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To analyse the content of the nursing diagnosis ineffective peripheral tissue perfusion in patients with diabetic foot.
A methodological study with a quantitative approach was performed.
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.
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.
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.
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.
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.
EQUATOR guidelines were adhered to using the GRRAS checklist for reporting reliability and agreement studies.
No patient or public contribution.
To explore nurse-midwives' perceptions of safety culture in maternity hospitals.
A descriptive phenomenological study was conducted using focus groups and reported following the Consolidated Criteria for Reporting Qualitative Research.
Data were obtained through two online focus group sessions in June 2022 with 13 nurse-midwives from two maternity hospitals in the central region of Portugal. The first focus group comprised 6 nurse-midwives, and the second comprised 7 nurse-midwives. Qualitative data were analysed using content analysis.
Two main themes emerged from the data: (i) barriers to promoting a safety culture; (ii) safety culture promotion strategies. The first theme is supported by four categories: ineffective communication, unproductive management, instability in teams and the problem of errors in care delivery. The second theme is supported by two categories: managers' commitment to safety and the promotion of effective communication.
The study results show that the safety culture in maternity hospitals is compromised by ineffective communication, team instability, insufficient allocation of nurse-midwives, a prevailing punitive culture and underreporting of adverse events. These highlight the need for managers to commit to providing better working conditions, encourage training with the development of a fairer safety culture and encourage reporting and learning from mistakes. There is also a need to invest in team leaders who allow better conflict management and optimization of communication skills is essential.
Disseminating these results will provide relevance to the safety culture problem, allowing greater awareness of nurse-midwives and managers about vulnerable areas, and lead to the implementation of effective changes for safe maternal and neonatal care.
There was no patient or public contribution as the study only concerned service providers, that is, nurse-midwives themselves.
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