Development and psychometric evaluation of the arterial puncture self-efficacy scale
Introduction
In acutely ill patients, the respiratory function must be closely monitored and the most frequently ordered laboratory test amongst those needing critical care is arterial blood gases (ABG) analysis (Andrews and Waterman, 2010). Arterial puncture is, therefore, a regularly performed invasive procedure within critical care units, emergency departments and some medical wards (Bobbia et al., 2013, Crawford, 2004). The radial artery is the most commonly chosen blood vessel to obtain a sample for ABG analysis (Dev et al., 2011). However, the radial artery puncture is not a totally safe procedure despite its accessibility, the presence of collateral circulation and the possibility to easily promote haemostasis by applying direct pressure on the area (Baskin et al., 2014, Masoorli, 2007). Indeed, arterial puncture has been associated with a risk of arteriospasm, nerve injury, pseudoaneurysm and acute compartment syndrome (Baskin et al., 2014, Bisarya et al., 2013, Dev et al., 2011, Leone et al., 2009, Masoorli, 2007). In addition, radial artery puncture is described as a very painful and difficult-to-perform procedure in which more than one attempt is usually needed to be successful (Bobbia et al., 2013, Crawford, 2004, Haynes and Mitchell, 2010, Matheson et al., 2014, Valero Marco et al., 2008), thus generating discomfort and stress in both patients and healthcare professionals (Baskin et al., 2014, Matheson et al., 2014).
Section snippets
Background
According to Simundic et al. (2013), in Spain, as in many other countries, nurses are responsible for drawing blood samples for ABG analysis. However, training in this invasive procedure is not always offered either as part of nursing programmes or as a continuous educational resource (Kleinpell, 2006, Simundic et al., 2013). In this context, the fact that patients have actively demanded that more skilled professionals carry out the procedure (Crawford, 2004) may indicate a need for formally
Study design and participants
An observational cross-sectional design was used in this study. A convenience sample of 342 nursing students was recruited from a southeastern Spanish university. All participants met the following inclusion criteria: (1) ≥ 18 years old and (2) enrolled in a Nursing degree programme during the 2014/2015 academic year. Demographic data collected included age, gender, and educational level. Furthermore, information about exposure to and training in arterial puncture was gathered.
Ethical considerations
This study received
Development of the initial instrument
I-CVI and reliability results for the initial version of the APSES are presented in Table 1. The panel of experts interpreted items 12, 13 and 14 as actions belonging to a different procedure and, therefore, not contributing to measure self-efficacy in arterial puncture. As these items' I-CVI < 0.70, they were removed from the initial version of the APSES before piloting it. In addition, after analysing the data from the pilot study (N = 58), the researchers decided to remove item 8. The decision
Discussion
In this study, a self-efficacy scale to measure nursing students' confidence in effectively performing arterial puncture for ABG analysis was developed and psychometrically tested.
According to Coaley (2014), when a psychological measurement tool is psychometrically evaluated, the two following questions must be answered: (1) How accurately does the tool measure? (2) What does the tool actually measure? While the former question refers to reliability of the instrument, the latter relates to its
Conclusions
The APSES has evidenced its excellent psychometric properties to measure nursing students' self-efficacy in effectively performing arterial puncture for ABG analysis. Together with other tools that assess knowledge and performance, the APSES could be considered a quick, reliable and concise instrument to be used as part of the process of assessing nursing students' competence in arterial puncture. Its easy application may promote the development, implementation and evaluation of new educational
Acknowledgements
Thank you to all nursing students who participated in this study. This work was part of a teaching innovation project funded by the University of Almería (Spain).
References (38)
- et al.
The comparison of heparinized insulin syringes and safety-engineered blood gas syringes used in arterial blood gas sampling in the ED setting (randomized controlled trial)
Am. J. Emerg. Med.
(2014) - et al.
Ultrasound guidance for radial arterial puncture: a randomized controlled trial
Am. J. Emerg. Med.
(2013) - et al.
Impact of peer teaching on nursing students: perceptions of learning environment, self-efficacy, and knowledge
Nurse Educ. Today
(2013) - et al.
Patient Educ. Couns.
(2013) - et al.
Effects of two retraining strategies on nursing students' acquisition and retention of BLS/AED skills: a cluster randomised trial
Resuscitation
(2015) - et al.
The effects of scenario-based simulation course training on nurses' communication competence and self-efficacy: a randomized controlled trial
J. Prof. Nurs.
(2015) - et al.
Reducing pain associated with arterial punctures for blood gas analysis
Pain Manag. Nurs.
(2014) - et al.
The role of simulation in nurse education
Nurse Educ. Today
(2010) - et al.
Teaching technical skills to medical students during a surgery clerkship: results of a small group curriculum
J. Surg. Res.
(2011) - et al.
The effects of simulation-based learning using standardized patients in nursing students: a meta-analysis
Nurse Educ. Today
(2015)
Epistemological beliefs and the self-efficacy scale in nursing students
Nurse Educ. Today
Local anesthesia in arterial puncture: nurses' knowledge and attitudes
Arch. Bronconeumol.
What factors affect arterial blood sampling patterns?
Nurs. Crit. Care
Effect of procedure simulation workshops on residents procedural confidence and competence
J. Grad. Med. Educ.
Self-Efficacy: The exercise of Control
Guide for Constructing Self-Efficacy Scales
Acute compartment syndrome of the forearm following blood gas analysis postthrombolysis for pulmonary embolism
Eplasty
Validation of a new general self-efficacy scale
Organ. Res. Methods
Understanding the influences on self- confidence among first-year undergraduate nursing students in Ireland
J. Adv. Nurs.
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