Paper
Thursday, July 12, 2007
This presentation is part of : Global Collaboration Updates
Cross-Cultural Patient Workload Instrument Validation: An Evidence-Based Model Designed to Promote Global Collaboration
Ana Maria Tranquitelli, PhD, Nursing Department, Sírio Libanês Hospital, São Paulo, Brazil, Katia Grillo Padilha, PhD, School of Nursing, University of São Paulo, São Paulo, Brazil, Karole Mourek, PhD, Consulo Inc, Riverside, IL, USA, and Kenneth W. Colbert, MS, QuadraMed Corporation, Chicago, IL, USA.
Learning Objective #1: list the steps in cross-cultural testing of a patient-needs-based workload measurement instrument built upon nursing assessment
Learning Objective #2: articulate the issues and challenges in cross-cultural instrument validity and reliability testing when dealing with workload measurement based upon individual patient care needs.
Background:  Although patient care needs are the same regardless of where the care is delivered, there exists little documentation of cross-cultural studies in workload measurement instrument validation and reliability.  This study addressed issues associated with instrument validation and reliability when testing a US-developed workload measurement tool based on measurement of patient care needs and completed via nursing assessment when it was applied in the Brazilian healthcare setting.  The instrument tested in Brazil was developed and is currently used in over 100 North America hospitals.  The ultimate research goal was to establish a valid and reliable instrument to support ongoing cross-cultural workload analysis research.

Design: Study design included multiple test stages.  Stage one focused on establishment of an accurate and functional instrument language translation.  Researchers then completed extensive intra-rater user reliability testing.  Once researchers were satisfied that language and intra-rater reliability issues had been addressed, the instrument was then tested in two critical care settings located in the Municipality of Sao Paulo.  Results using this instrument were compared to results from established Brazilian workload instruments concurrently used in order to evaluate the discriminating capability of the test instrument.

Population, Sample, Setting and Year:  The setting was two critical care units in Sao Paulo, Brazil in 2005.  The sample included all patients admitted over a designated period of time.  The study included fifty sets of patient scores.

Findings:  Statistically significant study results supported the validity and reliability in measuring patient care workload in the Brazilian critical care environment of the tested instrument.

Conclusions:  A detailed and rigorous study suggests successful cross-cultural application of the tested workload instrument.  Such success supports on-going cross-cultural workload analysis research as well as comparisons of workload, staffing and outcomes between Brazilian and North American hospitals.

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See more of The 18th International Nursing Research Congress Focusing on Evidence-Based Practice (11 -- 14 July, 2007)