Construction of evidence-based practice competencies for nurses in China: A modified Delphi study

A core competency evaluation index system for the graded use of clinical nurse specialists: A Delphi study

AIMS AND OBJECTIVES

To describe a grading system that can be used to evaluate core competency of clinical nurse specialists (CNSs) at different levels.

BACKGROUND

Evaluate core competence of CNSs at different levels reflects the quality of nursing and the development of the nursing profession.

DESIGN

This research employed the Delphi method.

METHODS

The STROBE checklist for observational cross-sectional studies was followed to report this research study. This study consisted of two main phases: a literature review and semistructured interviews. Individual semistructured interviews were conducted with 11 healthcare experts and two patients. Two rounds of questionnaire surveys were administered to 21 nursing experts using the Delphi method. The CNSs were classified as primary, intermediate or advanced based on their years of work, professional titles and educational qualifications.

RESULTS

The graded competency evaluation system consisted of five first-level indicators (clinical practice, consulting guidance and teaching, scientific research innovation, management and discipline development, and ethical decision-making), 15 second level indicators, and 40 third-level indicators. The authority coefficients (Cr) of the experts were .865 and .901. The Kendall's concordance coefficients of the three-level indicators were .417, .289 and .316 for primary CNSs; .384, .294 and .337 for intermediate CNSs; and .489, .289 and .239 for advanced CNSs.

CONCLUSION

The graded use evaluation system in clinical practice initially involves a comprehensive evaluation of the core abilities of CNSs. This is a tool for cultivating and grading the abilities of specialised nurses that can promote a practical upwards spiral.

RELEVANCE TO CLINICAL PRACTICE

The evaluation system can promote the scientific management and continuous improvement of CNSs in clinical nursing and can serve as a practical and objective reference for the effective management and development of CNSs.

PATIENT OR PUBLIC CONTRIBUTION

Patients participated in the data collection process, during which they shared their health-seeking experience with our research team.

Coping target checklist for home-based older adults living with disabilities and their spousal caregivers

BACKGROUND

The substantial rise in the population of older adults living with disabilities is a prominent concern, presenting a profound challenge for healthcare and social welfare systems. Community-based home care is seen as an effective approach to meet the care needs of older adults living with disabilities.

OBJECTIVE

To construct a coping target checklist for home-based older adults living with disabilities and their spousal caregivers.

METHODS

The initial draft was developed based on a comprehensive literature review, followed by two rounds of Delphi correspondence final version.

RESULTS

A comprehensive literature review resulted in the development of 7 modules, 20 topics. After round 1, 3 items were removed, 3 sections, 1 topic and 1 objective were new additions, 16 items were modified, split or combined. Four sections, 3 sections (Individual coping target for spousal caregivers, Individual coping target for older adults living with disabilities, and Shared coping target), 7 modules, 18 topics and 49 objectives were finally identified in round 2. The content of the list tool is derived from three perspectives: self-management strategies for older adults living with disabilities, caregiving strategies for spousal caregivers, and combined.

CONCLUSIONS

The coping target checklist was intended to be evidence-based and reflective of a practical direction for home-based older adults living with disabilities and their spousal caregivers living at home.

Assessing evidence-based practice competencies of undergraduate nursing students using a developed multi-criteria decision-analysis model

AIM

The developed multi-criteria decision analysis model was used to identify the inter-influence relationships and key factors affecting the EBP competencies of UNSs, to assess the EBP competencies of UNSs and based on these results, to formulate an improvement strategy to enhance the EBP competencies of UNSs.

BACKGROUND

EBP is considered a core competency in international nursing practice. However, few studies have developed EBP evaluation models and applied them to assessing and improving the EBP competencies of UNSs.

DESIGN

This is a quantitative study with multi-criteria decision-analysis model.

METHODS

Firstly, the questionnaire was designed based on the characteristics of the DEMATEL and VIKOR-AS methods, which was completed by 17 nursing experts from a case hospital in Zhejiang Province, China. Subsequently, the DEMATEL method was used to analyze the inter-influence relationships among various criteria to determine their respective weights. Finally, the VIKOR method is utilized to integrate multiple criteria and their relative weights to assign comprehensive scores to each UNSs.

RESULTS

The use of the DEMATEL method reveals that "Knowledge (C1)", "Mastering the basic scientific research methods during the study of the undergraduate courses (C11)", "Being able to consult clinical experts appropriately when encountering problems in clinical practice (C23)" and "Understanding the importance of reading journals related to the nursing profession regularly (C34)" were critical influencing factors. "Skill (C2)," "Being able to explain the essential roles of the best research evidence in determining clinical practice (C15)," "Being able to apply the collected research evidence to the individual case in nursing care (C25)" and "Paying attention to using the evidence-based nursing practice concept to determine the best clinical practice (C35)" were the most influential factors. According to the VIKOR method, the performance of the UNSs in the case hospitals in terms of EBP competencies from highest to lowest was Student C, Student B and Student A. However, all of these students suffered from deficiencies at the knowledge level.

