Reproducibility and confiability of a processual indicator to evaluate adherence to oral hygiene in patients with orotracheal intubation

The oral hygiene has been recognized as direct and relevant measure to prevent pneumonia in critically ill patients. Considering the assessment of quality of care through processual indicators as an important step to improve care, this study aimed to measure the intensity of agreement of "indicator to evaluate adherence to oral hygiene (IRHB)", in  critical ill patients with orotracheal intubation, through the Kappa test. This test recommends that assessments must be done by pairs of observers, which totaled 104 double-observations. Results showed a perfect agreement among three of four pairs of observers (74% k = 1.00) and almost perfect in a pair (26% k = 0.90). Of the 27 observations performed by this last pair, only the item related to the profession did not agree. These results indicate that there is a reduction of aleatory error, and suggest that the instrument could be applied at other institutions that assist critical ill patients, since the Kappa test is made to ensure the accuracy of the data.