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Candefjord S, Andersson Hagiwara M, Sjöqvist BA, Karlsson JE, Nordanstig A, Rosengren L, Söderholm HM. Video support for prehospital stroke consultation: implications for system design and clinical implementation from prehospital simulations. BMC Med Inform Decis Mak 2024; 24:146. [PMID: 38811986 PMCID: PMC11138054 DOI: 10.1186/s12911-024-02539-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 05/17/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Video consultations between hospital-based neurologists and Emergency Medical Services (EMS) have potential to increase precision of decisions regarding stroke patient assessment, management and transport. In this study we explored the use of real-time video streaming for neurologist-EMS consultation from the ambulance, using highly realistic full-scale prehospital simulations including role-play between on-scene EMS teams, simulated patients (actors), and neurologists specialized in stroke and reperfusion located at the remote regional stroke center. METHODS Video streams from three angles were used for collaborative assessment of stroke using the National Institutes of Health Stroke Scale (NIHSS) to assess symptoms affecting patient's legs, arms, language, and facial expressions. The aim of the assessment was to determine appropriate management and transport destination based on the combination of geographical location and severity of stroke symptoms. Two realistic patient scenarios were created, with severe and moderate stroke symptoms, respectively. Each scenario was simulated using a neurologist acting as stroke patient and an ambulance team performing patient assessment. Four ambulance teams with two nurses each all performed both scenarios, for a total of eight cases. All scenarios were video recorded using handheld and fixed cameras. The audio from the video consultations was transcribed. Each team participated in a semi-structured interview, and neurologists and actors were also interviewed. Interviews were audio recorded and transcribed. RESULTS Analysis of video-recordings and post-interviews (n = 7) show a more thorough prehospital patient assessment, but longer total on-scene time, compared to a baseline scenario not using video consultation. Both ambulance nurses and neurologists deem that video consultation has potential to provide improved precision of assessment of stroke patients. Interviews verify the system design effectiveness and suggest minor modifications. CONCLUSIONS The results indicate potential patient benefit based on a more effective assessment of the patient's condition, which could lead to increased precision in decisions and more patients receiving optimal care. The findings outline requirements for pilot implementation and future clinical tests.
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Affiliation(s)
- Stefan Candefjord
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, 412 96, Sweden.
| | - Magnus Andersson Hagiwara
- Center for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, 501 90, Sweden
| | - Bengt Arne Sjöqvist
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, 412 96, Sweden
| | - Jan-Erik Karlsson
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Annika Nordanstig
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Simulation Center West, Sahlgrenska University Hospital and University of Gothenburg, , Gothenburg, Sweden
| | - Lars Rosengren
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Henrico K, Makkink AW. Use of global rating scales and checklists in clinical simulation-based assessments: a protocol for a scoping review. BMJ Open 2023; 13:e065981. [PMID: 37173107 DOI: 10.1136/bmjopen-2022-065981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
INTRODUCTION Assessment in health sciences education remains a hotly debated topic, with measures of competency and how to determine them in simulation-based assessments enjoying much of the focus. Global rating scales (GRS) and checklists are widely used within simulation-based education but there is a question regarding how the two strategies are used within clinical simulation assessment. The aim of this proposed scoping review is to explore, map and summarise the nature, range and extent of published literature available relating to the use of GRS and checklists in clinical simulation-based assessment. METHODS We will follow the methodological frameworks and updates described by Arksey and O'Malley, Levac, Colquhoun and O'Brien, and Peters, Marnie and Tricco et al and will report using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We will search PubMed, CINAHL, ERIC, Cochrane Library, Scopus, EBSCO, ScienceDirect, Web of Science, the DOAJ and several sources of grey literature. We will be including all identified sources published in English after 1 January 2010 that relate to the use of GRS and/or checklists in clinical simulation-based assessments. The planned search will be conducted from 6 February 2023 to 20 February 2023. ETHICS AND DISSEMINATION An ethical waiver was received from a registered research ethics committee and findings will be disseminated through publications. The overview of literature the produced will help to identify knowledge gaps and inform future research on the use of GRS and checklists in clinical simulation-based assessments. This information will be valuable and useful for all stakeholders that are interested in clinical simulation-based assessments.
