Expert Nurses Research Articles

The development of a long-term care infection prevention compendium during the COVID-19 pandemic

Long-term care (LTC) facilitiesexperienced significant morbidity and mortality rates among both residents and staff during the COVID-19 pandemic, for which they were ill-prepared to practice adequate infection prevention and control (IPC). Our team developed a process for creating a compendium of curated IPC resources. This process harnessed the experience and expertise of nurses actively working in LTC during the pandemic. The publicly available online compendium of IPC resources is relevant to all departments found within LTC settings. The compendium contains a wide array of IPC tools, research, reports, international resources, and customizable educational slide decks. Online repositories of curated IPC resources can equip direct care workers with accurate, easily accessible resources to support the maintenance of proper IPC practice and protocol in LTC settings. Future research should evaluate the effectiveness and usefulness of this model and explore its utility in additional medical contexts.

A case study evaluation of the legacy practitioner role: implications for system and workforce transformation

Background: The World Health Organisation’s Global Strategy on Human Resources for Health: Workforce 2030 sets out how vital the healthcare workforce is to the resilience of communities and health systems. Nurses are the largest professional group in that workforce and therefore support for nurses’ practice roles and wellbeing is pivotal to sustaining the global health economy. Nurses with extensive experience can contribute significantly in this respect, and the notion of the legacy practitioner role arose in response to the need to retain the expertise of long-serving nurses. Aim: The aim of the pilot project evaluation was to gather impact evidence of a newly introduced legacy practitioner role, as a workforce planning strategy for retaining the expertise of professionals considering or close to retirement. Design: A mixed-methods case study evaluation was used to capture stakeholder-driven process and outcome data. Emphasis was placed on interacting with project participants and stakeholders with a view to understanding human interconnectedness in the context of sustainable learning and quality-driven improvements at system level. Data analysis used first-order thematic analysis to capture process indicators, followed by a second-order impact framework analysis of workforce and system-level transformation to capture potential sustainable outcome indicators. Conclusion: Evidence identified six core aspects of the legacy role, with one outcome indicator related to reducing attrition in the workplace. Two overarching themes – enhancing practice skills and knowledge exchange – considered the impact of the role, not only with existing healthcare staff but in ‘feeding forward’ practice expertise to the potential future workforce. Implications for practice: Evidence suggests the legacy role can enable knowledge and skill enhancement, and help stressed or anxious staff and learners overcome thoughts and intentions to leave The role provides clinically credible, practice-driven expertise, helping create the conditions for safe and effective person-centred practice Legacy roles can inspire a professional expertise, based on values of compassion and respect that are spread and sustained among new staff External stakeholders who engage with legacy practitioners can also experience positive outcomes

724 How Nursing Turnover Rates Effected a Series of Pediatric Mock Codes

Abstract Introduction Pediatric mock codes (PMC) were first introduced to the Burn Trauma ICU (BTICU) in Fall 2020. The goal of the PMCs were to increase efficiency in a code situation and to increase nursing confidence. However, due to the unique timing of initiation, this hospital also chose to look at how turnover rates affected the outcomes of the PMCs. The time period chosen was during the COVID crisis and the unit had an increasing number of nurses leaving for contract positions. Methods The PMCs created were specifically designed to replicate the pediatric population the team cares for. A different PMC scenario was presented every six months for a total of four mock codes. The nurses completed the PMCs with a team approach, with each team consisting of two to six nurses. During the mock code, the nurse educator kept track of time, monitored role assignments and completion of major tasks, and ensured pre and post surveys were completed. The pre and post surveys evaluated the nurse’s self-confidence, biggest concern regarding a pediatric code, and if they had previously participated in a PMC. Results Over the period of two years, 82 participants were captured. However, these were not unique individuals, as some nurses participated in all four mock codes. It was expected that each time the mock code was completed, the number of nurses who had participated in PMC would increase. However, as time progressed, the rate of previous participation actually decreased. Instead of improving on time to compressions or medication administration time, the times stayed the same over the two-year time frame. When evaluating the comments on the survey, the staff concerns also did not change over time. Medication administration remained the number one concern across all four mock codes. Even though the PMC did not improve skills, 100% of those who participated expressed an increase in confidence level. Conclusions Nursing units depend on novice nurses gaining knowledge and skills and progressing into the expert nurses on the unit. However, the loss of permanent staff and the hiring of new nurses has had an impact on this cycle. The unit lost many of its expert nurses before the new nurses had time to advance. This can be directly seen in the turnover rate and the previous participation in the PMC. Essentially this halted the unit as a whole from growing their skill set in the pediatric population. However, as the nursing market stabilizes, there are future plans to continue to evaluate the PMC skills and outcomes. Applicability of Research to Practice As nursing turnover rates increase, patient complications and outcomes should also be evaluated to see if a correlation is present.

