The validity of two quality assessment instruments: Monitor and Senior Monitor

This paper is concerned with validity of Monitor and Senior Monitor. The study carried out, which was funded by the Department of Health, attempted to establish the validity of the instruments through a multiple triangulation research design. Monitor and Senior Monitor were compared to another instrument, Qualpacs, and also to other methods that focused on quality of nursing care—observation of patients' activities and interactions with nurses, and interviews with patients and nurses on their perceptions of quality. The results did not reveal a clear picture. Convergent validity was relatively strong for Senior Monitor and the Monitor DG3 schedule, but not the DG1, DG2 and DG4 schedules, when compared to Qualpacs. The comparison with observation of nurse-patient activities and interactions supported Monitor rather more than Senior Monitor, particularly with respect to frequency of omitted activities. Both instruments showed considerable construct validity in that congruence emerged between their items and the views of patients and nurses on what constitutes quality.