...the impact on healthcare services has been immense, whether through the acute pressures on hospital capacity during each wave of the pandemic, the need to redesign service delivery in order to ...minimise face-to-face interaction, or the long-term consequences of reduced elective and preventative services. The WHO estimates that as of May 2021, approximately 115 000 healthcare workers have died from COVID-19.2 The impact of the pandemic on the mental health and well-being on practitioners has been well-documented, with anxiety, depression and post-traumatic stress disorder being reported in nurses,3 along with increased risk of burnout and emotional exhaustion.4 Some healthcare workers, including nurses, have also been subject to bullying and stigma, partly due to the perception that they are more likely to contract and spread COVID-19.5 In the short-term then, the nursing profession’s focus must be on supporting its members’ well-being as we hopefully (given the roll-out of vaccinations globally) move into final stages of the pandemic. ...any benefit from increased student nurse recruitment may be offset by nurses leaving the profession due to the psychological and physical impact of COVID-19.
What are Delphi studies? Barrett, David; Heale, Roberta
Evidence-based nursing
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3
Journal Article
Odprti dostop
Specifically, they developed an approach—named after the Ancient Greek Oracle of Delphi, who could predict the future—which promoted anonymity and avoided direct confrontation between experts, so ...that the methods employed “…appear to be more conducive to independent thought on the part of the experts and to aid them in the gradual formation of a considered opinion”.1 Though the original Delphi study was linked to the defence industry, the technique has spread to other research areas, including nursing.2 Characteristics of Delphi studies As with all research methods, the Delphi technique has evolved since it was first reported on in the 1960s. ...participants are able to see the results of previous rounds—including their own responses—allowing them to reflect on the views of others and reposition their own opinions accordingly.2 This also gives them the opportunity to consider and feedback on what they perceive to be the strengths and weaknesses of other’s responses. ...the findings of each round are always shared with the broader group anonymously. Analysis of this scoring then allowed for consensus conclusions on the top 10 human factors that contributed to nursing errors (with fatigue, heavy workload and communication problems the top three).3 In another example, nurse practitioners (NPs) were recruited to participate in a Delphi study to achieve consensus related to NP advance care planning competencies.
Correspondence to Dr Roberta Heale, School of Nursing, Laurentian University, Sudbury, ON P3E2C6, Canada; rheale@laurentian.ca Nurses’ burn-out Ghassemi, A. ‘Burnout in nurses during the COVID-19 ...pandemic: the rising need for development of evidence-based risk assessment and supportive interventions’ (July 2022) https://ebn.bmj.com/content/25/3/94 Commentary on: Mudallal, R., Othman, W., Hassan, N. ‘Nurses’ Burnout: The Influence of Leader Empowering Behaviors, Work Conditions, and Demographic Traits’ Inquiry. 2017 Jan-Dec; 54: 0046958017724944 doi: 10.1177/0046958017724944 ‘This study highlights the importance of the role of nurse leaders in improving work conditions and empowering and motivating nurses to decrease nurses’ feelings of burn-out, reduce turnover rates and improve the quality of nursing care.’ Gemine, R., Davies, G., Tarrant, S., Davies, R., James, M., Lewis, K. ‘Factors associated with work-related burn-out in NHS staff during COVID-19: a cross-sectional mixed-methods study’, BMJ Open https://bmjopen.bmj.com/content/11/1/e042591 Analysis linked burn-out included changes to workload and responsibility and lack of control through redeployment and working patterns.
Nurse practitioners (NPs) in Ontario work in a number of settings, including physician-led, interprofessional Family Health Teams (FHTs). However, many aspects of NP practice within the FHTs are ...unknown. Our study aimed to describe the characteristics of NP practice in FHTs and the relationships between NPs and physicians within this model. This cross-sectional descriptive study analyzed NP service and diagnostic code data collected for every NP patient encounter from 2012 to 2015. Encounter data were linked to health administrative data housed at the Institute for Clinical Evaluative Sciences to allow for comparison with physician service and diagnostic codes. Findings demonstrated that NPs saw patients across all age groups for one to more than five problems per encounter and that NPs handled both acute and episodic care and chronic disease management issues. Patients with chronic conditions had more encounters with physicians than with NPs. In addition, compared to physicians, NPs saw more female than male patients. Our findings provide a snapshot of NP practice in FHTs and may be useful in informing other practice models in Ontario, elsewhere in Canada, and internationally. More evidence is needed, however, to clarify the responsibilities of the NPs in collaborative relationships with physicians and to embed policies that will ensure that NPs work to their full potential. In addition, applying service coding to all health care providers in FHTs could enhance data on interprofessional teams and the individual clinicians that comprise them.
