CREATION AND CONTENT VALIDITY OF <i>5R-MEDSAFE</i>: ASSESSING ADHERENCE TO THE SAFE DRUG ADMINISTRATION “FIVE RIGHTS”

Andolhe, Rafaela; Padilha, Adriel; Guirardello, Edineis de Brito; Gallani, Maria Cecília Bueno Jayme; Rodrigues, Roberta Cunha Matheus

doi:10.1590/1980-265X-TCE-2023-0171en

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Special Section • Texto contexto - enferm. 33 • 2024 • https://doi.org/10.1590/1980-265X-TCE-2023-0171en copy

CREATION AND CONTENT VALIDITY OF 5R-MEDSAFE: ASSESSING ADHERENCE TO THE SAFE DRUG ADMINISTRATION “FIVE RIGHTS”

ELABORACIÓN Y VALIDEZ DE CONTENIDO DEL INSTRUMENTO 5R-MEDSAFE: EVALUACIÓN DE LA ADHESIÓN A LOS “CINCO CORRECTOS” DE LA ADMINISTRACIÓN SEGURA DE MEDICAMENTOS

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to present the creation and content validity stages of a questionnaire to assess the determinants of adherence to the safe drug administration five “rights” “x”, based on the Theory of Planned Behavior integrative model.

Method:

a methodological study to create and validate a self-reported measuring instrument for psychosocial variables. It took place in two public university teaching hospitals: one located in the South and the other in the Southeast of Brazil.

Results:

the results were organized according to each stage of the 5R-MEDSAFE content validation process.

Conclusion:

the results obtained in this creation and content validation study of the 5R-MEDSAFE indicated that the tool presented diverse content validity evidence. Its application can be useful in different contexts as a way of assessing adherence to these behaviors among Nursing workers. This will make it possible to identify which elements of the behaviors are amenable to intervention, as well as to implement the most appropriate intervention, according to the Theory of Planned Behavior constructs.

DESCRIPTORS:
Patient safety; Drug administration; Behavior; Nursing beliefs

Items	^* P	E1	E2	E3	E4	E5	CVI-I	CVI-Total	Consensus version
1. Intention
1.1 I intend to adhere to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks.	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
1.2 I plan to adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
1.3 I intend to adhere to safe drug administration behaviors...	^†C	4	4	4	3	4	1.0	-	Unchanged
	^‡R	4	4	4	3	4	1.0	-	Unchanged
1.4 I want to adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0		Unchanged
1.5 I will strive to adhere to safe drug administration behaviors	^†C	4	4	4	4	3	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
1.6 The probability of me adhering to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks is...	^†C	4	4	4	4	3	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
Items - Intention	^§S	4	4	4	4	4	1.0	1.0
2. Attitude
For me, adhering to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks is: 2.1 Very bad; bad; no opinion or neutral; good; very good	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
2.2 Very unnecessary; unnecessary; no opinion or neutral; necessary; very necessary	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
2.3 Very useless; useless; no opinion or neutral; useful; very useful	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
2.4 Very relevant; relevant; no opinion or neutral; irrelevant; very irrelevant	^†C	4	4	4	4	2	0.8	-	Very irrelevant; irrelevant; no opinion or neutral; relevant; very relevant
	^‡R	4	4	4	4	4	1.0
2.5 Very disadvantageous; disadvantageous; no opinion or neutral; advantageous; very advantageous	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
2.6 Very difficult; difficult; no opinion or neutral; easy; very easy	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	3	4	1.0	-	Unchanged
2.7 Very time-consuming; time-consuming; no opinion or neutral; fast; very fast.	^†C	4	4	4	2	4	0.8	-	Unchanged
	^‡R	4	4	4	2	4	0.8	-	Unchanged
2.8 Very repetitive; repetitive; no opinion or neutral; not very repetitive; not repetitive at all	^†C	4	4	4	3	4	1.0	-	Unchanged
	^‡R	4	4	3	3	4	1.0	-	Unchanged
Items - Attitude	^§S	4	3	4	4	4	1.0	1.0
3. Perceived Norm
3.1 People whose opinions are important to me would approve of me adhering to safe drug administration behaviors... (doing all 5 “rights”) over the next two weeks.	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
3.2 People whose opinions are important to me want me to adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
3.3 Most of my coworkers who are important to me will adhere to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks.	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
3.4 Among the coworkers I know: ( ) None of them ( ) Less than half ( ) Half ( ) More than half ( ) All of them ...adhere(s) to safe drug administration behaviors...	^†C	4	4	4	4	3	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
3.5 As a Nursing worker, I am expected to adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
Items - Perceived Norm	^§S	4	3	4	4	4	1.0	1.0	Unchanged
4. Perceived Behavior Control
4.1 It is only up to me to adhere to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks.	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
4.2 It is within my control to adhere to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks.	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
4.3 I am sure that I can adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
4.4 I am confident about my ability to adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
4.5 I am able to adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
4.6 It is only up to me to adhere to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks.	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
4.7 It is within my control to adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
4.8 I am sure that I can adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
4.9 I am confident about my ability to adhere to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Unchanged
	^‡R	4	4	4	4	4	1.0	-	Unchanged
Items - Perceived Behavior Control	^§S	4	4	4	4	4	1.0	1.0

