The development of a delirium knowledge test for intensive care nurses: A validity and reliability study

ObjectivesThis study aimed to determine the validity and reliability of the Delirium Knowledge Test for the Intensive Care Nurse.MethodThe item analysis and reliability of the test was assessed in a sample of 274 nurses working in the internal and surgical adult intensive care units of one public and three university hospitals in Turkey between 15 May and 15 August 2017. Content and face validity, item analysis and reliability coefficients were used to evaluate the psychometric properties of the test.ResultsThe item difficulty index and item discrimination index of the questions included in the draft form of the 40-item test were found to range from 0.22 to 0.93 and from 0.06 to 0.51, respectively. At the end of the analyses, 14 items were excluded from the draft test, 11 according to the item difficulty index and 3 according to the item discrimination index. Correspondingly, the final version of the test consisted of 26 questions. The item difficulty index of the final test was 0.22 to 0.79, and the item discrimination index was 0.20 to 0.51. The difficulty level of the final test was found to be 59%, and the Cronbach’s alpha reliability coefficient was 0.83.ConclusionThe results of the study showed that the test had good content and face validity and reliability for measuring the delirium knowledge of intensive care nurses.     

OSCE在护士临床能力评价中的设计与应用

中山大学附属第一医院自2017年应用OSCE进行护士临床能力评价。该文从考核目标、病例选择、考站设置、病人使用几方面介绍OSCE的设计,以2017年、2018年应用OSCE考核72名护理技能大赛选手为例,阐述了OSCE的实施方法和效果。通过合理设计OSCE并将其应用于护士临床能力评价中,不仅能全面、客观、灵活地评价护士能力,还能使临床护理管理者、教育者认识到当前护士在培训过程中存在的不足,有助于推动临床护士能力培养方式的变革,提升护士临床能力。     

社区护士核心能力评价指标的构建及信效度评价研究

2009年,《中共中央国务院关于深化卫生体制改革的意见》指出,应进一步加强社区卫生服务机构和社区医疗服务队伍建设。社区护士作为社区卫生服务队伍的重要力量,其核心能力直接影响着护理服务质量,也影响着社区卫生服务质量。目前,美国等相继制定了社区护士核心能力评价标准[1-4],而我国大陆地区尚无对社区护士核心能力评价体系构建的系统研究。因     

Force platform measures for evaluating postural control: reliability and validity

The reliability and validity of force platform measures used to evaluate steadiness of stance were investigated in a group of 28 healthy subjects in four basic stance positions: two-legged, step, tandem, and one-legged stance. In each stance position five indices of steadiness were obtained by sampling the three orthogonal force signals and the two horizontal center of pressure (CP) signals for 15 seconds and computing the standard deviation for each signal. Correlations between these five indices derived from the force platform showed that the relationship between force and CP measures was generally weak. In fact, approximately 40% of the correlations were nonsignificant (p greater than .05). There was a strong trend for the retest reliability of force measures to be higher than the retest reliability of CP measures. The difference was statistically significant in three stances (p less than .05). Force measures were more sensitive than CP measures in discriminating the changes in steadiness which resulted from alterations to the base of support in the four stance positions. Factor analysis showed that force measures were the best predictors of steadiness in each stance, but the axis varied according to the particular stance condition. Although it may be appropriate in some cases to justify the choice of measure according to the nature of the clinical condition being studied, these results provide a rationale for choosing force measures in preference to CP measures on the fundamental principles of reliability and validity.     

Evaluation of the clinical supervision and professional development of student nurses

severinsson e. & sand å. (2010) Journal of Nursing Management  18, 669–677
Evaluation of the clinical supervision and professional development of student nurses Aim The aim of the present study was to evaluate the clinical supervision and professional development of student nurses during their undergraduate education. Background Nursing education has undergone radical changes as a result of improvements in the academic-based clinical education required for the Bachelor’s degree. Methods The sample consisted of student nurses (n = 147) and data were collected by means of questionnaires. Results The results demonstrated that the frequency of sessions and the supervision model employed influence the student nurses’ professional development. Several significant correlations were found, most of which were related to the development of the student nurses’ professional relationships with their supervisors and reflection on the development of their skills. From the patients’ perspective, a high correlation was found between the factors ‘preserving integrity’ and ‘protecting participation by patients and family members’. Conclusions Clinical supervision strongly influences the student nurses’ development of a professional identity, enhancing decision-making ability and personal growth. However, development of documentation skills should include a greater level of user involvement. Implications for nursing management The findings highlight the need for management and staff nurses to engage in on-going professional development. Transformative leadership, which is value driven, can facilitate and enhance the supervision and development of student nurses.     

