Development of the intrahospital transport safety scale: a modified Delphi study

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Bergman, Lina
Chaboyer, Wendy
Pettersson, Monica
Carlstrom, Eric
Ringdal, Mona
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Melbourne, Australia


Introduction: Intrahospital transport (IHT) of critically ill patients is a complex high-risk process, associated with complications and unexpected events. Yet, no instrument to measure the safety during IHTs exist.

Objectives/Aims: To develop and test the content validity of an instrument to assess quality and safety during the IHT process in critically ill patients.

Methods: After ethics approval, a modified Delphi study of 18 international experts assessed items generated from the literature and our research for their relevance and clarity of wording. Items were informed by and grouped according to the five domains of the Systems Engineering Initiative for Patient Safety model (team input, transport-related tasks, tools and technologies, environment, and organization). Content Validity Index for each item (I-CVI) and for the total scale (S-CVI/Average) were calculated. The criteria of I-CVI ≥ 0.78 for relevance was used to retain items. Informed by experts’ ratings and comments, items were revised, deleted, and new items added.

Results: A total of 18 experts from North America, Europe and Australia participated. They had on an average 25.5 years of critical care experience (range 4.5-40). After two Delphi rounds, from the initial 91 items, 57 items were accepted for the final scale and four new items added. The final set of 61 items reflected the five domains (team input 17 items, transport-related tasks 9 items, tools and technologies 13 items, environment 9 items, and organisation 13 items).The final scale had a S-CVI/Average of 0.90 for relevance (range 0.78-1.00) and S-CVI/Average of 0.88 for clarity of wording (range 0.60-1.00).

Conclusion: International experts determined the final item set were relevant and clear. The IHT safety scale now requires more in-depth psychometric testing.

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Australian Critical Care

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Bergman, L; Chaboyer, W; Pettersson, M; Carlstrom, E; Ringdal, M,Development of the intrahospital transport safety scale: a modified Delphi study, Australian Critical Care, 2020, 33, pp. S6-S6