Development and Psychometric Testing of the Nursing Performance for Patient Safety Scale
Keywords:
Instrument development, Patient safety, Nursing performance, Psychometric testing, Quality, SafetyAbstract
In Thailand, patient safety measurement is based on nursing and midwifery standards. In this study we developed the Nursing Performance for Patient Safety Scale to assess individual nurses. The instrument development process involved six steps: 1) Identification of constructs from concept analysis. These included six sub-domains: protection, prevention, mitigation, promotion, interpersonal facilitation, and dedication; 2) Generating 141 items for item pool; 3) Determining format for measurement. Scaling responses were determined using a 6-point Likert-scale; 4) Verification of the 141 items by five experts and 73 items remained after the second round with the S-CVI of 1.00; 5) Determining reliability. The Cronbach’s alpha coefficient was 0.95; and 6) Field testing for construct validity.
The study settings were 8 regional and 9 general hospitals governed by Thailand Ministry of Public Health. There were 759 nurses selected using multistage sampling in four regions of Thailand, and simple random sampling was used. Item-total correlation ranged from 0.24 to 0.75. Principal component and oblique rotation by directoblimin was used for exploratory factor analysis. The final Scale had 64 items with 9 domains 1) protection through communication; 2) protection through risk management; 3) prevention through right drug and solution administration; 4) prevention through implementation of practice guideline; 5) prevention emergency adverse events through critical care; 6) prevention through effective patient care process; 7) mitigation; and 8) promotion through team and responsibility and 9) dedication to patient safety. This Scale can be used to produce evidence to helping to improve patient safety performance by nurses in Thailand. However, future studies are needed to refine the Scale.
References
1. World Health Organization. 10 facts on patient safety [Internet]. 2014 [cited 2014 Oct 10]. Available from http://www.who.int/features/factfiles/patient_safety/en/
2. The Joint Commission. National Patient Safety Goals [Internet]. 2015 [cited 2015 Feb 27]. Available from http://www.jointcommission.org/standards_ information/ npsgs.aspx
3. Healthcare Accreditation Institute (Public Organization). Thai patient safety goals SIMPLE[Internet]. 2008 [cited 2014Aug6]. Available from http://ha.phahol.go.th/File/ Patient_Safety_ Goals_ SIMPLE7.doc
4. Jirasinthipok T, Jermviwatkul P, Nidtayangkul S, Wongsuwansiri S, Wongjaroen S. The nursing standard in hospital. 2nd ed. Bangkok: The War Veterans Organization; 2008.
5. Thailand Nursing and Midwifery Council. Standard of nursing and midwifery[Internet]. 2006 [cited 2013 May 9]. Available from http://www.tnc.or.th/law/page-6.html
6. Donabedian A. Quality of care problems of measurement Part II Some issues in evaluating the quality of nursing care. AJPH [Internet]. 1969[cited 2015 Feb 27]; 59: 1833-6. Available from http://www.ncbi.nlm.nih.gov/pmc/articles/ PMC1226726
7. Donabedian A. The Quality of care how can it be assessed? JAMA [Internet]. 1988[cited 2015 Feb 27]; 260: 1743-8. Available from http://post.queensu.ca/~hh11/assets/ applets/The_Quality_of_Care_How_Can_it_Be_Assessed_-_ Donabedian.pdf
8. Austin JM, Andrea GD, Birkmeyer JD, Leape LL, Milstein A, Pronovost PJ et.al. Safety in number: the development of leapfrog’s composite patient safety score for U.S. hospitals.J Patient Saf [Internet]. 2013 [cited 2014 Oct 1]; 10: 64-71. Available from www.journalpatientsafety.com
9. Chassin MR, Loeb JM, Schmaltz SP, Wachter RM. Accountability Measures- using measurement to promote quality improvement. NEJM [Internet]. 2010 [cited 2014 Sep 2]; 363: 683-8. Available from www.nejm.org/doi/ pdf/10.1056/NEJMsb1002320
10. Mayer GM, Nelson EC, Pryor DB. More quality measures versus measuring what matters: a call for balance and parsimony. BMJ QualSaf [Internet]. 2014 [cited 2014 Sep10]; 21: 964-8. Available from http://qualitysafety. bmj.com/content/21/ 11/964. full. html
11. Simpson KP. Measuring perinatal patient safety: Review of current methods. The Association of Women’s Health, Obstetric and Neonatal Nurses. J ObstetGynecol Neonatal Nurs[Internet]. 2006 [cited 2013 Nov 11]; 35(3), 432-40. Available from http://dx.doi:10.1111/j.1552- 6909. 2006.00060.x
12. Padungsak S. Nurse’s perception on patient safety culture and incidence of adverse events in northern regional hospitals(Master’s thesis). Chiang Mai, Chiang Mai University; 2009.