Correspondence to Dr Roberta Heale, School of Nursing and Allied Health Professions, Laurentian University, Sudbury, ON P3E 2C6, Canada; rheale@laurentian.ca Long COVID Primary Care Nursing’s 'huge ...role' in long Covid, by Kate Oxtoby, Nursing in Practice, 22 December 2021 https://www.nursinginpractice.com/community-nursing/primary-care-nursings-huge-role-in-long-covid/ Primary care and community nurses have an important role in supporting patients with long COVID and can use their existing knowledge and skills in relation to long-term conditions to help individuals with this new condition. Recommendations for the recognition, diagnosis, and management of long COVID: a Delphi study, by Martine Nurek, Clare Rayner, Anette Freyer, Sharon Taylor, Linn Järte, Nathalie MacDermott and Brendan C Delaney https://bjgp.org/content/71/712/e815 A Delphi study was conducted with a panel of primary and secondary care doctors with the aim of providing a rapid expert guide for general practitioners (GPs) and long COVID clinical services. Evaluating and Caring for Patients with Post-COVID Conditions: Interim Guidance https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/post-covid-index.html This content offers detailed interim guidance for healthcare providers for the assessment and care of patients with post-COVID-19 conditions.
Table 1 Type of validity Description Content validity The extent to which a research instrument accurately measures all aspects of a construct Construct validity The extent to which a research ...instrument (or tool) measures the intended construct Criterion validity The extent to which a research instrument is related to other instruments that measure the same variables The first category is content validity. ...a correlation coefficient of less than 0.3 signifies a weak correlation, 0.3-0.5 is moderate and greater than 0.5 is strong. 4 Equivalence is assessed through inter-rater reliability.
Created by providers, for providers https://cep.health/ Enhancing Management of Chronic Conditions Using Virtual Care During COVID-19 ...https://tools.cep.health/tool/virtual-management-of-chronic-conditions-during-covid-19/ This resource is designed to improve provider confidence in implementing virtual care to support quality chronic disease management. Centers for Disease Control and Prevention https://www.cdc.gov/coronavirus/2019-ncov/index.html Evaluating and Caring for Patients with Post-COVID Conditions: Interim Guidance https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/post-covid-index.html This content offers detailed interim guidance for healthcare providers for the assessment and care of patients with post-COVID conditions. Registered Nurses' Association of Ontario www.rnao.org Nursing Quality Indicators for Reporting and Evaluation (NQuIRE) https://rnao.ca/bpg/initiatives/nquire NQuIRE collects, analyses and reports comparative data on nursing-sensitive indicators reflecting the structure, process and outcomes of care arising from Best Practice Guidelines implementation in organisations participating in Registered Nurses’Association of Ontario (RNAO’s)Best Practice Spotlight Organization designation.
The Nurse Practitioner-Led Clinic (NPLC) is a new model of primary healthcare. The wholistic approach of nurse practitioner (NP) led care in an NPLC that implements Advanced Access scheduling has the ...potential to enhance timely access to care and improve health outcomes. The purpose of this study was to determine the experience of patients in one NPLC as well as their healthcare behaviours related to Advanced Access scheduling. A previously developed survey with items related to appointment access, health behaviours and satisfaction was mailed once to patients at a NPLC in northern Ontario. 535 patients replied for a response rate of 29%. A majority (85.4%) were able to access same-day appointments. Access to same-day appointments was associated with less likelihood of attending a walk-in-clinic or emergency department in addition to self-reports of improvements in lifestyle and better control of medical condition(s). Advanced access scheduling contributes to optimal patient care in an NPLC setting. The NP role in lifestyle counselling and wholistic care in the NPLC model contributes to improved self-reported health. Access to an appointment at a point of ‘readiness’ may positively contribute to lifestyle changes and overall health of patients.
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