The Establishment And Reliability And Validity Test Of Clinical Nurses Self-evaluation Scale For Fall Prevention Of Inpatients

Objective:To develop clinical nurses self-evaluation scale for fall prevention of inpatients and test its reliability and validity, for evaluating whether clinical nurses’ fall prevention are in place.Methods:(1) With the internationally recognized injury prevention "5E" principle, namely "education, environmental modification, engineering, enforcement and evaluation" as the theoretical framework of scale. By reviewing the domestic and foreign fall-related literature, analyzing the causes of hospital falls, referring to the existing research results of fall prevention and interviewing with the nurses and hospital logistical personnel(cleaning staff and equipment maintenance personnel), the research group could collect scale items.By inviting delphi experts to screen, to modifiy, to supply and to delete some iterms twice, we form an initial scale.(2) There are 350 nurses from 3 three grade hospitals in Shanxi Province were investigated, of which 326 are valid questionnaires. whose clinical departments are the Department of Geriatrics, Neurology, Cardiology and Respiratory. We used the item analysis, exploratory factor analysis to further screen items.(3) There are 700 nurses from 6 three grade hospitals and 1 two grade hospital in Shanxi Province were investigated with the formal questionnaire( the clinical departments are the same), of which 672 are valid questionnaires. We used the content validity, the construct validity, the cronbach ’s alpha coefficient, the split half reliability and retest reliability etc, to test reliability and validity of the scale. Finally, the formal scale was formed.Results:(1) The results of expert consultation: after two rounds of expert consultation, we synthesized the suggestions of all experts, unified the subject of each item and formed the pre questionnaire. The expressions of 5 areas were: "education, environmental safety of patients, living appliances, hospital internal management, assessment and evaluation",which contained 11 dimensions and a total of 65 items. Statistical results showed that the experts have highly enthusiasm and authority.(2) The pre survey results: We deleted 15 items by the item analysis and exploratory factor analysis. The formal questionnaire contained 5 areas, 12 dimensions and a total of50 items, of which the cumulative contribution rate of the 12 factors were 70.15%.(3) The results of a formal investigation: The average scale content validity index(S-CVI/Ave) was 0.9788, and the item content validity index(I-CVI) ranged from 0.8125 to 1.0000; the cronbach ’s alpha coefficient of the scale was 0.950, the split half reliability was 0.811, and the test-retest reliability was 0.922; the results of confirmatory factor analysis showed that(RMSEA=0.086, RMR=0.044, NFI=0.92, NNFI=0.93, CFI=0.94,IFI=0.94, RFI=0.92) were all in acceptable range.Conclusion:(1) The establishment of clinical nurses self-evaluation scale for fall prevention of inpatients, including 5 primary dimensions, 12 second dimensions and a total of 50 items.(2) The scale has good reliability, validity and practicability, and can be used as a quantitative tool for whether a clinical nurse’s fall prevention measures are in place.