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To develop and psychometrically test a comprehensive Cancer Nurse Self-Assessment Tool (CaN-SAT).
Modified Delphi to assess content validity and cross-sectional survey to assess reliability and validity.
Phase 1: An expert group developed the tool structure and item content. Phase 2: Through a modified Delphi, cancer nursing experts rated the importance of each element of practice and assessed the relevance and clarity of each item. Content Validation Indexes (CVI) were calculated, and a CVI of ≥ 0.78 was required for items to be included. Phase 3: Cancer nurses participated in a survey to test internal consistency (using Cronbach's alpha coefficients) and known-group validity (through Mann–Whitney U tests). This study was reported using the Guidelines for Reporting Reliability and Agreement Studies (GRRAS) checklist.
The CaN-SAT underwent two rounds of Delphi with 24 then 15 cancer nursing experts. All elements of practice were rated as important. Only three items achieved a CVI < 0.78 after round one; however, based on open-ended comments, 26 items were revised and one new item added. After round two, all items received a CVI above 0.78. The final tool consisted of 93 items across 15 elements of practice. Cronbach's alpha coefficients were between 0.92 and 0.98 indicating good reliability. Mann–Whitney U tests demonstrated significant differences between clinical nurses and advanced practice nurses across 13 out of 15 elements of practice.
The CaN-SAT is a comprehensive, valid and reliable tool that can be used for cancer nurses to self-assess current skill levels, identify their learning needs and inform decisions about educational opportunities to optimise cancer care provision.
The research team included three patient advocates from Cancer Voices NSW, who were actively involved in all aspects of the study and are listed as authors.
Cluster analysis, a machine learning-based and data-driven technique for identifying groups in data, has demonstrated its potential in a wide range of contexts. However, critical appraisal and reproducibility are often limited by insufficient reporting, ultimately hampering the interpretation and trust of key stakeholders. The present paper describes the protocol that will guide the development of a reporting guideline and checklist for studies incorporating cluster analyses—Transparent Reporting of Cluster Analyses.
Following the recommended steps for developing reporting guidelines outlined by the Enhancing the QUAlity and Transparency Of health Research Network, the work will be divided into six stages. Stage 1: literature review to guide development of initial checklist. Stage 2: drafting of the initial checklist. Stage 3: internal revision of checklist. Stage 4: Delphi study in a global sample of researchers from varying fields (n=) to derive consensus regarding items in the checklist and piloting of the checklist. Stage 5: consensus meeting to consolidate checklist. Stage 6: production of statement paper and explanation and elaboration paper. Stage 7: dissemination via journals, conferences, social media and a dedicated web platform.
Due to local regulations, the planned study is exempt from the requirement of ethical review. The findings will be disseminated through peer-reviewed publications. The checklist with explanations will also be made available freely on a dedicated web platform (troca-statement.org) and in a repository.
To compile and compare the Comprehensive Geriatric Assessment (CGA) models that exist worldwide and their applicability in primary healthcare (PHC).
The world’s population is ageing rapidly, but health systems are slow to keep up with this trend, making it difficult to provide care for older adults. The broad concept of frailty has prompted a comprehensive and holistic approach to patients, where the assessment is related not only to functional, physical and cognitive abilities of the older adults, but also their social, environmental and economic context. In recent decades, the approach to frailty has taken the CGA as the gold standard. With this project, we intend to carry out a scoping review to identify and describe tools to help standardise and generalise CGA in PHC.
Individuals aged 65 years or over; CGA in a PHC setting; the CGA methods reported must include at least three domains: physical, cognitive and social; Articles without language restrictions; Articles published in the last 30 years.
All studies that refer to CGA models and fulfil the inclusion criteria will be selected. A bibliographic search of articles will be carried out using the following electronic scientific publication databases: MEDLINE-PubMed, Embase, Cochrane Library and Web of Science. We will search for grey literature on sites such as ‘OpenGrey’ and thesis repositories such as RCAAP, EBSCO and EThOS, as well as on the WHO pages. The articles will be independently selected by two reviewers, and the data will be presented in narrative format, structured according to the objective, focus and question of the review.
