General Submissions: Instruments, Tools, and Measurements

The Japanese Disaster Nursing Readiness Evaluation Index (JDNREI) is an index purposed for nurses' self-evaluation on their readiness and preparation for dispatch to perform medical care at disaster sites. This scale is based on the Readiness Estimate and Deployability Index (READI), which was developed in the U.S. in 1997, and was newly created in consideration of the Japanese cultural background. JDNREI is composed of 37 items pertaining to the following six subscales: (i) emergency nursing skills, (ii) practical skills for disaster response, (iii) communication skills for teamwork, (iv) effective coping with daily stress, (v) adaptability to stressful situations at disaster site, and (vi) cooperation skills. The proposed scale can be utilized to recognize and assess the individual nurse's level of readiness for future disasters answered using a 5-point rating scale ranging from 1=Hardly applies to me to 5=Applies to me. The 37 items were selectively designated for the purpose of the scale’s versatility and precision. These 37 items thus do not cover everything that is necessary for disaster dispatch activity. Moreover, JDNREI is designed to be used for acute phases of disaster cycles. Furthermore, individual readiness should be assessed using JDNREI's overall score, not each subscale. Furthermore, it can be used to help develop new educational programs for future disaster deployments. Thus, the JDNREI is highly expected to contribute to improving the disaster preparedness of registered nurses across Japan.

Background: Few objective measures of evidence-based practice (EBP) knowledge/skill exist.  The Fresno Test, one objective method, has only been validated with medicine, physical/ occupational/speech therapy, pediatric nursing and students.

Aim: The Fresno Test was adapted and tested with cohorts of acute care nurses. Six of 14 items required revision to achieve acceptable psychometrics.  The aim of this second validation study was to revise and validate a new version of the test to determine if it could distinguish EBP knowledge/skills among acute care nurses.

Methods: An expert panel engaged in multiple Delphi rounds to revise items. Individual-content validity indices (CVI) ranged from 0.83-1.0, with scale-CVI 0.92.  Using a cohort design, a cross-sectional sample of 90 novice, master and expert nurses were recruited via national listservs or snowball sampling to complete the revised test.  Potential participants were emailed an informational flyer about the purpose of the study and a link to the test created in web-survey software. Two doctorally prepared EBP experts independently scored tests using the standardized rubric.

Results: The Modified Fresno Test-Acute Care Nursing yielded strong psychometric properties (intra-class correlation coefficients>0.80; item discrimination indices>0.20; item-total correlations>0.30).  One poorly performing item was dropped.  The final test includes 13 items, with a Cronbach 0.76.  Item difficulty was moderate to high.  Most items discriminated well between cohorts.  Mean total scores were positively correlated with age, years since graduation, years acute care experience, and formal EBP or research workshops/conferences, courses or immersions.  Perceived level of EBP expertise was not associated with mean scores.

Conclusion: The validated 13-item Modified Fresno Exam-Acute Care Nursing can be used to evaluate EBP competencies of acute care nurses in academic and practice settings.  It can also be used by nurse scientists to build a stronger evidence base on types of educational programs that excel in advancing the critical competency of EBP among our nursing work force.

The test is best administered through web-based software.  Instructions for scoring the tests are included in its accompanying rubric.  The tests is in the public domain and thus, individuals may use the tool without permission.  The author does request an email communication to margohalm@gmail.com describing how the tool will be utilized to assist in understanding how individuals and organizations are finding value in the tool within various settings.  No modifications to the test items or scoring rubric are advised as changes would alter the psychometric properties of the test.  The manuscript describing the test's psychometrics is currently under review for publication.

This episode discusses new Tech Tools modules ANPD has launched in collaboration with the Montana Nurses Association.

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Aim: To develop a reliable and valid instrument for self-assessment of perceived level 3 informatics specialist and level 4 informatics innovator competencies in selected informatics activities.

Background: Cancer-related fatigue (CRF) is a very distressing symptom reported by oncology patients. Currently, CRF is measured by self-report instruments. Although clinician-administered questionnaires are more sensitive than self-report scales, there is no available clinician-administered instrument that is validated to measure CRF.                            

Purpose: This nurse-led, prospective, repeated measures study investigated the reliability and validity of a 7-item Saligan Fatigue Inventory (SalFI), a recently developed, clinician-administered tool to measure CRF.        

Methods: Significant correlations between SalFI and other reliable and valid CRF measures (Functional Assessment of Cancer Therapy–Fatigue [FACT-F], revised Piper Fatigue Scale [rPFS]) were explored using Spearman correlation tests. A global correlation matrix to compare correlations among study time points was developed using the Benjamin-Hockberg method. Study subjects were followed at baseline (T1, before primary cancer treatment), one month (T2) and 3 months (T3) after cancer treatment initiation from two study centers. The study was approved by the Institutional Review Boards of both recruitment centers.

Results: A total of 60 subjects were enrolled in the study. The SalFI was highly correlated with both FACT-F (rho=0.69, ppp

Conclusion: The SalFI is a reliable and valid clinician-administered measure of CRF. Validation studies in other cancer populations, other clinical populations, and in other languages are warranted.