Development And Preliminary Application Of A Health Assessment Competency Rating Scale For Clinical Nurses

Objective:1. To establish a scientific, objective and practical index system for evaluating nurses’ health assessment competency, and to develop a corresponding rating scale to provide strategically an evidence for clinical evaluation;2. Through the application of this evaluation system, the current situation of nurses’ health assessment competency will be understood, and the relevant influence on various demographic factors will be further explored and analyzed.Methods:1. A concept framework of a health assessment competency index system for Clinical Nurses was tentatively established by literature review and experts consulting.And the draft of dimensions and items of the scale was set.2. A multidisciplinary panel of22experts from clinical nursing, hospital nursing management, college teaching departments was selected for the study. The scale dimensions and the items were revised and developed after two rounds of Delphi procedure and membership degree.A primitive rating scale was finally formed after identifying the weight of the dimensions and the items by AHP.3. A small sample of the pre-survey was carried out by randomly selecting10clinical nurses of theJiangsu Provincial Hospital of TCM. And the initial rating scale was developed.4. An on-site assessment was held by choosing115clinical nurses of the Jiangsu Provincial Hospital of TCM randomly,and a repeating assessment was done after2weeks by selecting10out of the115nurses The initial rating scale was tested from various aspects which includes test-retest reliability, Cronbach’a coefficient, split-half reliability, content validity, construct validity and discriminative validity degree.5.144clinical nurses in the hospital were randomly selected for the health assessment capacity evaluation, and the relationship between the nurses’ health assessment capacity and related factors was further explored.Result:1. The item pool of nursing health assessment capability rating scale A scale consisting of6dimensions and20items was set by combining the results from experts and clinical nurses.2. The primitive scale of the nurses’ health assessment capacity rating scale was established.2.1Two rounds of the Delphi procedure were proceeded by delivering22questionnaire each time which was converted from assessment index items.All questionnaires were took back after1week which indicates the effective recovery rate was100%. The study shows the experts’ familiarity with the study and their authority was0.85and0.88.2.2Two items were modified according to the experts’ suggestion. A primitive rating scale which consists of6first class index and20second class index was finally formed after identifying the weight of the dimensions and the items by AHP.The weight of first class index was0.075,0.268,0.268,0.157,0.075, and0.157by turns, while the weight of the second class index ranges from0.016to0.134.3. Evaluation of the initial scale of the nurses’ health assessment capacity3.1Reliability of the scaleThe inventory had satisfying reliability. For overall scale the Cronbach’a coefficient was0.958, the Cronbach’α coefficient of the six dimensions was from0.848to0.942; The split-scale reliability coefficient was from0.418to0.857.The test-retest correlation coefficient of the scale was from0.715to0.995.3.2Validity of the scaleThe content validity index (CVI) for the overall scale and each dimension was from0.87to1.00. The correlation analysis indicated that structure of the scale was excellent. The construct validity in factor analysis was adopted, and the KMO statistic of0.897and Bartlett’s test of sphericity with X2=969.655(P=0.000) suggested that the factor analysis could be performed appropriately. Through factor analysis, the three common factors were worked out, which contained critical thinking ability, communication and solving ability, and logical reasoning ability, and the cumulative contribution rate was53.236%. Discriminative validity analyses showed that the different titles of nurses could be discriminated.4. A correlation analysis of influential factors on nurses’ health assessment competencyThe impact of demographic factors on nurses’health assessment competency is as follows: Nurses with different age groups, care age, title, duty, marital status and the primal nursing education degree showed different health assessment competency in this study; yet there was no significant variance among nurses with different final nursing education, economic status and their love to the nursing career.Conclusion:1. The formal rating scale contains six dimensions and twenty items.2. The scale with high reliability and validity can be used to measure clinical nurses’ health assessment competency.3. The scale can be used for evaluation of the nurses’ health assessment competency, and is also sensitive to the difference of nurses’ health assessment competency with various demographic factors.