13. Hughes RG. Tool and strategies for quality improvement and patient safety.In Hughes RG.Patient Safety and Quality: An Evidence-Based Handbook for Nurses [Internet].2008 [cited 2012 May 6]. Available from www. ncbi.nlm.nih.gov/books/NBK2682/pdf/ ch44.pdf
14. Sonnentag S, Frese M. Performance concepts and performance theory. In Sonnentag S, Frese M. Psychological Management of Individual Performance. Chichester: John Wiley & Sons, Ltd; 2002. 3-25.
15. Sorra JS, Dyer N. Multilevel psychometric properties of the AHRQ hospital survey on patient safety culture. BMC Health Services Research [Internet]. 2010[cited 2014 Nov 11]; 6:1-13. Available from http://www.biomedcentral. com/1472-6963/10/199.
16. Schnall R, Stone P. Currie L, Desjardins K, John RM, Bakken S. Development of a self-report instrument to measure patient safety attitudes skills, and knowledge. JNursScholarsh[Internet]. 2008 [cited 2013 May 8]; 40: 391-4. Available from http://www.ncbi.nlm.nih.gov/ pubmed/19094156
17. Cronenwett L, Sherwood G, Pohl J, Barnsteiner J, Moore S, Sullivan DT, et al. Quality and safety education for advanced nursing practice. NursOutlook[Internet]. 2009[cited 2010 April 1]; 57: 338-48. Available from http://www.nursingoutlook.org/article/S00296554(09)00135-3/fulltext
18. Fields W, Foltz J, Heaney K, Rizos A, Tedeschi C, Myers T, et al. Reducing preventable medication safety events by recognizing renal risk. CNS [Internet]. 2008[cited 2011 Jan 10]; 22: 73-8. Available from http://www.ncbi. nlm.nih.gov/pubmed/18418117
19. World Health Organization. Fundamentals in Patient safety [Internet].2012 [cited 2014 Oct 10]. Available from www.who.int/patientsafety/education/ curriculum/ course1_handout.pdf
20. The Joint Commission. The Joint Commission Accreditation Program: Hospital National Patient Safety Goals [Internet]. 2010 [cited 2010 July 1]. Available from http://www. jointcommission.org/patientsafety/ national patient safety goals/npsg facts.html
21. Webster’s New World College Dictionary. The dictionary for the 21stcentury. 4th ed. Ohio: Michael Agnes; 2000.
22. Motowildo SJ, Borman WC, Schmit MJ. A theory of individual differences in task and contextual performance. Human Performance[Internet]. 1997 [cited 2011 Jan 5]; 10: 71-83. Available from http://dx.doi.org/10.1207/ s15320743hup1002_1
23. Griffin MA, Neal A, Neale M. The contribution of task performance and contextual performance to effectiveness: Investigating the role of situational constraints. IAAP [Internet]. 2000[cited 2010 Feb 18]; 29: 517-33. Available from griffin.zydec.net.au/publication/Neal_ Griffin_APIR.pdf
24. Borman WC, Motowidlo SJ. Expanding the criterion domain to include elements of contextual performance. In: Schmitt N, Borman W, editors. Personnel selection in organizations. SanFrancisco: Jossey-Bass; 1993.p.71-97.
