-
Bulletin of the World Health... Mar 2021
Topics: Delphi Technique; Global Health; Humans; Public Health
PubMed: 33716337
DOI: 10.2471/BLT.21.010321 -
Public Health Nursing (Boston, Mass.) Jul 2022There is still a lack of health indicators for monitoring and evaluating health planning at the local level. In Portugal, local health plans (LHP) include a prioritized...
OBJECTIVE
There is still a lack of health indicators for monitoring and evaluating health planning at the local level. In Portugal, local health plans (LHP) include a prioritized set of health priorities, which should be monitored and evaluated. This study is an example of a low-resource method to identify and reuse indicators for LHP monitoring and evaluation already collected for other purposes.
DESIGN AND SAMPLE
A modified Delphi consensus method was applied, with three rounds of email rating questionnaires and a final meeting, between January 2018 and January 2019. The Delphi panel consisted of eight members from the Planning and Administration Group of the Espinho/Gaia Local Public Health Unit.
MEASUREMENTS
Panelists were asked to assess the indicators' validity for monitoring diseases/determinants from a pre-selected list of potential binomials between 140 PHC indicators and 15 diseases/determinants.
RESULTS
After four rounds, there was consensus in considering 141 binomials (34.0%) as appropriate, diabetes mellitus being the disease with more appropriate indicators.
CONCLUSION
This study portrays the applicability of a commonly used, easy and low-resource method in a Portuguese Local Public Health Unit to select and reuse primary health care indicators for LHP monitoring and evaluation.
Topics: Consensus; Delphi Technique; Health Planning; Humans; Quality Indicators, Health Care; Surveys and Questionnaires
PubMed: 34935199
DOI: 10.1111/phn.13036 -
Complementary Therapies in Clinical... Aug 2021There has been little attempt to date to narrow the education-practice gap in naturopathic medicine. A framework that brings naturopathic medicine education and practice...
BACKGROUND
There has been little attempt to date to narrow the education-practice gap in naturopathic medicine. A framework that brings naturopathic medicine education and practice closer together could help codify the knowledge of naturopathic medicine by providing simultaneous guidance on curriculum development and clinical decision-making in the discipline.
OBJECTIVE
To develop, refine and validate the Advancing Naturopathic Education and Practice (ADVANCER) framework.
METHODS
Published literature and pertinent government, professional association and institutional websites were scoped to identify key constructs for the ADVANCER framework. The constructs were grouped into ten domains, with each domain defined and translated into teaching and clinical practice outcomes. A two-round e-Delphi method, comprising international experts in naturopathic medicine education, was used to refine and validate the framework definitions and outcomes.
RESULTS
Sixteen academics, from five different countries, participated in the Delphi study. In round one, nine of the ten domains of the ADVANCER framework were rated as either very important or extremely important by 81.2% of participants. Only 68.8% of participants rated the tenth domain as either very important or extremely important. Participant feedback on each domain were pooled and reviewed, and where suggested changes were recommended by more than one participant, respective definitions and outcomes of each domain were amended. In round two, at least 90% of participants rated each domain of the amended ADVANCER framework as either very important or extremely important, meaning consensus to retain these domains, definitions and outcomes had been reached.
CONCLUSIONS
The study findings indicate that the ADVANCER framework is conceptually sound and potentially applicable to diverse institutions and countries. An important next step of this research is to establish whether implementation of the ADVANCER framework within naturopathic medicine education and practice is feasible, effective and sustainable.
Topics: Consensus; Delphi Technique; Humans; Naturopathy
PubMed: 33940334
DOI: 10.1016/j.ctcp.2021.101397 -
International Emergency Nursing May 2021To examine the application and methodological quality of the Delphi method used in developing guidance for emergency nursing practice. (Review)
Review
AIM
To examine the application and methodological quality of the Delphi method used in developing guidance for emergency nursing practice.
BACKGROUND
Emergency nursing scope of practice has rapidly expanded in response to increasing patient acuity, complexity and technological innovation. Determining best practice is crucial for delivering high quality, safe and effective emergency nursing care. The Delphi method has been used to identify, prioritise complex issues and develop evidence-driven guidance in emergency nursing practice. The use and quality of the Delphi method in emergency nursing practice has not been examined.
DESIGN
Systematic literature review.
DATABASES AND DATA TREATMENT
A systematic literature search was conducted using the following databases: SCOPUS, EMBASE, Medline and ProQuest from date of inception to August 2019. The database search was limited to scholarly articles or peer-reviewed journals. No language restrictions were applied. The Cochrane Collaboration method and PRISMA checks were utilized to conduct the review.
RESULTS
Of 246 records identified 22 (8.9%) studies met the inclusion criteria. A modified Delphi method was commonly used (n = 15; 68.2%) and often conducted online (n = 11; 50.0%). Eight practice guidance themes were identified. Overall study quality was high (score 12/14; range 4-13), transparency of reporting varied.
