title: The assessment of safe nursing care: development and psychometric evaluation.
abstract: OBJECTIVE
  To develop an instrument for the assessment of safe nursing care (ASNC) within the Iranian context and psychometrically evaluate its reliability and validity.
  
  
  BACKGROUND
  There is a need for a valid and reliable instrument to assess how nurses employ the components of safe nursing care in clinical practice in non-Western countries.
  
  
  METHODS
  This methodological study was conducted in two phases: (1) a qualitative phase of instrument development, and (2) a quantitative phase of psychometric evaluation of the assessment of safe nursing care (ASNC). The instrument's content validity was assessed by experts in the field of safe nursing care. The reliability of this instrument was examined using internal consistency reliability and intra-rater reliability analysis. Exploratory factor analysis was then conducted to establish the instrument's initial construct validity.
  
  
  RESULTS
  The instrument developed was a questionnaire with 32 items. The Cronbach's alpha of the scale was 0.92, and Intra-class Correlation Coefficient for intra-rater reliability was 0.78. Exploratory factor analysis resulted in a four-factor solution: (1) evaluation of nursing skills, (2) assessing the patient's psychological needs, (3) assessing the patient's physical need, and (4) Assessing nurses' teamwork. The four factors accounted for 63.54% of the observed variance.
  
  
  CONCLUSIONS
  The ASNC can be applied to a wide variety of settings because of the broad range of methods utilised to generate items and domains, its comprehensive consideration of the principles of safe care, and its initial reliability and validity.
  
  
  CONCLUSIONS
  The ASNC can help nurse managers assess whether clinical nurses are prepared to apply their safe care skills in clinical practice. It can also be used by clinical nurses to assess their own and peers' practice to detect potential areas for improvement in nursing care and help nurse managers with planning appropriate quality improvement programmes.
authors.affiliation: Faculty of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Farnoosh
authors.initials: F
authors.lastname: Rashvand
authors.affiliation: Behavioral Sciences Research Center, Nursing Faculty of Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Ebadi
authors.affiliation: Faculty of Professional Studies, Nord University, Bodø, Norway.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Vaismoradi
authors.affiliation: Faculty of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mahvash
authors.initials: M
authors.lastname: Salsali
authors.affiliation: School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mir Saeed
authors.initials: MS
authors.lastname: Yekaninejad
authors.affiliation: College of Human and Health Sciences, Swansea University, Swansea, UK.
authors.forename: Pauline
authors.initials: P
authors.lastname: Griffiths
authors.affiliation: College of Nursing, Montana State University, Bozeman, Montana, USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Sieloff
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D009732:Nursing Care / Q000592:standards* / Q000706:statistics & numerical data; D061214:Patient Safety / Q000592:standards* / Q000706:statistics & numerical data; D011594:Psychometrics / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D036301:Qualitative Research; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data; D015203:Reproducibility of Results
keywords: assessment; instrument; nurse manager; patient safety; psychometric evaluation; safe care