scholarly journals Measuring Seclusion in Psychiatric Intensive Care: Development and Measurement Properties of the Clinical Seclusion Checklist

2021 ◽  
Vol 12 ◽  
Author(s):  
Torleif Ruud ◽  
Espen Woldsengen Haugom ◽  
Harold Alan Pincus ◽  
Torfinn Hynnekleiv
Keyword(s):  
Intensive Care ◽  
Content Validity ◽  
Interrater Reliability ◽  
Delphi Process ◽  
Measurement Properties ◽  
Negative Consequences ◽  
Inpatient Psychiatric Care ◽  
Psychiatric Units ◽  
Different Response ◽  
Care Development

Background: Acute psychiatric units in general hospitals must ensure that acutely disturbed patients do not harm themselves or others, and simultaneously provide care and treatment and help patients regain control of their behavior. This led to the development of strategies for the seclusion of a patient in this state within a particular area separated from other patients in the ward. While versions of this practice have been used in different countries and settings, a systematic framework for describing the various parameters and types of seclusion interventions has not been available. The aims of the project were to develop and test a valid and reliable checklist for characterizing seclusion in inpatient psychiatric care.Methods: Development and testing of the checklist were accomplished in five stages. Staff in psychiatric units completed detailed descriptions of seclusion episodes. Elements of seclusion were identified by thematic analysis of this material, and consensus regarding these elements was achieved through a Delphi process comprising two rounds. Good content validity was ensured through the sample of seclusion episodes and the representative participants in the Delphi process. The first draft of the checklist was revised based on testing by clinicians assessing seclusion episodes. The revised checklist with six reasons for and 10 elements of seclusion was tested with different response scales, and acceptable interrater reliability was achieved.Results: The Clinical Seclusion Checklist is a brief and feasible tool measuring six reasons for seclusion, 10 elements of seclusion, and four contextual factors. It was developed through a transparent process and exhibited good content validity and acceptable interrater reliability.Conclusion: The checklist is a step toward achieving valid and clinically relevant measurements of seclusion. Its use in psychiatric units may contribute to quality assurance, more reliable statistics and comparisons across sites and periods, improved research on patients' experiences of seclusion and its effects, reduction of negative consequences of seclusion, and improvement of psychiatric intensive care.

scholarly journals Measurement Properties and Implementation of a Checklist to Assess Leadership Skills during Interdisciplinary Rounds in the Intensive Care Unit

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Elsbeth C. M. Ten Have ◽  
Raoul E. Nap ◽  
Jaap E. Tulleken
Keyword(s):  
Intensive Care Unit ◽  
Factor Analysis ◽  
Intensive Care ◽  
Internal Consistency ◽  
Interrater Reliability ◽  
Leadership Behavior ◽  
Leadership Skills ◽  
Measurement Properties ◽  
Interdisciplinary Rounds ◽  
Wide Range

The implementation of interdisciplinary teams in the intensive care unit (ICU) has focused attention on leadership behavior. A daily recurrent situation in ICUs in which both leadership behavior and interdisciplinary teamwork are integrated concerns the interdisciplinary rounds (IDRs). Although IDRs are recommended to provide optimal interdisciplinary and patient-centered care, there are no checklists available for leading physicians. We tested the measurement properties and implementation of a checklist to assess the quality of leadership skills in interdisciplinary rounds. The measurement properties of the checklist, which included 10 essential quality indicators, were tested for interrater reliability and internal consistency and by factor analysis. The interrater reliability among 3 raters was good (κ, 0.85) and the internal consistency was acceptable (α, 0.74). Factor analysis showed all factor loadings on 1 domain (>0.65). The checklist was further implemented during videotaped IDRs which were led by senior physicians and in which 99 patients were discussed. Implementation of the checklist showed a wide range of “no” and “yes” scores among the senior physicians. These results may underline the need for such a checklist to ensure tasks are synchronized within the team.

scholarly journals The German RECAP questionnaire: linguistic validation and cognitive debriefing in German adults with self-reported atopic eczema and parents of affected children

