A Delphi study on research priorities for trauma nursing

OBJECTIVES. To identify and prioritize research questions of importance to trauma patient care and of interest to trauma nurses. METHOD. A three-round Delphi technique was used to solicit, identify, and prioritize problems for trauma nursing research. In round 1, experienced trauma nurses (N = 208) generated 513 problems, which were analyzed, categorized, and collapsed into 111 items for subsequent rounds. Round 2 participants rated each research question on a 1 to 7 scale on two criteria: impact on patient welfare and value for practicing nurses. Group median scores provided by 166 round 2 respondents and respondents' individual round 2 scores were indicated on the round 3 questionnaire. Subjects rated the questions again on the same criteria and indicated whether nurses, independently or in collaboration with other health professionals, should assume responsibility for that research. Median and mean scores and rank order were determined for each item. RESULTS. Respondents who completed all three rounds (n = 137) had a mean of 8.3 years of trauma experience. Nine research questions ranked within the top 20 on both criteria. The two research questions that ranked highest on both criteria were: What are the most effective nursing interventions in the prevention of pulmonary and circulatory complications in trauma patients? and What are the most effective methods for preventing aspiration in trauma patients during the postoperative phase? The third-ranked question regarding patient welfare was: What psychological and lifestyle changes result from traumatic injury? Regarding value for practicing nurses, What are the most effective educational methods to prepare and maintain proficiency in trauma care providers? ranked third. CONCLUSION. These research priorities provide impetus and direction for nursing and collaborative investigation in trauma care.

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A consensus building exercise to determine research priorities for silver trauma

BMC Emergency Medicine ◽

10.1186/s12873-020-00357-4 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Abdullah Alshibani ◽

Jay Banerjee ◽

Fiona Lecky ◽

Timothy J. Coats ◽

Rebecca Prest ◽

...

Keyword(s):

Trauma Care ◽

Research Question ◽

Research Priorities ◽

Trauma Centre ◽

Future Research ◽

Trauma Patients ◽

List Type ◽

Modified Delphi ◽

Modified Delphi Technique ◽

Research Questions

Abstract Background Emergency care research into ‘Silver Trauma’, which is simply defined as major trauma consequent upon relatively minor injury mechanisms, is facing many challenges including that at present, there is no clear prioritisation of the issues. This study aimed to determine the top research priorities to guide future research. Methods This consensus-based prioritization exercise used a three-stage modified Delphi technique. The study consisted of an idea generating (divergent) first round, a ranking evaluation in the second round, and a (convergent) consensus meeting in the third round. Results A total of 20 research questions advanced to the final round of this study. After discussing the importance and clinical significance of each research question, five research questions were prioritised by the experts; the top three research priorities were: What are older people’s preferred goals of trauma care? Beyond the Emergency Department (ED), what is the appropriate combined geriatric and trauma care? Do older adults benefit from access to trauma centres? If so, do older trauma patients have equitable access to trauma centre compared to younger adults? Conclusion The results of this study will assist clinicians, researchers, and organisations that are interested in silver trauma in guiding their future efforts and funding toward addressing the identified research priorities.

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Consensus on research priorities for Essex & Herts Air Ambulance: a Delphi study

Scandinavian Journal of Trauma Resuscitation and Emergency Medicine ◽

10.1186/s13049-021-00835-z ◽

2021 ◽

Vol 29 (1) ◽

Author(s):

Sarah McLachlan ◽

Hilary Bungay

Keyword(s):

