Competencies of specialised wound care nurses: a European Delphi study

Content of a wound care mobile application for newly graduated nurses: an e-Delphi study

BACKGROUND

Wound care represents a considerable challenge, especially for newly graduated nurses. The development of a mobile application is envisioned to improve knowledge transfer and facilitate evidence-based practice. The aim of this study was to establish expert consensus on the initial content of the algorithm for a wound care mobile application for newly graduated nurses.

METHODS

Experts participated in online surveys conducted in three rounds. Twenty-nine expert wound care nurses participated in the first round, and 25 participated in the two subsequent rounds. The first round, which was qualitative, included a mandatory open-ended question solicitating suggestions for items to be included in the mobile application. The responses underwent content analysis. The subsequent two rounds were quantitative, with experts being asked to rate their level of agreement on a 5-point Likert scale. These rounds were carried out iteratively, allowing experts to review their responses and see anonymized results from the previous round. We calculated the weighted kappa to determine the individual stability of responses within-subjects between the quantitative rounds. A consensus threshold of 80% was predetermined.

RESULTS

In total, 80 items were divided into 6 categories based on the results of the first round. Of these, 75 (93.75%) achieved consensus during the two subsequent rounds. Notably, 5 items (6.25%) did not reach consensus. The items with the highest consensus related to the signs and symptoms of infection, pressure ulcers, and the essential elements for healing. Conversely, items such as toe pressure measurement, wounds around drains, and frostbite failed to achieve consensus.

CONCLUSIONS

The results of this study will inform the development of the initial content of the algorithm for a wound care mobile application. Expert participation and their insights on infection-related matters have the potential to support evidence-based wound care practice. Ongoing debates surround items without consensus. Finally, this study establishes expert wound care nurses' perspectives on the competencies anticipated from newly graduated nurses.

Defining a competency framework for health and social professionals to promote healthy aging throughout the lifespan: an international Delphi study

The promotion of healthy aging has become a priority in most parts of the world and should be promoted at all ages. However, the baseline training of health and social professionals is currently not adequately tailored to these challenges. This paper reports the results of a Delphi study conducted to reach expert agreement about health and social professionals' competencies to promote healthy aging throughout the lifespan within the SIENHA project. Materials and methods: This study was developed following the CREDES standards. The initial version of the competence framework was based on the results of a scoping review and following the CanMEDS model. The expert panel consisted of a purposive sample of twenty-two experts in healthy aging with diverse academic and clinical backgrounds, fields and years of expertise from seven European countries. Agreement was reached after three rounds. The final framework consisted of a set of 18 key competencies and 80 enabling competencies distributed across six domains. The SIENHA competence framework for healthy aging may help students and educators enrich their learning and the academic content of their subjects and/or programs and incentivize innovation.

Construction of an evaluation index system of core competencies for critical care blood purification nurses in China: A Delphi study

AIM

The purpose of this study was to construct a core competencies evaluation index system for critical care blood purification nurses in China.

BACKGROUND

While nursing is an integral part of critical care blood purification treatment, there are no established indicators to evaluate the core competencies of critical care blood purification nurses.

DESIGN

A Delphi study.

METHODS

An initial draft of the competencies evaluation index system for critical care blood purification nurses was developed through a literature review and semi-structured interviews. From February 2023 to March 2023, a two-round Delphi survey was conducted to consult with 18 experts in the field of critical care blood purification from eight provinces in China to rate the importance of each item and propose modifications to the evaluation index system.

RESULTS

The effective questionnaire recovery rates in two rounds of expert consultation were 94.4 % and 94.1 % and the average expert authority coefficients were 0.88 in both rounds. The core competencies evaluation index system of critical care blood purification nurses consisted of 39 items in five domains, namely theoretical knowledge, practical skills, professional development capability, critical thinking ability and personal qualities and attributes. The Kendall's W coefficients for the first- and second-level indicators were.21 and.20 in the first round and.23 and.25, respectively, in the second round of consultations (p < .01).

CONCLUSION

The core competencies evaluation index system of critical care blood purification nurses is scientific and reliable and can provide references for the recruitment, training and management of critical care blood purification nurses.

Expanding the Treatment Team

The optimal systemic sclerosis (SSc) care plan includes an occupational therapist and physical therapist as well as wound care experts and a registered dietitian if indicated. Screening instruments for functional and work disability, hand and mouth limitations, malnutrition, and dietary intake can identify the need for ancillary support services. Telemedicine can assist in developing effective ancillary treatment plans. Reimbursement for services may limit access for patients with SSc to expand their care team but a focus on prevention rather than management of damage is recognized as an important unmet need in SSc. In this review, the role of a comprehensive care team for SSc is discussed.

