Tai Jui-Fen, Wang Chi, Lin Li-Ying, Tang Pei-Ling
MS, RN, Head Nurse, Department of Nursing, Kaohsiung Veterans General Hospital, Taiwan, ROC.
MSN, RN, Director, Department of Nursing, Kaohsiung Veterans General Hospital, Taiwan, ROC.
Hu Li Za Zhi. 2022 Jun;69(3):31-40. doi: 10.6224/JN.202206_69(3).06.
A valid and reliable nursing record audit tool can simplify nursing records and provide a basis for quality auditing.
To ensure the validity and reliability of the Nursing Process Scale to promote accurate monitoring of nursing record quality.
This study employed structural equation modeling to examine the content validity and reliability of the current Nursing Process Scale. A total of 660 results from a medical center were used to revise the content and then the validity and reliability of the revised scale were analyzed. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used in three stages, namely item generation and content validity testing, item analysis and validity testing, and reliability testing.
Validity, reliability, and organization based on clinical practice were used to identify and remove scale items with low factor loadings. The remaining items were organized under several factors in the revised Nursing Process Scale, which had good internal consistency with a Cronbach's α of .653 in the EFA, a Kaiser-Meyer-Olkin value of .614, and a significant Bartlett's test of sphericity value. Five factors and 22 questions were extracted from the original 32 questions. The CFA conducted after the model correction reduced the number of questions to 10 and the number of factors to 3, with each index reaching the ideal level. To improve ease-of-use in clinical settings, the important items were reduced from 32 to 22 questions, including the 10 questions suggested by the CFA.
The validity, reliability, and organization based on clinical practice were considered in the removal of items with low factor loadings. Axial conversion was used to generate a component matrix, which allowed item rearrangement across factors and the revision of the Nursing Process Scale. The development of simple valid and reliable audit tools will save auditor time and allow the effective evaluation of nursing record quality and improvement in record integrity. This revised scale was reviewed and approved for implementation in 42 clinical wards.
一个有效且可靠的护理记录审核工具能够简化护理记录，并为质量审核提供依据。
确保护理程序量表的有效性和可靠性，以促进对护理记录质量的准确监测。
本研究采用结构方程模型来检验当前护理程序量表的内容效度和信度。来自一家医疗中心的660份结果被用于修订内容，然后分析修订后量表的效度和信度。探索性因素分析（EFA）和验证性因素分析（CFA）分三个阶段使用，即项目生成与内容效度测试、项目分析与效度测试以及信度测试。
基于临床实践的效度、信度和组织性被用于识别和剔除因子载荷低的量表项目。其余项目在修订后的护理程序量表中按照几个因子进行组织，在探索性因素分析中，其内部一致性良好，Cronbach's α为0.653，Kaiser-Meyer-Olkin值为0.614，Bartlett球形检验值显著。从最初的32个问题中提取出了5个因子和22个问题。模型校正后进行的验证性因素分析将问题数量减少到10个，因子数量减少到3个，各项指标均达到理想水平。为提高在临床环境中的易用性，重要项目从32个问题减少到22个问题，包括验证性因素分析建议的10个问题。
在剔除因子载荷低的项目时考虑了基于临床实践的效度、信度和组织性。采用轴转换生成成分矩阵，这使得项目能够跨因子重新排列，并对护理程序量表进行修订。开发简单有效且可靠的审核工具将节省审核人员的时间，并能有效评估护理记录质量以及提高记录完整性。这个修订后的量表经过审核并获批在42个临床病房实施。
