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Validity and Interrater Reliability of the Moline-Roberts Pharmacologic Sedation Scale

Moline, Beverly MS, RN-BC, ACNS-BC; Roberts, Melanie MS, APRN, CCNS, CCRN; Houser, Janet PhD, RN

doi: 10.1097/NUR.0b013e3182503fd6
Feature Article

Purpose: The objective of this study was to determine validity and reliability of the Moline-Roberts Pharmacologic Sedation Scale.

Design: A multidisciplinary expert panel was used to establish content validity. Reliability was determined by a prospective, randomized, psychometric evaluation of sedation assignment made by 2 nurse research assistants.

Setting: The study was conducted in a 260-bed nonprofit community hospital.

Sample: Eighty-six subjects were enrolled in the study. Inclusion criteria were as follows: receiving opioids, benzodiazepines, or anesthetic agents; ability to understand English; and normal or near-normal hearing.

Methods: Two bachelor of science in nursing–prepared nurses observed each subject and independently documented sedation levels at 3 or 4 points in time for each patient.

Findings: Content validity resulted in 100% agreement that the sedation scale reflected the concept of pharmacologic sedation. Internal reliability as measured by Cronbach α was .983 to .996. For each of the scale’s components, interrater reliability using Cohen κ ranged from 76.4% to 97.4%. The Cohen κ P value for all components at all points in time was statistically significant at P < .001.

Conclusion: The Moline-Roberts Pharmacologic Sedation Scale demonstrated content validity and strong reliability.

Implications: The sedation scale has clinical value in providing a standardized assessment and quantitative assignment of pharmacologically induced sedation that is reflective of the continuum of sedation. Information obtained regarding the patient’s sedation should be documented, trended, and incorporated into the decision-making process regarding additional administration of agents that produce or potentiate sedation. Further research is needed in populations not included in this study.

Author Affiliations: Acute Pain Clinical Nurse Specialist (Ms Moline), Poudre Valley Health System, Poudre Valley Hospital, Fort Collins, Colorado; Critical Care Clinical Nurse Specialist (Ms Roberts), Medical Center of the Rockies, Loveland, Colorado; Academic Dean (Dr Houser), Rueckert-Hartman College for Health Professions, Denver, Colorado.

This study was supported in part by the Colorado Trust/Five Million Lives Campaign, the Poudre Valley Hospital Foundation, and Medical Center of the Rockies Foundation.

The Moline-Roberts Pharmacologic Sedation Scale is a copyright of Poudre Valley Health System.

The authors report no conflicts of interest.

Correspondence: Melanie Roberts, MS, APRN, CCNS, CCRN, Medical Center of the Rockies, 2500 Rocky Mountain Ave, Loveland, CO 80538 (

© 2012 Lippincott Williams & Wilkins, Inc.