Nurse educators' experiences of providing education to patients and families

Nurse educators' experiences of providing education to patients and families

Identifying High-Need Primary Care Patients Using Nursing Knowledge and Machine Learning Methods.

Patient cohorts generated by machine learning can be enhanced with clinical knowledge to increase translational value and provide a practical approach to patient segmentation based on a mix of medical, behavioral, and social factors. This study aimed to generate a pragmatic example of how machine learning could be used to quickly and meaningfully cohort patients using unsupervised classification methods. Additionally, to demonstrate increased translational value of machine learning models through the integration of nursing knowledge. A primary care practice dataset (N = 3,438) of high-need patients defined by practice criteria was parsed to a subset population of patients with diabetes (n = 1233). Three expert nurses selected variables for k-means cluster analysis using knowledge of critical factors for care coordination. Nursing knowledge was again applied to describe the psychosocial phenotypes in four prominent clusters, aligned with social and medical care plans. Four distinct clusters interpreted and mapped to psychosocial need profiles, allowing for immediate translation to clinical practice through the creation of actionable social and medical care plans. (1) A large cluster of racially diverse female, non-English speakers with low medical complexity, and history of childhood illness; (2) a large cluster of English speakers with significant comorbidities (obesity and respiratory disease); (3) a small cluster of males with substance use disorder and significant comorbidities (mental health, liver and cardiovascular disease) who frequently visit the hospital; and (4) a moderate cluster of older, racially diverse patients with renal failure. This manuscript provides a practical method for analysis of primary care practice data using machine learning in tandem with expert clinical knowledge.

DEVELOPMENT OF SPIRITUALITY ASSESSMENT OF NURSING INSTRUMENTS IN NURSES AT LABUANG BAJI HOSPITAL MAKASSAR

Spiritual care is carried out by nurses for patients, to prevent more severe health effects and warn of their illness, besides fulfilling spiritual needs that are holistic care to improve patient rehabilitation and quality of life when patients are treated. The aim of the study was to find out the development of an instrument for assessing the spiritual aspects of patients. This research is a qualitative research, the researcher synthesizes and constructs an instrument for assessing the patient's spiritual aspects, while the informants are five expert nurses, nursing practitioners and experts in the field of nursing science specifying spiritual aspects. The stages of the instrument development process are the construction stage, the preparation of the grid, the development of variable dimensions and indicators, theoretical and empirical validation, expert panels and review revisions based on input from the expert panel.
 The results show that after carrying out the instrument development process, this research has found five dimensions of spiritual aspects assessment, namely: the dimensions of spiritual experience, positive emotions, the meaning of life, rituals (for non-Muslims) and rituals (for Muslims). While discussing spiritual experience is a manifestation of spirituality within a person in the form of specific and unique experiences related to his relationship with God at various levels, one's spirituality is related to the purpose and meaning of life as a whole as a manifestation of his relationship with God, spirituality has four dimensions, namely the meaning of life, positive emotions, spiritual experiences, and rituals

P050 GIRFT in action: Advanced Practice Physiotherapist and Advanced Practice Nurse expertise provides valuable triage and assessment clinics for non-urgent Rheumatology referrals

