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PubMed1992

Research priorities of VA nurses: a Delphi study.

The purpose of this study was to conduct a Delphi survey of a sample of Gainesville Veterans Affairs Medical Center staff and head nurses. The study consisted of three rounds of questionnaires completed by the nurses as they identified and narrowed the most pressing nursing research questions. Results indicated that in five of the six clinical settings, despite investigators' instructions to identify clinical nursing research questions, administrative research questions were identified and ranked consistently higher in priority than clinical research questions. The single exception was in home care, where clinical questions received the highest priority. This phenomena may suggest that institutional constraints interfere with nurses' full expression of their clinical practice.

Attitude of Health Personnel↗

PubMed2003

Delphi rating on the internet.

We designed an application to allow respondents to rate components of clinical guidelines on the Internet. Twenty-three invited experts completed the rating followed by a satisfaction survey using a 5-level Likert scale. The experts felt that Web data entry was convenient, acceptable and easily accessible. We conclude that Web-based Delphi rating for consensus development is a convenient and acceptable alternative to the traditional paper-based method.

Consensus↗

PubMed2004

Leadership, administration, management, and professionalism (LAMP) in physical therapy: a Delphi study.

BACKGROUND AND PURPOSE: The knowledge and skills needed by physical therapists entering practice in the areas of leadership, administration, management, and professionalism (LAMP) are not known. Using the LAMP components identified by American Physical Therapy Association's Section on Administration, this study sought to define the range of LAMP content pertinent to physical therapy clinical management and to explore LAMP knowledge and skills required of physical therapists upon entry into the profession. SUBJECTS AND METHODS: Thirty-four physical therapist managers participated in a Delphi study to (1) create a comprehensive list of defined LAMP components, (2) determine the perceived importance of each component in the management of clinical practices, and (3) identify the level of knowledge and skill for each component believed to be necessary for a new physical therapist graduate. RESULTS: Respondents agreed that 178 items should be on the LAMP component list. They perceived that almost all LAMP components are important in the management of a clinical practice, and they indicated that new graduates needed moderate to extensive knowledge in 44% of them. They believed that new graduates needed no skill in 29% of the components, whereas they needed at least intermediate skill for 22% of them. Top-ranked component categories across the 3 scales (importance, knowledge, and skill) were communication, professional involvement and ethical practice, delegation and supervision, stress management, reimbursement sources, time management, and health care industry scanning. DISCUSSION AND CONCLUSION: This study provides a basis for further exploration of which LAMP components should be included in professional (entry-level) physical therapist curricula and which components should be learned after graduation.

Delphi Technique↗

PubMed1992

[A study about the desirable characteristics of the qualified physicians: the application of Delphi method].

The purpose of this study is to adapt the Delphi Study method in establishing a consensus of good doctor characteristics from a panel of department heads (N = 22) at four medical colleges in Taiwan within three given categories: 1. professional knowledge and techniques; 2. attitudes and standards; and 3. interpersonal relationship. In this study three rounds of questionnaires were administered to the panel to extract their opinions regarding the characteristics of good doctoring. 76 items of good doctoring characteristics were solicited from the department heads at four medical colleges to the opening questionnaire. The conclusive results indicated that 15 of these 58 items were ranked as the most important characteristics by panel members. The findings from this investigation will help facilitate the decision making process of officials regarding innovation in the training of good doctor. Moreover, the conclusions could be included in developing and planning of instruments for the future doctor evaluation methods.

Clinical Competence↗

PubMed2004

[A study by the Delphi technique of expected competencies of public health nurses working in government organizations].