Approved by the ethics committee of the regional health administration of the centre, registered as Project 11/2024 and approved on 8 May 2024. The findings of this study will be disseminated through peer-reviewed publications and national or international conference presentations. Updates of the review will be conducted, as necessary.
Open Science (DOI 10.17605/OSF.IO/REH43).
by Mai Dinh Thanh, Gemma Agustí, Anneluise Mader, Francesc Codony
Staphylococcus (S.) aureus is a prominent foodborne pathogen that can cause food poisoning due to its staphylococcal toxins. Controlling the viable levels of S. aureus is crucial for ensuring food safety. The detection of S. aureus during routine quality control is still primarily conducted using traditional culture-based methods, which are time-consuming and unable to detect viable but non-culturable cells. Viability PCR (vPCR) – a combination of traditional (or quantitative) PCR with photo-reactive DNA-intercalating dye(s) – has been introduced as an alternative to detect viable cells by excluding those with compromised membranes using molecular methods. Despite the success of the vPCR methodology, avoiding false-positive results remains a significant challenge. To enhance the accuracy of vPCR results for S. aureus, several approaches have been proposed by various researchers in the past decade; however, complete PCR signal suppression of dead cells has not been achieved. In this study, we developed a strategy to detect only viable S. aureus cells by combining double PMA treatment with a low PMA concentration and performing a tube change between the last dark incubation and light exposure to improve the vPCR protocol. For pure cultures, the optimized protocol was able to completely suppress DNA signals from 5.0 × 107 dead cells in a final reaction volume of 200 µl. For artificially contaminated food samples with such a high dead cell count, complete PCR signal reduction was observed in ground pepper, - oregano, and infant milk powder, while ground paprika, - allspice, and - pork exhibited PCR signals close to the detection limit. To simulate conditions in real samples, we artificially contaminated ground paprika, - pork, and milk powder with a low number of viable cells (~1.9 cfu/ml) and a high number of heat-inactivated S. aureus (~4.8 × 10⁶ cells/ml). The results showed that the optimized protocol is effective in detecting only the desired live cells, even in the presence of a high dead cell count. Our findings highlight that vPCR can be an accurate and reliable method with strong potential for high-throughput detection of live S. aureus cells in certain food matrices.The aim of this study was to (i) identify barriers and enablers and (ii) inform mitigating or strengthening strategies for implementing nurse-initiated care protocols at scale in emergency departments (EDs).
Embedded mixed methods.
The study included four clusters with a total 29 EDs in NSW, Australia. Concurrent quantitative and qualitative data were collected via electronic nursing and medical staff surveys and analysed. Barriers and enablers to implementation were identified and mapped to the domains of the Theoretical Domains Framework (TDF). Selection of intervention functions and behaviour change techniques (BCTs) enabled development of implementation strategies.
In total, 847 responses from nursing and medical staff (43%) reported four enablers for use and implementation: (i) knowing or being able to learn to use simple nurse-initiated care; (ii) protocols help staff remember care; (iii) carefully considered education programme with protected time to attend training; and (iv) benefits of nurse-initiated care. Nine barriers were identified: (i) lack of knowledge; (ii) lack of skills to initiate complex care (paediatric patients, high-risk medications and imaging); (iii) risk for inappropriate care from influence of cognitive bias on decision-making; (iv) punitive re-enforcement; (v) protocols that are too limited, complex or lack clarity; (vi) perceived lack of support from medical or management; (vii) perception that tasks are outside nursing role; (viii) concern nurse-initiated care may increase the already high workload of medical and nursing staff; and (ix) context. The barriers and enablers were mapped to nine TDF domains, five intervention functions and 18 BCTs informing implementation using strategies, including an education programme, pre-existing videos, audit and feedback, clinical champions and an implementation plan.
