Design and validation of the INICIARE instrument, for the assessment of dependency level in acutely ill hospitalised patients

Abstract

Aims and objectives: The aim of this study was to establish the validity and reliability of an instrument (Inventario del NIvel de Cuidados mediante IndicAdores de clasificación de Resultados de Enfermería) used to assess the dependency level in acutely hospitalised patients. This instrument is novel, and it is based on the Nursing Outcomes Classification.

Background: Multiple existing instruments for needs assessment have been poorly validated and based predominately on interventions. Standardised Nursing Languages offer an ideal framework to develop nursing sensitive instruments.

Design: A cross-sectional validation study in two acute care hospitals in Spain.

Methods: This study was implemented in two phases. First, the research team developed the instrument to be validated. In the second phase, the validation process was performed by experts, and the data analysis was conducted to establish the psychometric properties of the instrument.

Results: Seven hundred and sixty-one patient ratings performed by nurses were collected during the course of the research study. Data analysis yielded a Cronbach's alpha of 0·91. An exploratory factorial analysis identified three factors (Physiological, Instrumental and Cognitive-behavioural), which explained 74% of the variance.

Conclusions: Inventario del NIvel de Cuidados mediante IndicAdores de clasificación de Resultados de Enfermería was demonstrated to be a valid and reliable instrument based on its use in acutely hospitalised patients to assess the level of dependency.

Relevance to clinical practice: Inventario del NIvel de Cuidados mediante IndicAdores de clasificación de Resultados de Enfermería can be used as an assessment tool in hospitalised patients during the nursing process throughout the entire hospitalisation period. It contributes information to support decisions on nursing diagnoses, interventions and outcomes. It also enables data codification in large databases.

Keywords: dependency; instrument development; nursing assessment; outcomes assessment; patient classification; psychometrics.