The Development of the Australian Basic Intensive Care Knowledge Test

doi:10.1016/S1036-7314(95)70284-3

Australian Critical Care

Volume 8, Issue 3, September 1995, Pages 10-16

https://doi.org/10.1016/S1036-7314(95)70284-3 Get rights and content

Abstract

The Basic Knowledge Assessment Tool (BKAT), a test developed in the United States, has been presented as a valid and reliable test of basic knowledge for critical care nursing. However, it was necessary to determine the BKAT's validity and reliability in the Australian intensive care (IC) context. The Delphi technique, utilising a panel of eleven experts, was used to determine the content validity of the BKAT. The Delphi process resulted in the development of a test with 105 questions. These questions consist of 49 original BKAT questions, 25 original BKAT questions slightly modified, 3 original BKAT questions with major modifications and 28 new questions. A criterion group design was used to establish the modified test's reliability and decision validity. Item analysis was undertaken using item difficulty and item discrimination indexes. The modified test was completed by 14 registered nurses with no IC experience, 18 registered nurses with intermediate IC experience and 25 registered nurses qualified as intensive care specialists. The mean score (and standard deviation) for the test for each of the respective groups was 41(9), 69(9) and 86(7). These results were significantly different (p<.0001). The reliability was established with a Cronbach Alpha coefficient of.96.

The modified test is a reliable and valid measure of IC-basic knowledge and can be used as a valuable adjunct in the assessment of IC orientation programs.

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Cited by (5)

