Vascular access and clinical competency: Which elements matter? The development of three bottom-up and evidence-grounded self-assessment tools

2021 ◽  
pp. 112972982110264
Author(s):  
Carla Rigo ◽  
Marco Grazioli ◽  
Giuseppe Caravella ◽  
Francesco Ursino ◽  
Pietro Zerla ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Vascular Access ◽  
Principal Components ◽  
Self Care ◽  
Assessment Tools ◽  
Face Validity ◽  
Future Research ◽  
Assessment Procedure ◽  
Cross Sectional ◽  
Central Catheters

Background: Assessing competency in the speciality of vascular access is still limited, and few valid and reliable tools are available. Therefore, this study aimed to develop and validate three different tools for assessing competency in managing the care of short peripheral cannulas (SPCs), midlines, peripherally inserted central catheters (PICCs), centrally inserted central catheters (CICCs), and arterial catheters (ACs) (tool one), placing SPCs (tool two), placing PICCs and midlines (tool three). Methods: A two-phase and multi-method design was adopted. Phase one was implemented to develop the initial pool of items for each tool, starting from a literature overview. Panel discussions were adopted for developing the items. In phase two, the developed items were tested for content and face validity, involving a panel of 10 experts. Once obtained adequate content validity, a cross-sectional data collection was implemented to enroll three samples of healthcare workers who had to assess their competency through the developed tools. Dimensionality was assessed by performing a principal component analysis (PCA) and assessing internal consistency (Cronbach’s α). Results: Tool one had 26 items, and the dimensionality was given by placement, risk assessment, procedure conformity and traceability, and patient education to self-care. Tool two had 35 items; its principal components were: risk evaluation, identification, clinical assessment and orientation to self-care, placement, and procedure registration shaped the competency of placing SPCs. Tool three had 31 items; its principal components were: risk assessment, placement, conformity to standards and procedure traceability, education, and orientation to self-care were the essential elements for adequately placing midlines and PICCs. Cronbach’s α values ranged between 0.806 and 0.959. Conclusions: The three developed tools reflected the core elements of competency in each application area, representing an initial framework that could be useful in future research and educational projects. Cross-national investigations are required to corroborate the described results.

Risk assessment and risk management in policing

2014 ◽  
Vol 37 (2) ◽  
pp. 239-258 ◽  
Author(s):  
Robert E. Worden ◽  
Christopher Harris ◽  
Sarah J. McLean
Keyword(s):  
Risk Assessment ◽  
Predictive Accuracy ◽  
Good Reason ◽  
Assessment Tools ◽  
Future Research ◽  
Police Misconduct ◽  
Limited Information ◽  
Cross Sectional ◽  
Content Type ◽  
Officer Performance

Purpose – The purpose of this paper is to critique contemporary tools for assessing and managing the risk of police misconduct and suggest directions for their improvement. Design/methodology/approach – The paper draws on extant literature, synthesizing several lines of inquiry to summarize what the authors know about patterns of police misconduct, and what the authors know about assessing and managing police misconduct. Then the paper draws from the literature on offender risk assessment in criminal justice to draw lessons for assessing and managing the risk of police misconduct. Findings – The authors found that there is good reason to believe that the tools used to assess the risk of misconduct make suboptimal predictions about officer performance because they rely on limited information of dubious value, but also that the predictive models on which the tools are based could be improved by better emulating procedures for assessing offenders’ risk of recidivism. Research limitations/implications – Future research should examine cross-sectional and longitudinal patterns of misconduct and associations between risk-related outputs and enforcement activity, develop better measures of criterion variables, and evaluate the predictive accuracy of risk assessment tools. Practical implications – Police managers should make better use of the information available to them, improve the quantity and quality of information if feasible, and cooperate in the necessary research. Originality/value – This paper offers a new synthesis of extant research to demonstrate the limitations of contemporary provisions for assessing the risk of police misconduct, and potential avenues for useful research and improved practice.

scholarly journals Complementary Medicine and Self-Care Strategies in Women with (Recurrent) Urinary Tract and Vaginal Infections: A Cross-Sectional Study on Use and Perceived Effectiveness in The Netherlands

Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 250
Author(s):  
Louise Witteman ◽  
Herman A. van Wietmarschen ◽  
Esther T. van der Werf
Keyword(s):  
Urinary Tract ◽  
The Netherlands ◽  
Complementary Medicine ◽  
Self Care ◽  
Future Research ◽  
Perceived Effectiveness ◽  
Vaginal Infections ◽  
Cross Sectional ◽  
Treatment Implementation ◽  
Specific Symptoms

