综合静脉注射困难评分工具的验证与可靠性

Jon A. Bell, C. Campos
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摘要

目的:评估综合困难IV通路(C-DIVA)工具的面部有效性和评分者间可靠性,该工具用于识别困难血管通路(DIVA)患者,并指导没有专业血管通路经验的临床医生(多面手)的护理。方法:采用一项前瞻性观察性研究,使用有血管通路经验的护士对C-DIVA工具进行内部验证。在验证该工具后,将场景提供给血管通路专家组进行评分者间可靠性测量。结果:一项评估面部有效性的调查收到了7名在职护士的回复。使用1-5 Likert量表,该工具的可用性评级为4.43。12名护士的额外评估提供了72个病例情景的独立评估,以确定评分者之间的可靠性。类内相关系数为49.4%,符合率为55.6%。结论:C-DIVA工具已通过来自不同临床地区的具有血管通路经验的护士样本进行了验证。C-DIVA工具的评分者间可靠性中等。该工具的使用应有助于多面手提供者(那些在血管通路放置方面没有受过专业培训或高级技能的提供者)识别DIVA患者,以便于分配适当的临床医生和资源,为难以进入的患者成功获得血管通路。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Validation and Reliability of the Comprehensive Difficult IV Access Scoring Tool
Objective: To assess the face validity and inter-rater reliability of the Comprehensive Difficulty IV Access (C-DIVA) tool for identifying difficult vascular access (DIVA) patients and directing care for clinicians without specialized vascular access experience (generalists). Methods : A prospective observational study was conducted using nurses experienced in vascular access to internally validate the C-DIVA tool. After validation of the tool, scenarios were provided to a vascular access specialist group for inter-rater reliability measurement. Results : A survey to assess face validity received responses from 7 nurses in active practice. Using a 1-5 Likert scale, the tool was rated at 4.43 for usability. Additional assessments by 12 nurses provided 72 independent assessments of case scenarios to establish inter-rater reliability. Intra-class correlation coefficient of 49.4% with 55.6% agreement was achieved. Conclusion : The C-DIVA tool was validated by a sample of nurses with vascular access experience from different clinical areas. The inter-rater reliability of the C-DIVA tool is moderate. The use of the tool should facilitate the identification of DIVA patients by generalist providers (those without specialized training or advanced skills in vascular access placement) to facilitate the allocation of appropriate clinicians and resources to achieve successful vascular access for patients with difficult access.
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