# Developing and psychometrics assessment of a checklist for safe intrahospital patient transfer

## TL;DR

This paper develops and validates a checklist to ensure safe patient transfers within hospitals, focusing on Iran.

## Contribution

The study introduces a new standardized checklist for intrahospital patient transfer with validated psychometric properties.

## Key findings

- A checklist with 38 items was developed and validated for patient transfer safety.
- The checklist demonstrated good reliability and validity metrics, including Cronbach’s alpha of 0.79.
- Three factors were identified in the checklist, covering pre-transfer, intra-transfer, and post-transfer phases.

## Abstract

The absence of clear policies and standardized guidelines for intrahospital transfer poses a substantial threat to patient safety. To address this gap, we designed a study to develop a comprehensive, standardized checklist for safe intrahospital patient transfer within Iranian hospitals.

A sequential exploratory mixed-methods design was employed in Shahid-Beheshti hospital, Kashan, Iran, in 2023 to develop and validate a checklist for safe intrahospital patient transfer. The process was planned and conducted in two phases: qualitative item generation and psychometric evaluation. Phase I involved item generation through a qualitative content analysis of the literature to identify essential care measures (across the pre-transfer, intra-transfer, and post-transfer phases) and expert consultations to elicit the experts’ tacit professional knowledge on the phenomenone under the study. Then, the research team integrated items generated by the two aforementioned methods and created a preliminary item pool. The research team then synthesized and refined these expert-generated items with those derived from the literature to create a comprehensive draft checklist. The validation process included assessments of face validity, content validity, and construct validity. To evaluate reliability, inter-rater agreement, Cohen’s kappa, intraclass correlation coefficients (ICC), and internal consistency (Cronbach’s alpha) were used.

The initial item pool consisted of 55 items, which were subsequently reduced to 45 items during the face validity and qualitative content validity assessments. Then, the number of items was reduced to 38 during the content validity ratio (CVR) and content validity index (CVI) assessments. The CVR of the remaining items ranged from 0.9 to 0.98, while their CVI ranged from 0.9 to 0.99. The mean Cohen’s kappa across items was 0.62 ± 0.12. The ICC for the total score was 0.86. Cronbach’s alpha for the entire checklist was 0.79. In construct validity assessment, three factors, consistent with the three domains of the checklist, were extracted that cumulatively explained 46.79% of the variance in patient transfer safety.

A comprehensive intrahospital patient transfer checklist was developed, demonstrating good validity and reliability, and can be used by healthcare professionals, particularly nurses, to ensure safe intrahospital patient transfers.

The online version contains supplementary material available at 10.1186/s12913-025-13987-w.