From the College of Nursing.
Applied Statistics Laboratory, University of Kentucky, Lexington, KY.
J Patient Saf. 2021 Aug 1;17(5):363-374. doi: 10.1097/PTS.0000000000000331.
An interprofessional group of health colleges' faculty created and piloted the Barriers to Error Disclosure Assessment tool as an instrument to measure barriers to medical error disclosure among health care providers.
A review of the literature guided the creation of items describing influences on the decision to disclose a medical error. Local and national experts in error disclosure used a modified Delphi process to gain consensus on the items included in the pilot. After receiving university institutional review board approval, researchers distributed the tool to a convenience sample of physicians (n = 19), pharmacists (n = 20), and nurses (n = 20) from an academic medical center. Means and SDs were used to describe the sample. Intraclass correlation coefficients were used to examine test-retest correspondence between the continuous items on the scale. Factor analysis with varimax rotation was used to determine factor loadings and examine internal consistency reliability. Cronbach α coefficients were calculated during initial and subsequent administrations to assess test-retest reliability.
After omitting 2 items with intraclass correlation coefficient of less than 0.40, intraclass correlation coefficients ranged from 0.43 to 0.70, indicating fair to good test-retest correspondence between the continuous items on the final draft. Factor analysis revealed the following factors during the initial administration: confidence and knowledge barriers, institutional barriers, psychological barriers, and financial concern barriers to medical error disclosure. α Coefficients of 0.85 to 0.93 at time 1 and 0.82 to 0.95 at time 2 supported test-retest reliability.
The final version of the 31-item tool can be used to measure perceptions about abilities for disclosing, impressions regarding institutional policies and climate, and specific barriers that inhibit disclosure by health care providers. Preliminary evidence supports the tool's validity and reliability for measuring disclosure variables.
一个跨专业的健康学院教师团队创建并试行障碍错误披露评估工具，作为衡量医疗保健提供者披露医疗错误障碍的工具。
文献回顾指导了描述对披露医疗错误决策有影响的项目的创建。错误披露方面的本地和国家专家使用修改后的 Delphi 流程就试点中包含的项目达成共识。在获得大学机构审查委员会的批准后，研究人员向学术医疗中心的医生（n=19）、药剂师（n=20）和护士（n=20）的便利样本分发了该工具。使用均值和标准差来描述样本。使用组内相关系数来检验量表连续项目之间的测试-重测一致性。使用方差极大旋转因子分析来确定因子负荷并检验内部一致性可靠性。在初始和随后的管理中计算 Cronbach α 系数，以评估测试-重测可靠性。
在删除组内相关系数小于 0.40 的 2 个项目后，组内相关系数范围为 0.43 至 0.70，表明最终草案中连续项目之间的测试-重测一致性良好。因子分析在初始管理中显示出以下因素：信心和知识障碍、制度障碍、心理障碍和医疗错误披露的财务关注障碍。第 1 次和第 2 次的α系数分别为 0.85 至 0.93 和 0.82 至 0.95，支持测试-重测可靠性。
最终版本的 31 项工具可用于衡量对披露能力的看法、对机构政策和氛围的印象以及抑制医疗保健提供者披露的具体障碍。初步证据支持该工具用于测量披露变量的有效性和可靠性。
