Study On Clinical Nurses Training Curriculum For Hospitalized Patients Fall Prevention By Applied Delphi Method

ObjectiveThis study use Delphi method, from various angles e.g. clinical nurse specialists,nurse managers, nursing teachers, clinicians, epidemiologists and medical statisticsexpert in five areas of three dimensions from the curriculum plate, course title, coursecontent to set up patients fall prevention curriculum clinical nurse training system.This can provide a theoretical basis to improve the ability of identifying risks for fallsin hospitalized patients and effective implementation of interventions. Trained clinicalnurse through the system might have ideological emphasis on patient falls, use thepatient fall prevention expertise and skills to use in clinical practice, to reduce the rateof falls in hospitalized patients, and protect patient safety.Objects and MethodsObjects: In accordance with Delphi expert selection criterion,4medical colleaguesand other departments clinical nurse specialists,13nurse managers,5nursingteachers, a clinical medical experts, as well as an epidemiology and medical statisticsexpert involved in the study of an expert consultation from18Guangdong Provincelevel three general hospitals.Methods:Firstly, literatures searching: access relevant literatures containing patient falls,nurses’ prevention attitudes on such knowledge, and skills of nurses trainingcurriculum. To identify research theme "Study on clinical nurses training curriculumfor patients fall prevention by applied Delphi method”.Secondly, Delphi method: Using the Delphi method to evaluate nurse trainingcurriculum content in falls patients prevention. Delphi method is an expertiseinvestigation; the core is sought by way of an anonymous expert opinion; the aim tosummarize the views of finishing each suggestion, each reference resent distributed todifferent experts for analysis and that the views put forward into new judgments.These repeatable cycles, making more convergence of views, to get a more consistentand reliable solution. 1. Established research team: members include four people, including a nursedirector and3nursing postgraduates; all are familiar with the application of theDelphi and statistical methods. Team members are responsible for developingresearch topics, the preparation of expert advice table, the selection consultants, aswell as the results of the consultation summary statistics and analysis.2. Selection of consultants: inclusion criteria are:(1) working fields: clinical care,nursing management, nursing education, clinical medicine, epidemiology and medicalstatistics in five areas.(2) Has a Bachelor degree or above;(3) has a subtropical highand above the title.(4) There are more than10years of professional work experiencein the above fields, are more familiar with the contents of this study;(5) willing toparticipate in this study.3. Expert advice literature review table: Base on experts interviews and theMinistry of Health in2011promulgated------"Technical intervention falls in elderlyGuideline" modeled on the self-designed " Patient fall prevention nurse trainingcurriculum content " expert consultation letter table. The main contents include fourparts:(1) Survey manuals: to describe the research background, purpose and meaning,as well as the Delphi method principles.(2) Experts basic status: including expertscorresponding sections or departments, age, administrative duties, titles, workexperience and so on.(3) Body of the questionnaires: Including fill requirements part,experts’ familiarity questionnaire assessed part and self-assessment form. The firstround of expert consultation questionnaire included first grade3indicators andsecond grade16indicators. The second round consultations, including second grade15indicators, third grade48indicators. The third round included second grade16indicators, third grade49indicators.(4) Expert opinions and suggestions form.4. Methods: Email survey forms are distributed as open-field consultationquestionnaires and recollected within two weeks. Research team statistical analysisthe consultation feedback results so as to the formation of the next roundquestionnaires.5. Statistical processing: Excel and SPSS17.0statistical software were used forDelphi data statistical analysis. Experts’ generally descriptive analysis data are represented by frequency and percentage; Rate of recovery coefficient represented theeffectiveness of consultation authority from questionnaire; Experts’ authority wereshowed with coefficient Cr; Experts’ advice were marked on the importance ofconcentration indicators and mean; Degree of coordination of expert opinionsexpressed by coordination coefficient (Kendall’s W).Result1. Delphi method experts’basic condition:24experts are invited from different18hospitals of medical colleges and other departments in Guangdong Province,including4clinical nurse specialists,13nurse managers,5nursing teachers and aclinical medical expert, and one epidemiology and medical statistics expert. Theaverage age of24experts was47.29±5.32years of professional work experience inthe field was26.5±6.87years: senior specialist titles (66.7%); associated professors(33.3%). Experts in education accounted for58.3%of undergraduate, masters anddoctoral accounted for25%and16.7%, respectively;8.3%are doctoral tutors,37.5%are Master Instructors.2. Positive coefficient of expert: The study had released into three roundsquestionnaires for experts’ advice as26,24and23, and the effective rate was92.3%,95.8%and100%collectively.3. Expert authority: Conditioned reflex (Cr) represented the degree of expertspecialists authority, which contains two factors: Certification Authority (Ca)----theexperts to make judgments based on the content and the Content of the Consultation(Cs)----expert familiarity due to the enquiry, for which the authority to determine thecoefficient and the coefficient is equal to the arithmetic mean of the familiarity factor.Three rounds authoritative expert advice factor in this study were0.86,0.89, and0.89.4. Degree of coordination: It refers to the evaluation of all expert as indicatorsthat represented considerable differences reflected by the coefficient of variation (Vj)and coordination coefficient (Kendall’s W). In this study, the three rounds meancoefficients of variation were0.11,0.13and0.12, their coefficient of variation <0.25.The first round of Kendall’s W is0.282; and as by joining third grade48indicators course content in the second round, so Kendall’s W declined to0.246; the third roundof expert opinion tends consistent, Kendall’s W is0.307. All three roundscoordination coefficient test was statistically significant, P=0.000.5. Patient fall prevention Nurse training curriculum determination: includes firstgrade3indicators (course plate), second grade16indicators (course title), third grade48indicators (course content).ConclusionDelphi is a method focus from a professional attitude, professional knowledge, andprofessional skills. It identified three dimensions of patient fall prevention nursetraining curriculum content, including16course titles and48course content,providing clinical nurse some suggestions on patients’ fall training and theoreticalsupport. This study intended nurse training the prevention patients’ falls in clinicalpractice, testing their scientific curriculum content, improve patients’ ability toidentify risks and take effective risk prevention measures to reduce patients’hospitalized rate, such that provide scientific basis to protect patient safety.