PURPOSE: The purpose of this study was to clarify, using the Delphi technique and by the consensus of Experts, the expected competencies of Public Health Nurses (PHNs) working in government organizations according to their number of years' experience. METHODS: Experts were nurses who had a PHN license in academic, administration and service areas. The criteria for selecting are as follows: Academic: professors of community nursing department, in nursing college. Administration: chief PHNs working in prefectural government organization, with the role of supervising and controlling PHNs. Service: recommended by each administration Expert and fulfilling all the following 3 points; (1) PHN experience of 10 years or more in a government organization, (2) a supervisory position over at least one junior PHN, and (3) an effective practical record as a PHN. 209 Experts who were chosen by the specified criteria were approached for their participation. At Round 1, Experts were asked to list competencies important for PHN under 3 headings: knowledge, skills and attitudes. From the response in Round 1, competency items were categorized. A list was obtained and used in Round 2, when Experts were asked to select and rate the importance of competencies for 4 ranges of PHN years of experience. At Round 2, these competencies were analyzed on the basis of importance. At Round 3, Experts were asked whether they agree or not with the results of Round 2. The criterion for consensus was set as an agreement rate of 90%. RESULTS: Of the total, 63 agreed to participate; 14 in the academic, 23 in the administration and 26 in the service area. Response were turned 63 from all at Round 1, 52 at Round 2 and 44 at Round 3. The result clarified the expected competencies into 47 items and 7 categories related to their importance in the experience year ranges. The 7 categories were: Conducting nursing processes; Conducting community health activities; Providing health care; Management; Information application; Human relations; and Personal characteristics. The very important competencies PHNs should have were regarded as follows: (1) At 1-3 years' experience, PHNs should have 2 categories (2) At 4-10 years, they should have the 5 categories (3) At 11-20 years they should have all 7 categories (4) At 21 or more years they should have at least 6 categories. At all levels PHNs were required to have the 2 categories of Providing health care and Personal characteristics. CONCLUSIONS: It was expected as PHNs gain experience they should obtain wider and more faranding competencies stepwise, from basic nursing care to community care, and on to administration.

Attitude of Health Personnel↗

PubMed1992

What will happen to the quality of care with fewer junior doctors? A Delphi study of consultant physicians' views.

Hospital medical staffing: achieving a balance proposed a reduction in the number of junior doctors and an expansion in the number of consultant posts. This change was to be subject to the 'safety net'--that the number of staff should not fall below a minimum safe level for 24-hour emergency cover. However, no operational definition of 'safe' was offered. Consultant physicians in one NHS region were interviewed to find out how they thought safety would be affected by a reduction in junior doctor numbers. It emerged that consultants' concerns over reductions in staff covered a wider range of issues than just the clinical effectiveness of care. The interpretation of safety extended to cover general adverse effects on care. A survey, using the Delphi method, revealed that consultant physicians were most concerned over reductions in the humanity of care if numbers of junior staff were reduced. This included such factors as the time spent by patients waiting in outpatient and A&E departments, and the time doctors spend talking to patients. Consultants were less concerned over the effect of reduced staff numbers on the technical efficiency of provision, and least of all on the effectiveness of care. This last point was seen to be a reflection of consultant physicians' confidence in the basic medical knowledge and skill of their junior staff.

Attitude of Health Personnel↗

PubMed1992

Osteoarthritis antirheumatic drug trials. III. Setting the delta for clinical trials--results of a consensus development (Delphi) exercise.

Defining the minimum clinically important difference or delta to be detected in a clinical trial depends on a number of factors including the research hypothesis, patient characteristics, the nature of the intervention and the trial design. In 2 studies, we have developed standardized procedures for conducting outcome measurement based on current Food and Drug Administration and European League Against Rheumatism guidelines for osteoarthritis clinical trials, and determined the standard deviation for these outcome measures. In the final component of this series of studies, we have used a Delphi technique to establish estimates for delta, and calculated the sample size requirements under 2 different conditions of Type I and Type II error probabilities.

Clinical Trials as Topic↗

PubMedDate not supplied

Digital dental radiography needs assessment utilizing the Delphi process.

This article reports the results of a needs assessment using the Delphi process. The purpose of this study was to determine the architecture and equipment (radiographic and computer network) for establishing and supporting an enterprise's vast digital dental radiographic program. Two panels of subject matter experts identified the needs for a digital dental radiography system; one expert panel consisted of dentists while the other panel's members were information management/information technology (IM/IT) experts. Panelists rated digital dental radiography needs using descriptive statistics and a 7-point bipolar scale. Among dentists, the four most important needs were the capability to store images, image appearance, centralized image storage, and a dedicated back-up server; among IM/IT panelists, they were ensuring HIPAA compliance, use of a standard formatting procedure, excellent print quality, and use of encryption for data transmission. This study's findings are useful for any organization seeking to initiate or improve its own digital radiography program.