Abstract Background/Aims Rheumatology referrals classified as non-urgent/routine are commonly non-inflammatory conditions or medically non-urgent and can have significant waiting times for appointments. These waits were further escalated by the COVID-19 pandemic. Early intervention for non-inflammatory conditions can be crucial to good outcomes and long wait-times can have significant adverse impacts while appropriate care pathways are determined. Recent UK GIRFT recommendations include using non-medical health professional expertise in assessment and management pathways to support right place, right time, right care. This study evaluated effectiveness, impacts and patient experiences of Advanced Practice Physiotherapist (APP) and Advanced Practice Nurse (APN) Triage and Assessment Clinics for routine new referrals. Methods The non-urgent/routine referral waiting list was e-triaged by a Rheumatology APP and APN supported by clinical record searches. Patients were contacted by telephone to update on clinical status and appointment requirements determined. Triage criteria were applied to determine new referrals suitable for APP and APN Rheumatology clinics, which included low likelihood of inflammatory disease or new referrals for known diagnosis/stable conditions. Clinics were undertaken with collocated Consultant clinical supervision. Assessment findings were discussed and management agreed, or seen if needed. With waiting list attrition, clinics were expanded to include Consultant-determined stable condition reviews and follow-up reviews for non-suspected inflammatory disease. Results At 01 July 2021, 214 new routine referrals were waiting a Consultant appointment (n=103 over 2yrs). Since service initiation, clinic outcomes to date include: 69% (n = 243/358) new routine referrals discharged to GP or directed to right pathway with information, advice and self-management resources; 8% (n=29) escalated to urgent; 3% (11/358) with medical complexity remained on Consultant waitlist. Most common presentations seen included: Osteoarthritis (general or hand); Back and other spinal pain; Fibromyalgia; Persistent Fatigue and Widespread Pain; JHS/hEDS; Positive ANA without clinical features; Musculoskeletal conditions- other. To date, no patients have been re-referred and 329 new patient and 89 follow-up Consultant direct consultations have been spared. There is currently no wait-time for non-urgent/routine appointments. Patient experience feedback on the service has offered a 100% recommendation to continue and expressed highly positive experiences with the MDT approach. Patients value the breadth of expertise and care support, and the timely, thorough and professional service provided. Conclusion Rheumatology non-urgent/routine new referrals with low probability of underlying autoimmune conditions may be effectively and efficiently managed in a collaborative model using an advanced practice physiotherapist and nurse. This innovation has expanded a traditionally medical pathway to an MDT model utilising value-adding non-medical expertise in service delivery. It has enhanced interdisciplinary learning and is a valued, collaborative approach to patient care. The initiative provides support to GIRFT recommendations of using an MDT skill-set to support improved patient access, service efficiencies and earlier intervention. Disclosure C. McCrum: Grants/research support; Funding grant to provide professional education workshops- Novartis, Janssen. B. Zeljkovic: None. C. Perera: None.

The role of the advanced clinical practitioner in arthroplasty care

Demand for joint arthroplasty surgery in the UK has increased significantly over the past 10 years. Advanced clinical practitioner (ACP) roles in arthroplasty care, typically fulfilled by expert nurses or physiotherapists, have been developed to alleviate service pressures and facilitate care for the growing number of patients undergoing arthroplasty surgery. There are numerous different models of ACP-led services both in the UK and internationally, driven by local service and population needs. ACPs in arthroplasty care will be involved throughout the patient journey, including pre-operative assessment, peri-operative care and long-term surveillance. ACPs in arthroplasty care will develop expertise across all four pillars of advanced clinical practice and have the potential to influence and contribute to the development of guidance and policy for the future of arthroplasty care delivery, ensuring best quality, evidence-based practice is achieved.

