Construct Validation of An Innovative Interactive Digital Ostomy Care Algorithm

Evidence-based practice, patient safety, and improving seamless care transitions across healthcare settings are becoming increasingly aligned with healthcare reimbursement.^1,2,Clinical practice guidelines, decision trees and best practice statements are available to promote safe patient care.  Algorithms incorporating evidence-based information can assist with knowledge-based error reduction.^2,3,4,5

The purpose of this research study was to obtain construct validation data for a content validated⁵ostomy algorithm with non-expert and experienced ostomy nurses. The algorithm is designed to guide nurses to optimal assessment and correct product choice for ostomy patients. A digital format of the ostomy care algorithm and testing site was constructed by third-party vendors.  Seven clinical scenarios of ostomy care challenges encountered by nurses were created using a panel of nine WOC nurse experts.  The scenarios were beta tested with a small group of WOC nurse experts verifying correct answer keys. Using two US-based registered nurse source lists, 31,000 nurses were invited to participate. A total of 1,439 nurses responded, 434 met inclusion criteria, and 297 completed the test. The goal was to recruit 100 nurses with ostomy experience and 200 with little or no ostomy experience. Using a cross sectional mixed methods study design, participants were asked to provide demographic data and then complete a test of the algorithms with the seven scenarios.

Respondents represented both acute and post-acute care settings. For non-expert nurses, percent correct averaged 82.49%. For experienced nurses, average percent correct scores were 91%. Lower correct scores were associated with more complex care situations. The high percent correct average score for both groups demonstrated a protective effect for use of the algorithms.  Study results support the construct validity of the new ostomy algorithm for patient care. Future research to ascertain its effect on ostomy care situations and complications in clinical settings is warranted.