Infant Nipple Feeding Assessment and Communication Tool: Face Validity and Inter-Rater Reliability Testing
- Discuss the use of the IN-FACT to assess an infant’s ability to bottle feed.
- Recognize use of the IN-FACT to facilitate communication between infant caregivers.
- Identify the key components the IN-FACT uses to asess bottle feeding sucess
To determine face validity and inter-rater reliability of the Infant Nipple Feeding Assessment and Communication Tool (IN-FACT)
Design:
Observational Study
Setting:
Acute care hospital specializing in women’s and children’s health, level III NICU in the southern region of the United States.
Patients/Participants:
The sample consisted of N=69 participants. Of the 69 participants, 94% (n=65) were Registered Nurses (RNs) and 6% (n=4) were Occupational Therapists / Physical Therapist (OT/PT).
Instrument:
The scale uses a ten-point rating system that includes five key factors of successful bottle-feeding: endurance, cardiovascular, respiratory, coordination, and participation. Each subscale is scored 0-2 points. The points are totaled and matched to the corresponding rating: well 8-10, fair 6-7, poor 0-5.
Methods:
Prior to implementation of the study, 4 content experts (OT/PT, Neonatologist, NICU Nurse and PhD Nurse Researcher) evaluated the Nipple Rating Instrument for face validity. Content Validity Index (CVI) was used to determine face validity.
The participants were shown 3 scenes of a video recording of infant feedings depicting a well, fair, and poor feeding. The participants watched each video and then independently scored the infant’s feeding using the Nipple Rating Instrument. Inter-rater reliability was determined using percent agreement.
Results:
Face validity as determined by the content experts yielded an overall content validity index of 97%. The percent agreement for each subscales were as follow: Endurance (100%), Cardiovascular (95%), Respiratory (95%), Coordination (100%), and Participation (95%).
Among the 69 participants, the overall percentage of agreement was 80.77%. The percent agreements for each subscale were as follows: Endurance (96.1%), Cardiovascular (85.02%), Respiratory (79.23%), Coordination (62.32%), and Participation (81.16%).
Conclusion/Implications for nursing practice:
Bottle-feeding ability serves as a major factor in assessing a neonate’s progress and discharge from a neonatal intensive care unit (NICU). Assessment tools currently available do not provide a practical means for evaluating every bottle-feeding attempt by an infant in the neonatal intensive care unit. A Woman’s Hospital quality improvement team developed the Infant Nipple Feeding Assessment and Communication Tool (IN-FACT) to objectively describe and communicate an infant’s ability to bottle-feed. Results have shown that the IN-FACT is a valid (CVI=97%) and reliable (80.77% agreement) tool that can be used to assess an infants ability to bottle feed.
Keywords: Infant, neonate, preterm, bottle feeding, assessment tool
