Development-centred neonatal care: validation study of the patient safety checklist

The Neonatal Patient Safety Checklist (NPSC) is a quality tool designed to assess compliance with care interventions by defining and operationalising neonatal quality and safety indicators. While many indicators have previously been validated and implemented in various international safety checklists, the NPSC is unique in including a set of safety indicators related to development-centred care (DCC), ensuring the quality and safety dimensions advocated by person-centred care. The aim of this study was to validate the NPSC indicators by ensuring consensus through representativeness and relevance to the neonatal care context.

The Delphi method was selected for this study. A sample of 19 experts participated in two rounds of structured questionnaires, which were administered individually in sequence. Researchers analysed and systematised the responses from each round, providing feedback in the form of a synthesis of the group's previous responses. This process aimed to develop a cumulative collective response and ensure a consensual construct.

Of the initial 56 indicators, only four had a content validity index (CVI) < 80%, indicating that the construct was not adequately represented. However, the qualitative input of the expert panel enabled the remaining indicators to be reformulated, achieving a CVI of at least 85.7%. This demonstrates that the NPSC is a robust, representative tool for neonatal care, with consensus achieved among experts.

Implementing this methodology resulted in the creation of a tool strongly linked to quality and safety. This was achieved by operationalising a set of innovative indicators that are representative of the neonatal intensive care unit target population. This approach moves away from static instruments that are not applicable in the neonatal context and incorporates indicators that are inherent to developmental care.