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Michaela Gabes ◽  
Christina Tischer ◽  
Anne Herrmann ◽  
Laura Howells ◽  
Christian Apfelbacher
Keyword(s):  
Atopic Eczema ◽  
Content Validity ◽  
Qualitative Content Analysis ◽  
Recall Period ◽  
Measurement Properties ◽  
German Population ◽  
German Version ◽  
Health Measurement ◽  
Response Options ◽  
Patient Reported

Abstract Background Recap of atopic eczema (RECAP) is a patient-reported outcome measure (PROM) assessing eczema control. Long-term control of eczema is one of the four core outcome domains for atopic eczema trials. This instrument has been recently developed in the UK. Objective This study aimed to translate the English RECAP into German and test its content validity in a German population with self-reported atopic eczema. Methods A six-step procedure including two forward and one backward translations, two consensus decisions and an expert review was performed to obtain a German version of RECAP. We conducted semi-standardized cognitive interviews with adults with atopic eczema (n = 7) and parents having children affected by this disease (n = 5). A “think-aloud” method was used and aspects of comprehensibility, comprehensiveness and relevance according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria were examined. Interviews were coded using qualitative content analysis. Results No particular linguistic problems were encountered during forward-backward translation. Minor wording changes were made as required. The title was adjusted to a more familiar German term of the disease (which is ‘Neurodermitis’). The recall period was rephrased from ‘over the last week’ to ‘over the last seven days’ since there was a different cultural understanding of the time frame. Regarding content validity, the items of the German RECAP were considered to be comprehensible, comprehensive and relevant for the participants and parents of affected children. The participants understood the instruction and considered the one-week recall period and the response options as appropriate. Conclusions A German version of RECAP that is linguistically equivalent to the original version is now available but further assessment of its measurement properties is needed.

scholarly journals Psychometric Testing of the Spanish Modified Version of the Mini-Suffering State Examination

2021 ◽  
Vol 18 (15) ◽  
pp. 7821
Author(s):  
Daniel Gutiérrez-Sánchez ◽  
Rafael Gómez-García ◽  
Isabel María López-Medina ◽  
Antonio I. Cuesta-Vargas
Keyword(s):  
Internal Consistency ◽  
Content Validity ◽  
Convergent Validity ◽  
Informal Caregivers ◽  
Psychometric Testing ◽  
Spanish Version ◽  
Measurement Properties ◽  
Quality Of Dying ◽  
State Examination

Background: The mini-suffering state examination is a valid and reliable measure that have been used to assess suffering in patients with advanced cancer. The aim of this study was to carry out a psychometric analysis of the Spanish version of the mini-suffering state examination. Method: A validation study was conducted. Seventy-two informal caregivers of deceased patients in palliative care were included in this study. A psychometric testing of content validity, internal consistency, and convergent validity with the Spanish version of the quality of dying and death questionnaire was performed. Results: The original instrument was modified to be used by informal caregivers. The content validity was acceptable (0.96), and the internal consistency was moderate (α = 0.67). Convergent validity was demonstrated (r = −0.64). Conclusion: The Spanish modified version of the MSSE showed satisfactory measurement properties. The Spanish modified version of MSSE can be useful to facilitate screening, monitor progress, and guide treatment decisions in end-of-life cancer patients.

scholarly journals Patient-Reported Outcome Measures for Post-mastectomy Breast Reconstruction: A Systematic Review of Development and Measurement Properties

2020 ◽  
Vol 28 (1) ◽  
pp. 386-404 ◽  
Author(s):  
C. F. Davies ◽  
R. Macefield ◽  
K. Avery ◽  
J. M. Blazeby ◽  
S. Potter
Keyword(s):  
Systematic Review ◽  
Breast Reconstruction ◽  
Content Validity ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Measurement Properties ◽  
Future Studies ◽  
Patient Reported ◽  
Eortc Qlq

