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Content analysis of the nursing diagnosis of ineffective peripheral tissue perfusion in patients with diabetic foot

Abstract

Aim

To analyse the content of the nursing diagnosis ineffective peripheral tissue perfusion in patients with diabetic foot.

Design

A methodological study with a quantitative approach was performed.

Methods

The analysis was performed between January and May 2021 by 34 nurses with clinical/theoretical/research experience with diabetes or nursing diagnoses. These nurses evaluated the relevance, clarity and precision of 12 diagnosis-specific etiological factors, 22 clinical indicators and their conceptual and operational definitions.

Findings

All 12 etiological factors analysed were considered relevant to diagnostic identification. However, five showed inconsistencies regarding the clarity or precision of the operational definitions, requiring adjustments. Regarding the 22 clinical indicators evaluated, all of them presented a Content Validity Index (CVI) that was statistically significant. However, in the indicators, the colour does not return to lowered limb after 1 min of leg elevation, and cold foot had Content Validity Index (CVI) <0.9 regarding relevance and accuracy of operational definitions.

Conclusions

Twelve etiological factors and 22 clinical indicators were validated. Thus, this study revealed new and relevant aspects characterising peripheral perfusion in patients with diabetic foot that have not yet been clinically validated.

Implications for Nursing Practice

This study contributes to support the professional practice of nurses through the early identification of etiological factors and clinical indicators in persons with diabetic foot. As a proposal, we suggest the inclusion of new defining characteristics and related factors for the nursing diagnosis ineffective peripheral tissue perfusion in the NANDA-I taxonomy.

Impact

The research highlights new and relevant aspects such as etiological factors and clinical indicators to characterise peripheral perfusion in patients with diabetic foot. Based on these findings, clinical validation is recommended to confirm the relevance of the proposed elements in the population studied for greater reliability and improved diagnostic assessment for the professional practice of nurses.

Reporting Method

EQUATOR guidelines were adhered to using the GRRAS checklist for reporting reliability and agreement studies.

Patient or Public Contribution

No patient or public contribution.

The Standardized Pressure Injury Prevention Protocol Checklist 2.0: Content validation

Abstract

Background

Pressure injury prevention is complex, and rates continue to rise. Checklists reduce human error, improve adherence and standardization with complex processes, focus attention on evidence-based practices derived from clinical practice guidelines and are arranged in a systematic manner to manage the entirety of a patient's risk for preventable outcomes. The original Standardized Pressure Injury Prevention Protocol was created to provide a checklist of pressure injury prevention measures but needed revision and validation.

Purpose

This article describes the revision and content validity testing of the Standardized Pressure Injury Prevention Protocol Checklist 2.0 that took place in 2022.

Methods

Using the International 2019 Clinical Practice Guideline as a foundation, items were identified/revised, and expert review of the items was obtained. The Standardized Pressure Injury Prevention Protocol 2.0 underwent three rounds of revision by experts from the National Pressure Injury Advisory Panel. A panel of eight national experts completed the content validity survey. Individual item content validity index and total scale content validity index were used to summarize the content validity survey scores.

Results

The individual item content validity index scores ranged from 0.5 to 1.0. One item (using a mirror to look at heels) was rated as 0.5, three items were 0.75, 20 items were 0.875 and 23 items were 1.0. The item scoring 0.5 was deleted. Those items scoring 0.75 were revised using the content experts' recommendations. The total scale content validity index was 0.93.

Conclusion

The Standardized Pressure Injury Prevention Protocol 2.0 provides a standardized checklist of evidence-based items that operationalize a rigorous clinical practice guideline for the prevention of pressure injuries. Early intervention using a standardized approach and evidence-based checklist that can be integrated into the workflow of the direct-care nurse and provider provides the best opportunity for successful and sustainable pressure injury prevention.

Preparación preoperatoria: la percepción de la persona que se somete a una cirugía programada

Objetivo principal: Conocer la percepción de la persona sometida a una cirugía general programada sobre su preparación preoperatoria. Método: Estudio cualitativo y exploratorio. Se realizaron diez entrevistas semiestructuradas con personas que se habían sometido a una cirugía general programada en los últimos seis meses en un hospital universitario de la región central de Portugal. Para analizar los datos se utilizó la técnica del análisis de contenido. Resultados principales: Surgieron cinco unidades temáticas, percepción de la experiencia quirúrgica, sentimientos/emociones percibidas, necesidades de información, expectativas sobre los cuidados de enfermería preoperatorios y perspectivas sobre la existencia de una consulta de enfermería, que se subdividieron en varias categorías y subcategorías. Conclusión principal: Algunas personas siguen viendo la experiencia quirúrgica como algo traumático y consideran el entorno quirúrgico como un generador de estrés. Este estudio refuerza la relevancia del personal de enfermería en la preparación de las personas en situaciones perioperatorias y puede proporcionar importantes contribuciones a la estructuración de una consulta de enfermería.

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