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Affiliation(s)
- Karien Henrico
- Emergency Medical Care, University of Johannesburg, Johannesburg, Gauteng, South Africa
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Oliveira RKCD, Santos AMRD, Nolêto JDS, Sá GGDM, Machado RDS, Gouveia MTDO, Madeira MZDA. Hospital emergency suitability protocol: translation and adaptation to the Brazilian culture. Rev Gaucha Enferm 2022; 43:e20210183. [PMID: 35920526 DOI: 10.1590/1983-1447.2022.20210183.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/10/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Translate and culturally adapt the Hospital Emergency Suitability Protocol (HESP) to Brazilian Portuguese. METHOD Methodological study, developed from 2019 to 2021, in an emergency hospital, and which followed the stages of translation, synthesis of translations, back-translation, review by an expert committee, pre-test and submission to the authors of the protocol. The sample included four translators, five experts, who assessed conceptual, semantic, cultural, and idiomatic equivalence, 21 nurses and nine physicians, who participated in the pre-test. Content Validity Index (CVI), Cronbach's alpha and Kendall's coefficient of concordance were used. RESULTS The final version of the adaptation presented Content Validity Index that ranged from 0.40 to 1.0. The internal consistency, according to Cronbach's alpha coefficient, showed Semantic Equivalence (α=0.815), Idiomatic Equivalence (α=0.924), Experiential Equivalence (α=0.682), Conceptual Equivalence (α=0.71), which presented acceptable values, except for the experiential equivalence. Kendall W's coefficient (W=0.14 to 0.58) revealed good reliability. CONCLUSION The translation and cultural adaptation process of the HESP originated an instrument applicable to the Brazilian context.
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Affiliation(s)
| | | | | | | | - Raylane da Silva Machado
- Universidade Federal do Piauí (UFPI), Programa de Pós-Graduação em Enfermagem. Teresina, Piauí, Brasil
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Oliveira RKCD, Santos AMRD, Nolêto JDS, Sá GGDM, Machado RDS, Gouveia MTDO, Madeira MZDA. Protocolo de Adecuación de urgencias hospitalarias: tradução e adaptação para a cultura brasileira. Rev Gaucha Enferm 2022. [DOI: 10.1590/1983-1447.2022.20210183.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: Traduzir e adaptar culturalmente o Protocolo de Adecuación de Urgencias Hospitalarias (PAUH) para o português do Brasil. Método: Estudo metodológico, desenvolvido no período de 2019 a 2021, em hospital de urgência, e que seguiu as etapas de tradução, síntese das traduções, retrotradução, revisão por comitê de experts, pré-teste e submissão aos autores do protocolo. A amostra incluiu quatro tradutores, cinco experts, que avaliaram equivalência conceitual, semântica, cultural e idiomática, 21 enfermeiros e nove médicos, que participaram do pré-teste. Utilizou-se Indíce de Validade de Conteúdo (IVC), alfa de Cronbach e concordância de Kendall. Resultados: A versão final da adaptação apresentou IVC que variou de 0,40 a 1,0. A consistência interna evidenciou Equivalência Semântica (α=0,815), Equivalência Idiomática (α=0,924) e Equivalência Conceitual (α=0,71), com valores aceitáveis. A concordância de Kendall revelou boa confiabilidade (W=0,14-0,58). Conclusão: O processo de tradução e adaptação cultural do PAUH originou instrumento aplicável ao contexto brasileiro.
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Unsworth J, Melling A, Porteous D. Development and Evaluation of the Validity and Reliability of the Leading and Managing Care Pre-Registration Nursing Student Assessment Tool. SAGE Open Nurs 2021; 7:23779608211000259. [PMID: 35155767 PMCID: PMC8832312 DOI: 10.1177/23779608211000259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/14/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Clinical nursing leadership influences patient safety and the quality of care provided. Nurses at all levels require leadership and management skills. Despite recognition of the importance of leadership, student nurses often feel ill prepared to make the transition to Registered Nurse and struggle with prioritisation and delegation. In order to standardise student experience and promote the development of skills and attributes, a leadership and management competency assessment was developed and implemented. AIMS This study aimed to identify the constructs that should be part of an assessment of student nurse competence in relation to clinical nursing leadership, and to evaluate the tool's reliability. METHOD The first phase was to construct the competency assessment tool, using a mixture of deductive methods, including literature and expert review. Second, psychometric evaluation of the tool, including tests to examine its internal consistency and reliability, comparing test and retest reliability, exploratory factor analysis and generalisability theory analysis to identify reliability and sources of error. RESULTS Five attributes were identified for inclusion in the tool alongside a scale of competence. 150 assessments were conducted with an average time between each assessment of three days. The results show that the tool was consistent over time with no significant difference in the mean scores. The Cronbach alpha was 0.84 and the tool had good internal consistency. The results of the factor analysis revealed loading onto a single construct. Generalisability theory analysis revealed 0.90 global reliability, with students accounting for the majority of the variation in scores. CONCLUSIONS The Leading and Managing Care assessment tool represents a valid and reliable assessment of student nurse competence to lead care delivery. Use of the tool during practice placement allows for a structured approach to the development of skills around prioritisation, management of resources, communication and the management of risk.
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Affiliation(s)
- John Unsworth
- Department of Nursing, Midwifery and Healthcare, Northumbria
University, Newcastle-upon-Tyne, United Kingdom
| | - Andrew Melling
- Department of Nursing, Midwifery and Healthcare, Northumbria
University, Newcastle-upon-Tyne, United Kingdom
| | - Debra Porteous
- Faculty of Health & Life Sciences, Northumbria University,
Newcastle-upon-Tyne, United Kingdom
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