Abstract Background Breast reconstruction (BR) is performed to improve outcomes for patients undergoing mastectomy. A recently developed core outcome set for BR includes six patient-reported outcomes that should be measured and reported in all future studies. It is vital that any instrument used to measure these outcomes as part of a core measurement set be robustly developed and validated so data are reliable and accurate. The aim of this systematic review is to evaluate the development and measurement properties of existing BR patient-reported outcome measures (PROMs) to inform instrument selection for future studies. Methods A PRISMA-compliant systematic review of development and validation studies of BR PROMs was conducted to assess their measurement properties. PROMs with adequate content validity were assessed using three steps: (1) the methodological quality of each identified study was assessed using the COSMIN Risk of Bias checklist; (2) criteria were applied for assessing good measurement properties; and (3) evidence was summarized and the quality of evidence assessed using a modified GRADE approach. Results Fourteen articles reported the development and measurement properties of six PROMs. Of these, only three (BREAST-Q, BRECON-31, and EORTC QLQ-BRECON-23) were considered to have adequate content validity and proceeded to full evaluation. This showed that all three PROMs had been robustly developed and validated and demonstrated adequate quality. Conclusions BREAST-Q, BRECON-31, and EORTC QLQ-BRECON-23 have been well-developed and demonstrate adequate measurement properties. Work with key stakeholders is now needed to generate consensus regarding which PROM should be recommended for inclusion in a core measurement set.

scholarly journals Nosocomial infections in a pediatric surgical intensive care unit: An unicentric cross-sectional study

2021 ◽  
Vol 74 (3-4) ◽  
pp. 112-116
Author(s):  
Marina Pandurov ◽  
Izabella Fabri-Galambos ◽  
Andjela Opancina ◽  
Anna Uram-Benka ◽  
Goran Rakic ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infections ◽  
Hospital Length Of Stay ◽  
Surgical Intensive Care Unit ◽  
Negative Consequences ◽  
Surgical Intensive Care ◽  
Acinetobacter Baumanii ◽  
Cross Sectional ◽  
The Impact

Introduction. Nosocomial infections are a common complication in patients hospitalized in intensive care units. The aims of this research were to examine the incidence of nosocomial infections in patients admitted to the pediatric surgical intensive care unit, the impact of hospital length of stay and type of surgical disease on the incidence of nosocomial infections, the frequency of microorganisms causing nosocomial infections and their antibiotic susceptibility profile. Material and Methods. Data on 50 subjects were extracted from the database. The following data were taken from the medical histories of the examinees: age, sex, diagnosis, number of days at the hospital before admission to the intensive care unit, number of days in the intensive care unit, levels of C-reactive protein, applied antimicrobial drugs, isolated microorganisms and their susceptibility to antibiotics. Results. The incidence of nosocomial infections in the study period was 52%. Patients who developed nosocomial infection remained longer in the intensive care unit than those who did not develop it (p = 0.003). Patients with the diagnosis of acute abdomen had a statistically significantly higher incidence of nosocomial infections compared to other patients (p = 0.001). Gram-negative bacteria were the most commonly isolated pathogens (46.8%). Acinetobacter baumanii proved to be the most resistant species in this study, since 80% of the strains did not show sensitivity to any of the tested antibiotics. Conclusion. Nosocomial infections are present in slightly more than half of the patients treated at the pediatric surgical intensive care unit. Patients who developed nosocomial infections stayed longer in the pediatric surgical intensive care unit, which had negative consequences for their health and treatment costs.

scholarly journals The Interrater Reliability of Inferior Vena Cava Ultrasonography Performed by Intensive Care Fellows

2021 ◽  
Author(s):  
Kazim Rollas ◽  
Banu Kilicaslan ◽  
Aydin Erden ◽  
Isa Kilicaslan ◽  
Ebru Ortac Ersoy ◽  
...  
Keyword(s):  
Intensive Care ◽  
Inferior Vena Cava ◽  
Interrater Reliability ◽  
Inferior Vena ◽  
Vena Cava

Designing and Validity Evaluation of Quality of Nursing Care Scale in Intensive Care Units

2014 ◽  
Vol 22 (3) ◽  
pp. 461-471
Author(s):  
Mashaalah Zeraati ◽  
Negin Masoudi Alavi
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Nursing Care ◽  
Content Validity ◽  
Scale Level ◽  
Validity Index ◽  
Critical Care Units ◽  
Quality Of Nursing

Background and Purpose: Quality of nursing care measurement is essential in critical care units. The aim of this study was to develop a scale to measure the quality of nursing care in intensive care units (ICUs). Methods: The 68 items of nursing care standards in critical care settings were explored in a literature review. Then, 30 experts evaluated the items’ content validity index (CVI) and content validity ratio (CVR). Items with a low CVI score (<0.78) and low CVR score (<0.33) were removed from the scale. Results: The 50 items remained in the scale. The Scale level-CVI and Scale level-CVR were 0.898 and 0.725, respectively. Conclusion: The nursing care scale in ICU (Quality of Nursing Care Scale-ICU) that was developed in this research had acceptable CVI and CVR.

