Endoscopy nurse-administered propofol sedation performance. Development of an assessment tool and a reliability testing model
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Endoscopy nurse-administered propofol sedation performance. Development of an assessment tool and a reliability testing model. / Jensen, Jeppe Thue; Konge, Lars; Møller, Ann; Hornslet, Pernille; Vilmann, Peter.
I: Scandinavian Journal of Gastroenterology, Bind 49, Nr. 8, 08.2014, s. 1014-1019.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Endoscopy nurse-administered propofol sedation performance. Development of an assessment tool and a reliability testing model
AU - Jensen, Jeppe Thue
AU - Konge, Lars
AU - Møller, Ann
AU - Hornslet, Pernille
AU - Vilmann, Peter
PY - 2014/8
Y1 - 2014/8
N2 - OBJECTIVE: A gold standard of skills required for nurse-administered propofol sedation (NAPS) for gastroenterological endoscopic procedures has been proposed but not established. Due to the potentially hazardous nature of NAPS, an assessment tool is needed to objectively judge the adequacy of training and for future certification. The aim of this study was to develop an assessment tool for measuring competency in propofol sedation and to explore the reliability and validity of the tool.MATERIAL AND METHODS: The nurse-administered propofol assessment tool (NAPSAT) was developed in a Delphi-like fashion. Consensus was achieved on 17 items. Validity evidence was gathered in a case-control study in a full-scale simulation setting. Six experienced nurses and six novice nurses were filmed in two scenarios for assessment according to the assessment tool by three content expert raters.RESULTS: A total of 72 NAPSAT assessment forms were analyzed. Inter-rater reliability, Cronbach's α = 0.54 and generalizability coefficient = 0.68. The experienced nurses scored higher than the novices, 52.8 versus 62.7, p = 0.009. The provided pass/borderline/fail assessment showed significant difference, p = < 0.001, Cronbach's α = 0.80, with the novices being more likely to fail and the experienced more likely to pass.CONCLUSION: Assessing sedation skills in a simulator is possible. Video assessment requires expert knowledge of the procedure and the rating matrix. Overall, NAPSAT showed fair inter-rater reliability and good construct validity. This makes NAPSAT fit for formative assessment and proficiency feedback; however, high stakes and summative assessment cannot be advised.
AB - OBJECTIVE: A gold standard of skills required for nurse-administered propofol sedation (NAPS) for gastroenterological endoscopic procedures has been proposed but not established. Due to the potentially hazardous nature of NAPS, an assessment tool is needed to objectively judge the adequacy of training and for future certification. The aim of this study was to develop an assessment tool for measuring competency in propofol sedation and to explore the reliability and validity of the tool.MATERIAL AND METHODS: The nurse-administered propofol assessment tool (NAPSAT) was developed in a Delphi-like fashion. Consensus was achieved on 17 items. Validity evidence was gathered in a case-control study in a full-scale simulation setting. Six experienced nurses and six novice nurses were filmed in two scenarios for assessment according to the assessment tool by three content expert raters.RESULTS: A total of 72 NAPSAT assessment forms were analyzed. Inter-rater reliability, Cronbach's α = 0.54 and generalizability coefficient = 0.68. The experienced nurses scored higher than the novices, 52.8 versus 62.7, p = 0.009. The provided pass/borderline/fail assessment showed significant difference, p = < 0.001, Cronbach's α = 0.80, with the novices being more likely to fail and the experienced more likely to pass.CONCLUSION: Assessing sedation skills in a simulator is possible. Video assessment requires expert knowledge of the procedure and the rating matrix. Overall, NAPSAT showed fair inter-rater reliability and good construct validity. This makes NAPSAT fit for formative assessment and proficiency feedback; however, high stakes and summative assessment cannot be advised.
KW - Clinical Competence
KW - Computer Simulation
KW - Denmark
KW - Endoscopy
KW - Humans
KW - Hypnotics and Sedatives
KW - Propofol
KW - Reproducibility of Results
U2 - 10.3109/00365521.2014.896411
DO - 10.3109/00365521.2014.896411
M3 - Journal article
C2 - 24989064
VL - 49
SP - 1014
EP - 1019
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
SN - 0036-5521
IS - 8
ER -
ID: 138141177