Items	^* P	E1	E2	E3	E4	E5	CVI-Item	CVI-Total	Consensus version
5 Behavioral Beliefs
Adhering to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks: 5.1 would prevent me from making mistakes when administering medications.	^†C	4	4	4	4	4	1.0	-	...would help me avoid making mistakes when administering medications.
	^‡R	4	4	4	4	4	1.0	-
5.2 would contribute to patient safety.	^†C	4	4	4	4	4	1.0	-	...would contribute to patient safety.
5.2 would contribute to patient safety.	^‡R	4	4	4	4	4	1.0	-	...would contribute to patient safety.
5.3 would enable me to act in accordance with Nursing professionals' ethics	^†C	4	4	4	4	4	1.0	-	...would increase the time I need to administer medications.
	^‡R	4	4	4	4	4	1.0	-
5.4 would increase the time I need to administer medications.	^†C	4	4	4	4	4	1.0	-	Excluded
	^‡R	4	4	4	4	4	1.0	-	Excluded
5.5 would give me a sense of accomplishment.	^†C	4	4	4	4	3	1.0	-	...would give me a sense of accomplishment.
5.5 would give me a sense of accomplishment.	^‡R	4	4	4	4	4	1.0	-	...would give me a sense of accomplishment.
Items - Behavioral Beliefs	^§S	4	4	3	4	4	1.0	1.0
6 Control Beliefs
6.1 Having knowledge would make it easier for me to adhere to safe drug administration behaviors...	^†C	4	4	4	4	3	1.0	-	Over the next two weeks, the following factors would ease my adherence to safe drug administration behaviors (doing all 5 “rights”): My knowledge level
	^‡R	4	4	4	4	4	1.0	-
6.2 Attending regular training sessions would make it easier for me to adhere to safe drug administration behaviors.	^†C	4	4	4	4	4	1.0	-	My participation in previous periodic training sessions
	^‡R	4	4	4	4	4	1.0	-	My participation in previous periodic training sessions
6.3 Having professional experience would make it easier for me to adhere to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks.	^†C	4	4	4	4	3	1.0	-	My level of professional experience
	^‡R	4	4	4	4	4	1.0	-	My level of professional experience
6.4 Supporting the safety culture in the workplace would make it easier for me to adhere to safe drug administration behaviors...	^†C	4	2	2	4	3	0.6	-	The institution's support for the safety culture in my work environment
	^‡R	4	4	4	4	4	1.0	-
6.5 Insufficient Nursing staffing would hinder my adherence to safe drug administration behaviors...	^†C	4	4	4	4	3	1.0	-	Appropriate Nursing staffing in my work environment
	^‡R	4	4	4	4	4	1.0	-	Appropriate Nursing staffing in my work environment
6.6 Resistance to changes in the work routine would hinder my adherence to safe drug administration behaviors...	^†C	2	2	4	4	2	0.4	-	Being open to changes in the work routine
	^‡R	4	3	4	4	3	1.0	-	Being open to changes in the work routine
6.7 Noise in the medication preparation room would hinder my adherence to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks.	^†C	4	4	4	4	2	0.8	-	Over the next two weeks, the following factors would hinder my adherence to safe drug administration behaviors (doing all 5 “rights”): Noise in the medication preparation environment
