Designing and Psychometry of the Evaluation Checklist for the Registration and Labeling Guidelines of Anesthetic Drugs in the Operating Room

Aims: The correct registration and labeling of anesthetic drugs in the operating room are the basic and important principles in order to maintain patient safety, reduce the wastage of drugs and their subsequent costs, and reduce environmental pollution. Therefore, the present study was conducted with the aim of designing and psychometry of evaluation checklist for the registration and labeling guidelines of anesthetic drugs in the operating room. Materials and Methods: This descriptive-analytical research was conducted in ۲۰۲۲ in the Iran University of Medical Sciences. In order to design the checklist, the latest and most reliable scientific sources in the field of anesthesia were examined and the opinions of experts of the university's Department of Anesthesia were used. To determine the validity of the checklist, face and content validity (content validity index and content validity ratio) were calculated. In order to determine the reliability of the checklist, two methods of test-retest reliability and inter-rater reliability were used. The research results were analyzed using SPSS ۲۲ software. Findings: All the examined items in the checklist had good status in terms of face validity index and terms of the obtained importance score in comparison with the optimal level of effect (۱.۵ and more) (Table ۱). Based on this, all items on the checklist obtained the necessary criteria for face validity and remained on the checklist. The evaluation results of the content validity index and value of the content validity index showed that most of the items had the desired statistical limits in the field of content validity, and their validity was confirmed in this respect; in other words, the measurement of the content validity ratio (CVR) showed that the score of ۱۵ of the ۱۹ initial items of the checklist was greater than the value of the Lawshe table (۰.۶۲) and these items remained in the checklist. This indicated that essential and important items were used in this checklist (Table ۲). The score of the item of "the method of writing capital letters is used for drugs with similar names" was obtained as ۰.۶۰; due to the closeness of this number to the optimal level and due to the high content validity index of this item which was obtained as ۱, and using the opinion of experts, this item was retained. Also, based on the research findings, the content validity index (CVI) in all items was more than ۰.۷۹; therefore, the mentioned items were recognized as suitable, and there was no change in the appearance of the items. Finally, using the results of CVR and CVI and considering the optimal level for these indicators, three items were removed from the checklist, and the final checklist with ۱۶ items was designed and psychometrically evaluated (Table ۲). The results of the retest method using the intraclass correlation coefficient are presented in Table ۳. In this method, ICC value was ۰.۹۹۲ (۹۵% confidence interval). Also, Cronbach's alpha was ۰.۹۱۲ for the preliminary test and ۰.۹۹۲ for the second test (retest), which results showed that the checklist designed in terms of reliability over time (using the test-retest or test-retest validity method) has good reliability. The results of the inter-rater agreement method using the intraclass correlation coefficient to check the reliability are presented in Table ۴. In this method, the ICC rate was ۰.۹۸۷ (with a ۹۵% confidence interval), which indicated that the checklist designed with the method of an inter-rater agreement had good reliability. Conclusion: The research findings show the checklist's face and content validity and good reliability. Therefore, it can be used to evaluate the level of observance of the guidelines for registering and labeling anesthetic drugs. Clinical & Practical Tips in POLICE MEDICINE: The current checklist is a practical tool to evaluate the process of registering and labeling intravenous anesthetics in operating rooms. Police hospitals can use this checklist as a quick and safe method to evaluate compliance with the instructions for registration and labeling of anesthetic drugs by the anesthesia experts working in the operating room. Acknowledgments: Iran University of Medical Sciences and the medical staff of Shafa Yahyayan Hospital in Tehran are gratefully acknowledged. Conflict of interest: The article's authors stated that the present study has no conflict of interest. Authors' Contribution: Data collection and article writing by Shaghayegh Taghizadeh; Presenting the idea and design of the study by Parisa Moradi Majd; Data collection by Shahnam Sediq Maroufi; Data interpretation by Azam Saei; Statistical data analysis by Jamile Abolghasemi. All authors have approved the present article, and they accept responsibility for the accuracy and correctness of the content. Financial Sources: The financial sponsor of the present study was the Research Vice-Chancellor of the Paramedical Faculty of Iran University of Medical Sciences.   