Expert Coordination Coefficient Research Articles

The construction of the index system for nurses' innovation competence evaluation in China: A Delphi study

BackgroundScientific and technological innovation has become the "key variable" of national social and economic development. Nurses' innovation ability can improve the quality of patient care, thus shorten the hospital stay, reduce the medical costs, and promote the rapid development of the nursing industry. Nowadays nurses have gradually involved in various innovation, but less concerns are focus on the evaluation of nurse’s innovation competence. ObjectiveTo develop evaluation index system for nurse's innovation competence. ParticipantsEleven experts with innovation experience from different regions in China. MethodsLiterature review and qualitative interview were used to establish first version of index system. Then, a two-round Delphi expert consultation was conducted to collect opinions from 11 experts. Then the final version of nurses' innovation competence evaluation index was used in one tertiary hospital for preliminary application. ResultsThe response rate of the two rounds was more than 90%, the expert familiarity coefficient was 0.818, the judgment coefficient was 0.918, and the authority coefficient was 0.868. The two rounds of expert coordination coefficient test showed P < 0.05. The evaluation index system of nurses' innovation competence includes 4 first-level indicators, 9 second-level indicators and 36 third-level indicators. The scores of innovation production and innovation subject were the lowest among all the first-level indicators when use this index for preliminary application. ConclusionThe constructed evaluation index system of nurses' innovation competence are scientific, reliable and practical, and can be used to promote nurse's innovation competence and innovation conversion competence in clinical practice. Hospital managers should pay more attention on cultivate nurse’s innovation competence and provide resources and multi-form platforms to support the nurses with innovative ideas and willingness.

Establishment and analysis of quality index system for pediatric tumor nursing.

Nursing management considers nursing quality management at its core. Evaluation indexes of nursing quality not only control nursing quality, measure work enthusiasm, and judge the difference in nursing levels but also help nurses accurately understand the satisfaction degree of patients. To analyze pediatric tumor nursing quality evaluation indexes and establish a scientific and rigorous index system of children's nursing quality. Based on the "structure-process-result" in this study, the Delphi method was used to carry out questionnaire investigations and opinion collection for domestic experts in pediatrics, pediatric oncology internal medicine, and pediatric oncology surgical care and clinical aspects two times. In addition, the Kendall coordination coefficient and analytic hierarchy process were used to determine the content of indicators at all levels, set the weight, and finally establish the quality index system of pediatric tumor nursing. The response rate of 27 experts in the first round of the questionnaire was 100%, Ca0.77, Cs,0.73, Cr0.75, and the W value of the expert coordination coefficient was 0.315. In the second round of 27 expert consultations, the reply rate was 96%, Ca0.81, Cs0.80, Cr0.805, and the specialist coordination coefficient W value was 0.369. After two rounds of consultation, the importance evaluation scores of each indicator ranged from 3.31 to 4.88 and 3.29 to 5.00, respectively, and more than 94.7% of the indicators' importance evaluation scores were higher than 3.50. Finally, 3 Level-1 indicators, 12 Level-2 indicators, and 54 Level-3 indicators are established. This study has established a simple, comprehensive, and scientific quality index system for pediatric tumor nursing, highlighted the characteristics of pediatric tumor nursing, and provided an evaluation system for specialized nursing of pediatric tumors to more standardized pediatric tumor nursing and contribute to the sustainable and scientific development of pediatric tumor nursing.

Establishment of infection prevention and control strategy in nursing managements during surgical operations in COVID-19 patients based on Delphi method.

The aim of this study was to establish an infection prevention and control strategy for nursing managements during surgical operations in coronavirus disease 2019 (COVID-19) patients. A Delphi method. Between November 2021 and March 2022, we first formulated a preliminary infection prevention and control strategy based on the literature review and institutional experience. Then, we applied Delphi method and performed expert surveys to reach a final strategy for nursing managements during surgical operations in COVID-19 patients. The strategy included seven dimensions with 34 items. The positive coefficients of Delphi experts in both surveys were 100%, indicating a high coordination among experts. The degree of authority and expert coordination coefficient were 0.91 and 0.097-0.213. After the second expert survey, value assignments for importance of each dimension and item were 4.21-5.00 and 4.21-4.76 points, respectively. The coefficients of variation for dimension and item were 0.09-0.19 and 0.05-0.19, respectively. Except the medical experts and research personnel, there was no other patient or public contribution involved in the study.

