Reliability and validity assessment of the Chinese version of the Intrahospital Transport Safety Scale (IHTSS) in intensive care units

Shuaishuai Li; Shuting Hou; Xianjiao Deng; Shihao Chen; Huaqin Wang; Li Tang; Man Ye; Jianhui Xie

doi:10.1186/s12912-024-01906-z

Reliability and validity assessment of the Chinese version of the Intrahospital Transport Safety Scale (IHTSS) in intensive care units

BMC Nurs. 2024 Apr 29;23(1):296. doi: 10.1186/s12912-024-01906-z.

Authors

Shuaishuai Li^{1

2}, Shuting Hou³, Xianjiao Deng¹, Shihao Chen¹, Huaqin Wang^{1

2}, Li Tang^{1

2}, Man Ye⁴, Jianhui Xie⁵

Affiliations

¹ Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, No. 139 Renmin Middle Road, 410011, Changsha, Hunan, China.
² Critical Care Medicine, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China.
³ Department of Nursing, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan children's hospital), No. 86 Ziyuan Road, 410011, Changsha, Hunan, China.
⁴ Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, No. 139 Renmin Middle Road, 410011, Changsha, Hunan, China. yeman82@csu.edu.cn.
⁵ Department of Nursing, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan children's hospital), No. 86 Ziyuan Road, 410011, Changsha, Hunan, China. 907139834@qq.com.

Abstract

Background: Intrahospital transport of critically ill patients is a common practice in intensive care units (ICUs), where patients' safety is constantly challenged in high-intensity and dynamic environments. While Intrahospital Transport Safety Scale (IHTSS) is widely used internationally to evaluate the intrahospital transport safety, it has not been introduced in China.

Objectives: This study aimed to assess the reliability and validity of the Chinese version of the IHTSS scale among critical care nurses in China.

Methods: A cross-sectional study was conducted using a cluster sampling method. A total of 544 critical care nurses from 25 ICUs in 10 tertiary hospitals were recruited. We employed exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to examine the questionnaire's underlying factor structure, ensuring construct validity. Additionally, internal consistency was assessed using Cronbach's alpha coefficient, test-retest reliability, and corrected item-total correlation.

Results: The Chinese version of the scale displayed robust psychometric properties, with a Cronbach's α coefficient of 0.976, a split-half reliability of 0.906, and a test-retest reliability of 0.856. EFA revealed a robust four-factor model that accounted for 75.970% of the variance, with the factor loadings of the items ranging from 0.433 to 0.951. CFA indicated a strong model fit, with a chi-square to degrees of freedom ratio (CMIN/DF) of 2.765, comparative fit index (CFI) of 0.943, incremental fit index (IFI) of 0.943, and goodness-of-fit index (GFI) of 0.845, supporting the efficacy of the four-factor model in assessing intrahospital transport safety for critically ill patients.

Conclusion: The Chinese version of the IHTSS demonstrated favourable reliability and validity among critical care nurses in China, making it a suitable tool for measuring the level of intrahospital transport safety for critically ill patients.

Keywords: Critical care; Critically ill patients; Intrahospital transport; Patient safety; Reliability; Scale; Validity.