Emergency Medical Identification in Adolescent Diabetes Patients: Prevalence and Response to Educational Intervention

Abstract

Background: Neonatal growth measurements (weight, length, head circumference) are used to assess fetal growth, determine neonatal and surveillance needs, and as a baseline for future growth monitoring. Measurements are often inaccurate and unreliable. To develop interventions for promoting evidencebased practice (EBP), we need to understand the knowledge, attitudes, practice behaviors, and bases of practice knowledge for neonatal growth measurement. A valid and reliable instrument did not exist. Aims: To develop and test the psychometric properties of the Neonatal Growth Measurement Survey (NGMS), we aimed to determine if it was a valid and reliable survey of neonatal growth measurement knowledge, attitudes, practice behaviors, and bases of practice knowledge. Methods: The survey included knowledge, attitude, practice behavior, and bases of practice knowledge questions constructed from best evidence and an EBP questionnaire. Content validity was assessed by seven clinical experts. A revised survey was pilot tested with a convenience sample of 20 neonatal nurses each from two mother-baby units and two NICUs. The same online survey was distributed twice 4 weeks apart to assess reliability. Data were analyzed for test-retest reliability and internal consistency. Results: The NGMS was validated to adequately represent the characteristics and constructs of neonatal growth measurement knowledge, attitudes, practice behaviors, and bases of practice knowledge. Sixty-two nurses completed the survey twice. Knowledge: Mean 83.9% agreement between responses from both survey administrations. Pearson correlation for total correct knowledge scores between time 1 and time 2 was .64. Cronbach's alpha was .37 for time 1 and .32 for time 2, indicating the scale did not measure a single construct. Attitudes: Mean Spearman's correlation between times was .51. Cronbach's alpha was .89 for time 1 and .88 for time 2. Practice behaviors: Agreement between time 1 and time 2 responses for head circumference (n=49): instruments 87.75%, techniques 91.94-100%; weight (n=62): instruments 91.94-100%, techniques 75.81-100%; length (n=49): instruments 87.75%, techniques 69.39-100%. Bases of practice knowledge: Mean Spearman's correlation between times was .44. Cronbach's alpha was .83 for time 1 and .84 for time 2. Conclusions: The NGMS was validated by content experts. Overall reliability was adequate, and suggested areas for further refinement. Clinical Implications: A refined NGMS will be used for a national study to understand current practices and barriers to EBP in order to develop nursing interventions to improve neonatal growth measurement accuracy and reliability.