Research Article: Psychometric properties of a short knowledge test to evaluate awareness of external ventricular drain care practices among Chinese nurses: a Rasch model analysis of an efficient 7-item self-reported assessment tool
Abstract:
External ventricular drainage (EVD) is an important intervention in the management of patients with severe neurological conditions, and standardized nursing care is essential for preventing complications and ensuring patient safety. Nurses’ knowledge of recommended EVD care practices is an important foundation for safe and evidence-based care. However, existing instruments for assessing EVD-related nursing knowledge are often lengthy or have limited psychometric validation, which may restrict their use in routine clinical assessment and large-scale training. Therefore, a brief, reliable, and psychometrically robust instrument is needed to efficiently assess nurses’ knowledge of EVD care practices and identify areas requiring targeted education.
To translate and culturally adapt the Short Knowledge Test to Evaluate Awareness of External Ventricular Drain Care Practices and evaluate its psychometric properties among Chinese nurses using the Rasch model, thereby providing a reliable tool for the rapid assessment of nurses’ self-reported knowledge of recommended EVD care practices and the identification of targeted training needs.
The original scale was translated and culturally adapted into Chinese using the Brislin forward–backward translation method, resulting in the Chinese version of the Short Knowledge Test to Evaluate Awareness of External Ventricular Drain Care Practices (C-SKT-EVD). A cross-sectional survey was conducted among clinical nurses recruited from First Affiliated Hospital of Jinzhou Medical University, Liaoning Province, mainland China. 242 valid participants included in the final analysis. Descriptive statistics were performed using SPSS version 26.0, and the psychometric properties of the scale were evaluated using the Rasch Rating Scale Model in Winsteps version 3.72.3, focusing on unidimensionality, item fit, category functioning, item–person distribution, test information function, separation indices and reliability, and differential item functioning (DIF).
The empirical variance explained by the measures was 55.1%, and the eigenvalue of the first contrast was 1.4, supporting the unidimensionality of the C-SKT-EVD. The Infit mean-square (MNSQ) values for the seven items ranged from 0.94 to 1.16, while the Outfit MNSQ values ranged from 0.94 to 1.07, all indicating acceptable fit to the Rasch model. The point-measure correlation coefficients (PT-Measure Corr.) ranged from 0.63 to 0.70, suggesting good alignment between the items and the underlying latent construct. The observed average measures across the five rating categories increased monotonically, and the category thresholds were ordered sequentially. The category probability curves also showed clearly defined peaks, indicating that the rating categories functioned well and that no category collapsing was required. The item difficulty distribution was generally well matched to the respondents’ levels of self-reported EVD care knowledge, and the test information function indicated higher measurement precision around the average level of the measured construct, with relatively less information provided for respondents with extremely high or low levels of the latent trait.
The C-SKT-EVD demonstrated generally acceptable Rasch measurement properties in the present sample of Chinese nurses, providing preliminary evidence for its use as a brief screening and educational assessment tool for self-reported knowledge of recommended EVD care practices. However, these findings do not establish comprehensive validity or objective clinical competence. Further multicenter studies in diverse nursing populations are needed to confirm its broader applicability.
Introduction:
External ventricular drainage (EVD) is an important intervention in the management of patients with severe neurological conditions, and standardized nursing care is essential for preventing complications and ensuring patient safety. Nurses’ knowledge of recommended EVD care practices is an important foundation for safe and evidence-based care. However, existing instruments for assessing EVD-related nursing knowledge are often lengthy or have limited psychometric validation, which may restrict their use in routine…
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