Two-round Expert Consultation Research Articles

Development and psychometric assessment of self-reported patient medication safety scale (SR-PMSS).

Patient medication safety can affect their clinical outcomes and plays an important role in patient safety management. However, few tools have been developed to assess patient medication safety. This study aimed to develop and validate the self-reported patient medication safety scale (SR-PMSS). We developed SR-PMSS guided by the Donabedian Structure-Process-Outcome framework and used psychometric methods to test its validity and reliability. A total of 501 patients with an average age of 56.81 ± 14.47 were enrolled in this study. The SR-PMSS consisted of 21 items and 5 factors. The content validity was good with item-level content validity index (CVI) > 0.78, average scale-level CVI (S-CVI) > 0.9, and universal agreement S-CVI > 0.8. Exploratory factor analysis extracted a five-factor solution with eigenvalues > 0.1, explaining 67.766% of the variance. Confirmatory factor analysis showed good model fit, acceptable convergent validity, and discriminant validity. The Cronbach's α coefficient for SR-PMSS was 0.929, the split-half reliability coefficient was 0.855, and the test-retest reliability coefficient was 0.978. The SR-PMSS was a valid and reliable instrument with good reliability and validity to evaluate the level of patient medication safety. The target users of the SR-PMSS are all people who are taking or have used prescription medications. The SR-PMSS can be used by healthcare providers in clinical practice and research to identify patients at risk for medication use and intervene with them to reduce adverse medication events and provide support for patient safety management. SR-PMSS - a self-reported tool to assess patient medication safetyMedication therapy was the most common and frequent treatment method to prevent and cure diseases. Medication safety issues may occur in the process of medication use. Patient medication safety can affect their clinical outcomes and plays an important role in patient safety management. However, there are few tools to assess patient medication safety currently, and most of them focused on medication safety related to hospitals or healthcare workers. We developed the self-reported patient medication safety scale (SR-PMSS) guided by the Donabedian Structure-Process-Outcome framework. Then, we conducted a two-round expert consultation, clarity verification, and item simplification to determine the final version of the scale. The SR-PMSS consisted of 21 items and 5 factors and it had good validity and reliability. The target users of the SR-PMSS are all people who are taking or have used prescription medications. Healthcare providers can use the SR-PMSS in clinical practice and research to identify patients at risk for medication use and intervene with them to reduce adverse medication events and provide support for patient safety management.

Proposal of new diagnostic criteria for fatal familial insomnia

BackgroundThe understanding of fatal familial insomnia (FFI), a rare neurodegenerative autosomal dominant prion disease, has improved in recent years as more cases were reported. This work aimed to propose new diagnostic criteria for FFI with optimal sensitivity, specificity, and likelihood ratio.MethodsAn international group of experts was established and 128 genetically confirmed FFI cases and 281 non-FFI prion disease controls are enrolled in the validation process. The new criteria were proposed based on the following steps with two-round expert consultation: (1) Validation of the 2018 FFI criteria. (2) Diagnostic item selection according to statistical analysis and expert consensus. (3) Validation of the new criteria.ResultsThe 2018 criteria for possible FFI had a sensitivity of 90.6%, a specificity of 83.3%, with a positive likelihood ratio (PLR) of 5.43, and a negative likelihood ratio (NLR) of 0.11; and the probable FFI criteria had a sensitivity of 83.6%, specificity of 92.9%, with a PLR of 11.77, and a NLR of 0.18. The new criteria included more specific and/or common clinical features, two exclusion items, and summarized a precise and flexible diagnostic hierarchy. The new criteria for possible FFI had therefore reached a better sensitivity and specificity (92.2% and 96.1%, respectively), a PLR of 23.64 and a NLR of 0.08, whereas the probable FFI criteria showed a sensitivity of 90.6%, a specificity of 98.2%, with a PLR of 50.33 and a NLR of 0.095.ConclusionsWe propose new clinical diagnostic criteria for FFI, for a better refining of the clinical hallmarks of the disease that ultimately would help an early recognition of FFI and a better differentiation from other prion diseases.

Establishing quality evaluation system of nursing management in fever clinics: A Delphi method.