Developing a framework for the participation of nursing managers in the health policy-making process in Iran: A Delphi study

AIMS

The aim of this study was to develop a framework for nursing managers to participate in the health policy-making process.

BACKGROUND

Nursing managers must be involved in the health policy process to provide appropriate health services, focus on nursing professional excellence, and improve the performance of the health system.

METHODS

This multimethod research was based on the Delphi study and experts' panel. Faculty members of the nursing, health policy, health services management, and nursing managers working at hospitals were selected via purposive sampling. The data collection tool was a demographic form and an open-ended questionnaire in the first round and a structured questionnaire in the next round. In the two rounds of Delphi, experts discussed and rated items of nursing managers' participation framework in the health policy-making process. At the expert panel session, the framework was finalized with a 12-part checklist. The data were analysed quantitatively using SPSS software version 22.

RESULTS

A total of 28 items were entered into the Delphi study. Experts who met the inclusion criteria responded to rounds 1 (n = 20) and 2 (n = 16). Following the two rounds of the Delphi study, 27 items were selected and discussed by experts using a 12-part checklist related to the framework. The final participation framework was divided into five sections: Barriers, facilitators, advantages, disadvantages, and factors affecting the participation of nursing managers in the health policy-making process.

CONCLUSION

In our findings, the relationship between the components of the framework and policy cycle was shown, which should be considered to lay the groundwork for participation. This can lead to health promotion, accountability, and financial participation in the health system, which can improve the proactive involvement of nursing managers in the health policy-making process.

IMPLICATIONS FOR NURSING MANAGEMENT

The proposed framework can be utilized across the spectrum of nursing, including practice, leadership, and education to enhance the participation of nursing managers in health policy activity.

Training and Management Status of Wound, Ostomy, and Continence (WOC) Nurses: A Cross-Sectional Survey From China

Objective: To investigate the current situation with regard to training and management of wound, ostomy, and continence (WOC) nurses in China.

Methods: A self-designed questionnaire was used to investigate the training and management of WOC nurses.

Results: A total of 218 WOC nurses received cross-sectional surveys. Out of these nurses, 57.30% graduated from the International Stoma Therapists School, 22.90% were full-time WOC nurses, only 24.80% had engaged in funded research, and 26.10% had an additional allowance. There is room for further improvement in the field of education, scientific research, and self-development.

Conclusion: WOC work has developed rapidly in China, and there have been some achievements in personnel training, specialized nursing, teaching, and scientific research.

Learning goals and content for wound care education in Finnish nursing education - A Delphi study

BACKGROUND

Caring for patients with wounds requires diverse competences from nursing professionals. However, wound care education in undergraduate nursing education is often fragmented and lacks consistent learning goals and content.

OBJECTIVES

To create learning goals and content for wound care education in Bachelor's level nursing education in Finland and to assess the consensus relating to these learning goals and content among wound care experts.

DESIGN

A consensus-building approach using the Delphi technique.

SETTINGS

A Delphi panel of wound care experts built on an online platform.

PARTICIPANTS

The participants of the Delphi panel were registered nurses, authorised wound care nurses, nurse educators and physicians.

METHODS

Learning goals and content for wound care education which had been formulated on the basis of previous focus-group interviews were presented to the Delphi panel. The data were collected in 2021 with two online Delphi rounds: 51 panellists participated in the first round and 36 in the second round. The data were analysed using statistical and qualitative analysis.

RESULTS

Learning goals and content were divided into four competence areas: 1) Anatomy and physiology, 2) Care of chronic and acute wounds, 3) Wound management and care of a patient with a wound, 4) Values and attitudes. These competence areas comprised 26 learning goals and 29 pieces of content. The consensus between the panellists was high, at >90% in all competence areas.

CONCLUSIONS

The basis of registered nurses' wound care competence is built during their undergraduate nursing studies. The results of this study can be used to standardise wound care education by implementing consistent learning goals and content in Bachelor's level nursing education.

Developing core competencies for clinical nurse educators: An e-Delphi-study

BACKGROUND

Clinical nurse educator plays an indispensable role in promoting the development of nursing staff and nursing students in clinical settings. Too few core competencies for clinical nurse educators applicable to a given clinical setting are developed and validated by the research process. A better understanding of the core competencies for clinical nurse educators can inform the selection, training, and evaluation of clinical nurse educator.

OBJECTIVE

To establish the core competencies for clinical nurse educators in China.

