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Yoshimatsu Y, Ohtake Y, Ukai M, Miyagami T, Morikawa T, Shimamura Y, Kataoka Y, Hashimoto T. "Diagnose, Treat, and SUPPORT". Clinical competencies in the management of older adults with aspiration pneumonia: a scoping review. Eur Geriatr Med 2024; 15:57-66. [PMID: 38060164 PMCID: PMC10876713 DOI: 10.1007/s41999-023-00898-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 10/31/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Aspiration pneumonia in older adults is increasingly common, with a high care burden and morbidity. However, clinical competencies in its management have not been developed, and healthcare professionals struggle on how to care for these patients with multimodal treatment needs. Therefore, we conducted a scoping review to investigate what is known about the desired clinical competencies for the management of older adults with aspiration pneumonia, to utilise in clinical practice, education, and future research. METHODS First, we defined aspiration pneumonia according to a preliminary search. We then searched the literature on MEDLINE and CINAHL, focusing on studies involving patients aged 65 years old and older diagnosed with aspiration pneumonia. All settings were included, with the exception of intensive care units. Publication dates were limited to January 2011 to July 2022 and languages to English and Japanese. The extracted data were used to refine the preliminary competency framework developed by the Japan Aspiration pneumonia inter-Professional team Educational Program (JAPEP) in preparation of this study. RESULTS Ninety-nine studies were included. Following data extraction from these studies, 3 competencies were renamed, and 3 new competencies were added, to create a list of 12 competencies. These were Diagnosis, Treatment, Swallow Assessment, Underlying condition management, Nutrition, Oral management, Rehabilitation, Multidisciplinary team, Decision making, Prevention, Prognosis, and Palliative care. CONCLUSIONS Our scoping review identified 12 clinical competencies required in the management of older adults with aspiration pneumonia, outlined in the phrase 'Diagnose, Treat and SUPPORT'. We encourage healthcare professionals to share these competencies as a team to identify areas of unmet need and improve their patient care, with an emphasis on supportive care.
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Affiliation(s)
- Yuki Yoshimatsu
- Elderly Care, Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, Stadium Rd, London, SE18 4QH, UK.
- Centre for Exercise Activity and Rehabilitation, School of Human Sciences, University of Greenwich, London, UK.
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan.
| | - Yoichi Ohtake
- Department of Internal Medicine, Imai Hospital, Hyogo, Japan
| | - Mamiko Ukai
- Department of Family Medicine, Kameda Family Clinic, Tateyama, Japan
- Department of Health Data Science, Yokohama City University, Kanagawa, Japan
| | - Taiju Miyagami
- Faculty of Medicine, Department of General Medicine, Juntendo University, Bunkyo City, Japan
| | - Toru Morikawa
- Department of General Medicine, Nara City Hospital, 1-50-1, Higashikideracho, Nara, 630-8305, Japan
| | - Yoshinosuke Shimamura
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
- Department of Nephrology, Teine Keijinkai Medical Center, 1-40, Maeda 1-12, Teine, Sapporo, Hokkaido, 006-8555, Japan
| | - Yuki Kataoka
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
- Department of Internal Medicine, Kyoto Min-Iren Asukai Hospital, Tanaka Asukai-cho 89, Sakyo-ku, Kyoto, 606-8226, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University Graduate School of Medicine, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
- Department of Healthcare Epidemiology, Graduate School of Medicine/Public Health, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Tadayuki Hashimoto
- Department of General Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