Determination of skill and knowledge requirements of an instrument nurse working in major vascular surgery for the development of a virtual reality training tool

BackgroundAn open abdominal aortic aneurysm (AAA) repair is a complex high-risk procedure, with limited opportunities for an instrument nurse to gain experience and develop the necessary skills to assist the surgeon in caring for the patient during surgery. The aim of the study was to inform the content for a virtual reality (VR) training tool to develop the skills of an instrument nurse when working in major vascular surgery. MethodsAn exploratory, descriptive qualitative design using focus groups and semistructured interviews was selected for this study to explore and understand the perceptions of consultant vascular surgeons and expert vascular instrument nurses about the skills required by an instrument nurse when caring for a patient undergoing major vascular surgery. Expert vascular instrument nurses (n = 9) and consultant vascular surgeon (n = 4) were recruited via the Australian College of Perioperative Nurses (ACORN) and the Australian and New Zealand Society for Vascular Surgery (ANZSVS), respectively. ResultsData were analyzed using thematic analysis (Braun & Clarke, 2012). Four themes emerged from the data analysis. These were: preparation for surgery, essential psychomotor skills, nontechnical skills, and the virtual reality training tool design and content. ConclusionExpert vascular instrument nurses and consultant vascular surgeons provided a detailed compilation of the knowledge and skills required by an instrument nurse which will inform the content and design of the proposed virtual reality training tool. Whilst this study is based on open AAA repair, it also provides a valuable insight into what surgeons and nurses consider important for an instrument nurse when assisting with a surgical procedure.

Examining the Organisational Skills of Nurse Managers at the Unit Level in Ghana: A Quantitative Cross-Sectional Study

The role of nurse managers has become demanding and multidimensional. However, many nurse managers perform their roles without adequate formal preparation and have to struggle with inadequate resources and challenges from other healthcare professionals in an effort to organise and maintain a favourable environment for care delivery in the unit. Therefore, optimum care is needed to ensure that competent and expert nurses are appointed unit-level managers. Nurse managers’ organisational skills have been identified as central to guaranteeing efficient shift schedules, managing logistics, planning staff needs, and performing professional duties for patients. To date, the organisational skills of unit-level nurse managers in Ghana have not been studied. Therefore, the purpose of the study was to investigate the organisational skills of nurse managers at the unit level in Ghanaian hospitals. We used a quantitative cross-sectional survey for data collection. The sample comprised 552 nursing staff from 19 healthcare facilities in the Greater Accra Region. Data were analysed using descriptive and linear regression using Statistical Package for the Social Sciences (SPSS) 27. The findings indicate that nurse managers showed moderate organisational skills. Training in management, gender, rank, age, work experience, experience as a nurse manager, and qualification were factors that together accounted for a statistically significant difference in nurse managers’ organisational skills. These findings call for management to support nurse managers through structured in-service training, mentorship, coaching, and delegation to build and maintain their organisational skills to enable efficiency at the unit level.

Gastroenterology: your quick guide

We ask expert nurses what students need to know about caring for patients with digestive conditions and the red flags to look for

Management of Hypertension Using a Plant-Based Diet Among Farmers: Protocol for a Mixed Methods Study

