First evidence on the validity and reliability of the Safety Organizing Scale-Nursing Home version (SOS-NH).

BACKGROUND: The Safety Organizing Scale is a valid and reliable measure on safety behaviors and practices in hospitals. PURPOSE OF THE STUDY: This study aimed to explore the psychometric properties of the Safety Organizing Scale-Nursing Home version (SOS-NH). DESIGN AND METHODS: In a cross-sectional analysis of staff survey data, we examined validity and reliability of the 9-item Safety SOS-NH using American Educational Research Association guidelines. SUBJECTS AND SETTING: This substudy of a larger trial used baseline survey data collected from staff members (n = 627) in a variety of work roles in 13 nursing homes (NHs) in North Carolina and Virginia. RESULTS: Psychometric evaluation of the SOS-NH revealed good response patterns with low average of missing values across all items (3.05%). Analyses of the SOS-NH's internal structure (eg, comparative fit indices = 0.929, standardized root mean square error of approximation = 0.045) and consistency (composite reliability = 0.94) suggested its 1-dimensionality. Significant between-facility variability, intraclass correlations, within-group agreement, and design effect confirmed appropriateness of the SOS-NH for measurement at the NH level, justifying data aggregation. The SOS-NH showed discriminate validity from one related concept: communication openness. IMPLICATIONS: Initial evidence regarding validity and reliability of the SOS-NH supports its utility in measuring safety behaviors and practices among a wide range of NH staff members, including those with low literacy. Further psychometric evaluation should focus on testing concurrent and criterion validity, using resident outcome measures (eg, patient fall rates).

Duke Scholars

Author Ruth A. Anderson School of Nursing

Author Cathleen Sellner Colon-Emeric Medicine, Geriatrics