Content Validation of the Selwan Hamza’s Bleeding Risk Assessment Tool (SH-BRAT)

Background: Bleeding complications significantly contribute to increased morbidity, mortality, and healthcare costs. Early identification of at-risk patients is essential; however, standardized, nurse-led bleeding risk assessment tools applicable across diverse clinical settings remain scarce. Aim: To establish the content validity of the Selwan Hamza’s Bleeding Risk Assessment Tool (SH-BRAT) for use in nursing practice. Design: A descriptive methodological study incorporating both quantitative expert scoring and qualitative feedback. Setting: The expert panel review was conducted electronically at King Saud Medical City (KSMC), a major tertiary care hospital in Riyadh, Saudi Arabia. Participants: A purposive sample of eight multidisciplinary experts—including a cardiothoracic surgeon, ICU physician, oncology and endoscopy nursing specialists, and senior nursing educators—all with a minimum of six years of clinical experience. Methods: Experts independently assessed the SH-BRAT using a structured review form evaluating item clarity, relevance, and comprehensiveness. The Scale-Level Content Validity Index (S-CVI/Ave) was calculated, and qualitative feedback was thematically analyzed to inform tool refinement. Results: The SH-BRAT demonstrated excellent content validity (S-CVI/Ave = 0.94). Expert consensus affirmed the tool’s relevance to clinical nursing practice, while qualitative feedback yielded actionable suggestions for minor refinements. Conclusion: The SH-BRAT is a valid, nurse-centered  tool for early identification of bleeding risk. Its structure supports seamless integration into routine nursing workflows across various clinical contexts. Recommendations: Further research is recommended to pilot the tool, evaluate its reliability, and assess its clinical utility in real-world settings.