The aim of this study is to construct a quality evaluation system for fever clinic nursing management. Fever clinic is the first line of defence against the epidemic during COVID-19 in China. Our study combines the Delphi method and the analytic hierarchy process. Delphi method was used to carry out two rounds of consultation for 18 experts, to select and revise indicators at all levels. Analytic hierarchy process was used to calculate the weight of indicators at all levels. A quality evaluation system of nursing management for fever clinics is built using Delphi method. It includes five first-level indexes, 14 second-level indexes and 82 third-level indexes. A two-round expert consultation is used to build the indicators. The recovery rates of expert questionnaires in the two rounds were, respectively, 100% and 94%, and expert authority coefficients were 0.925. The Kendall coefficients in the two rounds were, respectively, 0.205 and 0.162 (P < .001). The weight analysis shows that health management of nursing staff (0.2803) and disinfection isolation and treatment of medical waste (0.2803) are most important, followed by nursing post management and personnel training (0.1889), configuration and management of equipment (0.1427) and patient consultation management and nursing (0.1078). The quality evaluation system of nursing management in the constructed fever clinic is used to put forward a specific, objective and quantifiable evaluation criteria of nursing quality for fever clinic management, which can better meet the needs of epidemic prevention and control, and has a certain application and promotion value. The establishment and improvement of a quality system for fever clinic care management will help to respond to outbreaks such as COVID-19.

Strategies for Parental Involvement during Emergency Remote Teaching Scale: Its Psychometric Properties

&lt;p style="text-align:justify"&gt;Recently, Emergency Remote Teaching (ERT) has caused a considerable interest in the school community due to the wide-scale lockdown brought about by the COVID-19 pandemic. The curriculum's alteration necessitated a call to explore mechanisms for effective remote instruction delivery—including parental involvement. This research determined the psychometric properties of the "Strategies for Parental Involvement during Emergency Remote Teaching - Scale (SPIERT-S). The tool assesses the strategies used by teachers to facilitate parental involvement during ERT. Through a thorough literature review, 22 items about home and school collaboration and ERT were initially developed. Evidence related to content validity was established through two-round expert consultation, while data related to construct validity were gathered through factor analyses. The content validity analysis resulted in the deletion of four (4) items; hence, 18 items were retained. A three-factor structure was yielded from Exploratory Factor Analysis (parents as facilitators of learning, parents as sources of information, and parents as collaborators), and a total of 15 items were retained. The confirmatory factor analysis indicated an acceptable level of the goodness-of-fit indices measured. The internal consistency of the factors and the whole scale showed excellent reliability. The results suggest that the SPIERT-S has good, valid, and reliable psychometric qualities and can be used to examine the strategies for parental involvement that teachers utilize during emergency remote teaching. Recommendations and limitations of the study are discussed.&lt;/p&gt;

Construction of the Chinese culture oriented palliative care content for people with heart failure

Objective To explore the Chinese culture oriented palliative care content for people with heart failure. Methods After a comprehensive literature review and expert interviews, two-round expert consultation was conducted to confirm the Chinese culture oriented palliative care content indicators for people with heart failure. Results A scientific literature review was performed and finally 102 articles were included. Totally 13 experts were interviewed and 525 meaning units were identified in the interviews. The Chinese culture oriented palliative care content for people with heart failure contained 4 first-grade indicators, 10 second-grade indicators and 42 third-grade indicators. The expert′s enthusiasm of the two rounds of expert consultation were both 100%, the authoritative coefficient were 0.82 and 0.83, the coordination coefficient of Kendall′s W were 0.14 to 0.40 (P<0.01). Conclusions The Chinese culture oriented palliative care content for people with heart failure contributes to the development of new models for integrated heart failure care and palliative care which set with Chinese culture. Key words: Heart failure; Palliative care; Chinese culture

To be clinical validated for a nutritional risk screening tool of neonates

Objective To develop a neonatal nutritional risk screening tool for hospitalized neonates. Methods Delphi method was used to establish the indicator framework. Fifteen experts including doctors, nurses, and nutritionists who were engaged in neonate care were invited to participate in two-round specialist consultations. The weights of indicators were determined through the analytic hierarchy process. Results The weight and the content of each dimension and indicator were determined. There were 15 recycling valid questionnaires in a two-round expert consultation, and the expert enthusiasm coefficient of two rounds were 88% and 100% respectively. The average coefficient of expert authority degree was 0.9. The coordination coefficient of indicators were between 0.4 and 0.5, which showed the experts' opinion tended to be consistent. A neonatal nutritional risk screening tool including 4 dimensions (birth condition, weight change, nutritional intake approach, and disease diagnosis) and 31 indicators was established. Conclusion High expert enthusiasm coefficient, high expert authority degree, and coordination coefficient show that the content of the screening tool is reasonable. Key words: Infant, newborn; Delphi technique; Nutritional risk; Screening tools; Analytic hierarchy process

Development and reliability and validity test of peer support demand scale for patients with malignant tumor

