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Journal of Advanced Nursing Oct 2023To develop clinical practice recommendations for nurse-administered intramuscular injections in mental health. (Review)
Review
AIM
To develop clinical practice recommendations for nurse-administered intramuscular injections in mental health.
BACKGROUND
Intramuscular injection is the main route of long-acting injectable antipsychotics' administration that appear to improve the long-term prognosis of mental illness. Specific guidelines related to the nurse administration of intramuscular injections need to be updated and to explore not only the technical aspects of this procedure.
DESIGN
A modified RAND/University of California Los Angeles (UCLA) appropriateness method Delphi study was conducted between October 2019 and September 2020.
METHODS
A multidisciplinary steering committee conducted a literature review and developed a list of 96 recommendations. These recommendations were submitted in a two-round Delphi electronic survey to a panel of 49 experienced practicing nurses from five mental health hospitals in France. Each recommendation was rated for its appropriateness and applicability in clinical practice on a 9-point Likert scale. Consensus among nurses was evaluated. The steering committee discussed the results after each round and approved the final set of recommendations.
RESULTS
A final set of 79 specific recommendations were accepted for their appropriateness and applicability in clinical practice. Recommendations were classified in five domains: legal and quality assurance aspects, nurse-patient relationship, hygiene, pharmacology, and injection technique.
CONCLUSION
The established recommendations placed patients at the heart of the decisions concerning the intramuscular injection and underlined the need for specific training programs. Future research should focus on the integration of these recommendations in clinical practice, by both before-and-after studies and regular assessments of professional practices with relevant indicators.
IMPACT
The recommendations developed for good nursing practices explored not only the technical aspects but integrated the nurse-patient relationship. These recommendations may impact usual practices of administration of long-acting injectable antipsychotics and most of them could be applied in many countries.
NO PATIENT OR PUBLIC CONTRIBUTION
Due to the study design.
Topics: Humans; Mental Health; Injections, Intramuscular; Delphi Technique; Antipsychotic Agents; Mental Disorders
PubMed: 37209291
DOI: 10.1111/jan.15709 -
Journal of Surgical Education 2020Mediastinal mass resection and thymectomy are complex and related operations that are core components of competency for a general thoracic surgeon and an important...
OBJECTIVES
Mediastinal mass resection and thymectomy are complex and related operations that are core components of competency for a general thoracic surgeon and an important learning objective for thoracic surgery trainees. This study aimed to design a combined competency assessment instrument for mediastinal mass resection and thymectomy.
DESIGN
A comprehensive competency assessment instrument was designed by a process of logical analysis by 3 expert thoracic surgeons with an interest in mediastinal surgery. The instrument was then assessed and refined using a modified Delphi process.
SETTING
The Delphi questionnaire was distributed to all members of the Canadian Association of Thoracic Surgeons in 2018 to 2019.
PARTICIPANTS
The first round of the Delphi review was completed by 58 respondents (response rate 43.9%). Respondents represented all Canadian provinces with a wide range of clinical experience and a high rate of involvement in resident education.
RESULTS
A first draft of the competency assessment instrument included 42 steps in 6 categories. A total of 3 rounds of Delphi review were performed. Cronbach's alpha for the final round was 0.83. Ultimately, 29 items were retained from the original instrument and two modified and three new items were added. The final instrument has 34 steps in 5 categories.
CONCLUSIONS
A nationwide consensus was established on the key components of assessing competence to perform mediastinal mass resection and thymectomy. The resulting instrument could be used to guide competency based assessments of thoracic surgeons and trainees.
Topics: Canada; Clinical Competence; Delphi Technique; Humans; Surgeons; Thymectomy
PubMed: 32571689
DOI: 10.1016/j.jsurg.2020.06.004 -
Bulletin of the World Health... Jul 2022
Topics: Delphi Technique; Global Health; Humans; Public Health
PubMed: 35813517
DOI: 10.2471/BLT.22.010722 -
Journal of Athletic Training Nov 2021A single, widely accepted definition of sport specialization does not currently exist. A consensus definition is necessary to guide youth sport stakeholders on topics... (Review)
Review
CONTEXT
A single, widely accepted definition of sport specialization does not currently exist. A consensus definition is necessary to guide youth sport stakeholders on topics associated with sport specialization.