Computer Communication Networks↗

PubMed2005

Development of prostate cancer quality indicators: a modified Delphi approach.

OBJECTIVES: There is evidence of variation in both the processes and outcomes of prostate cancer care, resulting in possible harm to patients and increased costs to the health system. Care could be improved by first identifying critical, measurable indicators that correlate with quality of care. This work was conducted to develop indicators of prostate cancer care using a modified three-step Delphi approach. METHODS: A 17-member multidisciplinary panel reviewed potential indicators extracted from the medical literature through two consecutive rounds of rating followed by consensus discussion. The panel then prioritized the indicators selected in the previous two rounds. RESULTS: Of 31 possible indicators that emerged from 49 reviewed articles, 11 were prioritized by the panel as benchmarks for assessing the quality of surgical care for prostate cancer. The 11 indicators represent three levels of measurement (regional, hospital, individual provider) across several phases of care (diagnosis, surgery, pathology, and follow-up), as well as broad measures of outcomes. CONCLUSION: A systematic evidence- and consensus-based approach was used to develop quality indicators of prostate cancer care, with a focus on pre-, peri- and post-operative care as well as outcomes. Some of the indicators selected by the panel were also recommended by a similarly structured panel process. These indicators can be used by individual providers and organizations to monitor the quality of their services, and develop interventions to address any variations.

Delphi Technique↗

PubMed2005

Development of quality indicators for colorectal cancer surgery, using a 3-step modified Delphi approach.

BACKGROUND: Little performance measurement has been undertaken in the area of oncology, particularly for surgery, which is a pivotal event in the continuum of cancer care. This work was conducted to develop indicators of quality for colorectal cancer surgery, using a 3-step modified Delphi approach. METHODS: A multidisciplinary panel, comprising surgical and methodological co-chairs, 9 surgeons, a medical oncologist, a radiation oncologist, a nurse and a pathologist, reviewed potential indicators extracted from the medical literature through 2 consecutive rounds of rating followed by consensus discussion. The panel then prioritized the indicators selected in the previous 2 rounds. RESULTS: Of 45 possible indicators that emerged from 30 selected articles, 15 were prioritized by the panel as benchmarks for assessing the quality of surgical care. The 15 indicators represent 3 levels of measurement (provincial/regional, hospital, individual provider) across several phases of care (diagnosis, surgery, adjuvant therapy, pathology and follow-up), as well as broad measures of access and outcome. The indicators selected by the panel were more often supported by evidence than those that were discarded. CONCLUSIONS: This project represents a unique initiative, and the results may be applicable to colorectal cancer surgery in any jurisdiction.

Benchmarking↗

PubMed2006

Development of a school nursing research agenda in Florida: a Delphi study.

Research is important to the image, visibility, and viability of school nursing. Each state school nursing association should evaluate member commitment to school nursing research based on their unique set of financial, educational, and organizational resources. A 3-round Delphi study was conducted in which Florida school nurses identified research priorities. The 10 priority research topics were (a) obesity/nutrition, (b) role of the school nurse, (c) legal/ethical issues, (d) emergencies, (e) health education, (f) absenteeism/attendance, (g) diabetes and insulin, (h) injuries, (i) health services, and (j) asthma. These topics form the state research agenda and will be used to guide the development of multisite school nursing studies.

Absenteeism↗

PubMed2006

Prerequisites to providing culturally competent care to Mexican migrant farmworkers: a Delphi study.

The purpose of this study was to identify prerequisites to providing culturally competent care to Mexican migrant farmworkers. A national sample of nurse experts who worked with Mexican migrant farmworkers (N = 93 [50.2%] in round 1; and N = 142 [54.8%] in round 2) participated during the period of August 1998 to April 1999. Using a two-round modified Delphi method, a list of 89 items was generated. The nurse experts agreed that the 89 items identified were prerequisites to cultural competence, showing consensus rates of 85.4% in round 1 and 88.8% in round 2. The prerequisites to culturally competent care identified by participants encompassed caring, cultural sensitivity, cultural knowledge (general/specific), cultural abilities/skills, and others (bi-cultural status; cultural and learning experiences).