Measuring paediatric intensive care nursing knowledge in Australia and New Zealand: How the Basic Knowledge Assessment Tool for pediatric critical care nurses (PEDS-BKAT4) performs
2013, Australian Critical Care
Citation Excerpt :
Schaller and James16 examined the nutritional knowledge of nurses in Australia and questioned whether the theoretical concepts seen as relevant by the overseas developers of their nutrition tool were aligned with those perceived as relevant in Australia. Similar investigations of the adult version of the BKAT in Australia have also questioned the suitability of its items in the Australian context.32 Content for the PEDS-BKAT4 is based on an adult version of the tool, the Basic Knowledge Assessment Tool (BKAT).
Validated professional knowledge measures are limited in paediatric intensive care unit (PICU) nursing. The Basic Knowledge Assessment Tool for Pediatric Critical Care Nurses (PEDS-BKAT4) measures knowledge, however content and practice differences exist between various PICUs. The study aim was to evaluate the PEDS-BKAT4 in the Australian and New Zealand setting. A panel of 10 experts examined item and scale content validity. Items were evaluated for 31 evidence-based item writing flaws and for cognitive level, by a 4-person expert panel. Thirty-six PICU nurses completed the PEDS-BKAT4, with reliability and item analysis conducted. Mean item content validity was 0.70, and 43% of items had content validity less than 0.8. Overall (Scale) content validity was 0.71. Thirty-five percent of items were classified as flawed. Thirty-five percent of items were written at the ‘knowledge’ level, and 58% at ‘understanding’. The mean PEDS-BKAT4 score was 60.8 (SD = 9.6), KR-20 reliability 0.81. The mean item difficulty was 0.62, and the mean discrimination index was 0.23. The PEDS-BKAT4 was not a reliable and valid measure of basic PICU nursing knowledge in Australian and New Zealand. Further research into the types of knowledge and skills required of PICU nurses in this setting are needed to inform the development of a future tool.
A survey of European intensive care nurses' knowledge levels
2012, International Journal of Nursing Studies
Citation Excerpt :
This finding is in common with research into knowledge about evidence-based guidelines (Labeau et al., 2008, 2009) and earlier studies by Toth (1986, 2003) in North America and other non-European countries that have consistently identified that length of critical care experience is a predictor of basic knowledge levels among critical care nurses. To this end, tools such as the BKAT and I-HIT can be used as part of orientation programmes, to tailor education for those with previous ICU experience, evaluate effectiveness of in-house teaching programmes and contribute to an individual's annual appraisal (Boyle et al., 1995; Toth, 2007). Data from our study suggest that educational programmes need to concentrate on issues relating to ventilation, respiration, infection control and sepsis in an applied manner as these were the weakest when expressed as mean scores and when examined by length of experience.
The application of knowledge to the care of critically ill patients is a hallmark of professional nursing practice. However, the educational preparation of intensive care nurses varies from country to country, and there has been little research that has investigated knowledge levels of European critical care nurses.
The aim of this study was to examine the knowledge levels of European intensive care nurses.
The study was an international cross-sectional survey, with data collected from 20 European countries.
318 European intensive care units participated, and data were collected from 1142 intensive care nurses.
Data were collected between May and December 2009 using a 100-item multiple choice online questionnaire to assess intensive care nursing knowledge. The questionnaire was available in 16 languages, and data were collected in 11 knowledge areas.
A response rate of 60% was achieved; the majority of participants was female (77%). The largest groups of nurses had more than five years’ experience and were under 30 years of age. The overall mean knowledge score was 66% (SD 12). The main factor that contributed to variance in scores was nurses’ length of intensive care experience; in ten categories knowledge scores were progressively higher according to experience. If 50% is considered to be a pass mark, 90% of participants would have passed. However, in only six countries did all participants achieve a ‘pass’ score, and in five countries more than 10% of participants failed to meet this ‘pass’ criterion. The knowledge category which scored lowest was respiration and ventilation (mean score 56%, SD 15).
Although knowledge levels differed among countries, there were no major differences. However, the relatively low scores achieved in the respiration/ventilation category are a cause of concern, and suggest that this is an education area that should be prioritised. The results should be considered within the context of each country's healthcare and professional education systems, and strategies should be developed to improve knowledge in several key areas.
Biologial and physiological knowledge and skills of graduating Finnish nursing students to practice in intensive care
2004, Nurse Education Today
This study describes the basic biological and physiological knowledge and skills of graduating nurse students in Finland against the requirement of their being able to practice safely and effectively in intensive care. The study describes also their interest and willingness to work in intensive care. Measurements were based on the Basic Knowledge Assessment Tool (BKAT-5) developed by Toth in the United States. The sample consisted of 130 nursing students graduating in December 2001 and January 2002. The data were analysed statistically.
The students were most knowledgeable in the areas of appropriate precautions, living will and medical calculation, followed by neurology and endocrinology. Scores were poorest for pulmonary, gastrointestinal and cardiovascular knowledge. Intensive care studies and the desire to work in intensive care correlated significantly with the respondents' basic intensive care knowledge. It is important for nursing education to concentrate on developing those areas of intensive care studies where the performance of students is weakest.
Study to validate the outcome goal, competencies and educational objectives for use in intensive care orientation programs
1998, Australian Critical Care
Intensive care orientation programs have become an accepted component of intensive care education. To date, however, there have been no Australian-based standards defining the appropriate level of competence to be attained upon completion of orientation. The aim of this study was to validate a set of aims, competencies and educational objectives that could form the basis of intensive care orientation and which would ensure an outcome standard of safe and effective practice. An initial document containing a statement of the desired outcome goal, six competency statements and 182 educational objectives was developed through a review of the orientation programs developed by the investigators. The Delphi technique was used to gain consensus among 13 nurses recognised for their expertise in intensive care education. The expert group rated the acceptability of each of the study items and provided suggestions for objectives to be included. An approval rating of 80 per cent was required to retain each of the study items, with the document refined through three Delphi rounds. The final document contains a validated statement of outcome goal, competencies and educational objectives for intensive care orientation programs.
Basic competence in intensive and critical care nursing: Development and psychometric testing of a competence scale
2014, Journal of Clinical Nursing

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The Development of the Australian Basic Intensive Care Knowledge Test

Abstract

Care Nurses Journal

Aust. Crit. Care

Orientation: the transition from novice to competent critical care nurse

Crit. Care Nurse Quarterly

The ICU fellowship: an innovative orientation program for new graduates in critical care. Focus on Crit

Care

A nurse educators view of employing new graduates in critical care settings. Focus on Crit

Care

Students’ knowledge and perceptions of critical care nursing. Crit

Care Nurse

Individu alised orientation in critical care

Focus on Crit. Care

Self-learning packages in critical care. Crit

Care Nurse

Evaluating a critical care internship program. Dimensions of Crit

Care Nursing