Critical Care ◽

Delphi Study ◽

Local Level ◽

Research Priorities ◽

Clinical Work ◽

Research Strategy ◽

Consensus Methods ◽

Care Providers ◽

Air Ambulance ◽

Research Questions

Abstract Background Consensus methods such as the Delphi technique have been used widely for research priority setting in health care. Within pre-hospital emergency medicine, such approaches have helped to establish national and international research priorities. However, in a dynamic field such as pre-hospital critical care, it is necessary to regularly review the continued relevance of findings. Further, considering the variability between pre-hospital critical care providers, it is also important to determine priorities at the local level. Essex & Herts Air Ambulance (EHAAT) sought to develop a five-year research strategy that aligns with their clinical work streams and organisational priorities. Methods All staff and Trustees were invited to participate in an online Delphi study with three Rounds. The Delphi was administered via email and Online Surveys software. The first Round invited participants to submit up to five research questions that they felt were of greatest importance to EHAAT to advance the care provided to patients. In Round 2, participants were asked to rate the importance of questions from Round 1, while Round 3 required participants to rank questions that were prioritised in Round 2 in order of importance. Results 22 participants submitted a total of 86 research questions in Round 1, which were reduced to 69 questions following deduplication and refinement. 11 participants rated the importance of the questions in Round 2, resulting in 14 questions being taken forward to Round 3. Following the ranking exercise in Round 3, completed by 12 participants, a top five research priorities were identified. The question deemed most important was “How does a pre-hospital doctor-paramedic team affect the outcome of patients with severe head injuries?”. Conclusions The top five research priorities identified through the Delphi process will inform EHAAT’s research strategy. Findings suggest that there is still work to be done in addressing research priorities described in previous literature.

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PREDICT prioritisation study: establishing the research priorities of paediatric emergency medicine physicians in Australia and New Zealand

Emergency Medicine Journal ◽

10.1136/emermed-2017-206727 ◽

2017 ◽

Vol 35 (1) ◽

pp. 39-45 ◽

Cited By ~ 18

Author(s):

Heather Carol Deane ◽

Catherine L Wilson ◽

Franz E Babl ◽

Stuart R Dalziel ◽

John Alexander Cheek ◽

...

Keyword(s):

Emergency Medicine ◽

New Zealand ◽

Delphi Study ◽

Research Question ◽

Research Priorities ◽

Spine Injury ◽

Paediatric Emergency ◽

Paediatric Emergency Medicine ◽

Research Questions ◽

Multicentre Research

BackgroundThe Paediatric Research in Emergency Departments International Collaborative (PREDICT) performs multicentre research in Australia and New Zealand. Research priorities are difficult to determine, often relying on individual interests or prior work.ObjectiveTo identify the research priorities of paediatric emergency medicine (PEM) specialists working in Australia and New Zealand.MethodsOnline surveys were administered in a two-stage, modified Delphi study. Eligible participants were PEM specialists (consultants and senior advanced trainees in PEM from 14 PREDICT sites). Participants submitted up to 3 of their most important research questions (survey 1). Responses were collated and refined, then a shortlist of refined questions was returned to participants for prioritisation (survey 2). A further prioritisation exercise was carried out at a PREDICT meeting using the Hanlon Process of Prioritisation. This determined the priorities of active researchers in PEM including an emphasis on the feasibility of a research question.ResultsOne hundred and six of 254 (42%) eligible participants responded to survey 1 and 142/245 (58%) to survey 2. One hundred and sixty-eight (66%) took part in either or both surveys. Two hundred forty-six individual research questions were submitted in survey 1. Survey 2 established a prioritised list of 35 research questions. Priority topics from both the Delphi and Hanlon process included high flow oxygenation in intubation, fluid volume resuscitation in sepsis, imaging in cervical spine injury, intravenous therapy for asthma and vasopressor use in sepsis.ConclusionThis prioritisation process has established a list of research questions, which will inform multicentre PEM research in Australia and New Zealand. It has also emphasised the importance of the translation of new knowledge.

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Evaluation of Performance in Trauma Care: experts’ viewpoints

10.21203/rs.2.20168/v1 ◽

2020 ◽

Author(s):

Yalda Mousazadeh ◽

Ali Janati ◽

Homayoun Sadeghi-bazarghani ◽

Mahboub Pouraghaei

Keyword(s):