Due to the excessive use of antibiotic and antimycotic treatments, the risk of resistant microbes and fungi is rapidly emerging. Previous studies have demonstrated that many women with (recurrent) urinary tract infection (UTI) and/or vaginal infections (VIs) welcome alternative management approaches to reduce the use of antibiotics and antifungals and avoid short- and long-term adverse effects. This study aims to determine which complementary medicine (CM) and self-care strategies are being used by women suffering from (recurrent) UTI and VI in The Netherlands and how they perceive their effectiveness in order to define directions for future research on safety, cost-effectiveness, and implementation of best practices. A cross-sectional online survey was performed among women, ≥18 years old, with a history of UTIs; 162 respondents were included in the data analysis, with most participants aged between 50 and 64 years (36.4%). The women reported having consulted a CM practitioner for UTI-specific symptoms (23.5%) and VI-specific symptoms (13.6%). Consultations of homeopaths, acupuncturists, and herbal physicians are most often reported. Overall, 81.7% of the women suffering from UTI used complementary or self-care strategies besides regular treatment, and 68.7% reported using CM/self-care strategies to treat vaginal symptoms. UTI- related use of cranberries (51.9%), vitamin C (43.8%), and D-mannose (32.7%) were most reported. Perceived effectiveness was mostly reported for homeopathic remedies and D-mannose. The results showed a substantial burden of UTI and VI on daily and sexual activities. Besides the frequency of use, the indication of perceived effectiveness seems to be an important parameter for further and rigorously designed research to encourage nonantibiotic/antifungal treatment implementation into daily clinical practice.

Comparison of IDRS and ADA Diabetes Risk Assessment Tools Reveals Different Rsk Score in Same Population: A Cross-Sectional Analysis in a Tertiary Care Hospital

2021 ◽  
Vol 5 (1) ◽  
pp. 10-18
Author(s):  
N. Akter ◽  
N.K. Qureshi
Keyword(s):  
Type 2 Diabetes ◽  
Risk Assessment ◽  
High Risk ◽  
Risk Score ◽  
Diabetes Risk ◽  
Assessment Tools ◽  
Cross Sectional ◽  
Risk Assessment Tools ◽  
Predicted Risk

Background: To identify individuals at high risk of developing type2 diabetes (T2DM), use of a validated risk-assessment tool is currently recommended. Nevertheless, recent studies have shown that risk scores that are developed in the same country can lead to different results of an individual. The Objective of study was to reveal whether two different risk-assessment tools predict similar or dissimilar high-risk score in same population. Method: This cross-sectional analytical study was carried upon 336 non-diabetic adults visiting the outpatient department (OPD) of Medicine, MARKS Medical College & Hospital, Bangladesh from October 2018 to March 2019. Woman having previous history of Gestational Diabetes Mellitus (GDM) were also included. Both the Indian Diabetes risk Score (IDRS) and the American Diabetes (ADA) Risk Score questionnaire were used to collect the data on demographic and clinical characteristics, different risk factors of an individual subject, and to calculate predicted risk score for developing T2DM. Results: Among 336 subjects, 53.6% were female. The mean (±SD) age of the study subjects was 38.25±1.12 years. The average IDRS predicted risk score of developing T2DM was more in female subjects than male [p<0.05]. Whereas the ADA predicted increased risk score of developing type 2 diabetes was more in male subjects than female (p<0.05). IDRS categorized 37.2 % of individuals at high risk for developing diabetes; [p=0.10], while the ADA risk tool categorized 20.2% subjects in high risk group; [p<0.001]. Conclusions: The results indicate that risk for developing type 2 diabetes varies considerably according to the scoring system used. To adequately prevent T2DM, risk scoring systems must be validated for each population considered.

Translation, cultural adaptation, and validation of the mindful self-care scale among Brazilian palliative care providers

2021 ◽  
pp. 1-7
Author(s):  
Ana Cláudia Mesquita Garcia ◽  
Laura Soares Rodrigues Silva ◽  
Ana Cristina Gonçalves Ferreira ◽  
Vander Monteiro da Conceição ◽  
Everson Meireles ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cultural Adaptation ◽  
Self Care ◽  
Well Being ◽  
Future Research ◽  
Care Providers ◽  
Cross Sectional ◽  
Reliability Indices ◽  
Self Compassion ◽  
Hospice And Palliative Care