Developing a third-degree burn model of rats using the Delphi method

Animal experiments play an essential role in advances in the research and treatment of burns. Currently, researchers often rely on personal experience or the literature to complete the construction of animal disease models, which may lead to a lack of scientific rigor and a wide range of animal disease models with reference value. The purposes of this study were to establish a third-degree burn model of rats using the Delphi method to provide a reference. Two rounds of a Delphi expert consultation survey were conducted on experts (n = 13) in this study, and then the boundary value method was used to screen, modify and supplement the indicators. Next, the indicator weight was determined by dividing the boundary value, and finally, the index system of the rat model of third-degree burns was established. The statistical analysis results show that the positive coefficients of the two rounds of expert consultation are 100% and 88.67% respectively. The expert authority coefficient values were 0.73 and 0.67, respectively, and the expert coordination coefficient test was P < 0.001. According to the experts' suggestion, the third-degree burn model of rats with 8 first-degree indexes, 14 second-degree indexes and 46 third-degree indexes was finally established. According to the characteristics and quality requirements of animal models, this study constructs a rat model of third degree burns, which is expected to expressively improve the overall proficiency of burn research quality.

Development of an index system for evaluating the organisational capabilities of primary medical institutions: a modified Delphi study in China

ObjectiveThe low performance of primary medical institutions (PMIs) in China is a significant issue. The WHO proposed that the main reason for the failure of the healthcare system in developing...

Development of the competency assessment scale for clinical nursing teachers: Results of a Delphi study and validation

BackgroundHighly competent clinical faculty is a prerequisite for graduating competent nurses, and it is very important to explore the comprehensive ability and post competence of clinical nursing teachers (CNT). ObjectiveTo construct the competency evaluation elements of clinical nursing teachers and test the reliability and validity of the scale. DesignA Delphi study. Settings34 Grade A tertiary hospitals and eight colleges and universities in China, covering 14 provinces, autonomous regions, and municipalities directly under the Central Government. MethodsModified Delphi method was used in this study. Between August 2018 and May 2019, 40 experts participated in three rounds of consultation to build the CNT competency assessment scale. The expert coordination coefficient (W) and the coefficient of variation (CV) were used to examine the level of coordination and concentration of expert advice. Then, the reliability and validity of the scale were tested. Using the convenient sampling method, a total of 190 questionnaires were distributed to nursing teachers, and 187 were recovered. Cronbach's α coefficient was used to evaluate the reliability of the scale. Validity was evaluated using the content validity index. ResultsAfter the three rounds of expert consultation, the questionnaire contained five dimensions and 44 elements. After expert inquiry, the total coefficient of variation index (CVI) value of the scale was 0.992, and the CVI of each item was 0.95–1.00. The Spearman-Brown correlation coefficient was 0.984. By comparing the results of the two surveys 2 months apart, the Pearson correlation coefficient was tested, and the retest reliability was 0.852. The Cronbach's α of the scale was 0.962, indicating excellent internal consistency. ConclusionsThe scale of clinical nursing teachers' competence has high reliability and validity. This tool could be widely used to evaluate and improve nursing teaching.

Identifying the competencies of China’s paediatric residents: a modified Delphi method study

PurposeStandardised Training of Paediatric Resident (STPR) plays an essential role in training qualified paediatricians. Until now, China had no paediatric resident competency index system to effectively guide and evaluate the...

The establishment of ICU transitional care program

Objective To establish ICU transitional care program. Methods Delphi method was used to interview 25 experts and two rounds of mailing interview were taken. Results The returning rates of two rounds of mailing were both 100%. The authority coefficient of the experts was 0.808, and coordination coefficient of experts′ opinion was 0.179. The program included 7 first level indexes, 8 second level indexes, and 40 third level indexes, including purpose, nursing object, implementer, time point, place, nursing content and evaluation indicators. According to different time points, it was divided to three phases: before, during, and after transfer from the ICU to a general ward. Conclusions The program developed in this study is scientific and reliable, which can provide some reference for the practice and research of ICU transitional care in China. Key words: Intensive care units; Transitional care; Delphi method

Construction of content framework of pain management plan in perianal abscess patients after surgery

Objective To construct the content framework of pain management plan in perianal abscess patients after surgery so as to provide a basis for scientific pain control. Methods From July 2018 to May 2019, the first draft was developed based on the theory of Manchester pain management mode and cross-cultural nursing theory, evidence-based medicine extraction and needs of postoperative perianal abscess patients on pain management condensed by the qualitative interview. Totals of 15 medical and nursing experts engaging in pain management for a long time were selected in Shanghai by purposive sampling to revise the first draft with the Delphi method so as to construct the content framework of pain management plan in perianal abscess patients after surgery. Results Following two rounds of expert consultation, the content framework of pain management plan included 5 first-level indexes, 23 second-level indexes and 67 third-level indexes. The expert authority coefficient was 0.90. There was a statistical difference in the expert coordination coefficient (P<0.01) . Conclusions Construction of the content framework of pain management plan in perianal abscess patients after surgery is scientific and credible. The content combines with the evidence-based medicine as well as patient needs and is practical which plays a guidance role in postoperative pain management for perianal abscess patients. Key words: Pain; Abscess; Anus diseases; Delphi method; Postoperative; Construction

