Barriers and Facilitators Perceived by Spanish Experts Concerning Nursing Research: A Delphi Study

Assessment, Treatment, and Follow-Up of Phlebitis Related to Peripheral Venous Catheterisation: A Delphi Study in Spain

BACKGROUND

Phlebitis related to peripheral venous catheters (PVCs) is a common complication in patients who require these devices and can have important consequences for the patients and the healthcare system. The management and control of the PVC-associated complications is related to nursing competency. The present study aims to determine, at the national level in Spain, the consensus on the assessment, treatment, and follow-up of PVC-related phlebitis and the importance of the actions taken.

METHOD

A three-round Delphi technique was used with clinical care nurses who are experts in the field of in-hospital intravenous treatment in Spain. For this, an online questionnaire was developed with three open-ended questions on the dimensions of phlebitis assessment, treatment, and follow-up. For the statistical analysis of the results, frequencies and percentages were used to determine consensus, and the measures of central tendency (mean, standard deviation, and the coefficient of variation) were used to rank importance. The coefficient of variation was set as acceptable at ≤30%.

RESULTS

The final sample was 27 expert nurses. At the conclusion of round 3, actions were ranked according to their importance, with six items included in the PVC-related phlebitis assessment (symptomatology/observation, redness, the Maddox scale, induration, temperature, and pain), two in treatment (catheter removal, pentosan polysulphate sodium ointment + application of cold), and just one in follow-up (general monitoring + temperature control).

CONCLUSIONS

There is a major disparity in relation to the PVC-related phlebitis assessment, treatment, and follow-up actions. More clinical studies are therefore needed to minimise the complications associated with the use of PVCs, given their impact on the quality of care and patient safety and their economic cost.

Elaboration and validity of the Instrumento para Avaliação de Modelos metodológicos voltados ao Desenvolvimento de Tecnologias

OBJECTIVE

to elaborate and validate the Instrumento para Avaliação de Modelos metodológicos voltados ao Desenvolvimento de Tecnologias.

METHODS

a methodological study, developed in three stages: instrument structuring through documentary research and researchers' expertise; instrument validity with a panel of 11 expert judge nurses; and instrument final composition.

RESULTS

the instrument, after validity by experts, consisted of 30 items, divided into the content (26 items) and appearance (four items) domains. In the initial instrument validity process, 11 items were modified and seven were withdrawn, as they had a percentage of agreement below 0.80. The instrument showed excellent internal consistency, with values greater than 0.90 in its psychometric criteria.

CONCLUSION

the instrument produced and validated aimed at assessing research methodological models for technological development showed good reliability, and may contribute to the methodological rigor of technological development research in nursing.

Attitudes, capacities and perceived barriers in research of nurses of the Canary Health Service

OBJECTIVE

To evaluate the attitudes, capacities and perceived barriers associated with research among nurses and midwives of the Canary Health Service (SCS).

METHODS

Descriptive observational cross-sectional study with an analytical component carried out in the different SCS departments by means of an online survey in which sociodemographic and specific variables, the Spanish version of the Attitudes towards Research and Development within Nursing Questionnaire (ATRDNQ-e) instrument and the BARRIERS scale were collected. Authorisation was obtained from the two provincial ethics committees. A descriptive and inferential analysis (Mann-Whitney U test and Kruskal-Wallis test, post hoc contrast by Dwass-Steel-Critchlow-Fligne test) was performed with JAMOVI® v.2.3.24 software.

RESULTS

A total of 512 nurses and midwives with a mean age of 41.82 years participated in the study. Regarding the scores with the ATRDNQ-e instrument, the dimension with the lowest score was «Language of research» (mean = 3.55/SD = 0.84) and the highest «Assessment of nursing research and development of the nursing discipline» (mean = 4.54/SD = 0.52). The total mean score with the BARRIERS scale was 54.33 (SD = 16.52), with «Organizational characteristics» being the highest scoring subscale (mean = 17.25/SD = 5.90). The two highest perceived barriers were «Not enough time at work to implement new ideas» (mean = 2.55/SD = 1.11) and «Nursing does not have time to read research» (mean = 2.46/ SD = 1.11).

CONCLUSIONS

SCS nurses have a positive attitude towards research, although there are some barriers where improvement actions for nursing research should be implemented.