	^‡R	4	4	4	4	3	1.0	-
6.8 Absence of an exclusive place for preparing medications would hinder my adherence to safe drug administration behaviors...	^†C	4	4	4	4	2	0.8	-	Absence of an exclusive area for preparing medications.
	^‡R	4	4	4	4	3	1.0	-	Absence of an exclusive area for preparing medications.
6.9 Work overload would hinder my adherence to safe drug administration behaviors...	^†C	4	4	4	4	4	1.0	-	Work overload
	^‡R	4	4	4	4	4	1.0	-	Work overload
6.10 Performing too many activities at the same time would hinder my adherence to adhere to safe drug administration behaviors...	^†C	4	3	4	4	3	1.0	-	Performing several activities at the same time
	^‡R	4	3	4	4	4	1	-	Performing several activities at the same time
Items - Control Beliefs	^§S	4	3	4	4	4	1	1.0
7 Normative Beliefs
7.1 Most of the patients think that I should adhere to safe drug administration behaviors...	^†C	4	3	4	4	4	1.0	-	Unchanged
	^‡R	4	3	4	4	4	1.0	-	Unchanged
7.2 Most of the patients' relatives would expect me to adhere to safe drug administration behaviors...	^†C	4	3	4	4	4	1.0	-	Unchanged
	^‡R	4	3	4	4	4	1.0	-	Unchanged
7.3 My immediate manager and/or supervisors would expect me to adhere to safe drug administration behaviors...	^†C	4	3	4	4	4	1.0	-	Unchanged
	^‡R	4	3	4	4	4	1.0	-	Unchanged
7.4 All Nursing professionals think that I should adhere to safe drug administration behaviors...	^†C	4	3	4	4	4	1.0	-	Unchanged
	^‡R	4	3	4	4	4	1.0	-	Unchanged
7.5 Adhering to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks would mean doing the right thing.	^†C	4	4	4	4	3	1.0	-	Excluded
	^‡R	2	4	4	4	4	0.8	-	Excluded
7.6 Adhering to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks would mean acting in accordance with professional ethics.	^†C	4	4	4	4	4	1.0	-	Adhering to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks: 8.1...would mean acting in accordance with professional ethics
	^‡R	2	4	4	4	3	0.8	-
7.7 Adhering to the safe drug administration behaviors (doing all 5 “rights”) over the next two weeks is Nursing professionals' duty.	^†C	4	4	4	4	4	1.0	-	8.2 ...is Nursing professionals' duty.
	^‡R	2	4	4	4	3	0.8	-	8.2 ...is Nursing professionals' duty.
7.8 Adhering to safe drug administration behaviors (doing all 5 “rights”) over the next two weeks is Nursing professionals' responsibility.	^†C	4	4	4	4	4	1.0	-	8.3 ...is Nursing professionals' responsibility.
	^‡R	4	4	4	2	3	0.8	-	8.3 ...is Nursing professionals' responsibility.
Items - Normative Beliefs	^§S	4	3	4	2	4	0.8	1.0

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E-mail: textoecontexto@contato.ufsc.br

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[1] CORRESPONDING AUTHOR
Rafaela Andolhe rafaela.andolhe@ufsm.br