The development of competency standards for specialist critical care nurses

In defining the contemporary role of the specialist nurse it is necessary to challenge the concept of nursing as merely a combination of skills and knowledge. Nursing must be demonstrated and defined in the context of client care and include the broader notions of professional development and competence. This qualitative study sought to identify the competency standards for nurse specialists in critical care and to articulate the differences between entry-to-practice standards and the advanced practice of specialist nurses. Over 800 hours of specialist critical care nursing practice were observed and grouped into 'domains' or major themes of specialist practice using a constant comparison qualitative technique. These domains were further refined to describe attributes of the registered nurses which resulted in effective and/or superior performance (competency standards) and to provide examples of performance (performance criteria) which met the defined standard. Constant comparison of the emerging domains, competency standards and performance criteria to observations of specialist critical care practice, ensured the results provided a true reflection of the specialist nursing role. Data analysis resulted in 20 competency standards grouped into six domains: professional practice, reflective practice, enabling, clinical problem solving, teamwork, and leadership. Each of these domains is comprised of between two and seven competency standards. Each standard is further divided into component parts or 'elements' and the elements are illustrated with performance criteria. The competency standards are currently being used in several Australian critical care educational programmes and are the foundation for an emerging critical care credentialling process. They have been viewed with interest by a variety of non-critical care specialty groups and may form a common precursor from which further specialist nursing practice assessment will evolve.     

颈椎病临床评价量表的信度与效度研究

目的　制定一种对颈椎病患者的症状、体征和功能状态进行临床评估的临床评价量表(CASCS) ,并探讨其在颈椎病临床评价中的信度及效度。方法　对 92例颈椎病患者 (实验组 )应用CASCS与Vernon颈椎残障指数量表 (NDI)进行信度、效度和敏感度分析 ,同时应用CASCS对 2 0例正常人 (对照组 )进行评测。并对颈椎病患者康复治疗前、后的CASCS评测结果进行对比分析。结果　CASCS总积分与各条目积分间的组内相关系数 (ICC)为 0 .78～ 0 .99,信度系数Cronbachα为 0 .84。该量表与NDI有较好的相关性(r =0 .76,P <0 .0 1)。康复治疗前 ,颈椎病患者与正常人的CASCS评价结果间有极显著性差异 (t =14 .76,P <0 .0 1)。颈椎病患者康复治疗前、后的CASCS评测结果间有极显著性差异 (t =2 1.0 3,P <0 .0 1)。结论　CASCS具有较高的信度、效度和敏感度 ,是临床评价颈椎病的一种客观、行之有效的方法     

临床护士整体人文关怀感知量表的编制及信效度检验

目的 编制临床护士整体人文关怀感知量表,并检验其信效度。方法 在文献分析和半结构式访谈的基础上,通过德尔菲法构建量表初稿。2022年4月在武汉市某三级甲等医院选取20名临床护士进行预调查,检验量表可读性。2022年4月—5月选取咸宁市和泰安市2所医院的501名临床护士作为调查对象,对量表进行项目分析和信效度检验。结果临床护士整体人文关怀感知量表包括6个维度、40个条目。探索性因子分析共提取6个公因子,累计方差贡献率为79.05%;验证性因子分析结果显示,量表结构模型的拟合指数良好。量表水平的内容效度指数为0.94,条目水平的内容效度指数为0.78～1.00;量表总的Cronbach’s α系数为0.98,重测信度为0.87。结论 临床护士整体人文关怀感知量表信效度良好,可用于测量护士感知的整体人文关怀情况。     

护士进修动机量表编制与信效度分析

目的编制有良好信效度的护士进修动机量表,为进一步研究护士进修动机提供可靠测量工具。方法以国内外相关研究理论为基础,经专家咨询法、探索性因子分析形成护士进修动机量表,并对量表的重测信度、内部一致性、结构效度进行检验。结果编制5因子22条目护士进修动机量表,各因子和整体量表的克朗巴哈α系数均在0.8以上,具有良好的内部一致性;各因子得分和量表总分两次测试的相关系数均在0.7以上,重测信度较好;验证性因子分析显示问卷的结构效度拟合良好。结论本次编制的护士进修动机量表具有较高的信度与效度。     

临床护理人员文化能力量表的信效度测定

目的构建临床护理人员文化能力量表,并测定其信度和效度。方法初步拟定量表内容,经过2轮专家咨询后形成预初量表,对200名临床护理人员进行调查,测量量表的信度、效度。结果量表的总体Cronbach'sα系数为0.978,各维度Cronbach'sα系数为0.852~0.952;总体分半信度为0.968;内容效度为0.930;重测信度组内相关系数ICC为0.762。结构效度分析显示有文化知识、文化渴望、文化实践、文化互动、文化经历、文化意识、文化技能7个因子,最终确定84个条目。结论量表具有良好的信度、效度,可以作为临床护理人员文化能力的评价工具。     