DESIGN

Focus group interviews and the e-Delphi method were used.

SETTINGS

This study was conducted in five teaching hospitals in China.

PARTICIPANTS

Participants (n = 61), including nurse managers, clinical nurse educators, staff nurses, and nursing students were recruited for focus group interviews and 25 experts were selected for the e-Delphi study.

METHODS

Based on a literature review and the focus group interviews, a preliminary set of clinical nurse educator's core competencies was formed. Subsequently, experts provided supportive and modification advice on core competencies in the two rounds e-Delphi study. The consensus percentage and the weight of each first-level, second-level index and its connotations were calculated.

RESULTS

Two rounds of online Delphi expert consultation were completed by 25 experts, and the consensus was achieved on four first-level indices, 16 second-level specific competencies, and its 57 connotations. The first-level index included clinical teaching competency, clinical nursing skills, management and leadership competency, and innovation and research competency. Moreover, the consensus level of all indices was >75%, the coefficient of variation (CV) was less than 0.25 (p < 0.05) and the Kendall coefficient (W) was 0.169-0.503 (P < 0.01).

CONCLUSIONS

The explicit statements of expected competencies for clinical nurse educators can be applied to diverse clinical scenarios and provide a reference for selection, training, and evaluation of the clinical nurse educators.

The Value of Nurses Specialized in Wound, Ostomy, and Continence: A Systematic Review

OBJECTIVE

To critically appraise peer-reviewed evidence concerning the value, or implied sense of worth or benefit, of nurses specialized in wound, ostomy, and continence (WOC) care.

DATA SOURCES

The Preferred Reporting Items for Systematic Reviews and Meta-analyses was used to systematically review current literature in a single database from 2009 to the date of search (July 2019).

STUDY SELECTION

The initial search retrieved 2,340 elements; 10 studies were retained following removal of duplicate records, title and abstract reviews, and application of the inclusion/exclusion criteria.

DATA EXTRACTION

Literature was graded and critiqued with regard to design and research quality and then synthesized using a narrative approach.

DATA SYNTHESIS

Nine values that WOC nurses demonstrate were identified: improved quality of life for patients, teaching and mentoring, cost reduction, improved efficiency, improved wound outcomes, improved incontinence outcomes, advanced treatments, research, and leadership.

CONCLUSIONS

Although current studies suggest that there is value in the WOC nurse role, in all areas of the trispecialty, there is a need for high-quality literature with higher-level designs focused on bias reduction.

Construction of an index system of core competence assessment for infectious disease specialist nurse in China: a Delphi study

Aim and objective

This study was to establish an index system for the evaluation of Chinese infectious disease specialist nurses’ core competence.

Background

The index system for the evaluation of infectious disease specialist nurses’ core competence has not been established.

Design

A two-round Delphi survey was conducted to seek opinions from experts about the index system for the evaluation of infectious disease specialist nurses’ core competence.

Methods

The study adopted several research methods, including literature retrieval, theoretical analysis and qualitative research. Based on the above method, the draft of core competence evaluation index system of infectious disease specialist nurses was constructed. A Delphi survey was used for the study of 30 infectious disease experts from 8 provinces and cities around China. A modified recommendation for the Conducting and Reporting of Delphi studies (CREDES) was also used to guide this study. A STROBE checklist was used.

Results

The Core Competence Evaluation Index System of Infectious Disease Nurses is composed of 6 primary indicators, namely, Nursing Abilities for Infectious Diseases, Infection Prevention and Control Abilities, Responsiveness to Infectious Diseases, Professional Development Abilities, Communication and Management Abilities, and Professionalism and Humanistic Accomplishment, 16 secondary indicators and 47 tertiary indicators. The authority coefficient, judgment coefficient and familiarity degree of Delphi experts were 0.923, 0.933 and 0.913 respectively.

Conclusions

The evaluation index system of core competence of diseases specialist nurses is scientific and reliable. It can be reference for future training and assessment of Chinese infectious disease specialist nurses.

Relevance to clinical practice

Infectious disease specialist nurses are the main force for infectious disease nursing. Their core competence is related to the quality of infectious disease nursing and treatment. The core competence of the nurses is important for identification of training strategies and can be regarded as reference for nurse assessment and promotion. The construction of the index system is based on the consensus of infectious disease experts, which is not only helpful to standardize the training strategies and selection standards of infectious disease specialist nurses in the future, but also meet the society’s needs in clinical infectious disease nursing.

Graduating student nurses' and student podiatrists' wound care competence: a cross-sectional study

OBJECTIVE

To explore and describe graduating student nurses' (SNs) and student podiatrists' (SPs) theoretical wound care competence, as well as students' own perceptions of their wound care competence and their opinions about the received wound care education.

