Examining interrater reliability and validity of a paediatric cardiopulmonary physiotherapy discharge tool

Area of Science:

• Pediatric physiotherapy
• Clinical assessment tools
• Healthcare quality improvement

Background:

• Effective discharge planning is crucial for pediatric patients post-surgery.
• Standardized tools enhance consistency in patient assessments.
• The Paediatric Cardiopulmonary Physiotherapy (CPT) Discharge Tool aims to standardize readiness assessments.

Purpose of the Study:

• To evaluate the interrater reliability (IRR) of individual items within the Paediatric CPT Discharge Tool.
• To assess the consistency of assessments by different physiotherapists using the tool.
• To identify areas for improvement in the pediatric discharge tool.

Main Methods:

• Two independent assessors evaluated 33 pediatric patients (ages 2-<19) post-surgery.
• Assessments were conducted using the Paediatric CPT Discharge Tool within 4 hours of each other.
• Interrater agreement was analyzed using Kappa statistics.

Main Results:

• Oxygen saturation (κ=0.80) and mobility (κ=0.62) showed excellent to substantial agreement.
• Secretion clearance (κ=0.39) and discharge planning (κ=0.37) demonstrated moderate to fair agreement.
• Auscultation (κ=0.24) and respiratory distress (κ=-0.08) exhibited poor agreement.

Conclusions:

• The Paediatric CPT Discharge Tool has demonstrated good IRR for key items.
• The tool is suitable for further psychometric evaluation, particularly validity testing.
• Refinement may be needed for items with lower interrater reliability.