Information System ◽

Focus Group ◽

Trauma Care ◽

Group Discussion ◽

Monitoring And Evaluation ◽

Trauma Patients ◽

Care Providers ◽

Care Assessment ◽

The World ◽

Care Improvement

Abstract Background: Trauma is one of the leading causes of mortality across the world. Trauma patients had critical status and need timely, adequate and organized care. The different consequences of trauma care among service centers around the world and even within a country reveal the need for care assessment. This study was designed and executed to collect experts’ opinion on the evaluation of trauma care in Iran. Methods: This qualitative study with conventional content analysis approach, two focus group discussions with 12 participants and 16 face-to-face in-depth interviews were conducted to collect the required data. Participants were selected through purposive sampling method. The experts’ viewpoints were classified in accordance with the main and sub themes. Results: Four basic themes extracted from the interviews and focus group discussion including, trauma care importance (sub-themes: the involved Individuals’ being young and productive and the effectiveness of trauma care); trauma care indicators (sub-themes: pre-hospital indicators, in-hospital indicators and post-hospital indicators); stages of trauma care evaluation (sub-themes: evaluation prerequisites, finalization of indicators prior to evaluation, determining evaluation time scope, determining evaluation dimensions, monitoring and evaluation and use of evaluation results); trauma care promotion (sub-themes: balancing workload in trauma centers, enhancement of information system, considering extra-organizational dimensions in trauma care and empowerment of trauma care providers). Conclusion: Performance evaluation through acceptable indicators is basis of health care improvement. In addition to the evaluation, reforming macro policies, development of infrastructures, enhancement of information system and training care providers should be taken into account too. Keywords: Performance indicators, Evaluation, Hospital, Trauma care

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Identification of Research Priorities For Suicide Prevention In Nepal: A Delphi Study

10.21203/rs.3.rs-1029224/v1 ◽

2021 ◽

Author(s):

Elisha Joshi ◽

Santosh Bhatta ◽

Sunil Kumar Joshi ◽

Julie Mytton

Keyword(s):

Lived Experience ◽

Suicide Prevention ◽

Delphi Study ◽

Research Priorities ◽

Expert Consensus ◽

Psychiatric Nurses ◽

Health Concern ◽

Consensus Method ◽

Significant Public Health ◽

Research Questions

Abstract Background: Suicide is a significant public health concern in Nepal and there is a need for an evidence-based suicide prevention programme to facilitate stakeholders working towards suicide prevention in Nepal. Collaborative research between stakeholders focussing on shared priorities can help to prevent and control suicide. Hence, we aimed to develop a consensus list of research priorities for suicide prevention in Nepal. Methods: The Delphi expert consensus method was used to elicit the prioritized research questions for suicide prevention in Nepal. Participants comprised suicide prevention experts (psychologists, psychiatrists, psychiatric nurses, researchers and advocates) and people with lived experience. Three rounds of Delphi were conducted; round 1: constituted one to one interview involving open-ended questions used to generate research questions; round 2: ranking of the research questions using a 5-point Likert scale, and round 3: re-ranking of research questions in light of individual and group responses.Results: 42 participants participated in round 1 followed by 38 in round 2 and 39 in round 3. 522 research questions were generated through round 1 which were grouped together and reduced to 33 research questions sent for ranking in round 2. Using a cut off of at least 70% of the panel ranking questions as ‘very important’ or ‘important’, 22 questions were retained. These research questions were sent for re-rating in round 3 generating a final list of prioritized research questions.Conclusions: This is the first expert consensus study to identify the top research priorities for suicide prevention in Nepal and used experts in suicide prevention and those with lived experience. A consensus was reached regarding the research needed to improve suicide data quality, assess the burden and identify factors associated with suicide. A priority-driven approach to suicide prevention research may ensure that the research endeavour provides the most useful information for those whose day-t- day work involves trying to prevent suicide.

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Top research priorities in liver and gallbladder disorders in the UK

BMJ Open ◽

10.1136/bmjopen-2018-025045 ◽

2019 ◽

Vol 9 (3) ◽

pp. e025045 ◽

Cited By ~ 6

Author(s):

Kurinchi S Gurusamy ◽

Martine Walmsley ◽

Brian R Davidson ◽

Claire Frier ◽

Barry Fuller ◽

...

Keyword(s):

