Preimplementation of Critical Care Early Mobility Clinical Decision Support: A Content Validation Study

Area of Science:

• Critical care medicine
• Rehabilitation science
• Nursing research

Background:

• Early mobility, encompassing activities from in-bed exercises to ambulation, is crucial for limiting functional decline in post-intensive care patients.
• Widespread implementation of early mobility is hindered by various barriers.
• Existing clinical decision support systems do not specifically address early mobility in critical care settings.

Purpose of the Study:

• To develop and validate the operational definitions for a novel assessment instrument designed to support early mobility decisions in critical care.
• To establish the content validity of this new instrument through expert review.

Main Methods:

• Operational definitions for 30 items across four safety domains were developed by the research team.
• Content validation was performed in two rounds with 10 critical care nurse experts using a 7-point Likert scale.
• The Content Validity Index (CVI) was calculated for individual items and the scale overall.

Main Results:

• Initial item CVI scores ranged from 0.6 to 0.1, with items below 0.78 being revised for clarity.
• Following revisions, item CVI scores improved to a range of 0.8 to 1.0.
• The scale-level CVI reached 0.93, indicating excellent content validity after the second validation round.

Conclusions:

• The developed operational definitions for the critical care early mobility assessment instrument possess excellent content validity.
• This study represents a foundational methodological step towards creating a clinical decision support system for early mobility in critical care.
• Further development is needed to translate these validated definitions into a functional decision support tool.