Abstract Objective This study aimed to translate, culturally adapt, and validate the Mindful Self-Care Scale (MSCS, 33-item) in a Brazilian hospice and palliative care context. Method This was a cross-sectional study with a sample of 336 Brazilian hospice and palliative care providers. The European Organisation for Research and Treatment of Cancer — Quality of Life Group Translation Procedure protocol was used for the translation and the cultural adaptation process. Psychometric properties supporting the use of the MSCS were examined through confirmatory factor analysis (CFA) and correlation analysis with other instruments to assess congruence to related constructs (resilience and self-compassion). The reliability of the Brazilian-Portuguese version of the MSCS was assessed using Cronbach's α and composite reliability coefficients. Results The six-factor (33-item) model showed a good fit to the data, with satisfactory reliability indices and adequate representation of the scale's internal structure. Further validity is evidenced in the significant, positive correlations found between the MSCS, and similar well-being constructs, namely the Self-Compassion and Resilience scales. Significance of results The findings reveal that the MSCS (33-item) is a valid, reliable, and culturally appropriate instrument to examine the practice of mindful self-care by hospice and palliative care providers in Brazil. More broadly, it represents a promising instrument for future research into self-care practices and well-being among Brazilian healthcare providers.

scholarly journals An mHealth intervention to improve nurses’ atrial fibrillation and anticoagulation knowledge and practice: the EVICOAG study

2018 ◽  
Vol 18 (1) ◽  
pp. 7-15 ◽  
Author(s):  
Caleb Ferguson ◽  
Louise D Hickman ◽  
Jane Phillips ◽  
Phillip J Newton ◽  
Sally C Inglis ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Assessment ◽  
Anticoagulation Therapy ◽  
Bleeding Risk ◽  
Assessment Tools ◽  
Future Research ◽  
Post Intervention ◽  
Mhealth Intervention ◽  
Quasi Experimental ◽  
Nurses Knowledge

Background: There is a need to improve cardiovascular nurses’ knowledge and practices related to stroke prevention, atrial fibrillation and anticoagulation therapy. Aims: The aim of this study was to evaluate the efficacy of EVICOAG – a novel mHealth, smartphone-based, spaced-learning intervention on nurses’ knowledge of atrial fibrillation and anticoagulation. Methods: Nurses employed in four clinical specialties (neuroscience, stroke, rehabilitation, cardiology) across three hospitals were invited to participate. In this quasi-experimental study, 12 case-based atrial fibrillation and anticoagulation learning scenarios (hosted by an mHealth platform) were delivered to participants’ smartphones over a 6-week period (July–December 2016) using a spaced timing algorithm. Electronic surveys to assess awareness and knowledge were administered pre (T1) and post (T2) intervention. Results: From 74 participants recruited to T1, 40 completed T2. There was a 54% mean improvement in knowledge levels post-intervention. The largest improvement was achieved in domains related to medication interaction and stroke and bleeding risk assessment. Post-intervention, those who completed T2 were significantly more likely to use CHA2DS2-VASc (2.5% vs. 37.5%) and HAS-BLED (2.5% vs. 35%) tools to assess stroke and bleeding risk, respectively ( P<0.01). Conclusion: The EVICOAG intervention improved nurses’ knowledge of atrial fibrillation and anticoagulation, and influenced their uptake and use of stroke and bleeding risk assessment tools in clinical practice. Future research should focus on whether a similar intervention might improve patient-centred outcomes such as patients’ knowledge of their condition and therapies, medication adherence, time in the therapeutic range and quality of life.

Venous thromboembolism in medical outpatients – a cross-sectional survey of risk assessment and prophylaxis

2011 ◽  
Vol 105 (01) ◽  
pp. 190-196 ◽  
Author(s):  
Holger Lawall ◽  
Andreas Matthiessen ◽  
Volker Hohmann ◽  
Peter Bramlage ◽  
Sylvia Haas ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Medical Condition ◽  
Assessment Tools ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Limited Mobility ◽  
Substantial Risk ◽  
Medical Outpatients