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Noyes JA, Stewart SD, Gabarro JP, Welch PM. Development of a veterinary emergency open standard competency framework using a competency-based model of medical education. J Vet Emerg Crit Care (San Antonio) 2021; 31:727-741. [PMID: 34608749 DOI: 10.1111/vec.13145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 06/24/2021] [Accepted: 09/07/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To address the shortage of emergency veterinarians, the profession is exploring accelerated training pathways. We sought to contribute to the solution by developing the foundation for an open standard, competency-based veterinary emergency training curriculum for use by any program. We also developed a curricular delivery, tracking, and assessment system to demonstrate how the framework can be integrated into training programs. DESIGN: Hybrid Delphi method. SETTING: Academia and referral practice. ANIMALS: None. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS An emergency veterinary competency framework was developed by adapting the human Model of the Clinical Practice of Emergency Medicine, which aligns with the Competency-Based Veterinary Education framework, to produce 4 areas of core competency: Patient Care, Interpersonal/Communication, Professionalism, and Practice-based Learning/Improvement. A comprehensive list of veterinary emergency skills was generated and organized within the framework utilizing the hybrid Delphi method. An initial survey completed by 133 emergency and critical care specialists and emergency room clinicians produced data regarding the value of specific skills. An 11-member focus group consisting of survey participants iterated upon the survey results to produce a master library of skills and cases, including 56 Patient Care, 43 Interpersonal/Communication, 11 Practice-based Learning/Improvement, and 20 Professionalism skills, as well as 155 case types. The curricular delivery system tracks and assesses case management proficiency and development of knowledge and professional skills using a patient care eLearning program and simulation training environment. CONCLUSIONS: The increasing need for emergency veterinarians is a shared industry-wide challenge. To contribute toward a collective solution, we have undergone an evidence-based process to create the foundation for an open standard competency framework composed of a library of skills and cases. We offer this open standard framework to the veterinary profession and hope it continues to grow and evolve as we drive toward developing competency-based training programs that address the shortage of emergency veterinarians.
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Taylor RM, Feltbower RG, Aslam N, Raine R, Whelan JS, Gibson F. Modified international e-Delphi survey to define healthcare professional competencies for working with teenagers and young adults with cancer. BMJ Open 2016; 6:e011361. [PMID: 27142859 PMCID: PMC4861123 DOI: 10.1136/bmjopen-2016-011361] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES To provide international consensus on the competencies required by healthcare professionals in order to provide specialist care for teenagers and young adults (TYA) with cancer. DESIGN Modified e-Delphi survey. SETTING International, multicentre study. PARTICIPANTS Experts were defined as professionals having worked in TYA cancer care for more than 12 months. They were identified through publications and professional organisations. METHODS Round 1, developed from a previous qualitative study, included 87 closed-ended questions with responses on a nine-point Likert scale and further open-ended responses to identify other skills, knowledge and attitudes. Round 2 contained only items with no consensus in round 1 and suggestions of additional items of competency. Consensus was defined as a median score ranging from 7 to 9 and strength of agreement using mean absolute deviation of the median. RESULTS A total of 179 registered to be members of the expert panel; valid responses were available from 158 (88%) in round 1 and 136/158 (86%) in round 2. The majority of participants were nurses (35%) or doctors (39%) from Europe (55%) or North America (35%). All 87 items in round 1 reached consensus with an additional 15 items identified for round 2, which also reached consensus. The strength of agreement was mostly high for statements. The areas of competence rated most important were agreed to be: 'Identify the impact of disease on young people's life' (skill), 'Know about side effects of treatment and how this might be different to those experienced by children or older adults' (knowledge), 'Honesty' (attitude) and 'Listen to young people's concerns' (aspect of communication). CONCLUSIONS Given the high degree of consensus, this list of competencies should influence education curriculum, professional development and inform workforce planning. Variation in strength of agreement for some competencies between professional groups should be explored further in pursuit of effective multidisciplinary team working.