Farmers in Indonesia have a high risk for hypertension owing to their lifestyle and working environment. Diet management is a solution to reduce hypertension, and Indonesia has natural resources in the agricultural sector that could help manage hypertension. Optimizing vegetable and fruit intake in a plant-based diet (PBD) could help maintain blood pressure among farmers in Indonesia. This study aims to explore the health problem of hypertension and the characteristics of local food sources to formulate a PBD menu for treating hypertension, as well as assess the prevalence of hypertension, level of acceptability of a PBD, and associated sociodemographic factors. Further, we want to examine the effectiveness of a community-based nursing program for managing hypertension using a PBD. We will use the exploratory sequential mixed methods approach. There will be a qualitative study (phase I) in 2022 and a quantitative study (phase II) in 2023. We will analyze data using a thematic framework in phase I. In phase II, the study will involve (1) questionnaire development and validation; (2) examination of the prevalence of hypertension, the level of acceptability of a PBD, and the associated factors; and (3) a randomized controlled trial. We will recruit farmers with hypertension who meet the study criteria. Moreover, in phase II, we will invite expert nurses and nutritionists to assess the face and content validity of the questionnaire. We will use multiple logistic regression models to estimate the associated sociodemographic factors and the level of acceptability of a PBD. Furthermore, a linear generalized estimating equation will be used to estimate the parameters of a generalized linear model with a possible unmeasured correlation between observations from different time points for systolic and diastolic blood pressure. A model PBD for hypertension management is expected to be developed. In 2022, we will collect information on hypertension and the characteristics of local food sources for managing hypertension, and will formulate a PBD menu to treat hypertension among farmers. In 2023, we will develop a questionnaire to assess the acceptability of a PBD to manage hypertension among farmers, the prevalence of hypertension, and the sociodemographic factors associated with hypertension among farmers. We will implement a community-based nursing program for managing hypertension using a PBD among farmers. The PBD model will not be readily available for other agricultural areas since validation of local food variation is required to design the menu. We expect contributions from the local government to implement the intervention as one of the policies in the management of hypertension for farmers in the agricultural plantation areas of Jember. This program may also be implemented in other agricultural countries with similar problems, so that hypertension can be optimally treated among farmers. PRR1-10.2196/41146.

Expert nurses’ perceived parenting difficulties in Neonatal Intensive Care unit: A qualitative inductive study

PurposeThe birth of a high-risk newborn has significant psychosocial impacts on the family. Parents often experience difficulties in parenting after discharge. This study aimed to clarify the phenomena NICU expert nurses perceived and practiced during nursing care regarding concerns for parenting based on their focus and consciousness. Design and methodsThis qualitative descriptive study involved semi-structured interviews with six nurses (an average of 13.8 years of NICU nursing experience). Participants were asked to describe cases in which they provided nursing practices to parents with hospitalized children because they were concerned about their parenting. Fifteen cases with positive outcomes were inductively analyzed. ResultsFour main types of phenomena were observed: Adaptation to the parenting role, capacity of parenting including the parenting environment, readiness for parenthood, and an environment that nurtures parental confidence. Some cases involved more than one phenomenon. ConclusionsThe phenomenon wherein expert nurses anticipated the growing difficulties in parenting was found in interactions with parents of hospitalized children and in making them aware of their experiences. Clarifying their clinical reasoning and practice processes and the factors that enabled them may improve nurses’ practice skills and the well-being of children and families. Practice implicationsThe results may contribute to identifying parents who need careful support to achieve secure childcare and create a supportive environment for parents and children.

IMPROVING THE PROFESSIONAL ABILITY OF NURSES IN NURSING INTERVENTIONS IN HOSPITALS THROUGH EVIDENCE-BASED NURSING PRACTICE WORKSHOP

The evidence-based approach in Indonesia has not yet developed, including the use of research results in practice. Thus it is necessary to grow the attitude, willingness, awareness, and ability to develop EBNP or transform research results into practice so that nurses can improve the "quality of care" for patients. The purpose of community service activities is to improve the professional ability of nurses at RSUD Dr. Sososdoro Djatikoesoemo Bojonegoro in providing Nursing Care through an Evidence-based Nursing Practice (EBNP) workshop. The workshop took place on May 24-25, 2022, and was attended by 30 nurses from the Inpatient Installation. Nurses' knowledge was measured by an evaluation that use pre-test and post-test methods. The skills evaluation was conducted online on July 23, 2022, by presenting the EBNP project plan to be carried out. Community service participants are nurses at RSUD Dr. R Sosodoro Djatikoesoemo Bojonegoro who has characteristics of most (45%) nurses having an age between 41-50 years and having a working period of 11-20 years (44%), and most (67%) educated in Nurses. The functional positions of the most community service participants are Associate Expert nurses at 37% and there are Main Expert Nurses as much as 4%. The results of the activities through the Workshop showed an increase in the capacity of nurses regarding EBNP who previously had very poor knowledge of 19 people (63.3%) and increased to very good knowledge of 12 people (40.0%). Nurses who initially lacked knowledge increased to 3 people (10.0%) with good knowledge, but there were still 7 people (23.3%) who lacked knowledge. However, not all nurses have participated in the EBNP workshop, so it is necessary to conduct a workshop for the next generation so that all nurses can carry out nursing interventions based on evidence-based.

