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Developing an ultrasound-guided enteral nutrition protocol for critically ill patients based on the delphi method

NURSING IN CRITICAL CARE 2025年第3期30卷 e70023页

作者： Li, Zeyu He, Wei Tian, Dun Sun, Yang Yang, Qing Cao, Lan Cent South Univ Xiangya Sch Nursing Changsha Hunan Peoples R China Cent South Univ Xiangya Hosp Teaching & Res Sect Clin Nursing Changsha Hunan Peoples R China Capital Med Univ Beijing Tongren Hosp Dept Crit Care Med Beijing Peoples R China Cent South Univ Xiangya Hosp Crit Care Med Ctr Changsha Hunan Peoples R China

BackgroundEnteral nutrition is widely recommended in intensive care units, but its implementation is accompanied by some problems. AimThis study aimed to develop a current-evidence-based, operable and repeatable ultrasound-guided enteral nutrition (EN) programme for critically ill patients. Study DesignFirst, based on a literature review, we integrated guidelines, expert consensus, systematic review and clinical experimental studies on critically ill patients. Subsequently, after careful evaluation and selection of relevant EN management data, we formulated a preliminary draft of an ultrasound-guided EN protocol for critically ill patients. Based on feedback from delphi experts, the protocol was revised, and the final version of the programme was constructed. ResultsAfter two rounds of consultation, the expert opinions reached a consensus. The expert positive coefficient was 1.00, and the expert authority coefficient was 0.935. After the second round of consultation, the coefficient of variation for the importance score ranged from 0.04 to 0.19, and that for the feasibility score ranged from 0.04 to 0.21. The difference in Kendall harmony coefficients was statistically significant (p < .05). The final programme comprised four Level I, 15 Level II and 40 Level III projects. ConclusionsThe EN protocol for critically ill patients established in this study is comprehensive and feasible and can provide guidance for clinical practice. Relevance to Clinical PracticeThis study adopted the delphi method to develop an ultrasound-guided EN programme for critically ill patients, providing a new protocol by which critical care nurses can implement EN. This protocol provides a reliable and comprehensive basis for ensuring the quality and safety of EN management in critically ill patients in the future.

关键词： critically ill patients delphi method enteral nutrition ultrasound

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Development of the assessment standards of the International Classification of Functioning, Disability, and Health (ICF) Geriatric Core Set through a modified delphi method

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BMC GERIATRICS 2024年第1期24卷 1页

作者： Zhang, Malan Gao, Yan Xue, Jingjing Li, Kun Zhang, Lifang Yu, Jiani Yan, Tiebin Hou, Xiaohui Guangzhou Sport Univ Coll Exercise & Hlth Dept Exercise Rehabil Guangzhou Peoples R China Shenzhen Univ Shenzhen Peoples Hosp 2 Affiliated Hosp 1 Dept Rehabil Med Shenzhen Peoples R China Sun Yat Sen Univ Sun Yat Sen Mem Hosp Dept Rehabil Med Guangzhou Peoples R China Sun Yat Sen Univ Sch Nursing Guangzhou Peoples R China Youjiang Med Univ Nationalities Sch Nursing Baise Peoples R China GuangDong Prov Hosp Chinese Med Dept Rehabil Guangzhou Peoples R China

BackgroundThere is currently a lack of functional assessment tools based on the International Classification of Functioning, Disability, and Health (ICF) theoretical framework that are specific for older *** aim of the present study was to develop Chinese assessment standards of the ICF Geriatric Core Set for functional evaluation of older *** two-stage study process was conducted to develop the assessment standards of the ICF Geriatric Core Set: establishment of candidate assessment standards, and a modified delphi consensus process including a pilot survey and two-round formal expert survey. Thirty participants in the field of ICF and geriatric rehabilitation were recruited. The suitability of the assessment standards in the questionnaires was rated using a Likert 5-level scoring method. The arithmetic mean, the full mark ratio and the coefficient of variation (CV) were used as screening indicators for the assessment standards, and modification was made for several standards, in line with the delphi results and the expert panel ***-three candidate assessment standards belonging to 17 categories were generated. A total of 26 and 24 experts in the field of ICF and geriatric rehabilitation participated in the two-round survey, respectively. Five standards belonging to four categories entered into the second-round survey directly, five standards belonged to five categories entered with minor modification, and nine standards belonging to seven categories were redesigned based on the literature and discussion of the expert panel. In the second-round survey,15 assessment standards belonging to 15 categories met the screening requirements and four assessment standards belonged to the two remaining categories that needed a criterion and which the expert panel discussed for the final *** the modified delphi method, the assessment standards of the ICF Geriatric Core Set have been *** work sho

关键词： delphi method ICF Geriatrics Functional assessment

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Application and effect evaluation of multidisciplinary team management model: On central venous access device associated skin impairment based on delphi method

