Construct validation of an interactive digital algorithm for ostomy care
Janice M Beitz1, Mary A Gerlach, Vickie Schafer
1Janice M. Beitz, PhD, RN, CS, CNOR, CWOCN, CRNP, MAPWCA, FAAN, Professor of Nursing, School of Nursing-Camden, Rutgers, The State University of New Jersey, Camden. Mary A. Gerlach, MSN, RN, ACNS-BC, CWOCN, Clinical Nurse Specialist, Henry Ford Macomb Hospital, Clinton Township, Michigan. Vickie Schafer, MSN, RN, CWOCN, CCRA, Medical and Scientific Liaison, ConvaTec Inc, Skillman, New Jersey.
Purpose:
The purpose of this study was to evaluate construct validity for a previously face and content validated Ostomy Algorithm using digital real-life clinical scenarios.
Design:
A cross-sectional, mixed-methods Web-based survey design study was conducted.
Subjects And Setting:
Two hundred ninety-seven English-speaking RNs completed the study; participants practiced in both acute care and postacute settings, with 1 expert ostomy nurse (WOC nurse) and 2 nonexpert nurses.
Methods:
Following written consent, respondents answered demographic questions and completed a brief algorithm tutorial. Participants were then presented with 7 ostomy-related digital scenarios consisting of real-life photos and pertinent clinical information. Respondents used the 11 assessment components of the digital algorithm to choose management options. Participant written comments about the scenarios and the research process were collected.
Results:
The mean overall percentage of correct responses was 84.23%. Mean percentage of correct responses for respondents with a self-reported basic ostomy knowledge was 87.7%; for those with a self-reported intermediate ostomy knowledge was 85.88% and those who were self-reported experts in ostomy care achieved 82.77% correct response rate. Five respondents reported having no prior ostomy care knowledge at screening and achieved an overall 45.71% correct response rate. No negative comments regarding the algorithm were recorded by participants.
Conclusion:
The new standardized Ostomy Algorithm remains the only face, content, and construct validated digital clinical decision instrument currently available. Further research on application at the bedside while tracking patient outcomes is warranted.
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Ostomy Care
An ostomy is a surgical procedure that creates an artificial opening from the intestines to the outside of the body, allowing for the rerouting of effluent. This opening is known as a stoma. A stoma usually protrudes above the skin surface, appearing pink or red, moist, and round, and it lacks nerve sensations.
There are different types of ostomies, including colostomies, ileostomies, and urostomies:
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