CONCLUSION
Based on this review, the Delphi method is an appropriate method for exploring emergency nursing practice. The studies reviewed demonstrated that knowledge, skills and clinical expertise has progressively expanded in the specialty of emergency nursing. Variation in the application, conduct and transparency of reporting in Delphi studies developing guidance for emergency nursing practice is discussed.
Topics: Delphi Technique; Emergency Nursing; Humans
PubMed: 32238322
DOI: 10.1016/j.ienj.2020.100867 -
Health & Social Care in the Community Nov 2022Inequity in health outcomes is pervasive, with poorer health outcomes identified in rural, regional and remote communities. An international call to action emphasises... (Review)
Review
Inequity in health outcomes is pervasive, with poorer health outcomes identified in rural, regional and remote communities. An international call to action emphasises the need for service models adapted for less well-resourced settings. The aim of this study was to identify key elements of a framework for the adaptation of specialist community-based child and family health (CFH) service models for rural and other under-resourced settings. A modified Delphi study was undertaken with a 12-person expert panel in CFH including Australian and international professionals and parents from rural and remote communities. The study was informed by the WHO Framework for Strengthening Health Service Systems building blocks, the outcomes of an integrative review of literature and a Participatory Action Research study. Experts assessed 107 potential elements for service model development and rated them for importance when adapting service models for different contexts. Round 1 of the Delphi generated considerable consensus with 80 of the 107 potential elements identified as necessary for the service model adaptation framework. A further 17 elements for CFH service models were added in round 2. While multiple varied elements are important for adapting CFH service models for diverse settings, some elements had common themes. Experts highlighted the importance of community engagement and participation; utilising both data and local knowledge to develop a robust understanding of the community context; and the need for a flexible approach to funding and modes of service delivery to address barriers to implementation and access.
Topics: Child; Humans; Delphi Technique; Australia; Child Health Services; Community Health Services; Rural Population
PubMed: 36195997
DOI: 10.1111/hsc.14052 -
Nursing Open Feb 2023To establish a sensitive, scientific and practical evaluation system for haemodialysis nursing and to provide a reference for the evaluation of haemodialysis nursing... (Review)
Review
AIMS
To establish a sensitive, scientific and practical evaluation system for haemodialysis nursing and to provide a reference for the evaluation of haemodialysis nursing quality.
DESIGN
Through a literature review and Delphi method.
METHOD
According to the literature review, a preliminary nursing-sensitive quality indicators for haemodialysis were established, and an expert survey questionnaire was designed. Finally, the evaluation system for the nursing-sensitive quality indicators was determined using the Delphi method.
RESULTS
Thirteen nursing-sensitive quality indicators for haemodialysis were finally constructed, including two structural indicators, three process indicators and eight outcome indicators. The effective recovery rate of the two rounds of expert survey questionnaires was 100%, the coefficient of judgement basis is 0.956, the coefficient of familiarity is 0.833, the coefficient of authority is 0.895, and the Kendall's harmony coefficients of the two rounds of expert consultation were 0.158 ~ 0.307 and 0.170 ~ 0.315, respectively, with statistical significance (p < .05).
CLINICAL RELEVANCE
In this study, the nursing-sensitive quality indicators for haemodialysis were developed by the Delphi method and included structural indicators, outcome indicators and process indicators, which made up for some deficiencies noted in previous studies. The authors have provided a more reliable and comprehensive basis for evaluating the quality and safety of haemodialysis nursing in the future.
Topics: Quality Indicators, Health Care; Delphi Technique; Renal Dialysis; Group Processes; Surveys and Questionnaires
PubMed: 36040112
DOI: 10.1002/nop2.1349 -
Urogynecology (Philadelphia, Pa.) Oct 2022This clinical consensus statement on vaginal energy-based devices (EBDs) reflects an update by content experts from the American Urogynecologic Society's EBD writing...
This clinical consensus statement on vaginal energy-based devices (EBDs) reflects an update by content experts from the American Urogynecologic Society's EBD writing group. In 2019, the American Urogynecologic Society's EBD writing group used a modified Delphi process to assess statements that were evaluated for consensus after a structured literature search. A total of 40 statements were assessed and divided into 5 categories: (1) patient criteria, (2) health care provider criteria, (3) efficacy, (4) safety, and (5) treatment considerations. Of the 40 statements that were assessed, 28 reached consensus and the remaining 12 did not. Lack of evidence was among the main reasons that vulvovaginal EBD treatment statements did not reach consensus. In March 2022, these statements were reassessed using the interim literature.
