School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia.
Centre for Research in Aged Care, Edith Cowan University, Joondalup, Western Australia, Australia.
J Ren Care. 2022 Sep;48(3):185-196. doi: 10.1111/jorc.12390. Epub 2021 Jun 28.
The Western Australian Haemodialysis Vascular Access Classification instrument was developed to classify the cannulation complexity of the arteriovenous fistula or arteriovenous graft as simple, challenging, or complex. Although the instrument was developed by experts in haemodialysis nursing, the instrument had not undergone formal validity or reliability testing.
Evaluate the Western Australian Haemodialysis Vascular Access Classification instrument for content validity, interrater and test-retest reliability.
Prospective cohort study.
Content validity was assessed by haemodialysis nursing experts (n = 8). The reliability testing occurred in one in-centre and one satellite haemodialysis unit in Western Australia from September to November 2019. Reliability testing was performed by 38 haemodialysis nurses in 67 patients receiving haemodialysis and 247 episodes of cannulation.
Interrater and test-retest reliability assessment was conducted using κ, adjusted κ, Bland-Altman plots, intraclass correlation coefficient and Pearson's correlation coefficient.
The final version of the instrument (n = 20 items) had individual item-level content validity indices ranging from 0.625 to 1.00 with a scale-level content validity index of 0.89. For both interrater (n = 172 pairs) and test-retest (n = 101 pairs), most individual variables had excellent adjusted κ (n = 33 variables), some fair to good agreement (n = 6 variables) and one variable with poor agreement. The classification of simple, challenging and complex demonstrated adjusted κ of fair to good, to excellent agreement for interrater reliability with lower levels of agreement for test-retest reliability.
This instrument may be used to match a competency-assessed nurse to perform the cannulation thereby minimising the risk of missed cannulation and trauma.
西澳血液透析血管通路分类工具旨在对动静脉瘘或动静脉移植物的置管复杂性进行分类，分为简单、复杂或复杂。虽然该工具是由血液透析护理专家开发的，但该工具尚未经过正式的有效性或可靠性测试。
评估西澳血液透析血管通路分类工具的内容有效性、评分者间和重测信度。
前瞻性队列研究。
内容有效性由血液透析护理专家评估（n=8）。可靠性测试于 2019 年 9 月至 11 月在西澳大利亚的一个中心和一个卫星血液透析单位进行。可靠性测试由 38 名血液透析护士在 67 名接受血液透析的患者和 247 次置管中进行。
使用κ、调整κ、Bland-Altman 图、组内相关系数和 Pearson 相关系数进行评分者间和重测信度评估。
工具的最终版本（n=20 项）具有 0.625 至 1.00 的个体项目水平内容有效性指数和 0.89 的量表水平内容有效性指数。对于评分者间（n=172 对）和重测间（n=101 对），大多数个体变量均具有极好的调整κ（n=33 个变量），一些具有良好至尚可的一致性（n=6 个变量），而一个变量的一致性较差。简单、复杂和复杂的分类对于评分者间的可靠性具有良好至极好的调整κ，而对于重测间的可靠性，其一致性较低。
该工具可用于匹配经过能力评估的护士进行置管，从而最大程度地降低漏置管和创伤的风险。
