Development of a novice nurse clinical judgment support scale for fall prevention

Background: Falls in hospitalized patients are associated with various internal and external risk factors, however since novice nurses have limited knowledge, skills, and experience, they lack the ability to recognize these factors and protect patients from falls. Therefore, it is necessary to develop a scale for educational support which nurse supervisors can use as an educational tool. Aims: 1) To clarify the educational support required by novice nurses for improving clinical judgment for fall prevention (Stage 1), 2) To develop a support scale for advancing clinical judgment for fall prevention including consideration for novice nurses, based on the results of Stage 1 (Stage 2). Subjects: 1) A total of 32 expert nurses and nurse managers from three hospitals, 2) 357 nurses with at least one year of clinical experience from two hospitals other than those in Stage 1 (response rate: 60.7%; valid response rate: 59.5%). Methods: 1) Semi-structured interviews were conducted regarding educational support for advancing clinical judgment, and categories were extracted via content analysis. 2) Data collected from an anonymous self-administered questionnaire survey were analyzed for scale development. Results: 1) Four categories were extracted, three of which were categories regarding support for fall prevention education for novice nurses, and the other was regarding the limitation of support. 2) Exploratory factor analysis showed a three-factor structure with 25 items. Cronbach's alpha for the entire scale was 0.964, and criterion-related validity was 0.896. Confirmatory factor analysis showed a comparative fit index of 0.935 and a normal fix index of 0.904, with a root mean square error of approximation of 0.073. Conclusion: The results suggested that the reliability and validity of the scale were acceptable. It is necessary to verify whether the scale can be used by nurse supervisors in fall prevention education for novice nurses.