SummaryThe degree of thromboprophylaxis in medical outpatients is low despite a substantial risk for venous thromboembolism (VTE). This may be attributable to difficulties in assessing risk. Assessment tools like the Haas’ scorecard aid in determining the need for thromboprophylaxis. We aimed at evaluating how the use of this tool may aid physicians in appropriately using anticoagulants. This was an epidemiological, cross-sectional survey of acute medically ill patients with limited mobility treated by general practitioners and internists. Risk assessment for VTE by the treating physician was compared to calculated risk. Of 8,123 patients evaluated between August 2006 and April 2008, 7,271 fulfilled the in- and exclusion criteria. Mean age was 69.4 ± 13.6 years, and 45.2% were male. Of these 82.8% were high risk based on their acute medical condition, 37.9% based on their underlying chronic condition. Immobilisation, heart failure, pneumonia, age, obesity, and major varicosis were the most frequently encountered risk factors. The agreement between the Haas’ scorecard and physician indicated risk was high. At least 94.1% of patients with high risk received adequate anticoagulation mostly as low molecular weight heparins for a mean duration of 15.1 ± 30.5 days. There is a substantial risk for VTE in medical out-patients. Using a simple structured scorecard resulted in an overall appropriate risk assessment and high degree of anticoagulation. The scorecard may provide a tool to improve the overall awareness for VTE risk in medical outpatients, substantially improving the degree of prophylaxis in a patient population with largely underestimated risk.

scholarly journals Associations of maternal stress and/or depressive symptoms with diet quality during pregnancy: a narrative review

2020 ◽  
Author(s):  
Alycia K Boutté ◽  
Gabrielle M Turner-McGrievy ◽  
Sara Wilcox ◽  
Jihong Liu ◽  
Jan M Eberth ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Diet Quality ◽  
Fast Food ◽  
Current Data ◽  
Narrative Review ◽  
Assessment Tools ◽  
Future Research ◽  
Food Groups ◽  
Theoretical Frameworks ◽  
Cross Sectional

Abstract Background Pregnancy can be a stressful time for many women; however, it is unclear if higher stress and depressive symptoms are associated with poorer diet quality during pregnancy. Objective The aims for this narrative review were to (1) synthesize findings of original, peer-reviewed studies that examined associations of stress and/or depressive symptoms with diet quality during pregnancy; (2) review the measurement tools used to assess stress, depressive symptoms, and diet quality; (3) identify current gaps in the extant literature; and (4) offer recommendations for future research. Methods A search strategy was used to identify peer-reviewed manuscripts published between January 1997 and October 2018, using the following databases: PubMed, CINAHL Complete, PsycINFO, Academic Search Complete, and Psychology & Behavioral Sciences Collection. The search was updated December 2019. Two reviewers independently assessed title, abstract, and full-text of the studies that met the inclusion criteria. Data were extracted and a quality assessment was conducted. Results Twenty-seven observational studies were identified in this review (21 cross-sectional and 6 longitudinal). In 22 studies, higher stress and/or depressive symptoms were associated with poorer diet quality or unhealthy dietary patterns; 5 studies found no association. Findings are mixed and inconclusive regarding the relationship among stress, depressive symptoms, and food groups related to diet quality and frequency of fast-food consumption. Conclusions The current data suggest stress and depressive symptoms may be a barrier to proper diet quality during pregnancy; however, variability in the assessment tools, timing of assessments, and use of covariates likely contribute to the inconsistency in study findings. Gaps in the literature include limited use of longitudinal study designs, limited use of comprehensive diet-quality indices, underrepresentation of minority women, and lack of multilevel theoretical frameworks. Studies should address these factors to better assess associations of stress and/or depressive symptoms with diet quality during pregnancy.

scholarly journals Preliminary Validation of a Patient Satisfaction Instrument in the Emergency Department

2020 ◽  
Vol 12 (10) ◽  
pp. 107
Author(s):  
Ashraf Ahmed Zaghloul ◽  
Amal Kadry Attia ◽  
Mini Sara Abraham ◽  
Hanan Al Tawil
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Principal Components Analysis ◽  
United Arab Emirates ◽  
Principal Components ◽  
Content Validity ◽  
Face Validity ◽  
Oblique Rotation ◽  
Cross Sectional ◽  
Components Analysis

Statement of the purpose: The aim of this study was to develop a valid and reliable satisfaction tool that can be utilised in the emergency departments (EDs) of hospitals throughout Sharjah, United Arab Emirates (UAE). Methods: The study followed a cross-sectional study design. The study was conducted during the period from October 2018 to January 2019. The participants were conveniently sampled. The total number of eligible questionnaires for analysis accounted for 207. The data collection tool was developed following a review of literature which yielded 25 statements. Satisfaction levels were measured using a 3-point Likert scale (satisfied=3, do not know=2, dissatisfied=1). The tool was validated through face validity performed by the research team. Content validity performed by a panel of nine randomly selected specialists. Principal components analysis was done to extract the relevant components to the statements on the tool. Results: Scale content validity index= 0.836. Principal components analysis with oblique rotation extracted three components namely; medical staff performance, duration of the encounter, and general impression about the emergency department. Internal consistency for the tool using the split-half Cronbach&rsquo;s alpha, part 1=0.80, and part 2=0.82. Conclusion: The findings of the present study support the reliability and validity of the Emergency Services Patient Satisfaction Questionnaire for intended use, following an independent sample of patients at EDs in Sharjah, UAE. The scale is recommended for assessing patient satisfaction with service provision to help hospitals in Sharjah determine to what extent they are meeting the needs of their patients.