Priority Setting ◽

Healthcare Professionals ◽

Research Question ◽

Research Priorities ◽

Public Health Research ◽

Delphi Panel ◽

Delphi Consensus ◽

Treatment Research ◽

Research Questions ◽

Priority Setting Partnership

ObjectivesThere is a mismatch between research questions considered important by patients, carers and healthcare professionals and the research performed in many fields of medicine. The non-alcohol-related liver and gallbladder disorders priority setting partnership was established to identify the top research priorities in the prevention, diagnostic and treatment of gallbladder disorders and liver disorders not covered by the James-Lind Alliance (JLA) alcohol-related liver disease priority setting partnership.DesignThe methods broadly followed the principles of the JLA guidebook. The one major deviation from the JLA methodology was the final step of identifying priorities: instead of prioritisation by group discussions at a consensus workshop involving stakeholders, the prioritisation was achieved by a modified Delphi consensus process.ResultsA total of 428 unique valid diagnostic or treatment research questions were identified. A literature review established that none of these questions were considered ‘answered’ that is, high-quality systematic reviews suggest that further research is not required on the topic. The Delphi panel achieved consensus (at least 80% Delphi panel members agreed) that a research question was a top research priority for six questions. Four additional research questions with highest proportion of Delphi panel members ranking the question as highly important were added to constitute the top 10 research priorities.ConclusionsA priority setting process involving patients, carers and healthcare professionals has been used to identify the top 10priority areas for research related to liver and gallbladder disorders. Basic, translational, clinical and public health research are required to address these uncertainties.

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LO61: A modified Delphi study to identify trauma care modifiers for older adults

CJEM ◽

10.1017/cem.2020.116 ◽

2020 ◽

Vol 22 (S1) ◽

pp. S29-S30

Author(s):

K. Yadav ◽

V. Boucher ◽

N. Le Sage ◽

C. Malo ◽

E. Mercier ◽

...

Keyword(s):

Older Adults ◽

Trauma Care ◽

Delphi Study ◽

Major Trauma ◽

Expert Panel ◽

Trauma Team ◽

Trauma Centre ◽

Trauma Patients ◽

Median Score ◽

Modified Delphi

Introduction: Older (age >=65 years) trauma patients suffer increased morbidity and mortality. This is due to under-triage of older trauma victims, resulting in lack of transfer to a trauma centre or failure to activate the trauma team. There are currently no Canadian guidelines for the management of older trauma patients. The objective of this study was to identify modifiers to the prehospital and emergency department (ED) phases of major trauma care for older adults based on expert consensus. Methods: We conducted a modified Delphi study to assess senior-friendly major trauma care modifiers based on national expert consensus. The panel consisted of 24 trauma care providers across Canada, including medical directors, paramedics, emergency physicians, emergency nurses, trauma surgeons and trauma administrators. Following a literature review, we developed an online Delphi survey consisting of 16 trauma care modifiers. Three online survey rounds were distributed and panelists were asked to score items on a 9-point Likert scale. The following predetermined thresholds were used: appropriate (median score 7–9, without disagreement); inappropriate (median score 1–3; without disagreement), and uncertain (any median score with disagreement). The disagreement index (DI) is a method for measuring consensus within groups. Agreement was defined a priori as a DI score <1. Results: There was a 100% response rate for all survey rounds. Three new trauma care modifiers were suggested by panelists. Of 19 trauma care modifiers, the expert panel achieved consensus agreement for 17 items. The prehospital modifier with the strongest agreement to transfer to a trauma centre was a respiratory rate <10 or >20 breaths/minute or needing ventilatory support (DI = 0.24). The ED modifier with the strongest level of agreement was obtaining a 12-lead electrocardiogram following the primary and secondary survey for all older adults (DI = 0.01). Two trauma care modifiers failed to reach consensus agreement: transporting older patients with ground level falls to a trauma centre and activating the trauma team based solely on an age >=65 years. Conclusion: Using a modified Delphi process, an expert panel agreed upon 17 trauma care modifiers for older adults in the prehospital and ED phases of care. These modifiers may improve the delivery of senior-friendly trauma care and should be considered when developing local and national trauma guidelines.

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Pre-hospital emergency medicine and the trauma intensive care unit

Journal of the Intensive Care Society ◽

10.1177/1751143718783601 ◽

2018 ◽

Vol 20 (3) ◽

pp. 242-247

Author(s):

Emily Frostick ◽

Christopher Johnson

Keyword(s):

Intensive Care Unit ◽

Emergency Medicine ◽

Intensive Care ◽

Trauma Care ◽

Major Trauma ◽

Trauma Patients ◽

Care Providers ◽

Hospital Emergency ◽

Trauma Networks ◽

National Training

The system of trauma care has been revolutionised over the last decade with the introduction of major trauma networks across the United Kingdom and the development of subspecialist national training in pre-hospital emergency medicine. Pre-hospital care providers feed trauma patients into trauma units or major trauma centres depending upon the severity of their injuries and their stability for a potentially longer primary transfer to access specialist major trauma services. Trauma services are continually adapting and improving with the introduction of more advanced techniques into the pre-hospital arena are on the horizon, enabling trauma patients to receive more specialised treatment from medical professionals earlier after injury; this article will discuss some of the recent developments within pre-hospital emergency medicine, in-hospital trauma care and on into the intensive care unit, and how this has led to improved outcomes.

