Aim: To develop a validated tool to measure nursing and midwifery documentation burden.
Background: While an important record of care, documentation can be burdensome for nurses and midwives and may remove them from direct patient care, resulting in decreased job satisfaction, associated with decreased patient satisfaction. The amount of documentation is increasing at a time where staff rationalisation results in decreasing numbers of clinicians at the bedside. No instrument is available to measure staff perceptions of the burden of clinical documentation.
Design: Survey development, followed by rwo rounds of content validation (April and May 2019).
Methods: Based on the literature a 28 item survey, with items in 6 subscales, representing key areas of documentation burden was developed. Item (I-CVI), subscale (S-CVI/Ave by subscale) and overall content validity indexes (S-CVI/Ave) were calculated following two review rounds by an expert panel of clinical and academic nurses and midwives.
Results: Level of agreement for the first iteration of the survey was low, with many items failing to reach the critical I-CVI threshold of 0.78. No subscale reached a S-CVI/Ave above 0.8 and the overall scale only achieved a S-CVI/Ave score of 0.67. Thirteen items were removed, seven were edited and five new items added, based on the expert panel feedback, substantially improving the content validity. All individual items achieved an I-CVI ≥0.78, the S-CVI/Ave was above 0.85 for all subscales and the total S-CVI/Ave was 0.94.
Conclusion: The Burden of Documentation for Nurses and Midwives (BurDoNsaM) survey can be considered as content valid, according to the content validity analysis by an expert panel.
Impact: The BurDoNsaM survey may be used by nurse leaders and researchers to measure the burden of documentation, providing the opportunity to review practice and implement strategies to decrease documentation burden, potentially improving patient satisfaction with the care received.
目的: 开发有效工具来衡量护理和助产工作的文件记载负担。 背景: 虽然文件记载属于一项重要的护理记录工作,但其对护士和助产士来说可能很麻烦,并可能会使他们脱离直接的病人护理,导致工作满意度降低,进而病人满意度下降。在人员合理化导致病床临床医师人数减少的情况下,文件记载数量正在增加。尚无任何工具可用来衡量人员对临床文件记载负担的看法。 设计: 调查开展,然后进行两轮内容验证(2019年4月和5月)。 方法: 根据文献资料,采用6个分量表的条目,对文件记载负担的重要方面展开28个条目的调查。经临床和学术护士及助产士组成的专家小组进行两轮评估后,对条目(I-CVI)、分量表(根据分量表的平均S-CVI)以及总体的内容效度指数(平均S-CVI)进行了计算。 结果: 调查的首次迭代的一致性水平较低,许多条目未能达到I-CVI 临界值0.78。所有分量表的平均S-CVI均未达到0.8以上,总体量表的平均S-CVI得分仅为0.67。根据专家组的反馈意见,删除了13个条目,编辑了7个条目,并增加了5个新条目,大大提高了内容效度。所有单个条目的I-CVI均在0.78以上(含),各分量表的平均S-CVI均在0.85以上,总体平均S-CVI为0.94。 结论: 根据专家组对内容效度的分析,护士和助产士文件记载负担调查可视为内容有效。 影响: 护理组长和研究人员可使用护士和助产士文件记载负担调查来衡量文件记载的负担,提供机会来评估实践以及实施减轻文件记载负担的策略,从而有可能提高患者对所接受护理的满意度。.
Keywords: burden; content validation; documentation; instrument development; midwives; nurses; paperwork; questionnaire; survey.
© 2020 John Wiley & Sons Ltd.