Development and Psychometric Testing of the Nursing Performance for Patient Safety Scale

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Sopaporn Panthulawan
Wipada Kunaviktikul
Raymoul Nantsupawat
Wichit Srisuphan


             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.

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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 2022 Dec. 9];20(1):45-59. Available from:
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