25. VanScotter JR, Motowidlo SJ. Interpersonal facilitation and job dedication as separate facets of contextual performance. Journal of Applied Psychology[Internet]. 1996[cited 2011 Feb 15]; 81: 525-31. Available from http://doi.apa.org/journals/apl/81/5/525.pdf
26. World Health Organization. Conceptual framework for the international classification for patient safety [Internet]. 2009 [cited 2012 Feb 14]. Available from http://www. who.int/ patient safety/toxonomy/icps_full_report_pdf
27. Thompson Rivers University. Incident, accident & first aid reporting and investigation [Internet]. 2013 [cited 2012 Aug 14]. Available from http://www.tru.ca/hssafety/ incident_ reporting.html
28. Frankel A, Leonard M. Update on Safety Culture[Internet]. 2013 [cited 2014 Feb 9]. Available from http://webmm. ahrq.gov/perspective.aspx? Perspective ID=144
29. Nunnally JC, Bernstein IH. Psychometric theory. 3rded. New York: McGraw-Hill, Inc; 1994.
30. Lynn MR. Determination and quantification of content validity. Nurs Research 1986;35(6), 382-6.
31. Burns N, Grove SK. The practice of nursing research appraisal, synthesis, & generation of evidence. 6th ed. St Louis: W.B. Saunders; 2009.
32. DeVellis RF. Scale development theory and applications. 2nd ed. California: Sage;2003.
33. Hair JF, Black WC, Babin BJ, Anderson RE, &Tatham R. Multivariate data analysis. 6thed. New Jersey: Pearson Education; 2006.
34. Munro BH. Statistical methods for health care research. 4th ed. Lippincott: Philadelphia; 2001.
35. Lee P, Allen K, Daly M. A communication and patient safety’training programme for all healthcare staff: can it make a difference? BMJ QualSaf [Internet]. 2012 [cited 2014 Sep 8]; 21: 48-8 Available from http://qualitysafety. bmj.com
36. Donohue A. Managing risk: Protect yourself and your patients. ACA news[Internet]. 2015 [cited 2014 Dec 14]; 11: 30-1. Available from http://www.acatoday. org/ content_ css.cfm?CID=5610
37. Macdonald M. Examining the adequacy of the 5 rights of medication administration. C NS [Internet]. 2010 [cited 2013 Feb 4]; 24: 196-201. Available from http://www. ncbi. nlm.nih.gov/pubmed/20526120
38. Sammer CE, Lykens K, Singh KP, Mains DA, LackanNA. What is patient safety culture? A review of the literature. Nursing Scholarship [Internet]. 2010 [cited 2013 Jun25]; 42:156-65. Available from http://www.ncbi.nlm.nih. gov/pubmed/20618600
39. Pohl JM, Sarvin C, Fiandt K, Beauchesne M, Drayton-Brooks S, Scheibmeir M et al. Quality and safety in graduate nursing education: Cross-mapping QSEN graduate Competencies with NONPF’s NP core and practice doctorate competencies. Nursing Outlook[Internet]. 2009[cited 2015 Feb 25]; 57: 349-54. Available from http://www.ncbi.nlm.nih. gov/pubmed/19942036
2. The Joint Commission. National Patient Safety Goals [Internet]. 2015 [cited 2015 Feb 27]. Available from http://www.jointcommission.org/standards_ information/ npsgs.aspx
3. Healthcare Accreditation Institute (Public Organization). Thai patient safety goals SIMPLE[Internet]. 2008 [cited 2014Aug6]. Available from http://ha.phahol.go.th/File/ Patient_Safety_ Goals_ SIMPLE7.doc
4. Jirasinthipok T, Jermviwatkul P, Nidtayangkul S, Wongsuwansiri S, Wongjaroen S. The nursing standard in hospital. 2nd ed. Bangkok: The War Veterans Organization; 2008.
