Development of a self-report instrument to measure patient safety attitudes, skills, and knowledge

To describe the development and psychometric testing of the Patient Safety Attitudes, Skills and Knowledge Scale (PS-ASK).

Content validity of a 35-item instrument was established by a panel of experts. The instrument was pilot tested on 285 nursing students. Principal components analysis (PCA) with varimax rotation was conducted, and Cronbach's alphas were examined. Paired samples t-tests were used to show responsiveness of the scales pre- and post-patient safety curriculum.

The final instrument consists of 26 items and three separate scales: attitudes, skills, and knowledge. The attitudes and skills scales each had a three-factor solution. The knowledge items had a one-factor solution. Both skills and knowledge were significantly increased at Time 2 (p<0.001).

The skills and knowledge subscales had satisfactory internal consistency reliability, evidence for construct validity, and responsiveness for use as independent scales in future studies. The attitudes subscale needs further refinement before implementation. Comparison with other measures of patient safety skills (e.g., observation) and knowledge are warranted.

A tool to measure clinicians' attitudes, skills, and knowledge about patient safety might be useful to evaluate nurses and other clinicians during educational preparation and in practice.