Development of a Measure of Nurse Vigilance from the Patient \u27 s Perspective: A Content Validity Study

Problem: Since the landmark Institute of Medicine report, To Err is Human, was published in 1999, patient safety has become a major concern in healthcare systems. Although attention is being given to patient safety and preventing patient morbidity and mortality, experts indicate that little progress has been made in decreasing healthcare errors. Vigilance is a phenomenon often identified in the literature as a means to promote patient safety and well-being. Purpose: The aim of this study was to establish content validity in a newly developed instrument designed to measure nurse vigilance from a patient perspective. Method: Generated 130 items and following a card sort reduced that to 70 items. Four steps were completed to design the instrument: 1 ) A pool of 70 items was developed from five domains of vigilance, previously established from research: knowledge, connectedness, hope, going beyond the call of duty, and shared vigilance, as well as a domain to reflect quality patient outcomes such as safety and quality care. The domains were derived from a qualitative study of patient, family, and nurse experiences of vigilance and existing research literature; 2) An expert panel, consisting of eight professionals with knowledge about vigilance, quality, and safety was identified and they were asked to rate items for content validity; 3) A content validity survey was developed to rate each individual item according to the expert analysis of the relevance to its proposed domain of vigilance. 4) Using Statistical Package for the Social Sciences (SPSS) 21 , items were analyzed for internal consistency and content validity. Results: Statistical evidence and theoretical relevance guided the individual items to be retained as well as eliminated, which led to the delineation of a 35-item instrument. The instrument demonstrated an adequate degree of reliability with an alpha of 0.982, and an acceptable total CVI rating of 0 . 8 3