Development and psychometric appraisal of Head Nurse Research Leadership Scale

AIM

To develop a Head Nurse Research Leadership Scale and evaluate its reliability and validity.

DESIGN

A psychometric instrument validation study was conducted in two phases.

METHODS

The item tool was generated based on a literature review, semi-structured interview and brainstorming. Twenty experts validated the content of the initial version for two rounds. Thirty-nine clinical nurses conducted the HNRLS-v3 to test the readability of the items in pilot study I. Items were screened based on the critical ratio, correlation coefficient analysis, Cronbach's α coefficient and factor analysis using the data collected from 265 nurses in pilot study II. A cross-sectional survey was conducted in six hospitals to evaluate the reliability and validity between 4 January 2022 and 15 January 2022. Three hundred and sixteen nurses participated in this survey, and 60 completed the questionnaire to validate the test-retest reliability between 1 February and 6 February.

RESULTS

A 15-item Head Nurse Research Leadership Scale based on 5 dimensions was developed, and the content validity was satisfied. The 15 items accounted for 77.9% of the variance. Confirmatory factor analysis showed acceptable convergent validity and discriminant validity. The Cronbach's α coefficient, split-half reliability and test-retest reliability of the scale were 0.966, 0.9633 and 0.927, respectively.

Inpatient Geriatric Rehabilitation: Definitions and Appropriate Admission Criteria, as Established by Maltese National Experts

(1) Background: The importance of having an appropriate admissions system for geriatric rehabilitation is on the increase. However, the process of admitting patients to inpatient rehabilitation is a complex process. This is yet to be standardised across the European Union, as the approach to geriatric rehabilitation tends to vary from one Member State to another. (2) Objective: To discuss evidence-based practice with clinical experts, in order to define geriatric rehabilitation and admission criteria based on the Maltese population. (3) Method: The study entailed conducting four panel sessions using a purposive sample of thirteen local clinicians with extensive knowledge in clinical rehabilitation and healthcare management. A total of 48 items, based on the literature and clinical experience, were presented to the panel. Data analysis was done quantitatively and qualitatively, using IBM SPSS Statistics Version 24 and thematic analysis. (4) Results: The panel formulated a definition of rehabilitation, which shared common elements with the definition provided by the World Health Organization (WHO) and other sources/literature. The panel agreed on a list of eight criteria for appropriate inpatient geriatric rehabilitation admission in Malta. Consensus was also reached on: the need for a consultant-led multidisciplinary approach to assessment; the adoption of a standardised assessment processes for an equitable chance for all older adults assessed; the benefit of digital health in assessments; and the consideration that most patients would have some form of rehabilitation potential, depending on availability of resources. (5) Conclusion: Inpatient geriatric rehabilitation hospitals should have a unified strategy for rehabilitation services. The conclusions reached by the panel, could be useful in supporting the clinical evidence and establishing future rehabilitation guidelines and standards for inpatient rehabilitation.

Perceived barriers and enablers of nursing research in the Italian context: Findings from a systematic review

Introduction

The research capacity of nurses has been reported to be still constrained in several countries, and not fully implemented in its potentiality due to a large number of factors. Despite its relevance both for clinical and public health purposes, no summary has been compiled to date regarding factors influencing the research capacity in the Italian context. Therefore, the primary aim of this review was to identify the barriers and enablers of conducting research as perceived by Italian nurses.

Methods

We conducted a systematic review. The following databases have been searched: ILISI ® (Indice della Letteratura Italiana di Scienze Infermieristiche) MEDLINE-via PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Ovid, Open Grey, Google Scopus, and Web of Science. Eight studies met the inclusion criteria.

Results

The studies were mainly descriptive, with two quasi-experimental. A total of seven barriers and four facilitators of conducting research among Italian nurses were identified. The constraints were poor English knowledge, technology and library availability and accessibility, understaffing and lack of time, nursing culture characteristics, lack of nursing leadership support, scarce funding availability, and the bureaucratic ethical committee process. The facilitators were nursing journal reading, expert research team support, university and hospital partnerships, and international cooperation.

Conclusions

Given the small number and the high heterogeneity of the emerged studies, this systematic review provides an initial framework for the constraints that prevent, and the strategies that promote, Italian nurses’ participation/conducting of research projects that could inform policies in this field.