Development and Validation of a Meta-Instrument for the Assessment of Functional Capacity, the Risk of Falls and Pressure Injuries in Adult Hospitalization Units (VALENF Instrument) (Part II).

The nursing assessment is the first step of the nursing process and fundamental to detecting patients' care needs and at-risk situations. This article presents the psychometric properties of the VALENF Instrument, a recently developed meta-instrument with only seven items that integrates the assessment of functional capacity, risk of pressure injuries and risk of falls with a more parsimonious approach to nursing assessment in adult hospitalization units. A cross-sectional study based on recorded data in a sample of 1352 nursing assessments was conducted. Sociodemographic variables and assessments of the Barthel, Braden and Downton instruments were included at the time of admission through the electronic health history. Thus, the VALENF Instrument obtained high content validity (S-CVI = 0.961), construct validity (RMSEA = 0.072; TLI = 0.968) and internal consistency (Ω = 0.864). However, the inter-observer reliability results were not conclusive, with Kappa values ranging between 0.213 and 0.902 points. The VALENF Instrument has adequate psychometric properties (content validity, construct validity, internal consistency and inter-observer reliability) for assessing the level of functional capacity, risk of pressure injuries and risk of falls. Future studies are necessary to establish its diagnostic accuracy.

Development and Validation of a Meta-Instrument for Nursing Assessment in Adult Hospitalization Units (VALENF Instrument) (Part I).

Nursing assessment is the basis for performing interventions that match patient needs, but nurses perceive it as an administrative load. This research aims to develop and validate a meta-instrument that integrates the assessment of functional capacity, risk of pressure ulcers and risk of falling with a more parsimonious approach to nursing assessment in adult hospitalization units. Specifically, this manuscript presents the results of the development of this meta-instrument (VALENF instrument). A cross-sectional study based on recorded data was carried out in a sample of 1352 nursing assessments. Socio-demographic variables and assessments of Barthel, Braden and Downton indices at the time of admission were included. The meta-instrument's development process includes: (i) nominal group; (ii) correlation analysis; (iii) multiple linear regressions models; (iv) reliability analysis. A seven-item solution showed a high predictive capacity with Barthel (R2adj = 0.938), Braden (R2adj = 0.926) and Downton (R2adj = 0.921) indices. Likewise, reliability was significant (p < 0.001) for Barthel (ICC = 0.969; τ-b = 0.850), Braden (ICC = 0.943; τ-b = 0.842) and Downton (ICC = 0.905; κ = 7.17) indices. VALENF instrument has an adequate predictive capacity and reliability to assess the level of functional capacity, risk of pressure injuries and risk of falls.