Constructing quality evaluation system of clinical probation teaching on Psychiatric Nursing in undergraduate students

Objective To construct a scientific, practical and objective quality evaluation system for evaluating clinical probation teaching effects of Psychiatry Nursing in undergraduate students. Methods Protocol of the system was initially made via literature analysis method and experts interview method; indexes were screened via Delphi method; and the evaluation system was formed by comprehensively considering experts' suggestions. The data was analyzed by using SPSS 19.0. Results All expert authority coefficients were more than 0.8; expert activeness coefficients in two rounds were 100% and 88.3%, respectively; and expert coordination coefficient was 0.235 (P<0.01). The designed teaching evaluation system contained three first-level indexes, seven second-level indexes and forty-one third-level indexes. Conclusion The drafted teaching evaluation system for evaluating clinical probation teaching effects of Psychiatric Nursing reflects requirements and characteristics of psychiatric special training during clinical probation and pays attention to cultivate students' humanistic care and clinical practice ability, with high scientificness and reliability, so as to provide objective and quantitative basis for evaluating probation. Key words: Psychiatric Nursing; Clinical probation; Quality evaluation

Development of health care needs assessment tool for the elderly

Objective To develop a health care needs assessment tool for the elderly at home, which is in line with China's national conditions. Methods Guided by Zuluaga-Raysmith model theory, a health care needs assessment tool for the elderly was developed through literature review, theoretical analysis, expert review, expert consultation and pre-survey. Results An item pool of 10 first-level items and 72 second-level items, which were suitable for home-based elderly health care needs assessment tools was initially formed. Through three rounds of national expert consultation and pre-survey, an elderly health care needs assessment tool consisting of 7 first-level items, 10 second-level items and 61 third-level items was formed. The expert authority coefficient was 0.791, the expert positive coefficient was 100%, and the expert coordination coefficient was 0.935 (P<0.05) . Conclusions The pool of items for the assessment tool is reasonably formed, the results of Delphi expert consultation are reliable. The scale can be widely used after adjustment. It can help medical staff quickly and comprehensively understand the current situation of health care needs of the elderly, provide support for the accurate construction of long-term care service system for the elderly, and support the development of community/home care for the elderly. Key words: Aged; Health care; Needs; Assessment

Construction of ICU nursing workload performance appraisal index based on information system

Objective To develop a reasonable performance evaluation index system for ICU nursing workload based on the hospital information system and the structure-process-result model. Methods The preliminary indicators of ICU nurses' performance appraisal system were constructed by the research group. Delphi method was used for expert consultation to evaluate the importance of the indicators of the performance appraisal system. After summarizing, sorting out and modifying the expert opinions, the performance appraisal index system of ICU nurses was obtained. SPSS 19.0 software is used to describe the importance of experts' evaluation of indicators at all levels, such as mean, standard deviation, coordination coefficient of experts' opinions and degree of coordination. Results The effective recovery rate of expert consultation papers was 100%. In the first round of inquiry, the average of importance assignment was 2.05-5.00, the average of rationality assignment was 2.13-5.00, and the average of importance assignment in the second round was 4.57-5.00. The average of rationality assignment was 4.71-5.00. The coefficient of variation of all levels of indicators in the first round was 0.02-0.18, the coefficient of variation in the second round was 0.02-0.12, which was less than 0.2, the positive coefficient of experts was 100%, and the authoritative coefficient of experts in the second round was 0.86 and 0.88. After two rounds of Delphi expert consultation, the ICU nurses' performance appraisal index system was finally formed, including three first-level indicators and 37 second-level indicators. Conclusion This study is based on the information system, according to the structure-process-result model, using the expert consultation method to construct the ICU nursing workload performance assessment index system, and establish the weight of each index, the research results are helpful to further improve the performance appraisal system of ICU nursing staff and improve the scientific management level of ICU. Key words: Intensive care; Nursing workload; Performance appraisal; Information system; Index system