Table ۱) face validity of checklist items for the evaluation of guidelines  for registration and labeling of anesthetic drugs in the operating room Row Items Optimal impact score The resulting effect coefficient ۱ All drug syringes are labeled as soon as they are prepared. ۱.۵< ۵ ۲ Labels with appropriate size and transparent background have been used. ۱.۵< ۴.۸۰ ۳ Colored medicinal labels have been used. ۱.۵< ۴.۶۰ ۴ Labels are inserted vertically or below the graduation lines on the syringe. ۱.۵< ۴.۶۰ ۵ The full generic name of the drugs is written on the syringe label. ۱.۵< ۴.۹۰ ۶ The concentration of drugs in units per milliliter is written on the syringe label. ۱.۵< ۴.۹۰ ۷ The medicinal concentration units are fully written on the syringe label. If needed, the unit of micrograms is written in mcg and the unit of milligrams is written in mg on the syringe label.* ۱.۵< ۴.۸۰ ۸ The time of drug preparation is written on the syringe label. ۱.۵< ۴.۵۰ ۹ The date of drug preparation is written on the syringe label. ۱.۵< ۴.۵۰ ۱۰ The name of the person preparing the medicine is written on the syringe label. ۱.۵< ۳.۷۰ ۱۱ The name and volume of the drug dilution solution is written on the syringe label. ۱.۵< ۴ ۱۲ The expiration date of the drug after preparation is written on the syringe label. ۱.۵< ۴ ۱۳ Medication information is legibly written on the syringe label. ۱.۵< ۴.۹۰ ۱۴ Capital letters have been used for drugs with similar names. ۱.۵< ۴.۶۰ ۱۵ Drug information is not deleted after being recorded on the syringe label. ۱.۵< ۴.۶۰ ۱۶ The drug information is written in the registration sheet immediately after the injection to the patient. ۱.۵< ۴/۴۰ ۱۷ The name, dose, and time of administration of anesthesia-inducing drugs are written in the registration form. ۱.۵< ۴.۷۰ ۱۸ The name, dose and time of administration of anesthesia maintenance drugs are written in the registration form** ۱.۵< ۴.۷۰ ۱۹ The name, dose and time of administration of other drugs required during the procedure are written in the registration form*** ۱.۵< ۴.۷۰ *If there is a need to mention more information about the concentration of the drug **Using capital letters in writing the names of drugs with similar names to emphasize the  difference in the names ***Infusion of drugs**** such as drugs that neutralize the effect of neuromuscular relaxants, drugs To control pain, nausea and vomiting, inflammation, etc Table ۲) The content validity of checklist items for the evaluation of the guidelines  for registration and labeling of anesthetic drugs in the operating room Row Items CVR CVI ۱ All medication syringes are labeled as soon as they are prepared. ۱ ۱ ۲ Labels with appropriate size and transparent background have been used. ۰.۸۰ ۱ ۳ Colored medicinal labels have been used. ۰.۸۰ ۰.۸۰ ۴ Labels are inserted vertically or below the graduation lines on the syringe. ۰.۸۰ ۱ ۵ The full generic name of the drugs is written on the syringe label. ۱ ۱ ۶ The concentration of drugs in units per milliliter is written on the syringe label. ۱ ۱ ۷ The medicinal concentration units are fully written on the syringe label. If needed, the unit of micrograms is written in mcg and the unit of milligrams is written in mg on the syringe label.* ۱ ۱ ۸ The time of drug preparation is written on the syringe label. ۰.۸۰ ۱ ۹ The date of drug preparation is written on the syringe label. ۰.۸۰ ۱ ۱۰ The name of the person preparing the medicine is written on the syringe label. ۰.۲۰ ۰.۸۰ ۱۱ The name and volume of the drug dilution solution is written on the syringe label. ۰.۴۰ ۰.۸۰ ۱۲ The expiration date of the drug after preparation is written on the syringe label. ۰.۲۰ ۰.۸۰ ۱۳ Medication information is legibly written on the syringe label. ۱ ۰.۹۰ ۱۴ Capital letters have been used for drugs with similar names. ۰.۶۰ ۱ ۱۵ Drug information is not deleted after being recorded on the syringe label. ۰.۸۰ ۱ ۱۶ The drug information is written in the registration sheet immediately after the injection to the patient. ۰.۸۰ ۰.۸۰ ۱۷ The name, dose, and time of administration of anesthesia-inducing drugs are written in the registration form. ۱ ۱ ۱۸ The name, dose and time of administration of anesthesia maintenance drugs are written in the registration form** ۰.۸۰ ۱ ۱۹ The name, dose and time of administration of other drugs required during the procedure are written in the registration form*** ۱ ۱ * If it is necessary to mention more information about the concentration of the drug ** Using capital letters in writing the names of drugs with similar names to emphasize the  difference in the names *** Infusion of drugs **** such as drugs that neutralize the effect of neuromuscular relaxants, drugs for Control of pain, nausea and vomiting, inflammation, etc Table ۳) intraclass correlation coefficient (ICC) to check reliability (retest reliability) ICC Number of items lower limit ICC upper limit ICC Possibility ۰.۹۹۲ ۱۶ ۰.۹۸۰ ۰.۹۹۷ ۰.۰۰۱> Table ۴) intraclass correlation coefficient (ICC) to check reliability (Inter-rater agreement) ICC Number of items lower limit ICC upper limit ICC Possibility ۰.۹۸۷ ۱۶ ۰.۹۶۸ ۰.۹۹۵ ۰.۰۰۱>

Keywords:

Psychometrics , Checklist , Registration , Labeling , Anesthetic Drugs , روان سنجی , چک لیست , ثبت , برچسب گذاری , داروهای بیهوشی