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Identifying nursing research priorities in Vietnam: a modified Delphi study

Frontiers of Nursing ◽

10.2478/fon-2019-0044 ◽

2019 ◽

Vol 6 (4) ◽

pp. 249-259

Author(s):

Yupin Aungsuroch ◽

Xuan Ha Thi Nhu ◽

Tran Thuy Khanh Linh ◽

Rapin Polsook ◽

Rungrawee Navicharern ◽

...

Keyword(s):

Nursing Education ◽

Delphi Study ◽

Rank Order ◽

Group Discussion ◽

Research Priorities ◽

Care Quality ◽

Nursing Research ◽

Specific Domain ◽

Modified Delphi ◽

Management And Leadership

Abstract Objective There is no single study that has examined nursing research priorities in Vietnam. This study aimed to gain consensus from experts on the nursing research priorities in Vietnam. Methods A three-round modified Delphi study was used in this study. A focus group discussion among experts was conducted in round I to identify the nursing research priorities (n=23). Data in round I were analyzed using content analysis. In round II, participants were invited to rate the importance of each nursing priority topic in a 5-point Likert scale questionnaire, which had a 74% (n=17) response rate. In round III, the questionnaire was returned to the experts (n=17) until consensus was reached. Data from round II and round III were analyzed to produce mean score and final rank. Results The top 12 research priority lists were identified, which included subthemes and areas of possible investigations. All priorities were classified into three groups in the rank order, namely: (i) nursing management and leadership, which included (1) nursing care quality, (2) management and leadership of nurse managers, (3) nursing image, (4) professional nurse competency, and (5) human resource management; (ii) nursing education, which included (1) knowledge-specific domain, (2) the linkage between education and practice, and (3) nurse teacher workforce; and (iii) nursing service, which included (1) adult nursing concern, (2) patient safety, (3) public health nursing concern, and (4) quality of life of patients and nurses. Conclusions Consensus among experts was achiever, and the findings are considered as the basis of resources to the most essential research needs in Vietnam.

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Identifying research priorities in newborn medicine: a Delphi study of parents’ views

BMJ Open ◽

10.1136/bmjopen-2020-044836 ◽

2021 ◽

Vol 11 (11) ◽

pp. e044836

Author(s):

Abbey L Eeles ◽

Alice C Burnett ◽

Jeanie LY Cheong ◽

Alex Aldis ◽

Louise Pallot ◽

...

Keyword(s):

New Zealand ◽

Delphi Study ◽

Research Priorities ◽

Well Being ◽

Neonatal Care ◽

Parental Mental Health ◽

Parent Child Relationship ◽

Child Relationship ◽

Research Questions

ObjectiveNeonatal conditions can have lifelong implications for the health and well-being of children and families. Traditionally, parents and patients have not been included in shaping the agenda for research and yet they are profoundly affected by the neonatal experience and its consequences. This study aimed to identify consensus research priorities among parents/patients of newborn medicine in Australia and New Zealand.DesignParents/patients with experience of neonatal care in Australia and New Zealand completed an online Delphi study to identify research priorities across four epochs (neonatal admission, early childhood, childhood/adolescence and adulthood). Parents/patients first generated key challenges in each of these epochs. Through inductive thematic analysis, recurring topics were identified and research questions generated. Parents/patients rated these questions in terms of priorities and a list of questions consistently rated as high priority was identified.Participants393 individuals participated, 388 parents whose children had received neonatal care and 5 adults who had received neonatal care themselves.ResultsMany research questions were identified as high-priority across the lifespan. These included how to best support parental mental health, relationships between parents and neonatal clinical staff (including involvement in care and communication), bonding and the parent–child relationship, improving neonatal medical care and addressing long-term impacts on child health and neurodevelopment.ConclusionsParents with experience of newborn medicine have strong, clear and recurring research priorities spanning neonatal care practices, psychological and other impacts on families, and impacts on child development. These findings should guide neonatal research efforts. In addition to generating new knowledge, improved translation of existing evidence to parents is also needed.

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