | 0.75 | (0.59, 0.91) | < 0.001 |
Reviews prenatal exams | 0.67 | (0.50, 0.83) | < 0.001 |
Identifies history and risk factors for severe neonatal jaundicea | - | - | - |
Station 2. Comprehensive evaluation of the patient with jaundice | |||
Evaluates skin and mucosal colouration describing percentage of extent of involvementa | - | - | - |
Evaluates signs and symptoms of acute hyperbilirubinemic encephalopathy | 0.61 | (0.45, 0.78) | < 0.001 |
Evaluates signs and symptoms compatible with haemolysis | 0.84 | (0.68, 1.00) | < 0.001 |
Station 3: Definition of clinical behaviour | |||
Determines whether to use diagnostic testing and requests the appropriate ones | 0.75 | (0.59, 0.92) | < 0.001 |
Performs comprehensive interpretation of the data and classifies the patient | 0.60 | (0.44, 0.76) | < 0.001 |
Indicates that exchange transfusion is required according to the use of the nomograma | - | - | - |
Explains the behaviour to the parents and resolves their concerns | 0.78 | (0.62, 0.95) | < 0.001 |
Signed informed consent | 0.69 | (0.52, 0.85) | < 0.001 |
Station 4. Preparation of the equipment for the procedure | |||
The student verifies that they have the appropriate personnel to perform the procedure | 1.00 | (0.83, 1.1) | < 0.001 |
Properly select the cathetera | - | - | - |
Requests, prepares and verifies equipment for catheter passage | 1.00 | (0.83, 1.1) | < 0.001 |
Requests, prepares and checks equipment for exchange transfusion | - | - | - |
Requests the blood from the laboratory and verifies it when it is delivered | 0.88 | (0.79, 1.04) | < 0.001 |
Determines the type of fluid to be used and the volume of replacementa | - | - | - |
Station 5. Performing exchange transfusion | |||
Verifies patient condition and monitors vital signsa | - | - | - |
Performs the passage of the umbilical catheter properlya | - | - | - |
Performs sequential and orderly exchange transfusiona | - | - | - |
Indicates post-exchange transfusion monitoring to detect the appearance of early complicationsa | 1.00 | (0.83, 1.1) | < 0.001 |
Requests diagnostic testing at the end of the procedure and 6 h after ita | 0.70 | (0.53, 0.86) | < 0.001 |
Station 6. Information to parents | |||
Reports the outcomes of the procedure to parentsa | 0.75 | (0.59, 0.91) | < 0.001 |