Construction of nursing intervention scheme for stroke incontinence by Delphi

Objective To construct nursing program for incontinence patients with cerebral apoplexy, in order to reduce the incidence of incontinence and improve the quality of life of patients and their families. Methods Using the methods of literature review, theoretical analysis and clinical practice, the first draft of the urinary incontinence nursing intervention program for stroke was formulated. Through Delphi expert consultation method, the dimensions, indicators, and entries of the incontinence nursing intervention for stroke were finally determined. The weight coefficient of the index at all levels was established by hierarchy method. Results A total of 14 experts were selected for stroke, nursing, rehabilitation and urology. The positive coefficient of the two rounds of expert consultation questionnaire was 1.0. The authority coefficient were 0.873 and 0.893 respectively. The expert coordination coefficient tests were all P<0.01. The identified stroke urinary incontinence nursing intervention program includes 5 dimensions, 10 secondary indicators, and 37 tertiary items. Conclusions Nursing intervention program of urinary incontinence after stroke is formed by scientific method. The expert opinion is consistent, which could provide reference for clinical practice. Key words: Urinary incontinence; Stroke; Delphi method; Nursing interventions

Development on a hip functional score of adults based on patient-reported outcomes

Objective To develop a simple and patient-reported scoring system for evaluating the efficacy of functional reconstruction of adult hip diseases. Methods A candidate indicators list to evaluate hip function was established through literatures review and panel discussion. Using two rounds of Delphi method, experts were invited to judge and score the importance of screening indicators including pain, daily living ability, activity level, labor ability and self-assessment score of the overall hip status,with explanation of the degree of similarity and the basis for determination. In the second round of consultation, the content of integrity and rationality of the scale were added for evaluation. The final indexes of the scale were determined according to the boundary value of the indexes (average value, full frequency, coefficient of variation). The positive coefficient, authoritative coefficient, and coordination coefficient of the two rounds were calculated, and then the weights of each index was identified to form the final rating scale. Results Two rounds of Delphi reclaimed 25 and 24 experts’ responses, which from 28 and 25 questionnaires, and the positive coefficients of the two rounds experts were 89.3% and 96%, respectively. The authoritative coefficient of the first and second level indicators were generally above 0.85; and both of the expert coordination coefficient with the index importance (so called as Kendall coefficient) were above 0.3, and the second round of the coefficient was higher than the first one, and it indicated the final one was better at the consistency. The candidate index of bus in the mobility was rejected in accordance with the threshold of the boundary value on the importance. Finally, it was determined that the hip scoring system (Shanghai Sixth People’s Hospital, SSPH) consisted of two parts: the first part had ten indicators out of four dimensions such as pain, daily living ability, activity level, and labor ability; and the weight scores of these four aspects were 45, 25, 21, 9, respectively. The second part was the patient's self-evaluation score for the overall status of the hip (VAS, out of 100 points); the total score was the sum of the two parts, and the final weights accounted for 85% and 15% between the two parts respectively. Conclusion The SSPH hip score based on patient-reported outcomes formed by the Delphi is simple and feasible, and it can be used as a reference for evaluating the clinical efficacy of hip functional reconstruction. Key words: Delphi technique; Hip joint; Outcome assessment (Health Care)

Establishment of training program fornurses in the department of orthopedics based on the Miller pyramid competency model

Objective To establish a training program of nurses in the department of orthopedics-based on the Miller pyramid competency model. Methods Based on G. Miller's pyramid principle, the training program forspecialized nurses in department of orthopedics was constructed by referring to the training program at home and abroad and Combining withthe characteristics of orthopedics nursing work.We used Delphy Method with questionnaires fortworounds in making a consultation to 21experts and carried out statistical analysis. Results The rate of valid questionnaire was 100%. The authority coefficient of ex-pert consultation was from 0.79 to 1.0, the expert coordination coefficient for all indicators is 0.49/0.37/0.25, respectively. Based on the Miller pyramid model, a training scheme for orthopedic nurses was constructed. It included 4 first level indicators, 11 secondary indicators and, 58 third level indicators. Conclusion The positivecoefficient and authority coefficient of the experts were higher and the results were reliable. The training program of orthopedic nurses is of practical value. Key words: Orthopedics; Specialized nurse; Layered application; Miller’s pyramid principle; Delphi Technique

Applicability survey of Emotional and Social Dysfunction Scale on stroke patients′ by Delphi method