CONCLUSIONS

The application of the DEMATEL and VIKOR methods provides a systematic and comprehensive approach to the assessment of EBP competencies of UNSs. The lack of EBP competencies of UNSs in case hospitals is mainly reflected in knowledge level. To improve UNSs' EBP competencies, medical schools and hospital educators should propose short- and long-term strategies to improve knowledge.

Development of a humanistic care digital storytelling programme for intensive care unit nursing students: Feasibility and satisfaction analysis

BACKGROUND

Humanistic care has become an essential quality for modern nurses. However, previous studies have revealed that nursing students lack adequate preparation to meet the needs of patients in intensive care units using a humanistic care approach.

OBJECTIVES

To develop a humanistic care digital storytelling programme for intensive care nursing students and assess its acceptance and satisfaction among participants through a satisfaction survey.

METHODS

The development of the programme was based on the SHARE framework (S: sense patient's needs; H: help patient out; A: acknowledge patient's feelings; R: respect patient's dignity and privacy; E: explain what is happening) and involved three steps. Content analysis and narrative adaptation were used to develop a series of digital stories illustrating humanistic stories from clinical practice. The preliminary draft of the programme was modified based on Delphi consultation. Finally, the programme was piloted with nursing students and their satisfaction was evaluated using questionnaires. All statistical analyses were performed using Excel 2016 and SPSS 26.0.

RESULTS

Four digital stories were successfully selected and a total of 16 questionnaires were distributed and collected in two rounds of expert consultation. The effective Delphi rate was 100 %. The expert authority coefficients in rounds 1 and 2 were 0.82 and 0.875, respectively. The coefficient of variation for round 1 was 0-0.23, and for round 2, it was 0-0.14. The Kendall's coordination coefficient was 0.119 for round 1 and 0.054 for round 2. The nursing students highly evaluated the programme, with 100 % of participants reporting that the digital stories successfully evoked emotional responses and that they were satisfied with the course duration.

CONCLUSION

A scientifically valid, credible, and satisfactory humanistic care digital storytelling programme was developed for intensive care unit nursing students. The programme provides valuable guidance for nurse educators and scholars seeking to develop effective digital storytelling training programmes.

Construction of a risk index system for the prediction of chronic post-surgical pain after video-assisted thoracic surgery for lung resection: A modified Delphi study

In the present study, several research methods were adopted, including literature retrieval, theoretical analysis, and qualitative research, and then the draft of the prognostic factors for the chronic post-surgical pain (CPSP) index system after video-assisted thoracoscopic surgery (VATS) for lung resection was constructed. A Delphi survey was used for the study of 24 experts in the field of pain from three different grade-A tertiary hospitals in Guangzhou, China. In the two rounds of survey, the experts rated these indicators for the importance and feasibility of measurement (round 1, n = 21 participants; round 2, n = 20). Finally, we calculated Kendall's W index as a measure of consensus. A general consensus was reached on predicting CPSP after VATS, consisting of 10 first-level domains and 64 second-level indicators, involving biological, psychological and social perspectives. This study provides a comprehensive draft of risk factors developed and identified by experts to inform research-based evidence on chronic pain. Increased clinical awareness and a full understanding of how to screen and identify people with CPSP problems may lead to earlier recognition of chronic pain and greater facilitation of professional prevention.

Construction of a competency framework of dental hygienists: A Delphi study

AIM

To explore the basic and core competencies of dental hygienists, construct a systematic and scientific competency framework for dental hygienists taking into account China's national conditions and provide a theoretical basis for the future training in China and other countries that have not yet established the competencies of dental hygienists.

BACKGROUND

The establishment of dental hygienists role is essential for the public to improve the dental health level. Currently, more than 50 countries around the world have established the role of dental hygienists and defined the core competencies needed by dental hygienists. However, studies on developing a standardized and unified consensus of competencies of dental hygienists are lacking in China.

METHODS

Based on the literature review and theoretical research, this study explored the theoretical basis and fundamental principle of constructing the competency framework for dental hygienists. Moreover, a correspondence questionnaire on dental hygienists' competency framework was initially constructed to clarify the specific content of each competency. Finally, the Delphi method was adopted to establish the indicators of the dental hygienists' competency framework according to the principle of expert selection and inclusion criteria.

