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Systems Thinking for Transitions of Care: Reliability Testing for a Standardized Rubric.

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A new rubric standardizes systems thinking for clinical nurse specialists during care transitions. This tool demonstrates high validity and reliability, enhancing practical application and patient care.

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Area of Science:

  • Nursing
  • Healthcare Systems
  • Clinical Practice

Background:

  • Transitions of care are critical junctures in patient journeys.
  • Effective systems thinking by clinical nurse specialists is vital for safe and efficient care transitions.
  • A standardized approach is needed to evaluate and enhance systems thinking in this context.

Purpose of the Study:

  • To develop and validate a standardized rubric for assessing systems thinking in clinical nurse specialists.
  • To bridge theoretical frameworks of systems thinking with practical application in transitions of care.
  • To provide a measurable tool for evaluating competency in systems thinking.

Main Methods:

  • A mixed-methods study design was employed, utilizing the Systems Awareness Model.
  • Content validity was assessed using the content validity index (CVI).
  • Reliability was established through Cronbach's alpha and intraclass correlation coefficient; usability was evaluated via content analysis of focus group data.

Main Results:

  • The rubric achieved a content validity ratio of 1.0, indicating strong content validity.
  • High interrater reliability (Cronbach's α = 0.99) and strong section-specific reliability (α = 0.88–1.00) were demonstrated.
  • Usability themes included clarity, objectivity, and detail, with a recommendation for enhanced scholarly writing sections.

Conclusions:

  • The developed rubric is a valid and reliable tool for assessing systems thinking.
  • The rubric is recommended for use by clinical nurse specialists to reflect on and improve systems thinking during care transitions.
  • This tool can support professional development and enhance the quality of care transitions.