Final Version Of Tool Research Articles

Medication-Related Fall (MRF) screening and scoring tool: consensus Delphi validation

Abstract Introduction Falls are associated with negative health outcomes such as injury and mortality, as well as increased healthcare usage and costs. Risk factors for falls are multifactorial and include polypharmacy and the use of certain medications (1). Aim To develop and validate a medication-related fall (MRF) screening and scoring tool. Methods The MRF tool was developed from medication classes associated with falling in the Polypharmacy Guidance Realistic Prescribing 2018 (2), and additional medications identified and categorised by specialist and consultant pharmacists and physicians across a region of the United Kingdom. Medication classes were categorised as high-risk (three points), moderate-risk (two points) or low-risk (one point) in their ‘potential to cause falls’. The overall medication-related fall risk for the patient was determined by summing the scores for all medications. The MRF was validated using Delphi consensus methodology, whereby three iterative rounds of online surveys were conducted using SurveyMonkey®. Delphi panel experts were defined as individuals with recognised expertise in geriatric medicine and pharmacotherapy in older people. Twenty-two experts determined their agreement with the falls risk associated with each medication on a 5-point Likert scale with accompanying written feedback. Only medications with at least 75% of respondents agreeing or strongly agreeing were retained in the next round. Following the first validation round, any proposed criteria that did not meet retention requirements were removed. The second and third rounds of the survey were created based on the panel comments from the previous round. Results Consensus was reached for 19 medications/medication classes to be included in the final version of the MRF tool (table) and to reject eight medications/medication classes. Consensus was not reached regarding eight medications and they were not included in the final version of the tool. Conclusion The MRF tool is simple and feasible to use in healthcare settings to evaluate and optimise medications as a standalone screening instrument or as part of a multidisciplinary intervention to reduce fall risk and negative fall-related outcomes. The score from the MRF tool has potential for use as a clinical parameter to evaluate prescribing appropriateness. References (1) Public Health England (2020) Falls: applying All Our Health. Available at https://www.gov.uk/government/publications/falls-applying-all-our-health/falls-applying-all-our-health Guidance Falls: applying All Our Health. (Accessed: 4th April 2020) (2) Scottish Government Polypharmacy Model of Care Group (2018). Polypharmacy Guidance, Realistic Prescribing. 3rd Edition.

Development of a Positive Nursing Organizational Culture Measurement Tool

The purpose of this study was to develop a measurement tool for a positive nursing organizational culture and to verify its reliability and validity. A conceptual framework and construct factors were extracted through an extensive literature review and indepth interviews with nurses. The final version of the preliminary tool for the main survey was confirmed by experts through a content validity test and a preliminary survey of 40 nurses. Subsequently, the final tool was developed using a validity and reliability test containing 43 preliminary items. The final version of the tool was used with 327 hospital nurses in the testing phase for the main survey to assess validity and reliability. From the factor analysis, 4 factors and 26 items were selected. The factors were positive leadership of the nursing unit manager, pursuit of common values, formation of organizational relationships based on trust, and a fair management system. The entire determination coefficient was 67.7%. These factors were verified through convergent, discriminant, and concurrent validity testing. The internal consistency reliability was acceptable (Cronbach's α = .95). Both the validity and reliability of the scale were confirmed demonstrating its utility for measuring positive nursing organizational culture. It is expected to be used for education, research, and practical performance policies regarding the nursing organizational culture.

Development of a Questionnaire and Guideline to Find Out the Knowledge of Adolescent Girls Regarding Reproductive Health

Introduction: The adolescent population is the future of every country. Therefore, adolescent girls should be aware about the changes during puberty, menstruation and other reproductive health knowledge that help them in maintaining and promoting their health and can prevent many problems raised out of insufficient knowledge. To check the effectiveness of reproductive health education program for adolescent school going girls, it is necessary to develop the tool. The questionnaire was focused on the knowledge of puberty and its changes, menstruation and menstrual hygiene, knowledge on HIV and AIDS, nutrition of adolescent girls, worms’ infestation, pregnancy and childbirth. Objectives: There were following objectives for the development of tool. (1) To develop the questionnaire for changes during puberty among girls. (2) To develop questionnaire on menstrual hygiene and its practice. (3) To develop questionnaire on knowledge of reproductive health among adolescents girls. The tools was prepared to assess the existing knowledge and practice of adolescent girls about reproductive health and after reproductive health education how far target population gained the knowledge and improve the practice. Methods: The tool was developed in following manner generation of the items, selection of items, pooling of items, item analysis, re-selection of items and final version of tool. Content validity and linguistic validity was established. Results: Reliability of questionnaire was calculated by CA ( Cronbach’s Alpha) and value is 0.69 which shows questionnaire or tool was accepted and reliable for the target population. Conclusion: The questionnaire was effective to evaluate the effectiveness of reproductive health education among adolescent girls.