Topics: Female; Humans; United States; Delphi Technique; Consensus
PubMed: 36256959
DOI: 10.1097/SPV.0000000000001241 -
Journal of Foot and Ankle Research Mar 2022The coronavirus pandemic resulted in unique challenges for podiatrists in Australia. Podiatrists were tasked with having to make triage decisions about face-to-face care... (Review)
Review
Development and use of the PodEssential and Paeds-PodEssential triage tools to define "essential" podiatry services. A Delphi survey, scoping review, and face validity testing study.
BACKGROUND
The coronavirus pandemic resulted in unique challenges for podiatrists in Australia. Podiatrists were tasked with having to make triage decisions about face-to-face care without clear guidelines. This research aimed to develop podiatry triage tools to understand individual risk for adults and children, and explore the face validity of both tools.
METHODS
An online three-round modified Delphi technique was used to elicit podiatrists' opinions on conditions, assessments and social factors that elevate risk. Additional elements of known foot and/or leg risk were informed by a synchronous scoping review. Australian podiatrists who held a clinical role treating patients or directly managing podiatrists treating patients within the past six months were recruited. Where 70% of participants reported the same or similar theme in Round 1, statements were accepted with consensus. Where 50-69% of participants reported a similar theme, these were returned to participants to rate agreement using a four-point Likert agreement scale. Statements identified in the scoping review were added at Round 2, if not already identified by participants. The final round presented participants with triage tools, and a series of mock patient scenarios.. Participants were asked to indicate if they would or would not provide face to face podiatry service based on these scenarios.
RESULTS
There were 40 participants who responded to Round 1 (Adult presentations), of these, 23 participants also provided paediatric presentation responses. Participants developed and agreed upon 20 statements about risk in podiatry service delivery for both adults and children across Rounds 1 and 2. The PodEssential and Paed-PodEssential were developed based on these statements indicating stand-alone condition risk (tier 1), elements that should elevate risk (in the absence of a stand-alone condition) (tier 2), and assessments results identifiying a limb at risk (tier 3) in adults and children respectively. Participants utilising these tools in Round 3 more frequently indicated face-to-face service when mock patient scenarios included a greater number elements, suggesting the tool can be useful in making triage decisions.
CONCLUSION
The PodEssential and Paeds-PodEssential tools direct conditions requiring urgent attention as well as providing considered elements to a person's health status to assist in making triage decisions.
Topics: Adult; Australia; Child; Consensus; Delphi Technique; Humans; Podiatry; Reproducibility of Results; Triage
PubMed: 35260188
DOI: 10.1186/s13047-022-00525-8 -
Evidence-based Nursing Jul 2020
Topics: Consensus; Delphi Technique; Humans; Research Design
PubMed: 32430290
DOI: 10.1136/ebnurs-2020-103303 -
BMC Medical Education Mar 2021Being pharmaceutical care one of the four areas defined by the International Pharmaceutical Federation's Global Competence Framework, the curriculum redesigned scheme is...
BACKGROUND
Being pharmaceutical care one of the four areas defined by the International Pharmaceutical Federation's Global Competence Framework, the curriculum redesigned scheme is a priority task to perform a pharmaceutical workforce capable to contribute significantly to the appropriate use of medicines. Therefore, the pharmacy curriculum should be adapted, in order to provide pharmacists with new knowledge and skills to provide pharmaceutical care services. This study used a modified Delphi technique to define objectives and topical outlines for a pharmaceutical care course on a pharmacy curriculum.
METHODS
A modified Delphi process was used to determine a consensus among proposed course objectives and topical outlines. The preliminary phase of the study included a compilation of prospective objectives and outline topics on which to structure informational flow through the Delphi. A two-round modified Delphi process were completed by the participants in the study. The Delphi questionnaire was organized using six domains: the theoretical program foundation; recommended for teaching literature; instructional and educational objectives of the program (course structure); teaching methods; knowledge, skills and professional values considered; and students' performance assessments. Nineteen items for evaluation within the referred domains were considered.
RESULTS
Consensus was achieved among 15 participants regarding 10 objectives, and eleven topical outlines related to pharmaceutical care teaching in an undergraduate pharmacy course. Despite this favorable valuation and considering the qualitative evaluations provided by the participants, it was believed appropriate to analyze the recommendation for the inclusion of literature for the teaching of the course in Spanish language (73%). It resulted in a project proposal for the elaboration of a book by a group of authors from all the faculties of pharmacy in the country.
CONCLUSION
A Delphi expert panel achieved consensus on topical outline and objectives for a pharmaceutical care course. The results of this study can be used to underline the didactic guidance for pharmaceutical care teaching and learning useful for future pharmacy curriculum upgrades.
Topics: Curriculum; Delphi Technique; Education, Pharmacy; Humans; Pharmaceutical Services; Prospective Studies; Students, Pharmacy
PubMed: 33726748
DOI: 10.1186/s12909-021-02583-1