Background: There is no objective and standardized tool for stratification of high-alert medications (HAMs) that reflect each institution's practice of medication management, drug utilization in the institution, and patient safety protocols in the Korean hospital settings. We aimed to develop the Korean version of the high-alert medication stratification tool (K-HAMST) and assess its content validity and reliability.Methods: Ten clinical pharmacists from multi-site hospitals completed a two-round Delphi survey to assess the content validity of the translated High-Alert Medication Stratification Tool-Revised. Content validity was demonstrated using the item content validity index and scale content validity index (S-CVI). An expert meeting was conducted to revise the tool to accommodate the clinical practice and workflow in Korea based on the results of the content validity index. Reliability was assessed by calculating the risk scores for 37 HAMs and 37 control medications. The interrater reliability of each medication was assessed using the Kendall's coefficient of concordance (W).
Results:The initial S-CVI was 0.71. After revision, the final S-CVI of the K-HAMST was 0.92, indicating that the tool has content validity. The HAM scores ranged from 3 to 8 (n=37; median [interquartile {IQR},[4][5]), whereas the control medication scores ranged from 1 to 2 (n=37; median [IQR], 1 [1-1]). The Kendall's coefficient of concordance (W) was 0.57, indicating moderate agreement between raters (p<0.001).
Conclusion:The K-HAMST is a valid and reliable tool for assessing and evaluating HAMs in hospital settings.
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