OBJECTIVE
To develop a consensus definition of youth sport specialization and identify elements that support the construct of specialization.
DESIGN
Delphi study.
SETTING
Directed surveys.
PATIENTS OR OTHER PARTICIPANTS
A consensus panel of 17 experts was created to provide a broad multidisciplinary perspective on sport specialization in youth athletes.
DATA COLLECTION AND ANALYSIS
The final definition was developed per an iterative process that involved 4 rounds of review. A comprehensive review of the literature and expert input supported our initial proposed umbrella definition that included 6 additional elements. The study team reviewed the results after each round, and changes were made to the definition based on panel feedback.
MAIN OUTCOME MEASURE(S)
Panel members were provided with the definition and 6 elements and then asked to rate each specific to importance, relevance, and clarity using a 4-point Likert scale.
RESULTS
In 4 Delphi consensus rounds, 17 experts reviewed the umbrella definition and 6 elements before consensus was reached. The umbrella definition and 3 of the initial 6 elements achieved greater than 80% agreement for importance, relevance, and clarity after the fourth round of review. The remaining 3 components did not reach greater than 80% agreement, even after iterative edits, and were removed. The process resulted in a final consensus definition: Sport specialization is intentional and focused participation in a single sport for a majority of the year that restricts opportunities for engagement in other sports and activities.
CONCLUSIONS
A consensus-based conceptual definition for sport specialization was developed using a Delphi method. This definition has important implications for clinicians and sports medicine professionals who support youth athletes.
Topics: Adolescent; Humans; Athletic Injuries; Consensus; Risk Factors; Sports; Athletes; Delphi Technique
PubMed: 33787895
DOI: 10.4085/1062-6050-0725.20 -
Journal of Anatomy Jan 2024Anatomy forms a key component of veterinary curricula, but, in the context of an evolving profession, curricula are adapting and changing accordingly. There is a lack of...
Anatomy forms a key component of veterinary curricula, but, in the context of an evolving profession, curricula are adapting and changing accordingly. There is a lack of guidance for educators regarding the levels of anatomical knowledge required for a graduate to be considered safe or competent. A formal review of veterinary anatomy learning outcomes (LOs) is therefore timely to support curriculum development in this rapidly evolving field. This study aimed to create a set of LOs which reflect the recommended core requirements for a new graduate veterinarian. A consensus approach using a modified Delphi method was used. The Delphi panel consisted of 23 experienced and active veterinary anatomy educators from veterinary schools within the UK and Ireland. The process had four stages: (1) Research team review, pre-screening and modification of a list of existing LOs (adapted from the Core Regional Anatomy Syllabus) which then formed the initial set of outcomes sent for review; (2) Delphi Round 1; (3) Delphi Round 2; (4) Post-Delphi final screening and review. Qualitative data outlining the rationale for modification and rejection of LOs were analysed via content analysis. 167 LOs were initially presented to the Delphi panel in Round 1. 64 of those were accepted, 79 recommended for modification and 23 rejected. 122 LOs were presented to the Delphi panel in Round 2. Of these, 86 outcomes were accepted, 10 modified and 26 rejected. 160 LOs were ultimately accepted and form the Veterinary Anatomy Core Syllabus. Key themes arising from analysis include the removal of unnecessary detail and increased focus on the relevance of competencies required of a new veterinary graduate. The syllabus presented may be used by curriculum planners, teachers and students within veterinary education worldwide.
Topics: Humans; Anatomy, Veterinary; Delphi Technique; Anatomy, Regional; Curriculum; Education, Medical, Undergraduate; Anatomy
PubMed: 37664883
DOI: 10.1111/joa.13948 -
European Journal of Hospital Pharmacy :... Mar 2023To develop and validate a standardized Best Possible Medication History (BPMH) form that could be used by clinical pharmacists.
