Developing a trauma care syllabus for intensive care nurses in the United Kingdom: A Delphi study

Development of a care package to prevent medical device-related pressure injuries using the Delphi Method: A maintenance care package development study

AIM

The purpose is to develop a care package for the prevention of medical device-related pressure injuries using the Delphi Method.

DESIGN

The study is a methodological.

METHOD

The care package was developed using the Delphi Method, a consensus-based technique. Two expert groups were selected to develop the care package to prevent medical device-related pressure injuries. The invitation letter and the questionnaire consisting of two questions were sent to the relevant experts via email and completed in three rounds after receiving responses. The scores from the experts were uploaded to the SPSS 25.0 software package. The range (R) was calculated as R = Q3-Q1. The differences (R) between the quartiles were examined. Items with R < 1.2 were accepted as having reached a consensus.

RESULTS

As a result of the evaluation, it was organized as 83 items. As a result of the analysis of the scores of the second round of the Delphi Method, the range values of each item were examined. In the third round of the Delphi Method, it was found that consensus was reached in the third round on items 18, 29, and 56, on which consensus could not be reached in the second round, and the care package was accepted with 83 items.

CONCLUSION

An 83-item care package was created to prevent medical device-related pressure injuries in children.

Developing effective In-Service Education for intensive care nurses: Exploring the views of clinical stakeholders in the Kingdom of Saudi Arabia

BACKGROUND

Evidence-based in-service education (ISE) in the intensive care unit (ICU) is essential to maintaining nurse skill and competence in this complex clinical area. However, there has been limited research that has focused on developing and optimising the specialised training required by ICU nurses working in trauma care.

OBJECTIVES

To explore the perspectives of ICU clinical stakeholders regarding their needs and preferences for ISE to inform the future development and implementation of effective educational interventions.

DESIGN

A qualitative, multiple-case study supported by the "Empowering Education" theoretical framework, which emphasises the importance of stakeholder involvement in education development.

SETTINGS

Adult ICUs in three major hospitals located in two geographical areas in Saudi Arabia.

PARTICIPANTS

Forty clinical nurses, twelve nurse managers, nine nurse leaders and seven clinical educators participated.

METHODS

Data were collected through semi-structured interviews followed by focus groups. Framework analysis was used for data analysis.

FINDINGS

Stakeholders wanted ISE and training by subject experts characterised by: (i): relevant educational content; (ii): a range of educational techniques and (iii) flexible delivery and format. Nurses also identified factors that encouraged them to participate in ISE including adequate resources and a supportive work environment, whilst heavy workloads, cost and scheduling issues hindered engagement.

CONCLUSION

This paper highlights the importance of considering staff needs and local context when developing in-service ICU education to support nurses' competence. Further recommendations and a proposed framework to develop future ISE in the ICU are provided.

TWEETABLE ABSTRACT

The key to effective in-service education for ICU nurses is understanding stakeholders' needs and motivational drivers, whilst addressing barriers to successful implementation.

In-service education in trauma care for intensive care unit nurses: An exploratory multiple case study

AIM

This study explores the perceptions of intensive care units (ICUs) nurses with different educational backgrounds regarding their abilities in trauma care and the in-service education they receive to support it.

BACKGROUND

The advanced care of patients with traumatic injuries in ICU environments requires skilled and knowledgeable nurses, who need continuing and in-service education to provide the best care. Therefore, it is essential to understand the competencies and educational support these nurses may need in the ICUs to ensure safe and effective care delivery.

DESIGN

An exploratory multiple case study design was used, comprising three hospitals located in two different regions of Saudi Arabia.

METHODS

The study was conducted between October 2021 and March 2022. A total of forty ICU clinical staff, twelve managers, nine leaders and seven clinical educators participated in semi-structured interviews, which were complemented by a review of available documents on the trauma care in-service education syllabi, competencies and protocols. Interview data were analysed according to the Framework analysis approach, while documents were reviewed using qualitative content analysis.

FINDINGS

The data analysis revealed two interrelated categories relevant to trauma care: (i) care practice and (ii) education practice. The trauma care practice category highlighted the limited competencies and education in trauma care, as well as the perceived challenges and educational needs of nurses. The education practice category described the staff learning behaviours, supervision practices and in-service education systems in the participants' settings.

CONCLUSIONS

The study concludes that there is a lack of trauma care education at the examined sites. It suggests the need for further research to develop a theoretical foundation for trauma care education that can meet ICU nurses' educational needs while this being feasible to implement in the specific ICU context and practice.

Developing a core competency training curriculum system for emergency trauma nurses in China: a modified Delphi method study

OBJECTIVES

To develop a core competency training curriculum system for emergency trauma nurses in China.

DESIGN

A modified Delphi study design.

PARTICIPANTS

The selection criteria for participants identified in practitioner roles were to be currently engaged in trauma care for over 5 years, to serve as the manager of emergency or trauma surgery department, and to have a bachelor's degree or higher. A total of 15 trauma experts from three grade A tertiary hospitals were invited to participate in this study by email or face to face in January 2022. The expert group comprised four trauma specialist doctors and 11 trauma specialist nurses. There were 11 women and 4 men. The age ranged from 32 to 50 (40.27±5.120) years. The number of years worked ranged from 6 to 32 (15.87±7.110).

