Chronic kidney disease patient safety in hemodialysis: evidence of scale validity and reliability.
Leticia Lima Aguiar, Marina Guerra Martins, Renan Alves Silva and 3 others
PMID 40802441WHAT IT FOUND
The revised 15-item scale for observing hemodialysis safety practices scored up to 45.
A proposed cutoff above 34 flags stronger safety practices; below 34 flags greater vulnerability. Some items were not consistently scored.
Key findings
01The final EASPRCH had 15 items in three domains, explained 72.41% of variance, and had a total Cronbach’s alpha of 0.78.
02A score above 34 on the 45-point scale was proposed as the adequacy cutoff, using ROC analysis with sensitivity 100% and specificity 80%.
03The validation had psychometric weaknesses: KMO was 0.5, four test-retest Kappa values were below threshold, and ten inter-observer Kappa values were negative.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Data were collected in only three hemodialysis clinics in one city in Brazil, with similar settings. The factor analysis had low sample adequacy, with KMO 0.5, so the three-factor structure needs confirmation. Some items had poor internal consistency, temporal stability, or inter-observer agreement. Only 3 specialists participated in the in-person meetings after the initial online review by 11 judges. The authors recommend further testing of reproducibility and adaptation to acute dialysis settings, so the current evidence is limited.
The easy way to misread this
Do not assume the scale improves patient safety. It was only tested as an observation tool, and some items had weak agreement, so it has not been shown to reduce adverse events.