A clinimetric analysis of the Pressure Ulcer Risk Primary or Secondary Evaluation Tool: PURPOSE-T

2019 ◽  
Vol 28 (20) ◽  
pp. S4-S8
Author(s):  
Matthew Wynn ◽  
Samantha Holloway
Keyword(s):  
Risk Assessment ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Evidence Base ◽  
Assessment Tools ◽  
Future Research ◽  
Advisory Panel ◽  
Evaluation Tool ◽  
Risk Assessment Tools ◽  
Patients At Risk

The assessment of patients' risk for developing pressure ulcers is a routine and fundamental nursing process undertaken to prevent avoidable harm to patients in all care settings. Many risk assessment tools are currently used in clinical practice, however no individual tool is recommended by advisory bodies such as the National Institute for Health and Care Excellence or the European Pressure Ulcer Advisory Panel. The evidence base on the value of structured risk assessment tools in reducing the incidence or severity of pressure ulcers is poor. This purpose of this article is to provide a clinimetric analysis of the recently developed Pressure Ulcer Risk Primary or Secondary Evaluation Tool (PURPOSE-T) and identify areas for future research to improve the utility of structured risk assessment in identifying patients at risk of developing pressure ulcers.

scholarly journals An international survey of pediatric and neonatal clinicians' vascular access practice: PediSIG assessment of vascular access, education, and support (PAVES) catheter selection

2020 ◽  
Vol 29 (14) ◽  
pp. S40-S48
Author(s):  
Mary Beth Hovda Davis ◽  
Mari Takashima ◽  
Constance Girgenti ◽  
Amanda J. Ullman
Keyword(s):  
Vascular Access ◽  
Pain Control ◽  
Pediatric Patients ◽  
Future Research ◽  
Clinical Practices ◽  
Cross Sectional ◽  
Electronic Survey ◽  
Clinician Training ◽  
Proper Training ◽  
Procedural Support

Highlights There is a wide variance in neonatal and pediatric vascular access workforce models, training, and competency assessments. Pain control during procedures is critical for children, yet it is not consistently used. Procedural support has shown improved patient outcomes, yet is not standardly used for every distressful procedure. Core standards are needed to ensure proper training and support for the pediatric and neonatal vascular access clinicians. Background: Despite evidence to support best practice in neonatal and pediatric venipuncture delivery and procedural support, there are inconsistencies in practice. To inform future research, education, and workforce innovation, the Association for Vascular Access Pediatric Special Interest Group (PediSIG) developed and undertook a survey to describe the current vascular access practice for clinicians caring for neonatal and pediatric patients. Objective: Describe the current state of workforce models, training, and clinical practices surrounding pediatric and neonatal vascular access. Design: Cross-sectional, electronic survey using convenience sampling. Settings: International clinicians who provide vascular access (peripheral intravenous catheter insertion, venipuncture for blood sampling) for neonatal and pediatric patients. Methods: An electronic survey was developed by the PediSIG. The survey covered workforce models, clinician training and competency, pain relief, procedural support, and device securement. The electronic survey was then distributed to the PediSIG membership and shared among several neonatal/pediatric email lists. Data were analyzed descriptively, with an exploration of association between clinical outcomes, workforce, and training. Results There were 242 responses from 5 countries showing a wide variance of practice. Workforce models showed many different team names and responsibilities along with a variance of personnel and staffing hours. Clinician training was described as 4 hours or less by 44% (n = 69) of respondents. Less than half of the responses (47%; n = 99) reported having a formal procedure to escalate a patient to an expert care and not having a set number of max attempts before escalation. Only two-thirds (n = 115) of respondents said they had a standardized protocol for pain control and procedural support, with only 13% (n = 23) and 15% (n = 27), respectively, self-reporting that they always followed the protocol. Conclusions The respondents reported a wide variance in neonatal and pediatric vascular access procedures and the resources used to support this practice. Core standards need to be developed to help guide neonatal and pediatric clinicians and their institutions. The standards should encompass recommendations for workforce models, proper training, competency, insertion guidelines, pain control,

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