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Validation of a Barriers Scale for Local Anesthesia in Arterial Blood Sampling
Fernando Barroso-Rodríguez1, Azuzena González-Sanz2, Beatriz Muñoz-Martín3
1Department of Pulmonology, Hospital Virgen de la Concha, Regional Health Authority of Castilla and León (SACYL), Zamora, Spain.
Nurses face barriers to using local anesthesia for arterial blood gas sampling. A new scale identifies these barriers, focusing on training, knowledge, and organizational factors to improve patient pain management.
Area of Science:
- Nursing Practice
- Pain Management
- Medical Procedures
Background:
- Arterial blood gas (ABG) sampling is a common procedure associated with significant patient pain.
- Despite evidence supporting local anesthesia (LA) for pain reduction, its clinical application before ABG sampling is limited.
- Identifying barriers to LA use is crucial for improving pain management during ABG sampling.
Purpose of the Study:
- To develop and validate a psychometrically sound scale to assess nurses' perceived barriers to using infiltrated local anesthesia before arterial blood gas sampling.
- The scale aims to provide a tool for understanding and addressing obstacles to effective pain management in this common procedure.
Main Methods:
- A two-stage study involving instrument development and psychometric validation.
- Stage 1: Item generation via literature review and a four-round Delphi process with expert nurses, assessing content validity.
- Stage 2: Cross-sectional online survey of 558 nurses in Spain, evaluating construct validity (Rasch analysis) and reliability (internal consistency, test-retest).
Main Results:
- A 30-item "ABG-LA Barriers Scale" was finalized with good psychometric properties and no differential item functioning.
- The scale demonstrated excellent internal consistency (omega = 0.898, alpha = 0.892) and test-retest reliability (ICC = 0.912).
- Nurses reported higher barriers related to training, knowledge, and organizational factors.
Conclusions:
- The ABG-LA Barriers Scale is a valid and reliable instrument for assessing nurses' perceived barriers to local anesthesia use before ABG sampling.
- This scale can inform clinical decision-making and guide the development of targeted strategies to enhance pain management.
- Implementing this scale may lead to improved patient experiences and more effective pain control during ABG procedures.
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