Initial Psychometric Evaluation of the Staff Perception of the Disruptive Patient Behavior Scale.

OBJECTIVE: The aim of this study is to develop and psychometrically test the Staff Perception of Disruptive Patient Behavior (SPDPB) Scale. BACKGROUND: Disruptive patient behaviors impact work safety for nurses in hospitals. There is no standardized approach to capturing staff perceptions of these behaviors. METHOD: A mixed-methods approach was used to develop and psychometrically evaluate the SPDPB Scale. Items were generated from a survey completed by 770 healthcare providers. A prototype 66-item instrument was developed and content validity was obtained. Evaluation of the psychometric properties of the SPDPB Scale was completed with 558 nurses. Evaluation included internal consistency reliability, principal components analysis, and internal consistency reliability derived subscales to refine the final scale. RESULTS: The SPDPB Scale is a multidimensional measure of perceptions of disruptive patient behaviors. The analysis identified 6 components explaining 54.1% of the variance. The final scale contained 65 items. CONCLUSION: This scale demonstrated psychometric adequacy and can be recommended to measure staff perceptions of disruptive patient behavior.

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Development and application of a brief multi-faceted tool for evaluating inpatient psychiatric care.

Increasingly, hospitals are expected to monitor and document service delivery variables, such as treatment outcome and patient satisfaction with care, which are thought to be associated with the quality of care received by patients. Documenting the patient's collaboration in the treatment-planning process also has become more important. However, for many clinically oriented units, translating these expectations into a useable instrument and an efficient measurement procedure is a complex and difficult task. This paper outlines the development of a brief multi-faceted program evaluation instrument and assessment process for completing these tasks. The authors describe the rationale behind their approach to these measurement issues, and they introduce an instrument capable of effectively measuring both outcome and satisfaction. They also provide an overview of how they apply the instrument in their inpatient psychiatry service. The strengths and weakness of this assessment strategy are reviewed.

Predicting length of stay on an acute care medical psychiatric inpatient service.

The goal of this study was to identify variables associated with length of stay (LOS) and to incorporate into the authors' routine preadmission assessment the measurement of these variables. A retrospective study of 80 discharged patients explored the association of 25 variables reflecting a mixture of patient/demographic variables, illness variables, and treatment variables with LOS. Multivariate analysis revealed that 10 variables independently accounted for 62% of the variance in LOS. The information used was obtained primarily in the preadmission screening. The predictive power of the variables shrank in the prospective study. However, fewer individual variables were significantly associated with LOS; the summed score of the variables predicted 17% of the LOS variance. Results indicated that factors important for estimating LOS are available at the time of admission, and these variables can be systematically assessed and incorporated into clinical decision making.