Perceived barriers and facilitators to geriatric trauma risk assessment: Instrument development and validation

Abstract

Background: In the fast-paced and high-stress environment of the ED, conducting a thorough and efficient risk assessment may be associated with various challenges such as time constraints and competing priorities. The aim of this study is to develop and validate a survey instrument that will comprehensively assess emergency provider and nurses perceived barriers and facilitators to geriatric trauma risk assessment. Methods: We designed two six-item surveys that each assess the barriers and facilitators to geriatric trauma risk assessment using the American College of Surgeons geriatric trauma management guidelines. Each item in the survey has a quantitative section, answered on a binary scale, and qualitative open-ended responses. Nine content experts performed content validation of the items in the scale and we computed Cohen Kappa, and item and scale content validity indices (CVIs). Results: Most of the experts were male (56%), and non-Hispanic Whites (44%). A third of the content experts are MDs. Of the six items in the perceived barriers scale, five items were retained. The Cohen Kappa value across the five items ranged from 0.4 to 0.9 and the item and scale CVIs for the five items were 0.76 each. Of the six items in the perceived facilitators to geriatric trauma risk assessment, all six items were retained. The Cohen Kappa value across the six items was 1.00 and the item and scale CVIs for the six items were 1.00 each. Conclusion: We present an instrument that can assess the perceived barriers and facilitators to geriatric trauma risk assessment experienced by emergency providers and nurses.