Purpose: Previous research has validated the Urostomy Education Scale as a standardised evidence based
tool to document patients' level of stoma self-care skills. The aim of this study was to test the scale's
inter-rater reliability among urology nurses in a continuous validation of the Urostomy Education Scale.
Methods: During the study period from June 2011 to September 2012, 38 ward nurses performing
standard stoma care attended 150 validation sessions evaluating 70 patients' level of stoma self-care
skills using the Urostomy Education Scale. In pairs, the nurses randomly observed the patients during
a training episode involving change of a stoma appliance. Data were categorised into three groups to
investigate the impact of nurses’ experience on reliability: comparing two inexperienced nurses, two
experienced or one of each. Data were compared for agreement by testing variation between groups and
analysing Bland Altman Plots with Limits of Agreement.
Results: The variation in scores was not influenced by the nurses' level of experience (p > 0.05). Reliability
was found to be high with Bland Altman Plot and Limits of Agreement documenting that 84% of
scores (95% CI (Confidence interval): 74; 89) were within a range of 2 points.
Conclusion: The Urostomy Education Scale demonstrates high reliability irrespective of nurses’ different
levels of experience. The results are clinically relevant and contribute to a precise documentation of
stoma self-care skills. The tool ensures evidence based patient education and can provide a high standard
of communication in transitions between sectors.