ObjectiveTo describe the development and clinimetric validation of the Advanced Practice Nursing Competency Assessment Instrument (APNCAI) through several evidence sources about reliability and validity in the Spanish context.Design and settingAPNCAI development was based on a multisequential and systematic process: literature review, instrument content consensus through qualitative Delphi method approach (a panel of 51 Advanced Practice in Nursing –APN– experts was selected) and the clinimetric validation process based on a sample of 600 nurses from the Balearic Islands public healthcare setting.MethodsAn initial step for tool's content development process based on Delphi method approach of expert consensus was implemented. A subsequent phase of tool validation started from the analysis of APN core competencies latent measurement model, including exploratory and confirmatory techniques. Reliability evidence for each latent factor was also obtained. Items' scores were submitted to descriptive analysis, plus univariate and multivariate normality tests.ResultsAn eight-factor competency assessment latent model obtained adequate fit, and it was composed by ‘Research and Evidence-Based Practice’, ‘Clinical and Professional Leadership’, ‘Interprofessional Relationship and Mentoring’, ‘Professional Autonomy’, ‘Quality Management’, ‘Care Management’, ‘Professional Teaching and Education’ and ‘Health Promotion’.ConclusionsAdequate empirical evidence of reliability and validity for APNCAI makes it useful for application in healthcare policy programmes for APN competency assessment in Spain.
Peripheral venous catheterization is a common technique in hospitals which is not always successful, resulting in multiple punctures and degradation of the vessels. This scenario, which we have termed 'difficult peripheral venous access', is associated to delays in care, obtention of samples or diagnosis, as well as a higher use of central catheters. This study intends to identify risk factors associated to the incidence of 'difficult peripheral venous access' in adults at hospital. We designed a systematic review of published studies (protocol PROSPERO 2018 CRD42018089160). We conducted structured electronic searches using key words and specific vocabulary, as well as directed searches in several databases. After validity analysis, we selected 7 studies with observational methodology. We found great variability in the definition of 'difficult peripheral venous access' and in the variables proposed as risk factors. Statistically significant factors through studies include demographic and anthropometric variables (gender, Body Mass Index), as well as medical and health conditions (diabetes, renal insufficiency, parenteral drug abuse, cancer chemotherapy), together with variables related to the vein or vascular access (vein visibility and palpability, vessel diameter, previous history of difficulty). Some studies have also considered variables related to the professional performing the technique. Meta-analyses were carried out for gender and obesity as potential risk factors. Only obesity appeared as a statistically significant risk factor with OR of 1.48; 95% CI (1.03 to 1.93; p = 0.016). Methodological heterogeneity prevented the development of further meta-analyses. It is essential to design future studies with diverse hospital populations, in which a wide selection of potential risk factors can be studied in a unique analysis. Our work identifies the most relevant variables that should be included in those studies.
IntroductionMost of the EBP measuring instruments available to date present limitations both in the operationalisation of the construct and also in the rigour of their psychometric development, as revealed in the literature review performed. The aim of this paper is to provide rigorous and adequate reliability and validity evidence of the scores of a new transdisciplinary psychometric tool, the Health Sciences Evidence-Based Practice (HS-EBP), for measuring the construct EBP in Health Sciences professionals.MethodsA pilot study and a subsequent two-stage validation test sample were conducted to progressively refine the instrument until a reduced 60-item version with a five-factor latent structure. Reliability was analysed through both Cronbach’s alpha coefficient and intraclass correlations (ICC). Latent structure was contrasted using confirmatory factor analysis (CFA) following a model comparison aproach. Evidence of criterion validity of the scores obtained was achieved by considering attitudinal resistance to change, burnout, and quality of professional life as criterion variables; while convergent validity was assessed using the Spanish version of the Evidence-Based Practice Questionnaire (EBPQ-19).ResultsAdequate evidence of both reliability and ICC was obtained for the five dimensions of the questionnaire. According to the CFA model comparison, the best fit corresponded to the five-factor model (RMSEA = 0.049; CI 90% RMSEA = [0.047; 0.050]; CFI = 0.99). Adequate criterion and convergent validity evidence was also provided. Finally, the HS-EBP showed the capability to find differences between EBP training levels as an important evidence of decision validity.ConclusionsReliability and validity evidence obtained regarding the HS-EBP confirm the adequate operationalisation of the EBP construct as a process put into practice to respond to every clinical situation arising in the daily practice of professionals in health sciences (transprofessional). The tool could be useful for EBP individual assessment and for evaluating the impact of specific interventions to improve EBP.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.