Psychiatric intensive care – development and definition

2009 ◽  
pp. 3-11 ◽  
Author(s):  
M. Dominic Beer ◽  
Stephen M. Pereira ◽  
Carol Paton ◽  
M. Dominic Beer ◽  
Stephen M. Pereira ◽  
...  
Keyword(s):  
Intensive Care ◽  
Care Development

P33 Health information technology and the changing nature of medication errors in paediatric intensive care – a modified delphi process

2018 ◽  
Vol 103 (2) ◽  
pp. e2.37-e2
Author(s):  
Moninne Howlett ◽  
Brian Cleary ◽  
Cormac Breatnach
Keyword(s):  
Information Technology ◽  
Intensive Care ◽  
Medication Error ◽  
Health Information ◽  
Medication Errors ◽  
Delphi Process ◽  
Paediatric Intensive Care ◽  
Electronic Prescribing ◽  
Prescribing Error ◽  
Smart Pump

AimsThe term ‘medication error’ has numerous definitions, impeding comparison between studies and is susceptible to subjectivity.1 The Delphi Process is widely used in health research to achieve consensus and has been previously used to define and specify medication error scenarios in both paediatric and adult settings.2,3 Novel technology-generated errors are emerging with increasing use of health information technology (HIT).4 Application of earlier Delphi studies to novel errors and those common in the prescribing of infusions in paediatric intensive care is limited. This study aims to achieve consensus on medication error scenarios identified in a paediatric intensive care unit (PICU) that have not been previously defined.MethodsStage 1 identified the scenarios requiring consensus. These were grouped into 3 error categories: electronic prescribing, smart-pump and prescribing of PICU infusions. Stage 2 selected a multidisciplinary expert panel using both purposive and convenience sampling. Stage 3 involved iterative rounds of consensus using paper-based and newer e-Delphi techniques. Participants independently scored on a 9-point scale their extent of agreement on the inclusion of each scenario as an error. Median and inter-quartile ranges were used to assess group consensus and to provide controlled feedback after each round.Results19 scenarios requiring consensus were identified. A panel of 37 participants was selected, comprising of 15 doctors, 13 nurses and 9 pharmacists. 35 participants were from the study site, 1 pharmacist from a local PICU and 1 from a local NICU. Round 1 achieved consensus on 11 scenarios, increasing to 14 in Round 2. Round 3 consisted of 2 scenarios, both electronic prescribing related. Individual opinion on these was diverse, with 1 remaining equivocal after round 3. Some differences between healthcare professionals were found, but were only significant (p<0.05) for two and three scenarios in rounds 2 and 3 respectively.ConclusionThe Delphi Process can successfully be employed to reach consensus on HIT-generated novel errors. The complexity of electronic prescribing systems is evident in the included errors and the difficulty in obtaining consensus. In contrast, the broad consensus reached on all smart-pump scenarios reflects the known risks associated with infusion pumps. The included scenarios highlight the limitation of smart-pump technology as a single intervention. Further similar studies are likely to be required as more novel errors emerge with increased HIT implementation across the entire medication use process. This extended tool should add to the quality of future paediatric medication error studies across a broad range of settings.ReferencesLisby M, Nielsen LP, Brock B, et al. How are medication errors defined? A systematic literature review of definitions and characteristics. Int J Qual Health Care2010;22(6):507–18.Dean B, Barber N, Schachter M. What is a prescribing error?Qual Health Care2000;9(4):232–7.Ghaleb MA, Barber N, Dean Franklin B, et al. What constitutes a prescribing error in paediatrics?Qual Saf Health Care2005;14(5):352–7.Walsh KE, Landrigan CP, Adams WG, et al. Effect of computer order entry on prevention of serious medication errors in hospitalised children. Paediatrics2008;121(3):e421–7.

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