A Literature Review of Simulation-Based Nursing Education in Korea

Simulation-based education started receiving attention as a pedagogical method in order to provide medical service of high quality in an ethical and safe environment. This has been of great importance during the coronavirus disease 2019 global pandemic. This literature review was conducted to suggest a direction for simulation-based nursing education in Korea. For literature searches, the authors used the following search terms in the Web of Science, CINAHL, Scopus, PubMed-'utilization', 'simulation,' 'nursing student', 'nursing education'. A final search was conducted on 6 January 2021. The materials for this study were collected through literature searches according to the PRISMA guidelines. 25 papers were selected as the final literature for analysis. The study was conducted for 48 percent of senior students in nursing college students in Korea (N = 12). High fidelity (HF) as the simulation type was 44 percent (N = 11). The simulation education subjects were composed of 52 percent adult health nursing (N = 13). According to educational goals described by Benzamine Bloom (1956), 90% in the psychomotor domain is considered a positive learning achievement. Effectiveness in the psychomotor domain through simulation-based training is correlated with expert nursing. It is essential to develop a systematic debriefing model and methods to evaluate performance and learning in the short- and long-term to expand the effectiveness of simulation-based education in nursing.

An objective test to measure evidence-based practice knowledge and skill competency of acute care nurses: Apsychometric validation study.

Few objective measures of evidence-based practice (EBP) knowledge/skill exist. The Fresno Test, one objective method, was validated first with medicine, followed by versions for physical therapists, occupational therapists, speech therapists, social workers, dietitians, pediatric nurses, and health care students. The Fresno Test was adapted and tested with cohorts of acute care nurses. Six of the 14 items required revision to achieve acceptable psychometrics. The aim of this second validation study was to revise and validate a new version of the test, The Modified Fresno Test-Acute Care Nursing (MFT-ACN), to determine if it could distinguish EBP knowledge/skills among acute care nurses. A panel of eight EBP experts were engaged in multiple Delphi rounds to revise items. Individual-content validity indices (CVI) ranged from 0.83 to 1.0, with scale-CVI 0.92. Using a cohort design, a cross-sectional sample of 90 novice, master, and expert nurses were recruited via national listservs or snowball sampling to complete the revised test. Two doctorally prepared EBP experts independently scored tests using the standardized rubric. The MFT-ACN yielded strong psychometric properties (intra-class correlation coefficients > 0.80; item discrimination indices > 0.20; item-total correlations > 0.30). One poorly performing item was dropped per a priori cut-off values. The final test included 13 items, with a Cronbach's alpha=0.77. Item difficulty was moderate to high. Most items discriminated well between cohorts. Mean total scores were positively correlated with age, years since graduation, years of acute care experience, and formal EBP or research workshops or conferences or courses or immersions. Perceived level of EBP expertise was not associated with mean scores. Further research is recommended with a larger sample to assess the tests' responsiveness to change in EBP knowledge/skills over time and enhance its acceptability and feasibility. Additional research should further evaluate construct and concurrent validity against other objective assessments of EBP knowledge/skills. The validated 13-item MFT-ACN can be used to evaluate EBP competencies of acute care nurses in academic and practice settings. It can also be used by nurse scientists to build a stronger evidence base on types of educational programs that excel in advancing the critical competency of EBP among our nursing workforce.

Advancing Health Equity Through Graduate Forensic Nursing Education.

Social justice is a core value of nursing and is deeply rooted within forensic nursing. Forensic nurses are uniquely positioned to examine and address social determinants of health that contribute to victimization, lack of access to forensic nursing services, and inability to utilize resources and services aimed at restoring health after an injury or illness related to trauma or violence. To achieve this, forensic nursing capacity and expertise must be strengthened through robust education. A graduate, forensic nursing, program sought to address this educational need by integrating content related to social justice, health equity, health disparity, and social determinants of health throughout its specialty curriculum.