OBJECTIVE
To develop and validate a standardized Best Possible Medication History (BPMH) form that could be used by clinical pharmacists.
METHODS
The draft version was presented to a focus group and was adapted following their comments. A three-rounds e-Delphi method was used to validate content, usability and face validity of the BPMH form. We supplemented the quantitative analysis with a qualitative analysis of comments for each Delphi round.
RESULTS
The draft BPMH form contained 23 items grouped into eight tabs. Refinement of these tabs and items by the focus group resulted in 7 tabs and 21 items, which were included in the Delphi survey. The consensus was obtained for all tabs within the second round (p=0.072). Consensus was reached on 76% (16/21) of items in the third round. 20 items were included following the qualitative analysis of the experts' comments in the third round.
CONCLUSIONS
The findings of this study provide data on the content of the BPMH form. This form can be used to help clinical pharmacists to collect a complete and accurate medication list on admission. It could have an impact on inpatient safety and improve inpatient management. Studies with an international e-Delphi should be conducted for wider use.
Topics: Humans; Delphi Technique; Pharmacists; Consensus; Reproducibility of Results
PubMed: 35414586
DOI: 10.1136/ejhpharm-2021-003095 -
BMC Health Services Research Jun 2021There is general scarcity of research on key elements of implementation processes and the factors which impact implementation success. Implementation of healthcare...
BACKGROUND
There is general scarcity of research on key elements of implementation processes and the factors which impact implementation success. Implementation of healthcare interventions is a complex process. Tools to support implementation can facilitate this process and improve effectiveness of the interventions and clinical outcomes. Understanding the impact of implementation support tools is a critical aspect of this process. The objective of this study was to solicit knowledge and agreement from relevant implementation science and knowledge translation healthcare experts in order to develop a process model of key elements in the implementation process.
METHODS
A two round, modified Delphi study involving international experts in knowledge translation and implementation (researchers, scientists, professors, decision-makers) was conducted. Participants rated and commented on all aspects of the process model, including the organization, content, scope, and structure. Delphi questions rated at 75% agreement or lower were reviewed and revised. Qualitative comments supported the restructuring and refinement. A second-round survey followed the same process as Round 1.
RESULTS
Fifty-four experts participated in Round 1, and 32 experts participated in Round 2. Twelve percent (n = 6) of the Round 1 questions did not reach agreement. Key themes for revision and refinement were: stakeholder engagement throughout the process, iterative nature of the implementation process; importance of context; and importance of using guiding theories or frameworks. The process model was revised and refined based on the quantitative and qualitative data and reassessed by the experts in Round 2. Agreement was achieved on all items in Round 2 and the Delphi concluded. Additional feedback was obtained regarding terminology, target users and definition of the implementation process.
CONCLUSIONS
High levels of agreement were attained for all sub-domains, elements, and sub-elements of the Implementation Process Model. This model will be used to develop an Implementation Support Tool to be used by healthcare providers to facilitate effective implementation and improved clinical outcomes.
Topics: Delivery of Health Care; Delphi Technique; Health Personnel; Humans; Surveys and Questionnaires; Translational Research, Biomedical
PubMed: 34098952
DOI: 10.1186/s12913-021-06501-5 -
Journal of Clinical Epidemiology Jul 2019The mixed methods appraisal tool (MMAT) was developed for critically appraising different study designs. This study aimed to improve the content validity of three of the... (Review)
Review
OBJECTIVE
The mixed methods appraisal tool (MMAT) was developed for critically appraising different study designs. This study aimed to improve the content validity of three of the five categories of studies in the MMAT by identifying relevant methodological criteria for appraising the quality of qualitative, survey, and mixed methods studies.
STUDY DESIGN AND SETTING
First, we performed a literature review to identify critical appraisal tools and extract methodological criteria. Second, we conducted a two-round modified e-Delphi technique. We asked three method-specific panels of experts to rate the relevance of each criterion on a five-point Likert scale.
