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Testing a classification instrument for the ambulatory care setting.

J A Verran

    Research in Nursing & Health
    |December 1, 1986
    PubMed
    Summary
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    This study validated an instrument measuring nursing care complexity in ambulatory settings. The tool shows good construct validity and reliability but requires consideration of clinic type for generalizability across services.

    Area of Science:

    • Nursing
    • Healthcare Administration
    • Health Services Research

    Background:

    • Measuring nursing care complexity is crucial for resource allocation and quality improvement in ambulatory settings.
    • Existing instruments may lack validity or generalizability in diverse ambulatory care environments.
    • A new classification instrument was developed based on organizational theory and knowledge technology.

    Purpose of the Study:

    • To evaluate the construct validity of a nursing care complexity instrument for ambulatory settings.
    • To assess the generalizability of the instrument across different services.
    • To determine the interrater reliability of the instrument.

    Main Methods:

    • The instrument, based on 44 activity categories within six responsibility areas, was developed using Delphi methodology.

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  • Data were collected from 641 patient ratings in seven areas of a hospital-based ambulatory care setting.
  • Statistical analyses were performed to assess validity, generalizability, and interrater reliability.
  • Main Results:

    • The instrument demonstrated beginning construct validity.
    • High interrater reliability was achieved after training.
    • The instrument's generalizability across services was limited unless clinic type was considered.

    Conclusions:

    • The developed instrument shows promise for measuring nursing care complexity in ambulatory settings.
    • Training is essential for achieving high interrater reliability.
    • Further research is needed to enhance the instrument's generalizability across diverse ambulatory care services.