Surgical wound assessment tool: Construct validity and inter-rater reliability of a tool designed for nurses

Abstract

Aims and objectives: To validate construct validity and inter-rater reliability of a surgical wound assessment tool.

Background: Wound assessment is central to appropriate wound management. However, limited standard surgical wound assessment tools are available to assist nurses in assessing and recording progress in the healing of surgical wounds.

Design: A prospective observational study was utilised to test the validity and reliability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline was used.

Methods: Convenience sampling was used to recruit 260 patients who underwent elective or emergency surgery at a hospital in Vietnam. Exploratory factor analysis was used to examine the construct validity of the surgical wound assessment tool. Inter-rater reliability was calculated using the intraclass correlation coefficient and Cohen's kappa to determine reliability of the overall scale and identified items.

Results: The results of the exploratory factor analysis supported a three-component structure of the surgical wound assessment tool. The intraclass correlation coefficient value of the overall scale was 0.79 (95% CI 0.67-0.89), p < .001, confirming excellent inter-rater reliability. Cohen's kappa value ranged from 0.5 to 1, demonstrating moderate to almost perfect level of agreement for individual items, except for one item on pain.

Conclusion: The surgical wound assessment tool was deemed to be acceptable, valid and reliable for monitoring the status of surgical wound healing. However, further modification and testing are needed to strengthen the tool and to determine the applicability of the tool in other populations.

Relevance to clinical practice: The application of the SWAT would improve the assessment of surgical wounds in daily nursing practice which will promote improved postoperative wound management. It is an easy and practical tool for enhancing inter-disciplinary communication and care outcomes for all patients with surgical wounds.

Keywords: reliability; surgical wound assessment; surgical wound assessment tool; validity.