Attitude of Health Personnel↗

PubMedDate not supplied

A Delphi survey of clinical nursing research priorities in Western Australia.

In 1989-1990 an investigation was undertaken to ascertain which problems WA nurses considered required researching. A modified Delphi technique was employed to obtain data from nurses in hospitals and health care agencies throughout the metropolitan and rural regions in the state. Participants worked in areas of acute care, mental health, paediatrics, gerontology, community health and domiciliary services and addictions. Problems identified were categorised into three streams; clinical, management and staff development. Respondents were required to assign a value to items according to their importance to nurses and to patients. They were also asked to indicate whether they considered there was an adequate research base relevant to each item. Results reported here are based on the 10 priority items identified in the clinical stream.

Clinical Nursing Research↗

PubMed1991

Rheumatoid arthritis antirheumatic drug trials. III. Setting the delta for clinical trials of antirheumatic drugs--results of a consensus development (Delphi) exercise.

Defining the minimum clinically important difference or delta to be detected in a clinical trial depends on a number of factors including the research hypothesis, patient characteristics, the nature of the intervention and the trial design. In 2 previous studies, we have developed standardized procedures for conducting outcome measurement based on current Food and Drug Administration and European League Against Rheumatism guidelines for RA clinical trials, and thereafter, determined the standard deviation for these outcome measures. In the final component of this series of studies, we employed a Delphi technique to establish estimates for delta and calculated the sample size requirements under different conditions of Type I and Type II error probabilities.

Arthritis, Rheumatoid↗

PubMed1990

[The basic minimum set of data in primary care. A Delphi study].

The term basic minimal unit of data in primary care is used for those essential data required so that all primary care professionals may carry out their work. The results of a study performed with the Delphi technique about the basic unit of data by 35 Spanish physician are reported. The results are distributed in three areas: clinical interview (12 basic data were considered), clinical history (27 essential data) and health care performance (19 minimal data).

Data Collection↗

PubMedDate not supplied

Future directions in family medicine: results of a Delphi study.

A Delphi study using a panel of 17 experts in family medicine predicted the characteristics of family medicine in the future to anticipate changes needed in residency education. Proposed new competencies included managing the medical care of the patient, skills in geriatrics, emphasis on health maintenance, health promotion and disease screening, and expertise in computers and data management. Competencies to be de-emphasized included major surgical procedures, specific technical and procedural aspects of hospital care, and obstetrics (except in rural areas). In addition, panelists thought the basic principles and values of family medicine will not change, although there will be emphasis on managed health care, increased care of the elderly, and changes in the professional status of the physician. Curricular changes will require help from other disciplines, new educational settings, and additional faculty and financial resources.

Curriculum↗

PubMedDate not supplied

Factors influencing the development and use of interactive video in nursing education. A Delphi study.

The purpose of this study was to identify factors impeding development and use of interactive video (IAV) in nursing education in order to specify actions that would facilitate its development and use. Nurse educators with experience in development of IAV programs were defined as the experts, and a three-round Delphi study was conducted. Study findings revealed that participants were aware of obstacles to development and were able to suggest some ways to overcome them. Subjects clearly identified content they want in IAV programs, and were especially united on applications for simulations. They agreed on benefits of IAV for students, but were less certain about how it might affect faculty roles, and were undecided about measurable advantages of IAV. Conservative predictions were made about how evolving IAV technology might change the process of nurse education in the future. To promote IAV development and use the author recommends cooperative efforts between nurse educators and developers in the business sector and an educational thrust targeted for specific groups. Moving beyond existing nursing roles and institutional models, the author makes two major suggestions: establishment of a new nursing specialist, the nurse/instructional designer, and the creation of an information center staffed by these new specialists who will design and develop programs, provide education and consultation, maintain a clearinghouse for IAV programs, research, and technology, and take a leadership role in the integration of this powerful instructional delivery system into the entire health field.

Communication↗

PubMedDate not supplied

The Delphi technique.

The Delphi technique is an easy-to-use research instrument which has become an accepted method of achieving consensus among individuals and experts. This paper describes its techniques, parameters for its successful application, variety of uses and some advantages and disadvantages.

Delphi Technique↗