METHOD

A descriptive cross-sectional design was used. Data were collected from five Finnish universities using a graduating SNs and SPs wound care competence (WCC) questionnaire, which included a wound care knowledge test and a wound care competence self-evaluation. Data were analysed statistically and with qualitative content analysis.

RESULTS

A total of 213 students (response rate: 86%) participated in the study. Of these, 194 were SNs and 19 SPs. Students answered 48% of the knowledge test questions correctly (SNs 46%, total score 14/29; SPs 60%, total score 13/22). SPs' wound care competence was statistically significantly higher (p<0.0001) than that of SNs. Both groups self-evaluated their wound care competence to be deficient. Students who had more practical training in wound care during practical training periods scored statistically significantly better in the knowledge test. Students showed a positive attitude towards wound care by expressing an interest in it and acknowledging its importance.

CONCLUSION

Graduating SNs' and SPs' theoretical wound care competence is limited. The results showed that more wound care education, especially practical training, is needed in SNs' and SPs' education curriculums to adequately respond to the increasing needs in wound care.

Core Competencies Required for Gastroenterology Nursing Specialists in China

Healthcare professionals responsible for patients with gastrointestinal diseases need a particular level of nursing knowledge and abilities to ensure excellent care. This study aims to propose a set of core competencies for the gastroenterology nursing specialists (GNS) in China. This research integrates quantitative and qualitative research methods. Literature review, semistructured interview, and the Delphi approach were used to develop the core competency items of GNS in China. SPSS 16.0 was used to analyze the data. Finally, 28 of 30 experts participated in the study resulting in a consensual list containing 7 domains (clinical nursing practice, communication and collaboration, education and counseling, critical thinking, leadership, ethical and legal practice, and professional development), 23 aspects, and 66 competencies required for GNS. The authority coefficient (Cr) of the consensus was 0.77, and the Kendall (W) value of each level of competencies all scored above 0.5. Results of the study can serve as a foundation of work performance evaluation for GNS as well as promote nurses' professional development.

Non-antibiotic antimicrobial interventions and antimicrobial stewardship in wound care

Control of wound infection today relies largely on antibiotics, but the continual emergence of antibiotic-resistant microorganisms threatens a return to the pre-antibiotic era when physicians used antiseptics to prevent and manage infection. Some of those antiseptics are still used today, and others have become available. A diverse variety of non-antibiotic antimicrobial interventions are found on modern formularies. Unlike the mode of action of antibiotics, which affect specific cellular target sites of pathogens, many non-antibiotic antimicrobials affect multiple cellular target sites in a non-specific way. Although this reduces the likelihood of selecting for resistant strains of microorganisms, some have emerged and cross-resistance between antibiotics and antiseptics has been detected. With the prospect of a post-antibiotic era looming, ways to maintain and extend our antimicrobial armamentarium must be found. In this narrative review, current and emerging non-antibiotic antimicrobial strategies will be considered and the need for antimicrobial stewardship in wound care will be explained.

Competency framework for specialist critical care nurses: A modified Delphi study

BACKGROUND

The specialist critical care nurse plays a vital role in the delivery of evidence-based practice, and specific competency guidance has been established to facilitate critical care nursing practice and education development in many developed countries. However, no research has been conducted to develop a competency framework for specialist critical care nurses in China.

AIMS AND OBJECTIVES

To construct a competency framework specific to specialist critical care nurses in China.

DESIGN AND METHODS

A two-phased procedure was implemented. In phase 1, a literature review and four focus groups were used to develop the initial competency framework, which consisted of 101 statements. During phase 2, three rounds of a modified Delphi process were conducted and involved a national panel of 30 experts, including physicians, specialist critical care nurses, managers, and educators, who responded to the survey using a 5-point Likert-type scale to indicate their level of agreement with the competency framework. A 75% threshold for each competency was used to achieve panel consensus.

RESULTS

Experts in the field of critical care responded to rounds 1 (n = 29), 2 (n = 28), and 3 (n = 28). Seventy-eight competencies were agreed upon after round 1, increasing to 88 after round 2 and 92 after round 3. The final competency framework was classified into six domains: evidence-based practice, complex decisions, professionalism, communication and co-operation, education and development, and leadership.

CONCLUSION

The output of this study is an expert consensus competency framework that provides a sound foundation for the assessment and training of specialist critical care nurses.

RELEVANCE TO CLINICAL PRACTICE

The proposed competency framework should be used to assess nursing performance, promote continuing professional development, and further improve the delivery of quality health care and optimal patient outcomes.