5. Thailand Nursing and Midwifery Council. Standard of nursing and midwifery[Internet]. 2006 [cited 2013 May 9]. Available from http://www.tnc.or.th/law/page-6.html
6. Donabedian A. Quality of care problems of measurement Part II Some issues in evaluating the quality of nursing care. AJPH [Internet]. 1969[cited 2015 Feb 27]; 59: 1833-6. Available from http://www.ncbi.nlm.nih.gov/pmc/articles/ PMC1226726
7. Donabedian A. The Quality of care how can it be assessed? JAMA [Internet]. 1988[cited 2015 Feb 27]; 260: 1743-8. Available from http://post.queensu.ca/~hh11/assets/ applets/The_Quality_of_Care_How_Can_it_Be_Assessed_-_ Donabedian.pdf
8. Austin JM, Andrea GD, Birkmeyer JD, Leape LL, Milstein A, Pronovost PJ et.al. Safety in number: the development of leapfrog’s composite patient safety score for U.S. hospitals.J Patient Saf [Internet]. 2013 [cited 2014 Oct 1]; 10: 64-71. Available from www.journalpatientsafety.com
9. Chassin MR, Loeb JM, Schmaltz SP, Wachter RM. Accountability Measures- using measurement to promote quality improvement. NEJM [Internet]. 2010 [cited 2014 Sep 2]; 363: 683-8. Available from www.nejm.org/doi/ pdf/10.1056/NEJMsb1002320
10. Mayer GM, Nelson EC, Pryor DB. More quality measures versus measuring what matters: a call for balance and parsimony. BMJ QualSaf [Internet]. 2014 [cited 2014 Sep10]; 21: 964-8. Available from http://qualitysafety. bmj.com/content/21/ 11/964. full. html
11. Simpson KP. Measuring perinatal patient safety: Review of current methods. The Association of Women’s Health, Obstetric and Neonatal Nurses. J ObstetGynecol Neonatal Nurs[Internet]. 2006 [cited 2013 Nov 11]; 35(3), 432-40. Available from http://dx.doi:10.1111/j.1552- 6909. 2006.00060.x
12. Padungsak S. Nurse’s perception on patient safety culture and incidence of adverse events in northern regional hospitals(Master’s thesis). Chiang Mai, Chiang Mai University; 2009.
13. Hughes RG. Tool and strategies for quality improvement and patient safety.In Hughes RG.Patient Safety and Quality: An Evidence-Based Handbook for Nurses [Internet].2008 [cited 2012 May 6]. Available from www. ncbi.nlm.nih.gov/books/NBK2682/pdf/ ch44.pdf
14. Sonnentag S, Frese M. Performance concepts and performance theory. In Sonnentag S, Frese M. Psychological Management of Individual Performance. Chichester: John Wiley & Sons, Ltd; 2002. 3-25.
15. Sorra JS, Dyer N. Multilevel psychometric properties of the AHRQ hospital survey on patient safety culture. BMC Health Services Research [Internet]. 2010[cited 2014 Nov 11]; 6:1-13. Available from http://www.biomedcentral. com/1472-6963/10/199.
16. Schnall R, Stone P. Currie L, Desjardins K, John RM, Bakken S. Development of a self-report instrument to measure patient safety attitudes skills, and knowledge. JNursScholarsh[Internet]. 2008 [cited 2013 May 8]; 40: 391-4. Available from http://www.ncbi.nlm.nih.gov/ pubmed/19094156
17. Cronenwett L, Sherwood G, Pohl J, Barnsteiner J, Moore S, Sullivan DT, et al. Quality and safety education for advanced nursing practice. NursOutlook[Internet]. 2009[cited 2010 April 1]; 57: 338-48. Available from http://www.nursingoutlook.org/article/S00296554(09)00135-3/fulltext
18. Fields W, Foltz J, Heaney K, Rizos A, Tedeschi C, Myers T, et al. Reducing preventable medication safety events by recognizing renal risk. CNS [Internet]. 2008[cited 2011 Jan 10]; 22: 73-8. Available from http://www.ncbi. nlm.nih.gov/pubmed/18418117
19. World Health Organization. Fundamentals in Patient safety [Internet].2012 [cited 2014 Oct 10]. Available from www.who.int/patientsafety/education/ curriculum/ course1_handout.pdf
20. The Joint Commission. The Joint Commission Accreditation Program: Hospital National Patient Safety Goals [Internet]. 2010 [cited 2010 July 1]. Available from http://www. jointcommission.org/patientsafety/ national patient safety goals/npsg facts.html