RESULTS

Two rounds of questionnaires were issued to 15 experts in each round, and the effective recovery rate was 100.00%. In this study, expert judgement=0.947, expert familiarity with the content=0.807 and authority coefficient=0.877, and the results are highly reliable. The Kendall's W of the two rounds in this study ranged from 0.208 to 0.467, and the difference was statistically significant (p<0.05). In the two rounds of expert consultations, four items were deleted, five items were modified, two items were added and one item was merged. Ultimately, the curriculum system of core competency training for emergency trauma nurses includes training objectives (8 theoretical knowledge and 9 practical skills), training contents (6 first-level indicators, 13 second-level indicators and 70 third-level indicators), training methods (9), evaluation indicators (4) and evaluation methodologies (4).

CONCLUSIONS

This study proposed a core competency training curriculum system with systematic and standardised courses for emergency trauma nurses, which could be applied to assess trauma care performance, highlight areas for improvement for emergency trauma nurses and contribute to the accreditation of emergency trauma specialist nurses.

Establishing the research priorities for major trauma in the United Kingdom: A Delphi study of nurses and allied health professionals

BACKGROUND

Research prioritisation exercises are used to determine which areas of research are important. In major trauma care, nurses and allied health professionals are central to the delivery of evidence-based care but their opinions on research priorities are under-represented in the literature. We aimed to identify the research priorities of major trauma nurses and allied health professionals in the UK.

METHODS

A three-round electronic Delphi study was conducted in the UK between November 2019 and May 2021. Round one aimed to generate research questions with rounds two and three questions in order of priority. In stages two and three responses were analysed using descriptive statistics to compute frequencies and proportions for the ranking of each question.

RESULTS

Survey rounds were completed by 180, 100 and 91 respondents respectively. The first round generated 285 statements that were condensed into 71 research questions. Analysis of rankings in subsequent rounds prioritised 54 research questions across themes of adult / children's acute care, psychological care and workforce, training and education.

DISCUSSION

Nurses and AHPs are well-positioned to determine research priorities in major trauma care. Focusing on these priorities will guide future research and help to build an evidence-base in trauma care.

Psychological and psychosocial aspects of major trauma care in the United Kingdom: A scoping review of primary research

Introduction

More people are surviving major trauma, often with life changing injuries. Alongside physical injury, many survivors of major trauma experience psychological and psychosocial impacts. Presently, there is little guidance at the UK national level for psychological and psychosocial aspects of major trauma care. Set in the context of the regional model of major trauma care implemented in the UK in 2012, the purpose of this review was to identify and bring together primary research about psychological and psychosocial aspects of major trauma care in the UK to produce an overview of the field to date, identify knowledge gaps and set research priorities.

Methods

A scoping review was undertaken. Seven electronic databases (MEDLINE, Cochrane Library, CINAHL, Embase, PsycINFO, SocINDEX with Full Text and PROSPERO) were searched alongside a targeted grey literature search. Data from included studies were extracted using a predefined extraction form and underwent bibliometric analysis. Included studies were then grouped by type of research, summarised, and synthesised to produce a descriptive summary and overview of the field.

Results

The searches identified 5,975 articles. Following screening, 43 primary research studies were included in the scoping review. The scoping review, along with previous research, illustrates that psychological and psychosocial impacts are to be expected following major trauma. However, it also found that these aspects of care are commonly underserved and that there are inherent inequities across major trauma care pathways in the UK.

Conclusion

Though the scoping review identified a growing body of research investigating psychological and psychosocial aspects of major trauma care pathways in the UK, significant gaps in the evidence base remain. Research is needed to establish clinically effective psychological and psychosocial assessment tools, corresponding interventions, and patient-centred outcome measures so that survivors of major trauma (and family members or carers) receive the most appropriate care and intervention.

The effectiveness of educational interventions on trauma intensive care unit nurses' competence: A systematic review and meta-analysis

OBJECTIVES

To examine the current evidence on the effect of education on intensive care unit nurses' knowledge and skills competence in caring for adult major trauma patients.

METHODOLOGY

A systematic review and meta-analysis was conducted to identify relevant studies through a comprehensive search, following strict eligibility criteria. Five databases were searched: MEDLINE, PubMed, CINAHL, Cochrane and Web of Science. A subsequent hand search was performed. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument tool was used to assess methodological quality.

RESULTS

Five eligible quantitative studies were identified and appraised. The overall results demonstrated that educational interventions have positive effects in improving intensive care nurses' knowledge and practice in managing major trauma patients. Meta-analysis was applied to three homogenous studies relating to knowledge outcome. Results demonstrated significant improvements immediately post-intervention and at one-to three-month follow-up [MD (mean difference) = 29.12, 95%CI (confidence interval) 10.29-47.95; P < 0.00001], and [MD = 23.70, 95%CI 8.84-38.56; P < 0.00001], respectively. A slight decrease in the knowledge and practice scores was noted from one- to three-month follow-up.

CONCLUSION

This review demonstrated the significant effects of trauma education on improving intensive care nurses' knowledge and practices. Further research should develop valid competencies and policies to drive nurses' practice and potentially improve the safety and quality of care.

Determining the Education and Research Priorities in Pediatric Trauma Nursing: A Delphi Study

Trauma has a greater impact on morbidity and mortality than all other disease processes in the pediatric population; yet, there is a gap in the literature related to the scientific basis for educating and researching future practice. The purpose of this research study was to utilize the Delphi technique to identify the current education and research priorities for pediatric trauma nursing as described by the members of the Society of Trauma Nurses. Consensus on the education and research priorities was derived from a sample (n = 25) of trauma nursing experts. The pediatric trauma nursing education priorities are the following: (1) initial resuscitation; (2) assessment; and (3) evidence-based practice. The pediatric trauma nursing research priorities are the following: (1) impact of nursing care on outcomes; (2) initial resuscitation; and (3) critical care. Future efforts in educational program development and research study should focus on these priorities.