Raurell-Torredà Marta, Zaragoza-García Ignacio, Arrogante Oscar, Aliberch-Raurell Anna María, Sánchez-Chillón Francisco Javier, Torralba-Melero Martín, Rojo-Rojo Andrés, Muriel-García Alfonso, Amaya Arias Ana Carolina, Roldán-Merino Juan, Farrés-Tarafa Mariona
Department of Fundamental and Clinical Care Nursing, Hospitalet del Llobregat, Universitat de Barcelona, Campus de Bellvitge, Barcelona, Spain.
Simulation Group of the Spanish Society for Intensive Care and Coronary Unit Nursing (SEEIUC), Madrid, Spain.
PLoS One. 2024 Dec 31;19(12):e0313175. doi: 10.1371/journal.pone.0313175. eCollection 2024.
To analyse the interrater reliability of the NEUMOBACT checklist and verify whether consistent results are reproducible.
A validation study with a cross-sectional design, compliant with the GRRAS checklist, among ICU nurses attending a SIMULAZERO course with an Objective Structured Clinical Evaluation simulation format, to verify transfer from theory to clinical practice of knowledge and skills in ventilator-associated pneumonia (VAP) and catheter-related bacteraemia (CRB) prevention. A minimum sample size of 111 pairs of nurse raters was calculated. Interrater agreement was analysed using Gwet's AC1 for each item and as a total for each of the three checklists in the NEUMOBACT instrument.
A total of 95 pairs of valid NEUMOBACT checklists were completed by 190 raters with a median age of 29 [25-35] years, 93.7% were female. At the Central Venous Catheter insertion station, Gwet's AC1 was 0.934 (95% CI [0.919-0.949]). Only 2 of the 17 items scored below 0.9. At the Endotracheal Suctioning station, Gwet's AC1 was 0.869 (95% CI [0.851-0.886]). Of the 26 items that made up this station, 16 had an agreement percentage above 0.9, a further 9 were between 0.821 and 0.884, and item 13 had a value of 0.789. At the Patient Care station, Gwet's AC1 was 0.911 (95% CI [0.896-0.927]). Of the 21 items, 17 showed an agreement percentage above 0.9 and 4 were between 0.810 and 0.894.
The interrater reliability of the NEUMOBACT checklist shows substantial agreement between pairs of raters and is therefore validated in this large sample of ICU nurses.
The NEUMOBACT checklist can be useful for assessing skills before and after training in VAP and CRB prevention measures and during debriefing (post-simulation feedback), to reinforce the scientific evidence behind actions and decisions for items that have been performed incorrectly, thus consolidating training already received.
分析NEUMOBACT检查表的评分者间信度，并验证一致的结果是否具有可重复性。
采用横断面设计的验证性研究，符合GRRAS检查表，在参加具有客观结构化临床评估模拟形式的SIMULAZERO课程的重症监护病房护士中进行，以验证呼吸机相关性肺炎（VAP）和导管相关菌血症（CRB）预防知识和技能从理论到临床实践的转化。计算出最小样本量为111对护士评分者。使用Gwet's AC1分析每个项目以及NEUMOBACT工具中三个检查表各自的总分的评分者间一致性。
190名评分者共完成了95对有效的NEUMOBACT检查表，评分者的中位年龄为29[25 - 35]岁，93.7%为女性。在中心静脉导管插入站，Gwet's AC1为0.934（95%可信区间[0.919 - 0.949]）。17个项目中只有2个得分低于0.9。在气管内吸痰站，Gwet's AC1为0.869（95%可信区间[0.851 - 0.886]）。构成该站的26个项目中，16个项目的一致性百分比高于0.9，另外9个在0.821至0.884之间，项目13的值为0.789。在患者护理站，Gwet's AC1为0.911（95%可信区间[0.896 - 0.927]）。21个项目中，17个项目的一致性百分比高于0.9，4个在0.810至0.894之间。
NEUMOBACT检查表的评分者间信度显示评分者对之间具有高度一致性，因此在这个大型重症监护病房护士样本中得到了验证。
NEUMOBACT检查表可用于在VAP和CRB预防措施培训前后以及汇报（模拟后反馈）期间评估技能，以强化对执行错误项目的行动和决策背后的科学依据，从而巩固已接受的培训。