Objective To discuss applicability of Emotional and Social Dysfunction Scale in Chinese stroke patients. Methods The Chinese version of Emotional and Social Dysfunction Scale was translated and revised, design the questionnaire to conduct two rounds of consultation on 16 experts, and the positive coefficient, the degree of coordination and the degree of authoritativeness of expert opinions were statistically analyzed. Results The positive degree of two rounds consultation were higher. The expert authority coefficient was 0.89. The expert coordination coefficient were 0.375 and 0.571 (P < 0.01 for both). Preliminary revised scale contained 6 dimensions and 27 items. Conclusions Emotional and Social Dysfunction Scale is highly reliable and represent, and it can be used as a tool for Chinese stroke patients to assess emotional and social dysfunction,which can provide references for medical staff and patients′ family members to conduct targeted psychological intervention. Key words: Delphi technique; Stroke; Emotional and social dysfunction scale; Assessment instruments

Development of a questionnaire on caregiving knowledge of primary caregivers in children with nephrotic syndrome

Objective To explore an assessment questionnaire for assessing caregiving knowledge of primary caregivers in children with nephrotic syndrome. Methods Delphi method was used to review the literature. Ten primary caregivers of children with nephrotic syndrome were interviewed and five medical, nursing experts were pre-surveyed to form an expert consultation questionnaire. Sixteen experts from some provinces were selected to carry out two rounds expert consultation. To screen the dimensions, factors, entries of the questionnaire and to analyze the reliability and validity of the questionnaire. Results The positive coefficient was 100%, the expert authority coefficient was 0.95 and the expert co-ordination coefficient W test was P 65.633%. Conclusions The questionnaire of caregiving knowledge of primary caregivers of children with nephrotic syndrome developed by Delphi method has high reliability. The questionnaire is of practical significance for evaluating the care of primary caregivers of children with nephrotic syndrome. Key words: Nephrosis, lipoid; Child; Delphi method; Primary caregivers; Caregiving knowledge

Development of a cardiac rehabilitation management program for patients with PCI based on Omaha System

Objective To establish a cardiac rehabilitation management program for patients with percutaneous coronary intervention(PCI) based on Omaha System. Methods Delphi method was used to interview 27 experts from October to December 2015, and we took two rounds mailing interview. Results The effective returning rates of the first and second round mailing interview were 100% and 92.60%. The authority coefficient of the experts was 0.92, and the coordination coefficient of experts′ opinion was 0.19.Eventually, the cardiac rehabilitation management program included 13 project indicators, 37 assessment indicators, 37 intervention indicators and 5 follow-up time indicators. Conclusions The result of the study is reliable and it may provide references for medical institutions to having a comprehensive knowledge of patients with PCI, thus they can accurately improve the effect of PCI cardiac management and offer evidence for reducing adverse cardiac events. Key words: Delphi technique; Cardiac rehabilitation; Omaha system; Percutaneous coronary intervention

Key point setting in the training examination of Chinese flight nurses

Objective Based on the establishment of flight nurses′ competency standard indexes and core knowledge system in the early stage, key points of the training examination were set up for Chinese flight nurses. Rationality and effectiveness of the key points were investigated, providing theoretical support for the subsequent training and examination of Chinese flight nurses. Methods Fifteen experts from different areas were consulted by letter in two rounds using the methods of literature analysis, expert interviews, Delphi, analytic hierarchy process. Data were analyzed by Excel 2010 and SPSS 16.0 software. Results In the two rounds of questionnaires, the positive coefficient of experts was 100%, the authority coefficient of experts was above 0.77, the test of the coordination coefficient of experts was P<0.05. Finally six key points of the training examination of Chinese flight nurses were established. Conclusions In light of the excellent and mature standards of flight nurses′ training examination in western developed countries and combined with the actual requirement of Chinese air evacuation, the related key points of the training examination of flight nurses are set up and the items with experts′ high recognition and low recognition are summarized and analyzed in depth, providing a reference and a theoretical basis for further revision and improvement of flight nurses′ training examination standards. Key words: Fight nurse; Training examination; Delphi method

Establishment and validation of an indicator system of risk assessment for mechanical cuts

To establish an indicator system of risk assessment for mechanical cuts, and to validate the system using examples. An indicator system was proposed by the expert investigation method. The index weight, expert authority coefficient, and degree of coordination were determined. The reasonability and stability of the expert questionnaire were evaluated by the reliability analysis. Some on-site examples were given to validate the indicator system. An indicator system containing 3 first-class indicators, 10 second-class indicators, and 34 third-class indicators was obtained by screening indicators using the boundary value method and the assignment transformation method. The average expert authority coefficient was 0.79. The average expert coordination coefficient was 0.47. The overall reliability coefficient was 0.884. The scores obtained using the indicator system were significantly correlated with the actual injury results in six workplaces (r=0.866, P<0.01). The indicator system of risk assessment for mechanical cuts proposed in this study is reasonable and highly consistent with the actual injury results. However, this indicator system still needs further validation and optimization.