RESULTS

The three rounds of Delphi consultation experts were from nursing, stomatology and management and other fields. Three rounds of Delphi results showed that the expert authority, enthusiasm and coordination coefficients were high. Thereafter, a competency framework of dental hygienists with 4 primary indicators, 15 secondary indicators and 50 tertiary indicators was constructed, which included theoretical knowledge, professional skills, professional abilities and occupational qualities.

CONCLUSION

Literature and theoretical research methods along with Delphi expert consultation were used to construct the competency framework of dental hygienists based on the onion model. The competency framework of dental hygienists was scientific, reasonable and practical, which is consistent with the current health situation in China and has distinct Chinese characteristics. Some of our findings, offer ideas for other developing countries that have not yet set up the role of dental hygienists or are in an initial stage.

Developing a core competency framework for advanced practice nursing in mainland China: a sequential exploratory study

BACKGROUND

Advanced Practice Nursing (APN) have been highly valued and an integral part of the health care system. Development and establishment of new APN roles is a complex process that has resulted from a wide variety of reasons, key component is a lack of a competency map delineation and role evaluation. Currently, however, competence framework has not been compared at an international level. In mainland China, APN have been introduced in some organizations but their competency domains have not yet been clearly defined, this study aimed to identify the core competencies for advanced practice nursing.

METHODS

This study was performed in two phases: first, in-depth and semi-structured individual interviews with 46 participants from key stakeholders were carried out followed by a qualitative content analysis, then an item pool of core competencies was constructed by extracting data from the first phase and the results from previous studies, scales and documents; second, a Delphi technique was conducted with the participation of 28 experts from 7 areas of China to form the final core competency framework for advanced practice nursing.

RESULTS

Through the qualitative phase, the core competency framework with six domains and 70 items emerged and then entered into the Delphi phase. Twenty-eight of 30 experts finished 2 rounds of Delphi approaches. The final core competencies for advanced practice nursing consisted of six domains with 61 items, including direct clinical nursing practice, research and evidence-based nursing practice, professional development, organization and management, mentoring and consultation, and ethical/legal practice.

CONCLUSION

This core competency framework consisted of six domains with 61 items can be used in competency-based education to cultivate advanced practice nurses as well as competency level assessment.

Developing a competency framework for extracorporeal membrane oxygenation nurses: A qualitative study

AIM

To develop a competency framework applicable to Chinese extracorporeal membrane oxygenation (ECMO) nurses.

DESIGN

A qualitative study was performed following the consolidated criteria for reporting qualitative research.

METHODS

Semi-structured interviews based on the critical incident technique were conducted among 21 ECMO care providers recruited from five well-known ECMO centres in Guangzhou, China. Interview transcripts were coded and analysed using the constant comparative method. The data collection period lasted from November 2021 to April 2022.

RESULTS

A competency framework for ECMO nurses was identified. It included four domains: knowledge, skills, behaviours and attitudes, containing 33 subcompetencies and 66 items.

RELEVANCE TO CLINICAL PRACTICE

This framework can be a reference for the assessment and training of ECMO nurses.

Construction of learning objectives and content for newly graduated nurses in tertiary teaching hospitals: A Delphi study

BACKGROUND

Transition education is a robust strategy to improve the core competency of newly graduated nurses and the quality of clinical nursing and ensure people's safety. Limited information about the learning objectives and educational content for newly graduated nurses in China was available.

OBJECTIVE

Construct the learning objectives and educational content for newly graduated nurses based on defined core competencies.

DESIGN

We used a literature review and the e-Delphi method to conduct this study.

SETTINGS

Ten tertiary teaching hospitals and six nursing schools in Zhejiang Province, China, were selected.

PARTICIPANTS

Experts (n = 21) were invited to the e-Delphi study.

METHODS

Based on seven competencies from the literature review and the research group discussions, we formed an initial set of objectives and specific educational content for newly graduated nurses. Subsequently, experts provided supportive and modification advice on the competencies, objectives, and specific content in the two Delphi rounds. The consensus percentage and the weight of each first-level, second-level, and third-level item were calculated.

RESULTS

Consensus was achieved on seven core competencies, 44 learning objectives, and 60 components of educational content. The positive coefficient of the two Delphi rounds was 100 %, the authority coefficient was 0.83 and 0.87, the proportion of experts who made suggestions was 71.40 %, the coefficient of variation (CV) was <0.25 (P < 0.05) except for two items and the Kendall coefficient (W) was 0.15-0.48 (P < 0.01).

CONCLUSION

The developed objectives and content framework provide a reference for implementing systematic and standardized education for newly graduated nurses.