The validity and reliability of the Perometer in evaluating human knee volume

BACKGROUND: Accurate knee swelling evaluation is important in monitoring the progress of a patient's condition and rehabilitation. Water volumetry is the current gold standard of volume assessment but can be time consuming and unsuitable for assessing patients with open wounds. No previous study has reported the potential use of an optoelectronic device in assessing knee volume. OBJECTIVES: To evaluate an optoelectronic device, the Perometer in knee volume assessment in uninjured subjects and compare it to the current gold standard of volume assessment - water displacement. MATERIALS AND METHODS: Bilateral knee measurements were measured in 20 uninjured individuals with both methods on two separate days using a one-way repeated measures design. A cylindrical object was also measured 10 times with both tools. RESULTS: The mathematically calculated volume of the cylinder was 1568 ml. The mean volume obtained by the Perometer was 1602 and 1620 ml by the volumeter. This represented an over-estimation of the true volume of 2.2% by the Perometer and 3.4% by the volumeter. A high correlation was found for repeated measures of knee volumes with both methods (r = 0.94, P<0.01). Limits of agreement (LOA) were calculated to assess the amount of agreement between the two methods and these ranged from -130 to 207 ml indicating a low degree of agreement. CONCLUSIONS: The results indicate that the Perometer is as reliable as the knee volumeter in assessing knee volume. However, the wide LOA suggest the two methods should not be used interchangeably.     

社区老年人跌倒危险评估工具的信效度检验

目的:通过测试内部一致性、条目分析、重测信度,评价自制跌倒危险量表的可靠性,分析其在社区老年人跌倒预防中应用的可行性。方法:使用老年人跌倒评估量表对100名社区老年人进行跌倒危险评估,根据评估结果检验该工具的信度和效度。结果:老年人跌倒评估量表Cronbach’sα系数为0.706,具有较好的内部一致性,护理实习生和社区医生应用老年人跌倒评估量表测评结果比较,差异无统计学意义(P0.05)。有跌倒与无跌倒的老年人评分比较,差异有统计学意义(P0.01)。结论:老年人跌倒评估量表是一种简单、方便、安全的评估工具,其信度和效度较好,适合社区卫生服务人员评估老年人的跌倒危险性。     

护生管床责任制教学模式的临床实践

目的探讨护生管床责任制教学模式的临床实践效果。方法选择2010年6月～2012年4月妇一科实习护生作为实验组,实行护生管床责任制,固定班次与床位,在带教老师指导下完成所管床位病人护理工作;选择同期妇二科实习护生作为对照组,护生不具体管床,每天班次不同工作任务不同。实习结束时比较两组护生对病人病情掌握情况及病人对护生工作满意度。结果两组护生对病人病情掌握程度及病人对护生工作满意度比较,均P〈O．05,差异具有统计学意义,实验组优于对照组。结论护生管床责任制带教模式能增强护生工作责任心,有利于提高护理教学质量及病人满意度。     

A risk assessment scale for the prediction of pressure sore development: reliability and validity

BACKGROUND: The ability to assess the risk of a patient developing pressure sores is a major issue in pressure sore prevention. Risk assessment scales should be valid, reliable and easy to use in clinical practice. AIM: To develop further a risk assessment scale, for predicting pressure sore development and, in addition, to present the validity and reliability of this scale. METHODS: The risk assessment pressure sore (RAPS) scale, includes 12 variables, five from the re-modified Norton scale, three from the Braden scale and three from other research results. Five hundred and thirty patients without pressure sores on admission were included in the study and assessed over a maximum period of 12 weeks. Internal consistency was examined by item analysis and equivalence by interrater reliability. To estimate equivalence, 10 pairs of nurses assessed a total of 116 patients. The underlying dimensions of the scale were examined by factor analysis. The predictive validity was examined by determination of sensitivity, specificity and predictive value. RESULTS: Two variables were excluded as a result of low item-item and item-total correlations. The average percentage of agreement and the intraclass correlation between raters were 70% and 0.83, respectively. The factor analysis gave three factors, with a total variance explained of 65.1%. Sensitivity, specificity and predictive value were high among patients at medical and infection wards. CONCLUSION: The RAPS scale is a reliable scale for predicting pressure sore development. The validity is especially good for patients undergoing treatment in medical wards and wards for infectious diseases. This indicates that the RAPS scale may be useful in clinical practice for these groups of patients. For patients undergoing surgical treatment, further analysis will be performed.     

Evaluation of a mentor-arranged clinical practice placement for student nurses

Second year nursing students evaluated a new initiative, the Mentor-Arranged Clinical Practice (MACP), which supplemented their other clinical experiences. Seventy-eight students (95.6%) returned their completed questionnaires. Results indicated that the MACP program was beneficial to the students in the acquisition of knowledge, improvement of basic nursing skills, time management, prioritisation in patient care, and improvement in their confidence and self-esteem. Students identified six positive aspects of the MACP program: continuity and consolidation of nursing skills, improved communication and reporting skills, working in a variety of shifts, and working as a team member. Characteristics of a good mentor encompassed four areas: personality traits, teaching ability, nursing competence and interpersonal relationship. Findings suggest that there is a need for the development of mentorship models in the clinical experiences of undergraduate nursing courses, and the importance of effective clinical teachers in preparing nursing students for the workforce.