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Background and Purpose: Assessing nurses' perceived leadership abilities during clinical deterioration provides a starting point for designing educational interventions to support leadership improvement. The study purpose was to provide psychometric testing of the Clinical Deterioration Leadership Ability Scale (CDLAS). Methods: The psychometric properties and factor structure of the CDLAS was examined. Results: Factor analysis determined a 1-factor structure (eigenvalues 5.783). Construct validity was supported by a significant difference between experienced ( M 5 3.48, SD 5 .57) and less experienced nurses (M 5 3.27, SD 5 .68; t(146) 5 22.00, p 5 .047). Acceptable levels of internal consistency reliability were found (.93, .95, and .94). Conclusion: The CDLAS has demonstrated acceptable validity and reliability. Further testing is needed in diverse populations and establishment of test-retest reliability.
Keywords: clinical deterioration events; factor analysis; leadership ability; nurses; psychometric testing
Over the last decade, patient acuity levels on medical-surgical (MS) units have increased (Needleman, 2013) requiring MS nurses to hone skills in recognizing and responding to clinical deterioration events. MS nurses have the responsibility to assess, monitor, and intervene when changes in patients' vital signs warrant emergent care. Late to rescue or failure to rescue patients in clinical deteriorating events has been reported to result in death or life changing conditions (Hogan et al., 2012; National Confidential Enquiry into Patient Outcome and Death, 2012; Schmid, Hoffman, Happ, Wolf, & Devita, 2007).
MS nurses are usually the first responders who activate lifesaving interventions in clinical deteriorating events (Friese & Aiken, 2008). MS nurses should possess the necessary skills and competencies to effectively intervene in an expedient and competent manner to ensure optimal patient outcomes. Leadership skills are essential in coordinating responders, communicating pertinent clinical information, performing handover procedures to medical emergency or code team, supporting and performing lifesaving interventions, and using appropriate resources during clinical deterioration events.
Understanding nurses' leadership abilities in managing clinical deterioration events will provide evidence to develop intervention programs to improve nurses' leadership skills in managing such events. Therefore, the study purpose was to provide further validity and reliability testing of the Clinical Deterioration Leadership Ability Scale (CDLAS), an eight-item questionnaire that measures nurses' leadership abilities in managing clinical deterioration events.
BACKGROUND
Researchers have examined nurses' abilities to recognize and respond to clinical deterioration...