Related factors of actual turnover among nurses: a cross-sectional study

<p>Turnover exacerbates the global nursing shortage; the loss of skilled and expert nurses has a negative impact on patient outcomes. The study examined the influence of job satisfaction, work environment, leadership styles, organizational commitment and work-family support on actual turnover among nurses working in the hospital of Indonesia. A cross-sectional survey was carried out in Jakarta, Indonesia. The sample in this study was nurses who leave the jobs from hospital during period of time October 2019 to October 2020. A total of 170 nurses responded to the survey. Nurses reported poor leadership style (2.84±0.82), organization commitment (2.99±0.76), as well as dissatisfaction with organization (2.76±0.80) and leadership support (2.89±0.89). Job satisfaction (p=0.007), work environment (p=0.032), leadership style (p=0.001), organizational commitment (p=0.010), and work-family support (p=0.026) remained statistically significant affected turnover. The findings of this study emphasize the critical role of satisfaction, organizational commitment, work-family support, and leadership style in determining nurse intention to stay and provide employers with a road map for reducing turnover. Future studies may need to understand more deeper regarding the actual turnover experience and its associated factors using longitudinal or qualitative studies.</p>

Designing Immersive Virtual Reality Environments for Supporting Patients at Home: Translating Input From Home Care Nurse Experts to Design Requirements.

Immersive virtual reality computer programs provide new experimental and treatment interventions that hold great promise for nursing. Immersive virtual reality uses sensory cues to represent real-world environments in a way that makes participants feel as if they are in a physical space different from the one in which they currently exist. As the acceptance of immersive virtual reality as a clinical and experimental tool has grown, so has the need to ensure that the context depicted in the environment mirrors both the sensory and the task requirements of the real-world situation. Here, we describe the use of nurse expert key informant group interviews to generate requirements that must be fulfilled in immersive virtual reality environments designed to evoke and engage participants in self-management tasks. An expert panel of four home care nurses participated in three sessions designed to elicit details of common home care challenges, frequency of variation, and typical participants. More than 20 potential scenarios were identified. The design team later used this information to create design requirements for two key scenarios and subsequently develop immersive virtual reality environments for use in research studies, mapping sensory and functional expectations to immersive virtual reality implementations. Challenges in mapping from key informant group findings to requirements are addressed.

Content, implementation strategies and knowledge assessment tool on venous leg ulcers: An e-Delphi study

To get consensus on the knowledge and skills that nursing students need to acquire regarding venous leg ulcer care, the strategies that can be applied during education and to design a first draft of a questionnaire to assess knowledge to be validated. Venous leg ulcers' care is included on undergraduate nursing education programmes but without specifying the content and training implementation strategies. Different tools have been validated to assess knowledge, but have been found inadequate. An e-Delphi study. The participants were Chronic Wound Care expert nurses. Two questions were constructed and agreed on by the research team to define the problem. To answer the third question, a search was conducted for publications on venous leg ulcers, to help design the questionnaire. A 2-round e-Delphi study was conducted from January to March 2022. A panel of 17 experts participated in both rounds. The data were analysed using statistical and qualitative analysis. Content must fulfil knowledge-skill areas: epidemiology, venous pathophysiology and aetiology, classification scales, knowing how to determine a differential diagnosis, treatment, measures for prevention and care of the venous return circuit, quality-of-life scales. As implementation strategies, proposals were made in four areas: subject profile where training is to be acquired, theoretical teaching, practical teaching in the classroom and clinical practice. The average consensus of the questionnaire proposal was high (>86 %) both in relevance and clarity in both rounds. We thereby obtained a questionnaire with 72 items. Seven categories and eight subcategories were created regarding knowledge/skills that nursing students should acquire. Four categories were recognised as strategies that can be implemented during education. A high level of consensus was reached on the items in the initial versions of the questionnaire.