Acute surgical wound-dressing procedure: Description of the steps involved in the development and validation of an observational metric

The aim of this study was to develop an observational metric that could be used to assess the performance of a practitioner in completing an acute surgical wound-dressing procedure using aseptic non-touch technique (ANTT). A team of clinicians, academics, and researchers came together to develop an observational metric using an iterative six-stage process, culminating in a Delphi panel meeting. A scoping review of the literature provided a background empirical perspective relating to wound-dressing procedure performance. Video recordings of acute surgical wound-dressing procedures performed by nurses in clinical (n = 11) and simulated (n = 3) settings were viewed repeatedly and were iteratively deconstructed by the metric development group. This facilitated the identification of the discrete component steps, potential errors, and sentinel (serious) errors, which characterise a wound dressing procedure and formed part of the observational metric. The ANTT wound-dressing observational metric was stress tested for clarity, the ability to be scored, and interrater reliability, calculated during a further phase of video analysis. The metric was then subjected to a process of cyclical evaluation by a Delphi panel (n = 21) to obtain face and content validity of the metric. The Delphi panel deliberation verified the face and content validity of the metric. The final metric has three phases, 31 individual steps, 18 errors, and 27 sentinel errors. The metric is a tool that identifies the standard to be attained in the performance of acute surgical wound dressings. It can be used as both an adjunct to an educational programme and as a tool to assess a practitioner's performance of a wound-dressing procedure in both simulated and clinical practice contexts.

A Delphi Study to Determine Leveling of the Interprofessional Core Competencies for Four Levels of Interprofessional Practice

INTRODUCTION

Although the Core Competencies for Interprofessional Education (IPE) provide guidance in developing interprofessional learning experiences, the literature is sparse in how to incorporate them across varying levels of learning activities. Thus, the purpose of this study was to explore consensus for leveling the IPEC Core Competencies for use across four levels of interprofessional practice. Initially, Benner's novice to expert theory was used to develop a leveling document for planning educational experiences appropriate for pre-licensure through practice learners. Using this document, a Delphi study was conducted to gain consensus on leveling the Core Competencies.

METHODS

A modified Delphi technique was employed using an expert panel of 48 healthcare faculty experienced in interprofessional education. Participants were asked to select their opinion of the level of learner for which each of the competencies were most appropriate.

RESULTS

After three rounds of questionnaires, 34 of the 38 competencies achieved consensus at a 70% agreement. Four competencies did not reach consensus.

CONCLUSIONS

Using a developmental approach, this study provides a foundational point for establishing guidelines for progressive organization and consistency in interprofessional learning activities. Although four competencies did not reach consensus, the results suggest that leveling is possible. Ongoing research is needed to further validate or revise the findings from this study.

Anatomical Society core regional anatomy syllabus for undergraduate medicine: the Delphi process

A modified Delphi method was employed to seek consensus when revising the UK and Ireland's core syllabus for regional anatomy in undergraduate medicine. A Delphi panel was constructed involving 'expert' (individuals with at least 5 years' experience in teaching medical students anatomy at the level required for graduation). The panel (n = 39) was selected and nominated by members of Council and/or the Education Committee of the Anatomical Society and included a range of specialists including surgeons, radiologists and anatomists. The experts were asked in two stages to 'accept', 'reject' or 'modify' (first stage only) each learning outcome. A third stage, which was not part of the Delphi method, then allowed the original authors of the syllabus to make changes either to correct any anatomical errors or to make minor syntax changes. From the original syllabus of 182 learning outcomes, removing the neuroanatomy component (163), 23 learning outcomes (15%) remained unchanged, seven learning outcomes were removed and two new learning outcomes added. The remaining 133 learning outcomes were modified. All learning outcomes on the new core syllabus achieved over 90% acceptance by the panel.

Future distinguishing competencies of baccalaureate-educated registered nurses in nursing homes

In view of the likelihood that the complexity of care required by those admitted to nursing homes will continue to increase, an expert consensus study was conducted to reach consensus on the competencies which distinguish baccalaureate-educated registered nurses from other nursing staff working in nursing homes. Thirty-one international experts, identified through literature and our professional network, participated in a two-round web-based survey and an expert meeting. Experts reached consensus on 16 desirable competencies, including some not traditionally associated with nursing expertise e.g. being a team leader, role model and coach within the nursing team. These findings suggest that revision of current nursing curricula, nurse training programs and nursing home job profiles might be needed to meet the medically and psychologically complex needs of nursing home residents.