RESULTS
A total of 383 criteria were extracted from 18 critical appraisal tools and a literature review on the quality of mixed methods studies, and 60 were retained. In the first and second rounds of the e-Delphi, 73 and 56 experts participated, respectively. Consensus was reached for six qualitative criteria, eight survey criteria, and seven mixed methods criteria. These results led to modifications of eight of the 11 MMAT (version 2011) criteria. Specifically, we reformulated two criteria, replaced four, and removed two. Moreover, we added six new criteria.
CONCLUSION
Results of this study led to improve the content validity of this tool, revise it, and propose a new version (MMAT version 2018).
Topics: Delphi Technique; Reproducibility of Results; Research Design
PubMed: 30905698
DOI: 10.1016/j.jclinepi.2019.03.008 -
BMC Public Health Apr 2022Life-and-death education is intimately related to palliative-and-hospice care. It should be implemented among groups of all ages, especially for the elderly. This study...
BACKGROUND
Life-and-death education is intimately related to palliative-and-hospice care. It should be implemented among groups of all ages, especially for the elderly. This study aims to establish expert consensus on a set of scientific and systematic life-and-death education contents for the elderly and provide reference for the practice on the elderly.
METHODS
This study designed three rounds of expert consultation by using a Delphi method. A panel of 22 experts from the fields of palliative-and-hospice care, life-and-death education, geriatric nursing, humanities and ethics, and geriatric psychology participated in the study.
RESULTS
This study finally reached expert consensus on the contents of life-and-death education for the elderly, containing 4 first-level items, Life-and-death literacy promotion in the elderly; Life-and-death concept establishment of the elderly; Life-and-death planning of the elderly; Life-and-death thoughts of the elderly with affiliated 9 second-level items, and corresponding 23 detailed third-level items.
CONCLUSIONS
The life-and-death education contents for the elderly offer a basis for publicity for health professionals, promote dialogues on death, preparation, and planning for death and dying. The life-and-death education contents system was clear in coherence containing definite and comprehensive contents, which enriched life-and-death education resources globally. The results could assist in the planning of palliative-and-hospice care services to improve quality of death of the elderly.
Topics: Aged; Consensus; Delphi Technique; Hospice Care; Humans; Palliative Care; Referral and Consultation
PubMed: 35449042
DOI: 10.1186/s12889-022-13197-7 -
Cirugia Pediatrica : Organo Oficial de... Apr 2024The course in Primary Care in Pediatric Trauma (ATIP in Spanish) has been taught in Spain since 1997, and there are currently 9 accredited training centers. Care of... (Review)
Review
INTRODUCTION
The course in Primary Care in Pediatric Trauma (ATIP in Spanish) has been taught in Spain since 1997, and there are currently 9 accredited training centers. Care of polytraumatized pediatric patients often takes place in an environment conducive to errors resulting from forgetfulness, which is why checklists - mnemonic tools widely used in industry and medicine - are particularly useful to avoid such errors. Although several checklists exist for pediatric trauma care, none have been developed within the setting of our course.
MATERIALS AND METHODS
The criteria for being selected as an expert in Primary Care in Pediatric Trauma were agreed upon with the scientific polytrauma committee of the Spanish Pediatric Surgery Society. The items that make up the checklist were obtained from a review of the literature and consultation with selected experts, using the Delphi Technique.
RESULTS
10 experts representing the 9 groups or training centers in Primary Care in Pediatric Trauma were selected, and a 28-item checklist was drawn up in accordance with their design recommendations.
CONCLUSIONS
With the consensus of all the groups, a checklist for the treatment of polytraumatized pediatric patients was drawn up using the Delphi Technique, an essential requirement for the dissemination of this checklist, which should be adapted and validated for use in each healthcare center.
Topics: Humans; Child; Checklist; Delphi Technique; Consensus; Multiple Trauma; Primary Health Care
PubMed: 38623796
DOI: 10.54847/cp.2024.02.12