A modified Delphi study on establishing a curriculum content structure for the leadership and management competency cultivation for future nurse managers in China

Background

It is critical to train future nursing managers in advance for the prospective development of healthcare organizations, but a widely recognized curriculum content structure for leadership and management competency development for nurturing future nurse managers was lacking in China.

Objective

To establish a curriculum content structure for the leadership and management competency cultivation for future nurse managers in Chinese healthcare setting.

Methods

A modified Delphi study was conducted. 22 experts who have in-depth knowledge of nursing leadership and management from 4 main geographical regions in China were included. The initial curriculum content structure was constructed based on a previous qualitative study and two team meetings. Subsequently, a two-round Delphi survey was conducted with 22 panelists in the first round and 19 in the second round. Scores of importance and textual comments were collected and used to judge the achievement of consensus.

Results

After the two-round Delphi process, consensus was reached, as each item was rated ≥4 by 84.21-100% of the experts and each one had a coefficient of variance (CV) ≤ 0.174. The finalized curriculum content contains 9 modules and 27 items.

Conclusions

This study formed a curriculum content structure for leadership and management competency training for nurses preparing for managerial roles, which contribute to the establishment of a nursing management talent pipeline to meet the needs of healthcare institutions for contemporary nurse managers.

Research on Translation of Chinese Medicine Constitution (Tizhi) Academic Terms: Based on Memetics and Delphi Method

Background. With the continuous in-depth research of Chinese medicine constitution (tizhi) and the continuous expansion of cross research with new disciplines, internationalization will become the future trend of Chinese medicine constitution (tizhi). Translating the terms of Chinese medicine constitution (tizhi) into English is the first step for Chinese medicine constitution (tizhi) to go international. Language memes play an important role in information transmission in social interpersonal communication activities. The continuous replication and dissemination of translation memes make language spread and popularized. Because there is no fixed translation method at present, based on the particularity of Chinese medicine constitution (tizhi), we decided to use the Delphi method to complete the term translation research. Objective. The purpose of this study is to provide a standard and unified translation method for terms of traditional Chinese medicine (TCM) constitution with Chinese characteristics through the Delphi expert consultation strategy. Methods. Forward translation and expert consensus were conducted to complete this study. We sorted out the related terms of Chinese medicine constitution (tizhi) theory and invited an expert from the World Federation of Chinese Medicine Societies (WFCMS) to complete the initial forward translation. An expert of Chinese medicine constitution (tizhi) theory joined this process. Then, we invite relevant professionals to evaluate this translation version using the Delphi method. Results. Following a 3-round Delphi survey, the translation criteria of 61 (92.42%) terms were unified, and 5 terms resulted in no consensus and reached consensus on the translation method of Chinese medicine constitution (tizhi) theory. A major problem about how to translate “中医体质学” is identified. 25 experts participated in this study, and the drop-out rate is 0% in the 3-round Delphi survey. Translation challenges include the following: (1) translation methods of “Chinese medicine constitution (tizhi) theory”; (2) experts’ understanding deviation on the definitions of some terms. Conclusions. The average mode, full score ratio, standard deviation, coefficient of variation, and variation ratio of expert scores are analyzed. The diversity of regions and professional titles of experts shows that they have a high degree of authority. The scores of terms indicate the consistent of study results, so they can be used as a reference for the translation of Chinese medicine constitution (tizhi) theory.

Core competencies for a biomedical laboratory scientist - a Delphi study

BACKGROUND

After completing university education, biomedical laboratory scientists work in clinical laboratories, in biomedical research laboratories, in biotech, and in pharmaceutical companies. Laboratory diagnostics have undergone rapid development over the recent years, with the pace showing no signs of abatement. This rapid development challenges the competence of the staff and will most certainly influence the education of future staff. This study aimed to examine what was considered the necessary competencies needed to pursue a career as a biomedical laboratory scientist.

METHODS

A modified Delphi technique was used, with the panel of experts expressing their views in a series of three questionnaire. Consensus was defined as the point which 75 % or more of the panel participants agreed that a particular competency was necessary.

RESULTS

The study highlights the perceived importance of mostly generic competencies that relate to quality, quality assurance, and accuracy, as well as different aspects of safety, respect, trustworthiness (towards patients/clients and colleagues), and communication skills. The results also stress the significance of self-awareness and professionality.

CONCLUSIONS

We identified important competencies for biomedical laboratory scientists. Together with complementary information from other sources, i.e., guidelines, laws, and scientific publications, the competencies identified can be used as learning outcomes in a competency-based education to provide students with all the competencies needed to work as professional biomedical laboratory scientists.