Development and Validation of an Instrument for Essential Actions for Patient Safety

Abstract

Objectives: To develop and obtain evidence of content validity and preliminary reliability of an instrument to assess compliance with the AESP in hospital institutions.

Methods: Methodological instrument-development study conducted in Mexico in 2026. The process included a scoping review, item construction, readability analysis, content validation through successive rounds of expert review, pilot testing, internal consistency analysis, and linguistic review. Content validity was estimated using Aiken's V, and preliminary reliability was assessed using Cronbach's alpha. The pilot test included 32 nursing professionals from a secondary-care hospital.

Results: The initial version comprised 161 items distributed across eight dimensions. After three rounds of expert review, an 88-item version was obtained; all dimensions exceeded the Aiken's V criterion of ≥0,80. In the pilot test, the overall Cronbach's alpha was 0,97, with values ranging from 0,69 to 0,94 across dimensions. Completion time ranged from 15 to 20 minutes. Based on an exploratory classification derived from percentile groups in the pilot sample (n = 32), 25 % of participants showed low compliance, 50 % moderate compliance, and 25 % high compliance; these proportions describe only the study sample and should not be interpreted as population estimates.

Conclusions: The instrument demonstrated evidence of content validity and feasibility, as well as high overall internal consistency. It represents a promising tool for comprehensively assessing compliance with the AESP; however, its measurement properties should be confirmed in a larger sample before it is recommended for definitive use.