Interrater reliability of 2 sedation scales in a medical intensive care unit: a preliminary report.
BACKGROUND
Critical care nurses must assess the effectiveness of sedatives and analgesic agents in order to titrate doses.


OBJECTIVE
To measure the interrater reliability of 2 sedation scales used to assess patients in medical intensive care units.


METHODS
The interrater reliabilities of the Motor Activity Assessment Scale and the Luer sedation scale were compared prospectively in 31 patients receiving mechanical ventilation in an 18-bed medical intensive care unit of a tertiary care institution. Three registered nurses, 1 clinical pharmacist, and 1 physician simultaneously and independently followed a standardized procedure to rate each patient by using the 2 scales. Scales were randomly ordered to counteract ordering effect. Analysis of variance with post hoc Duncan multiple range tests was used to detect bias; a correlation coefficient matrix was used to examine degree of association among raters; and the intraclass correlation coefficient was measured to control for multiple raters.


RESULTS
No significant bias was detected with either scale. The Motor Activity Assessment Scale had less variation (Pearson r = 0.75-0.92) than did the Luer scale (Pearson r = 0.37-0.94) and had a stronger intraclass correlation coefficient (0.81 vs 0.79).


CONCLUSIONS
The Motor Activity Assessment Scale showed the highest consistency among raters.
Hogg
L H
LH
Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Bobek
M B
MB
Mion
L C
LC
Legere
B M
BM
Banjac
S
S
VanKerkhove
K
K
Arroliga
A C
AC
D000700:Analgesics / Q000008:administration & dosage*; D016292:Procedural Sedation / Q000145:classification*; D003422:Critical Care / Q000592:standards*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007362:Intensive Care Units; D009043:Motor Activity / Q000187:drug effects; D009730:Nursing Assessment; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012015:Reference Standards; D015203:Reproducibility of Results
D000700:Analgesics; D006993:Hypnotics and Sedatives