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Affiliation(s)
- Rachel M Taylor
- NIHR University College London Hospitals Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
- School of Health and Social Care, London South Bank University, London, UK
| | - Richard G Feltbower
- Division of Epidemiology & Biostatistics, School of Medicine, University of Leeds, Leeds, UK
| | - Natasha Aslam
- NIHR University College London Hospitals Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
| | - Rosalind Raine
- Department of Applied Health Research, University College London, London, UK
| | - Jeremy S Whelan
- NIHR University College London Hospitals Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
| | - Faith Gibson
- School of Health and Social Care, London South Bank University, London, UK
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Kelo M, Eriksson E, Eriksson I. Perceptions of patient education during hospital visit - described by school-age children with a chronic illness and their parents. Scand J Caring Sci 2012; 27:894-904. [DOI: 10.1111/scs.12001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 09/16/2012] [Indexed: 10/27/2022]
Affiliation(s)
- Marjatta Kelo
- Faculty of Health Care and Nursing; Helsinki Metropolia University of Applied Sciences; Helsinki Finland
| | - Elina Eriksson
- Department of Nursing Science; University of Turku; Turku Finland
| | - Ilse Eriksson
- Department of Education; Faculty of Behavioural Sciences; University of Helsinki; Helsinki Finland
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GIBSON F, FERN L, WHELAN J, PEARCE S, LEWIS I, HOBIN D, TAYLOR R. A scoping exercise of favourable characteristics of professionals working in teenage and young adult cancer care: ‘thinking outside of the box’. Eur J Cancer Care (Engl) 2012; 21:330-9. [DOI: 10.1111/j.1365-2354.2011.01322.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bray L, Sanders C, Flynn A. Paediatric catheterisation: exploring and understanding children's nurses' perceptions and practice in an acute setting. J Clin Nurs 2011; 19:3235-43. [PMID: 21040025 DOI: 10.1111/j.1365-2702.2010.03414.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES This research study explored the factors which influenced the ability of children's nurses to urethrally catheterise children in their care. BACKGROUND There is currently limited evidence to inform the clinical skills training of children's nurses and the impact of competencies and other educational documents on practice. The project aimed to use data to inform local service provision and the design and development of future training programmes in an acute paediatric hospital. DESIGN A mixed method study using questionnaires and focus groups. METHODS Data were obtained through two focus groups (n = 10) and questionnaires (n = 34, response rate 88%) with trained children's nurses to explore the influencing factors on their ability to conduct this clinical skill. RESULTS The children's nurses discussed that barriers to being competent and confident to catheterise included a lack of exposure to the clinical skill, increasing awareness of the role of competencies and litigation and the presence of specialist roles. Current catheterisation training was evaluated positively with most nurses stating their knowledge and clinical skills had increased; despite this only 55% (n = 18) identified that would feel able to catheterise a child in their care. CONCLUSIONS Comprehensive training of all children's nurses in an acute care setting may not provide a workforce, which is competent and confident in urethrally catheterising children, and resources for training may be more appropriately deployed to ensure the optimum care of children and families. RELEVANCE TO CLINICAL PRACTICE This study highlights the difficulties encountered for clinical nurses to remain competent in infrequently used clinical skills. This has relevance to the challenges of providing a multi-skilled workforce in children's nursing.
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Affiliation(s)
- Lucy Bray
- Evidence-based Practice Research Centre, Edge Hill University, Ormskirk, UK.
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Abstract
Research relating to patients’ views of the good nurse has mainly focused on the perspectives of adult patients, with little exploring the perceptions of children. This article presents findings from a qualitative study that explored views of the good nurse from the perspective of hospitalized children. The aims of the study were threefold: to remedy a gap in the literature; to identify characteristics of the good nurse from the perspective of children in hospital; and to inform children’s nursing practice. Twenty-two children were interviewed using an adapted ‘draw and write’ technique. Five themes relating to children’s views of the good nurse emerged from the analysis: communication; professional competence; safety; professional appearance; and virtues. Each of these will be discussed in relation to good nurse literature and recommendations made for children’s nursing practice.
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Affiliation(s)
- Mary Brady
- Faculty of Health and Social Care Sciences, Kingston University & St George's University of London, Cranmer Terrace, London SW17 0RE, UK,
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Long T, Hale C, Sanderson L, Tomlinson P, Carr K. Evaluation of educational preparation for cancer and palliative care nursing for children and adolescents in England. Eur J Oncol Nurs 2008; 12:65-74. [PMID: 17719850 DOI: 10.1016/j.ejon.2007.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2007] [Revised: 05/19/2007] [Accepted: 05/22/2007] [Indexed: 11/20/2022]
Abstract
This paper reports the findings of a study which was carried out to evaluate the educational preparation of cancer and palliative care nurses in England. The study was carried out in three stages and covered the following areas; documentary analysis of curriculae, assessment of practice, patients and professionals views of threshold and expert practice. The findings suggested that although there was widespread compliance with a national standard for cancer nursing, this was not the case for palliative care nursing. There was uncertainty about what should be assessed in practice and ambiguity about what was actually assessed. Partnership with children and their parents, clinical skills, multi-disciplinary working, and personal attributes were the main foci for expectations of threshold practice but an expert panel had difficulty in describing the attributes of higher level practice. The paper also describes how some of recommendations from the study are being taken forward in current policy and practice.
