Inter-Rater Reliability of the Vascular Access Assessment and Device Selection (VAADS) Tool

Student Author(s)

Eric Vachon

Faculty Mentor(s)

Amy Kyes MSN, RN, CRNI1 and Barbara Vincensi, PhD, RN, FNP 2 (1Spectrum Health Zeeland Community Hospital and 2Hope College Department of Nursing)

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Intravenous (IV) access is necessary to deliver medications, fluids, and blood products via venous route. However, staff nurses often do not have adequate education to assure that the appropriate IV-access device is chosen. The purpose of this research is to assess the inter-rater reliability of the Vascular Access Assessment and Device Selection (VAADS) Tool between vascular access team nurses and staff nurses. The tool was developed based on the research literature and Infusion Nurses Society (INS) standards to help nurses select the most appropriate IV-access device, early in a patient’s hospital stay. Benner’s “From Novice to Expert” theory looks at five levels of nursing experience. Using Benner’s theory, the researcher identified the vascular access team nurses as experts in comparison to staff nurses. The study was conducted at a small, midwest community hospital using a prospective, observational design with one venous expert, two staff nurses, and six patients. Cohen’s Kappa coefficient was used to measure the inter-rater reliability. The results showed moderate significance (p-value: 0.006, 0.171) in the rater agreement between the expert and staff nurses. The limited data of this pilot study makes conclusions difficult to draw, but further psychometric testing and staff education is needed. Limitations include that the research was conducted at one small, community hospital which also lacked diversity of participants, and a limited amount of data. Not only does the introduction of the VAADS help in assessment of patients’ vascular access needs, but with this particular study researchers will be able to identify potential education needs of nurses.

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