1. DEVELOPING AND TESTING THE STANDARD OF PRACTICE AND EVALUATION OF CRITICAL-CARE-NURSING TOOL (SPECT) FOR GRADUATES OF CRITICAL CARE NURSE EDUCATION PROGRAMS. Gill, FJ 1,2, Leslie, GD 1, Grech, C 3, Boldy, D 1, & Latour, JM 1,4 Curtin University 1, Princess Margaret Hospital 2, University of South Australia 3, Plymouth University 4 Aim To address the need for validated critical care education graduate practice outcomes informed by consumer input, we undertook a multiphase study to develop practice standards for graduates of critical care nurse education 1 The 5 phase study (fig 1) developed and tested a clinical assessment tool derived from the standards: the Standards of Practice and Evaluation of Critical- Care-Nursing Tool (SPECT) 2 Conclusion Critical care nursing practice standards and an assessment tool have been developed informed by critical care nursing stakeholders as well as patients and families 3 The SPECT appears to have clinical feasibility, preliminary validity and reliability, and provides a clear definition for the expected practice level of critical care nurses after the completion of a critical care education program (Fig 2). References 1.Gill FJ, Leslie GD, Grech C, Boldy D, Latour JM. Development of Australian clinical practice outcome standards for graduates of critical care nurse education J Clin Nurs. 2014;Advance online ahead of print 2.Gill FJ, Leslie GD, Grech C, Boldy D, Latour JM. Developing and testing the Standard of Practice and Evaluation of Critical-care-nursing Tool (SPECT) for critical care nursing practice. J Contin Educ Nurs. 2014;45(7):312-20 3.Gill FJ, Leslie GD, Grech C, Latour JM. Health consumers’ experiences in Australian critical care Units: postgraduate nurse education implications. Nurs Crit Care. 2013;18(2):93-102 Fig 1: The 5 phases used to develop the SPECT Acknowledgements We thank all the critical care nurses who participated in the national study and the Australian College of Critical Care Nurses who facilitated participant recruitment and provided support for the study to proceed. Data analysis Descriptive statistics included mean, median scores, interquartile ranges and standard deviations Student t-tests for comparison of continuous variables. Level of significance p<0.05 Pilot panel: Qualitative data review Panel 1: Individual statement and domain content validity index (CVI) Panel 2: Level of agreement (5-point Likert scale) Internal consistency: Cronbach’s α domain level for Round I and Round II Test-retest: Spearman’s rank correlation Intra-rater reliability: Kappa statistic (responses were collapsed into dichotomous variables) Clinical feasibility of using the SPECT using 8 statements (4-point Likert scale) and 1 open question Methods The standards were arranged into a practical tool (SPECT) to measure graduate level practice (Table A). This study (phase five) assessed the validity, reliability, and clinical feasibility of the SPECT Steps: Pilot panel Five critical care nurses tested the electronic survey format of the draft SPECT Panel 1(6 course coordinators) assessed for content validity Panel 2 (23 clinical assessors and 13 recent course graduates) assessed reliability (internal consistency, test-retest and intra-rater) and clinical feasibility Results Panel 2 response rate for round I was 36 of 44 (82%) In round II, 34 of 36 (94%) completed the test-retest Table 1 shows the panel 2 participant characteristics Content validity Statement CVI range 0.66 - 1.00 For 97 of 104 (93%) statements, the CVI=1.00 At the domain level, the CVI range was 0.95 - 1.00 (mean 0.98) Reliability Table 2 shows the domain level internal consistency and correlation between rounds The bivariate correlation (Spearman rank correlation) of each domain between the round I and round II surveys ranged from 0.772 to 0.887 The intra-rater reliability between survey rounds I And II for each rater was statistically significant (p < 0.005) for 102 of 104 statements Table 3 shows the relative strength of agreement Clinical Feasibility Table 4 shows the panel responses to the 8 statements were positive There were no suggestions for additions or changes to the statements Abstract Introduction: We developed practice standards for critical care nurse education that were based on a literature review, analysis of courses, health consumer views and a national stakeholder Delphi Study. A translation of these standards to a reliable, valid and authentic clinical assessment tool – the SPECT was a logical final step. Study objectives: To measure the reliability, validity and clinical feasibility of the SPECT. Methods: Following institutional ethics committee approval an electronic survey format of the SPECT was pilot tested for face validity by a panel of 5 critical care nurses (4 experienced and 1 who had recently graduated from a course). An expert panel (6 course coordinators) assessed the SPECT for content validity. Critical care clinical assessment tool users recruited nationally (23 clinical assessors and 13 nurses who had completed a course within 18 months responded to the round 1 survey) participated in reliability testing and assessment of clinical feasibility. Results: Testing of the SPECT revealed strong content validity (index domain range 0.95-1.00 and statement range 0.66 - 1.00), good internal consistency (Cronbach’s α >0.864), test- retest (Spearman’s Rank correlation range 0.772 - 0.887) and intra-rater agreement was statistically significant (p 0.41). The majority of panel responses (66%) were ranked as clinically feasible. There were no suggestions for additions or changes. Conclusion: The SPECT reflects the views of health consumers and critical care nursing stakeholders. Testing revealed that it is reliable, face and content valid and appears to be a useful tool for assessing practice in this group. The SPECT provides a clear definition for the expected practice level for a graduate of a critical care nurse education program. Aim To address the need for validated critical care education graduate practice outcomes informed by consumer input, we undertook a multiphase study to develop practice standards for graduates of critical care nurse education 1 The 5 phase study (Fig 1) developed and tested a clinical assessment tool derived from the standards: the Standards of Practice and Evaluation of Critical-Care-Nursing Tool (SPECT) 2 Fig 2: Demonstration of graduate practice standards