用于评估心电图节律识别能力的三仪器工具包的设计与验证

Design and validation of a three-instrument toolkit for the assessment of competence in electrocardiogram rhythm recognition.

作者信息

Hernández-Padilla José M, Granero-Molina José, Márquez-Hernández Verónica V, Suthers Fiona, López-Entrambasaguas Olga M, Fernández-Sola Cayetano

机构信息

1 Adult, Child and Midwifery Department, Middlesex University, UK.

2 Nursing, Physiotherapy and Medicine Department, University of Almeria, Spain.

出版信息

Eur J Cardiovasc Nurs. 2017 Jun;16(5):425-434. doi: 10.1177/1474515116687444. Epub 2017 Jan 3.

DOI:10.1177/1474515116687444

PMID:28045334

Abstract

BACKGROUND

Rapid and accurate interpretation of cardiac arrhythmias by nurses has been linked with safe practice and positive patient outcomes. Although training in electrocardiogram rhythm recognition is part of most undergraduate nursing programmes, research continues to suggest that nurses and nursing students lack competence in recognising cardiac rhythms. In order to promote patient safety, nursing educators must develop valid and reliable assessment tools that allow the rigorous assessment of this competence before nursing students are allowed to practise without supervision.

AIM

The aim of this study was to develop and psychometrically evaluate a toolkit to holistically assess competence in electrocardiogram rhythm recognition.

METHODS

Following a convenience sampling technique, 293 nursing students from a nursing faculty in a Spanish university were recruited for the study. The following three instruments were developed and psychometrically tested: an electrocardiogram knowledge assessment tool (ECG-KAT), an electrocardiogram skills assessment tool (ECG-SAT) and an electrocardiogram self-efficacy assessment tool (ECG-SES). Reliability and validity (content, criterion and construct) of these tools were meticulously examined.

RESULTS

A high Cronbach's alpha coefficient demonstrated the excellent reliability of the instruments (ECG-KAT=0.89; ECG-SAT=0.93; ECG-SES=0.98). An excellent context validity index (scales' average content validity index>0.94) and very good criterion validity were evidenced for all the tools. Regarding construct validity, principal component analysis revealed that all items comprising the instruments contributed to measure knowledge, skills or self-efficacy in electrocardiogram rhythm recognition. Moreover, known-groups analysis showed the tools' ability to detect expected differences in competence between groups with different training experiences.

CONCLUSION

The three-instrument toolkit developed showed excellent psychometric properties for measuring competence in electrocardiogram rhythm recognition.

摘要

背景

护士对心律失常的快速准确解读与安全实践及患者的良好预后相关。尽管心电图节律识别培训是大多数本科护理课程的一部分，但研究仍表明护士和护理专业学生在识别心脏节律方面缺乏能力。为了促进患者安全，护理教育工作者必须开发有效且可靠的评估工具，以便在允许护理专业学生在无监督的情况下进行实践之前，对这种能力进行严格评估。

目的

本研究的目的是开发一套工具包，并对其进行心理测量学评估，以全面评估心电图节律识别能力。

方法

采用便利抽样技术，招募了西班牙一所大学护理学院的293名护理专业学生参与研究。开发并对以下三种工具进行了心理测量学测试：心电图知识评估工具（ECG-KAT）、心电图技能评估工具（ECG-SAT）和心电图自我效能评估工具（ECG-SES）。对这些工具的信度和效度（内容效度、效标效度和结构效度）进行了细致审查。

结果

较高的克朗巴哈α系数表明这些工具具有出色的信度（ECG-KAT = 0.89；ECG-SAT = 0.93；ECG-SES = 0.98）。所有工具均显示出出色的内容效度指数（量表的平均内容效度指数>0.94）和良好的效标效度。关于结构效度，主成分分析表明，构成这些工具的所有项目都有助于测量心电图节律识别方面的知识、技能或自我效能。此外，已知群体分析显示这些工具能够检测出具有不同培训经历的群体在能力方面的预期差异。