The retained surgical items risk assessment scale: Development and psychometric characteristics

The retained surgical items, is a serious patient safety problem, especially for patients undergoing surgery. The purpose of this study was to develop the "Retained Surgical Items Risk Assessment Scale" in the operating room and to examined its psychometric properties. The research was a methodological study and was conducted with 270 patients who underwent surgery in a university hospital between October 2022 and February 2023. Patients over 18 years of age who voluntarily agreed to participate and were scheduled for surgery were included in the sample. The data of the study were collected with the "Sociodemographic and Clinical Characteristics Form," the "Operating Room Count Control Form," and the developed "Retained Surgical Items Risk Assessment Scale". In the analysis of the data, Content Validity Index (CVI), Cronbach α, item-total score correlation, Kuder-Richardson, Cohen Kappa, exploratory and confirmatory factor analysis and Receiver Operating Characteristic (ROC) curve analysis were performed. Ethics committee permission, institutional permission, and patients and health care professionals permission were obtained to conduct the study. It was 60% of the patients in the study were women. Patients were 30.4% had surgery due to the medical diagnosis of neoplasm. The mean age of the patients was 50.7±16.5 years. The CVI of the scale was found to be 0.92. Cohen Kappa value was found to be 0.993 and p<0.001 significant. The variance explained in the exploratory factor analysis of the scale was 50.03%. After confirmatory factor analysis, two factors were obtained for the final version of 15 items. Factors; It has been determined as "Count and Surgery" and "Equipment". Among the sub-dimensions of the scale, Cronbach's α values were between 0.742 and 0.760, and 0.722 for the whole scale. When the ROC analysis results were examined, the cut-off point was ≥ 8 points, the specificity was 93.13%, and the sensitivity was 87.50%. The area under the ROC curve (AUC) was calculated as 0.938 and p<0.001. As a result, the Retained Surgical Items Risk Assessment Scale developed in this study was a valid and reliable risk assessment scale. It has been determined that the scale has a high level of distinguishing between patients with and without the retained surgical items risk, and it has been determined that it can distinguish this risk at a perfect level. Nurses can emphasize patient safety practices in order to prevent retained surgical items in high-risk patients determined by the Retained Surgical Items Risk Assessment Scale in operating rooms.