目的:在日本尚未开发出标准重症监护护理(SCCN)的明确开发过程和经过科学验证的临床实践能力。因此,这项研究旨在开发一套基于共识的SCCN能力,为重症监护护理教育提供框架,培训和评估。
方法:多步,改良的德尔菲研究(系统综述,焦点小组访谈,三轮基于网络的德尔福调查和外部验证过程)。
方法:对23项研究进行系统评价,12位专家的焦点小组访谈,239名重症监护专家(医生,护士和物理治疗师)和5名专家(医生和护士)的外部验证。
结果:一项系统评价确定了685项独特能力。焦点小组访谈结果增加了3个绩效指标项目,合成2个子域和10个元素。在239名参与者中,218(91.2%),209(98.9%)和201(96.2%)在德尔福调查的第1、2和3轮中做出了回应,分别。在第3轮之后,有57个项目低于共识水平,并在最后一轮被删除。经过两次修订后,从专家那里收到了外部验证过程反馈,以确保最终能力有效,适用,有用且清晰。最后一组能力被分为6个领域,26个子域,99个要素和525个性能指标。
结论:这项研究发现了一系列SCCN能力,改进的德尔菲研究。这项研究的结果是稳健的,能力框架可以在多个领域使用,以改善临床实践,包括评估,标准重症监护护士的培训和认证。
A clear development process and scientifically validated clinical practice competencies in standard critical care nursing (SCCN) have not yet been developed in Japan. Thus, this study aimed to develop a
consensus-based set of SCCN competencies to provide a framework for critical care nursing education, training and evaluation.
Multistep, modified Delphi study (a systematic review, focus group interviews, a three-round web-based Delphi survey and an external validation process).
A systematic review of 23 studies, focus group interviews by 12 experts, a Delphi survey by 239 critical care experts (physicians, nurses and physical therapists) and an external validation by 5 experts (physicians and nurses).
A systematic review identified 685 unique competencies. The focus group interviews resulted in the addition of 3 performance indicator items, a synthesis of 2 subdomains and 10 elements. Of the 239 participants, 218 (91.2%), 209 (98.9%) and 201 (96.2%) responded in rounds 1, 2 and 3 of the Delphi survey, respectively. After round 3, 57 items were below the
consensus level and were removed in the final round. External validation process feedback was received from experts after two revisions to ensure that the final competencies were valid, applicable, useful and clear. The final set of competencies was classified into 6 domains, 26 subdomains, 99 elements and 525 performance indicators.
This study found a set of SCCN competencies after a multistep, modified Delphi study. The results of this study are robust, and the competency framework can be used in multiple areas to improve clinical practice, including the assessment, training and certification of standard critical care nurses.