21. Webster’s New World College Dictionary. The dictionary for the 21stcentury. 4th ed. Ohio: Michael Agnes; 2000.
22. Motowildo SJ, Borman WC, Schmit MJ. A theory of individual differences in task and contextual performance. Human Performance[Internet]. 1997 [cited 2011 Jan 5]; 10: 71-83. Available from http://dx.doi.org/10.1207/ s15320743hup1002_1
23. Griffin MA, Neal A, Neale M. The contribution of task performance and contextual performance to effectiveness: Investigating the role of situational constraints. IAAP [Internet]. 2000[cited 2010 Feb 18]; 29: 517-33. Available from griffin.zydec.net.au/publication/Neal_ Griffin_APIR.pdf
24. Borman WC, Motowidlo SJ. Expanding the criterion domain to include elements of contextual performance. In: Schmitt N, Borman W, editors. Personnel selection in organizations. SanFrancisco: Jossey-Bass; 1993.p.71-97.
25. VanScotter JR, Motowidlo SJ. Interpersonal facilitation and job dedication as separate facets of contextual performance. Journal of Applied Psychology[Internet]. 1996[cited 2011 Feb 15]; 81: 525-31. Available from http://doi.apa.org/journals/apl/81/5/525.pdf
26. World Health Organization. Conceptual framework for the international classification for patient safety [Internet]. 2009 [cited 2012 Feb 14]. Available from http://www. who.int/ patient safety/toxonomy/icps_full_report_pdf
27. Thompson Rivers University. Incident, accident & first aid reporting and investigation [Internet]. 2013 [cited 2012 Aug 14]. Available from http://www.tru.ca/hssafety/ incident_ reporting.html
28. Frankel A, Leonard M. Update on Safety Culture[Internet]. 2013 [cited 2014 Feb 9]. Available from http://webmm. ahrq.gov/perspective.aspx? Perspective ID=144
29. Nunnally JC, Bernstein IH. Psychometric theory. 3rded. New York: McGraw-Hill, Inc; 1994.
30. Lynn MR. Determination and quantification of content validity. Nurs Research 1986;35(6), 382-6.
31. Burns N, Grove SK. The practice of nursing research appraisal, synthesis, & generation of evidence. 6th ed. St Louis: W.B. Saunders; 2009.
32. DeVellis RF. Scale development theory and applications. 2nd ed. California: Sage;2003.
33. Hair JF, Black WC, Babin BJ, Anderson RE, &Tatham R. Multivariate data analysis. 6thed. New Jersey: Pearson Education; 2006.
34. Munro BH. Statistical methods for health care research. 4th ed. Lippincott: Philadelphia; 2001.
35. Lee P, Allen K, Daly M. A communication and patient safety’training programme for all healthcare staff: can it make a difference? BMJ QualSaf [Internet]. 2012 [cited 2014 Sep 8]; 21: 48-8 Available from http://qualitysafety. bmj.com
36. Donohue A. Managing risk: Protect yourself and your patients. ACA news[Internet]. 2015 [cited 2014 Dec 14]; 11: 30-1. Available from http://www.acatoday. org/ content_ css.cfm?CID=5610
37. Macdonald M. Examining the adequacy of the 5 rights of medication administration. C NS [Internet]. 2010 [cited 2013 Feb 4]; 24: 196-201. Available from http://www. ncbi. nlm.nih.gov/pubmed/20526120
38. Sammer CE, Lykens K, Singh KP, Mains DA, LackanNA. What is patient safety culture? A review of the literature. Nursing Scholarship [Internet]. 2010 [cited 2013 Jun25]; 42:156-65. Available from http://www.ncbi.nlm.nih. gov/pubmed/20618600
39. Pohl JM, Sarvin C, Fiandt K, Beauchesne M, Drayton-Brooks S, Scheibmeir M et al. Quality and safety in graduate nursing education: Cross-mapping QSEN graduate Competencies with NONPF’s NP core and practice doctorate competencies. Nursing Outlook[Internet]. 2009[cited 2015 Feb 25]; 57: 349-54. Available from http://www.ncbi.nlm.nih. gov/pubmed/19942036
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2016-01-25
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Panthulawan S, Kunaviktikul W, Nantsupawat R, Srisuphan W. Development and Psychometric Testing of the Nursing Performance for Patient Safety Scale. PRIJNR [Internet]. 2016 Jan. 25 [cited 2024 Nov. 6];20(1):45-59. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/23368
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