Testing inter-rater reliability of the Urostomy Education Scale.

PURPOSE: Previous research has validated the Urostomy Education Scale as a standardised evidence based tool to document patients' level of stoma self-care skills. The aim of this study was to test the scale's inter-rater reliability among urology nurses in a continuous validation of the Urostomy Education Scale. METHODS: During the study period from June 2011 to September 2012, 38 ward nurses performing standard stoma care attended 150 validation sessions evaluating 70 patients' level of stoma self-care skills using the Urostomy Education Scale. In pairs, the nurses randomly observed the patients during a training episode involving change of a stoma appliance. Data were categorised into three groups to investigate the impact of nurses' experience on reliability: comparing two inexperienced nurses, two experienced or one of each. Data were compared for agreement by testing variation between groups and analysing Bland Altman Plots with Limits of Agreement. RESULTS: The variation in scores was not influenced by the nurses' level of experience (p > 0.05). Reliability was found to be high with Bland Altman Plot and Limits of Agreement documenting that 84% of scores (95% CI (Confidence interval): 74; 89) were within a range of 2 points. CONCLUSION: The Urostomy Education Scale demonstrates high reliability irrespective of nurses' different levels of experience. The results are clinically relevant and contribute to a precise documentation of stoma self-care skills. The tool ensures evidence based patient education and can provide a high standard of communication in transitions between sectors.

Validation of the urostomy education scale: the European experience.

Bladder cancer is the fourth most common cancer among European males. Once diagnosed with muscle invasive bladder cancer, a radical cystectomy is the first line treatment, which results in a urostomy. The placement of a urostomy and the care required impacts the patient's life. Previous research validated the Urostomy Education Scale as the first standardized tool capable of documenting the patients' level of stoma self-care skills and useful to guide patient education interventions. A Danish-Dutch Fellowship was established to support and provide further evidence of applicability of the Urostomy Education Scale.