Medication administration evaluation tool design: An expert panel review

Abstract

Background: Tools currently available to evaluate nurse medication administration practices have limitations and are either not validated or have poor reliability.

Aim: To identify criteria and content for inclusion in a tool to evaluate medication administration by nurses in the clinical setting, using an expert panel.

Methods: A peer review process using an expert multidisciplinary panel rated the relevance of the content on three tools; Medication Administration Safety Assessment Tool, Medication with Respect Tool and Clinical Skills Assessment Tool, using a four-point rating scale. Expert opinion was provided on relevance of content, rating scales and frequency of nurse evaluation. The level of agreement was analysed by item content validity index, mean item content validity index, mean expert proportion, scale content validity index with universal agreement, probability of chance agreement and a modified kappa rating. Qualitative themes were also reviewed.

Findings: The item and scale content validity index and the kappa index both rated the Medication Administration Safety Assessment Tool and Clinical Skills Assessment Tool as excellent. For the Medication with Respect Tool less than half of the item content validity index ratings rated as good and the kappa index rated as excellent, therefore the scale content validity did not achieve a good rating.

Conclusions: The expert panel review identified items of high level of agreement for relevance and determined that content needed to be clear, concise, observable, generic and practical to be useful for all nurses. Self-evaluation, feedback and a developmental plan were also key criteria.