A rigorous, systematic process generated a multifaceted implementation strategy for optimising nurse-initiated care in rural, regional and metropolitan EDs.
Staff wanted safe interventions that did not lead to increased workload. Staff also wanted support from management and medical teams. Common barriers included a lack of knowledge and skill in advanced practice. Clinicians and policymakers can consider these barriers and enablers globally when implementing in the ED and other high-acuity areas. Successful strategies targeting barriers to advanced practice by emergency nurses can be addressed at the local, state and national levels.
Implementation of new clinical practices in the ED is complex and presents challenges. Key barriers and enablers, including those related to initiating care and workloads in the ED were identified in this study. This research broadly impacts ED staff and policymakers globally.
Mixed Methods Reporting in Rehabilitation & Health Sciences (MMR-RHS).
Site senior nurse researchers for each cluster worked closely with site stakeholders, including local consumer groups. Consumer councils were engaged at all the sites. Site visits by the research nurses have been an important strategy for discussing the study with key stakeholders.
Australian and New Zealand Clinical Trial: ACTRN12622001480774p
To develop and psychometrically test two newly developed Cancer Nurse Self-Assessment Tools for early and metastatic breast cancer (CaN-SAT-eBC and CAN-SAT-mBC).
Instrument development and psychometric testing of content validity, reliability and construct validity.
A three-phase procedure was conducted. Phase 1: An expert working group was formed to design and develop each tool using Benner's Model of Clinical Competence. Phase 2: The Content Validation Index (CVI) was used to assess the relevance and clarity of each item on the tools with breast cancer nurse experts and nursing educators. A CVI ≥ 0.78 was required for an item to be included in each tool. Phase 3: The tools were tested for internal consistency using Cronbach's alpha and construct validity using principal component analysis (PCA). The Guidelines for Reporting Reliability and Agreement Studies were followed in reporting this study.
Each tool underwent two rounds of content validation. Ten experts were involved in the content validation for the CaN-SAT-eBC and 12 experts involved for CaN-SAT-mBC. The final versions comprised 18 (CAN-SAT-eBC) and 22 elements (CaN-SAT-mBC). All items obtained a satisfactory CVI of 0.83–1.0. Data from 159 and 126 nurses were analysed to evaluate reliability for CaN-SAT-eBC and CaN-SAT-mBC, respectively. The Cronbach's alpha coefficients for all elements were between 0.83 and 0.98. The PCA supported that each element was unidimensional and composed of internally correlated items, with the exception of the ‘Diagnostics’ element of practice which has a two-component structure measuring basic and advanced diagnostic tasks.
The two CaN-SATs are comprehensive, valid and reliable. They can be used for self-assessment by nurses in relation to breast cancer care and for identifying learning needs for long-term professional development. The self-assessment tools can also be used to develop education initiatives for specialised breast cancer nurses.
No patient or public contribution.
Objetivo principal: Identificar los factores que subyacen al juicio clínico de las enfermeras sobre el empoderamiento del cuidador. Metodología: Estudio cualitativo y exploratorio. Los participantes fueron 10 enfermeras expertas que pertenecían a un grupo que apoya a sus colegas en el diseño de los cuidados apoyados en modelos teóricos y enfermeras expertas en el empoderamiento de los cuidadores, en un hospital universitario. Se realizaron entrevistas semiestructuradas con grabación de audio. Los datos se analizaron mediante la técnica de análisis de contenido. Resultados principales: Emergieron tres temas, las enfermeras, los cuidadores y las dificultades y limitaciones, que se subdividieron en ocho subtemas. Se identificaron factores facilitadores, así como limitaciones y dificultades asociadas a la asunción y gestión del rol de cuidador. Conclusión principal: El empoderamiento del cuidador es un proceso complejo, en el que los cuidados de enfermería se centran más en la persona dependiente y menos en el cuidador, lo que demuestra que es un área que requiere mayor atención y conceptualización por parte de las enfermeras.
FreshRSS 