Reliability and criterion-related validity testing (construct) of the Endotracheal Suction Assessment Tool (ESAT©)

Aims and objectivesTo establish criterion-related construct validity and test-retest reliability for the Endotracheal Suction Assessment Tool (c) (ESAT (c)). BackgroundEndotracheal tube suction performed in children can significantly affect clinical stability. Previously identified clinical indicators for endotracheal tube suction were used as criteria when designing the ESAT (c). Content validity was reported previously. The final stages of psychometric testing are presented. DesignObservational testing was used to measure construct validity and determine whether the ESAT (c) could guide inexperienced paediatric intensive care nurses' decision-making regarding endotracheal tube suction. Test-retest reliability of the ESAT (c) was performed at two time points. MethodsThe researchers and paediatric intensive care nurse experts developed 10 hypothetical clinical scenarios with predetermined endotracheal tube suction outcomes. Experienced (n=12) and inexperienced (n=14) paediatric intensive care nurses were presented with the scenarios and the ESAT (c) guiding decision-making about whether to perform endotracheal tube suction for each scenario. Outcomes were compared with those predetermined by the experts (n=9). Test-retest reliability of the ESAT (c) was measured at two consecutive time points (4weeks apart) with experienced and inexperienced paediatric intensive care nurses using the same scenarios and tool to guide decision-making. ResultsNo differences were observed between endotracheal tube suction decisions made by experts (n=9), inexperienced (n=14) and experienced (n=12) nurses confirming the tool's construct validity. No differences were observed between groups for endotracheal tube suction decisions at T1 and T2. ConclusionCriterion-related construct validity and test-retest reliability of the ESAT (c) were demonstrated. Further testing is recommended to confirm reliability in the clinical setting with the inexperienced nurse to guide decision-making related to endotracheal tube suction. Relevance to clinical practiceThe ESAT (c) is the first validated tool to systematically guide endotracheal nursing practice for the inexperienced nurse.