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Affiliation(s)
- Tony Long
- Centre for Nursing Midwifery and Collaborative Research, University of Salford, UK
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Davis R, Turner E, Hicks D, Tipson M. Developing an integrated career and competency framework for diabetes nursing. J Clin Nurs 2007; 17:168-74. [PMID: 17419796 DOI: 10.1111/j.1365-2702.2006.01866.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To describe the development of an integrated career and competency framework for diabetes nursing. BACKGROUND The UK Nursing and Midwifery Council provides a definition of competence, but the terminology used in relation to the subject is often ambiguous and confusing. These concepts are explored in relation to nursing practice and the different approaches to competency framework development are described. To work alongside the Royal College of Nursing (RCN) and Skills for Health competency initiatives, a Diabetes Nursing Strategy Group representing nurses working in diabetes care was formed to oversee the development of an integrated career and competency framework for diabetes nursing. DESIGN At the outset, the design was guided by the RCN Practice Development Team and employed qualitative methodology including the modified Delphi and nominal group technique. METHODS A purposive sample of nurses representing all sectors and grades of staff involved in diabetes care was invited to workshops to undertake a values clarification exercise. Content analysis was performed to identify themes. Further workshops identified areas of specialist practice and competence statements were developed and refined in a series of consultations. RESULTS Competence statements for a range of diabetes-related areas were produced for nurses at the levels of unregistered practitioners, competent nurses, experience/proficient nurses, senior practitioners/expert nurses and consultant nurses. CONCLUSIONS The description of the process of developing of the integrated career and competency framework should help other groups going through the same process. Relevance to clinical practice. In addition to helping groups identify a formula for the development of a competency framework, the framework itself is designed to provide a basis for educational programmes, personal career development and a tool for managers managing career progression within diabetes nursing.
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Affiliation(s)
- Ruth Davis
- Care Sciences, University of Glamorgan, Pontypridd, UK.
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Gibson F. Evidence in action: fostering growth of research-based practice in children's cancer nursing. Eur J Oncol Nurs 2005; 9:8-20. [PMID: 15774337 DOI: 10.1016/j.ejon.2005.01.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
It is an honour to be the first children's nurse to be asked to deliver the Robert Tiffany Lecture. However, the invite also provoked some anxiety: the responsibility weighs heavy. An opportunity to both celebrate the success of the speciality and explore the challenges that still face children's cancer nurses could not be missed. Two themes provide the focus for this paper, that of growth and evidence in action. Firstly, I will spend some time reflecting on how far we have come, describing stages of growth, development, maturation and differentiation in children's cancer nursing that defines nurses, and the speciality, as both similar and different to other nurses and other specialities. Secondly, I want to explore the notion of evidence and action and share some of the challenges we face in developing research for practice. The challenges themselves are of interest to all cancer nurses, as the solutions described have the potential for translation to other areas within cancer care. Children's cancer nursing is a relatively new speciality, and in terms of research in nursing this has only become integrated into our work in more recent years. Like many areas in nursing we continue to evolve, by anticipating and responding to changes in cancer treatments and thus influence healthcare delivery. This paper represents a point in time in the United Kingdom. Children's cancer nursing has unique qualities that attract nurses to work in the speciality, the essence of which is knowing about children and young people.
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Affiliation(s)
- Faith Gibson
- Children's Nursing Research Institute of Child Health, Great Ormond Street Hospital for Children NHS Trust and Kings College London, Centre for Nursing and Allied Health Professions Research, London WCIN 3JH, UK.
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