Objective To develop a peer support demand scale for patients with malignant tumor, and to test its reliability and validity, so as to provide an assessment tool for evaluating demand of peer support in patients with malignant tumor. Methods Guided by peer support theory, with theoretical review and qualitative interview, item pool of the peer support demand scale was preliminarily made. After a two-round expert consultation and preliminary scale investigation, first draft of the items was determined. 300 patients with malignant tumor were surveyed by the first draft of the scale, so that reliability and validity of the scale were tested. Results In the peer support demand scale for patients with malignant tumor, 4 factors with 21 items were included, namely demands on peer support understanding, emotion, information and evaluation, The cumulative variance contribution rate was 59.684%. The content validity (S-CVI) was 0.920. Cronbacha's α coefficient of the internal consistency reliability was 0.815, and the retest reliability was 0.824. Conclusions Content validity and internal consistency reliability are within acceptable range, which makes it basically qualified and can be used for investigation on patients with malignant tumor about their peer support demands. Key words: Neoplasms; Peer support; Demand; Scale development

Research learning evaluation system and indicators connotation of problem-based in small-group teaching model

Objective To build learning evaluation system and indicators connotation of problem-based in small-group teaching model. Methods Delphi technique was used to build learning evaluation system of problem-based for course of nursing education through a two-round expert consultation among 30 experts in Zhejiang province. Results The experts' authority coefficient was 0.89, determination coefficient was 0.90, and familiar confficient was 0.88. The finally learning evaluation system of problem-based for course of nursing education consisted of 3 first-level indicators, 14 second-level indicators and 41 third-level indicators. The coordination coefficients of first-level indicators and second-level indicators were 0.37 and 0.31, respectively, there was significant difference, P <0.01. Conclusion This project has a rigorous and reliable construction process with strong theoretical and practical significance, and could be used as a guidance and reference for problem-based in small-group teaching for course of nursing education. Key words: Education, nursing; Problem-based learning; Group teaching; Learning effect evaluation; Evaluation system

Construction of evaluation index for clinical nurses' daily nursing competence of peripherally inserted central catheter

Objective To construct evaluation index for clinical nurses' daily nursing competence of peripherally inserted central catheter (PICC). Methods Literature review and expert interview methods were used to set indexes initially, and the two-round expert consultation with Delphi method was applied to screen the indexes, and the weight of each index was determined. Results After two-round expert consultation, the evaluation index for clinical nurses' daily nursing competence of PICC was set up, including 3 first-class index-es, 8 second-class indexes and 31 third-class indexes. Conclusions The experts have good authority and co-ordination, the evaluation index is scientific and reliable. It can provide reference for evaluating clinical nurs-es' daily nursing competence of PICC. Key words: Nursing staff; Clinical competence; Catheterization, central venous; Evaluation

Development of a framework and indicators on a midwives' three-stage standardized training program in a tertiary teaching hospital

Objective To develop a three-stage standardized and systematic training program framework and indicator systems for clinical midwives.Methods Based upon literature review,Delphi technique was used to formulate index system and indicators for midwives' training program through tworound expert consultation among 29 experts.Results After two-round expert consultation,the response rates were 96.7％ and 100.0％,respectively.Experts' authority coefficient was 0.874.The training program framework consisted of a three-level index system.Average importance scores of the three-level indexes were 4.10 to 4.97,4.07 to 4.97,and 4.00 to 5.00,respectively.And their variance coefficients were 0.037 to 0.119,0.037 to 0.130,and 0 to 0.141,respectively.Then a progressive and integrated three-year standardized training framework and index system for clinical midwives was finally formed,which totally contained 5 first-level indicators or training modules,including professional competence and safety awareness,specialized and basic knowledge,specialized practical skills,emergency management,and basic capacity for teaching and research.Conclusions The three-level framework and indicators for clinical midwives' training program has been proved to be acceptable,reliable and scientific,thus providing a theoretical and referential basis for training clinical midwives and improving teaching quality. Key words: Junior midwives; Midwifery; Midwifery profession; In-service training; Delphi technique

Research on stakeholders of public hospital in China

Objective To confirm the connotation, constitution and classification of the stakeholders in public hospital. Methods The stakeholders of public hospital were proposed through the brainstorm method and literature search. On this basis, the expert consultation scale was developed by using the score-based approach for reference The stakeholders of public hospital were confirmed and classified through two-round expert consultation. Results The research confirms 16 stakeholders of public hospital on the 80% level of support ratio by experts. There were 10 core stakeholders, 5 latent stakeholders and 1 marginal stakeholder. Conclusion Appropriate stakeholder management strategy should be taken for different types of stakeholders. Key words: Public hospital; Stakeholder