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JOURNAL OF VASCULAR ACCESS 2024年第3期25卷 759-766页

作者： Li, Ji-Yue Li, Jia Fan, Yu-Ying Lin, Xi-Ling Huang, Chun-Li Qin, Hui-Ying Sun Yat Sen Univ Sch Nursing Guangzhou Guangdong Peoples R China Sun Yat Sen Univ Dept Catheter Clin Ctr Canc Guangzhou Guangdong Peoples R China Sun Yat Sen Univ Nasopharyngeal Dept Ctr Canc Guangzhou Guangdong Peoples R China Sun Yat Sen Univ Dept Nursing Ctr Canc 651 Dongfeng East Rd Guangzhou 510060 Guangdong Peoples R China

Objective: To establish a multidisciplinary management model based on delphi method to guide nursing practice and reduce the incidence of CVAD-associated Skin Impairment (CASI) in tumor patients. methods: On the basis of literature review and focus group interview, the initial item pool of CASI management model for cancer patients was determined. The delphi method was used to conduct two rounds of letter consultation with 36 authoritative and representative experts to determine the content and weight of indicators of CASI multidisciplinary management model for cancer patients. Results: Most of the research group were experts with bachelor degree or above. More than 90% of experts have worked for more than 10 years;Areas of expertise include oncology care, venous therapy, wound stomatology, and dermatology. The recovery rate of the two rounds of expert correspondence questionnaire was 100%. The authority coefficient of experts was 0.898, indicating a good degree of authority. Kendall's harmony coefficients were 0.193 and 0.250, with statistically significant differences (p < 0.001). After two rounds of expert letter consultation, a multidisciplinary management model of CASI for cancer patients was initially formed, which included 15 first-level prevention indexes and 38 second-level prevention indexes of CASI for cancer patients. There were 9 first-level indexes and 16 second-level indexes of CASI treatment in tumor patients. Conclusion: Cancer patients based on delphi method to construct CASI multidisciplinary management model has high reliability and scientificity, multidisciplinary management model in the management of patients with tumor CASI exploration will provide new methods for central venous catheter nursing and the new way of thinking, will also be intravenous fluids will provide a scientific basis for professional development and quality improvement and practical experience.

关键词： Central venous access device (CVAD) CVAD-associated skin impairment (CASI) multidisciplinary team management model delphi method nursing

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Identifying cost-based quality and performance indicators for home care: a modified delphi method study

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BMC HEALTH SERVICES RESEARCH 2024年第1期24卷 835页

作者： Jajszczok, Max Eastwood, Cathy A. Lu, Mingshan Cunningham, Ceara Southern, Danielle A. Quan, Hude Univ Calgary Community Hlth Sci Cumming Sch Med 3280 Hosp Dr NW Calgary AB T2N 4Z6 Canada Univ Calgary Dept Econ 2500 Univ Dr NW Calgary AB T2N1N4 Canada Univ Calgary Dept Community Hlth Sci 2500 Univ Dr NW Calgary AB T2N1N4 Canada Univ Calgary Ctr Hlth Informat 3280 Hosp Dr NW Calgary AB T2N 4Z6 Canada

BackgroundThis study, part of a multi-study program, aimed to identify a core set of cost-based quality and performance indicators using a modified delphi research approach. Conceptually, this core set of cost-based indicators is intended for use within a broader health system performance framework for evaluating home care programming in *** study used findings from a recently published scoping review identifying 34 cost-focused home care program PQIs. A purposive and snowball technique was employed to recruit a national panel of system-level operational and content experts in home care. We collected data through progressive surveys and engagement sessions. In the first round of surveying, the panel scored each indicator on Importance, Actionable, and Interpretable criteria. The panel set the second round of ranking the remaining indicators' consensus criteria. The panel ranked by importance their top five indicators from operational and system perspectives. Indicators selected by over 50% of the panel were accepted as *** identified 13 panellists. 12 completed the first round which identified that 30 met the predetermined inclusion criteria. Eight completed the ranking exercise, with one of the eight completing one of two components. The second round resulted in three PQIs meeting the consensus criteria: one operational and two systems-policy-focused. The PQIs: "Average cost per day per home care client," "Home care service cost (mean) per home care client 1y, 3y and 7y per health authority and provincially and nationally", and "Home care funding as a percent of overall health care expenditures."ConclusionsThe findings from this study offer a crucial foundation for assessing operational and health system outcomes. Notably, this research pioneers identifying key cost-based PQIs through a national expert panel and modified delphi methodology. This study contributes to the literature on PQIs for home care and provides a basis for future

关键词： delphi method Home health care Quadruple AIM Financial measurement Quality indicators

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Construction of individualised care programmes for patients with pancreatic cancer with postoperative weight-loss control based on the delphi method: a cross-sectional study in China

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JOURNAL OF HEALTH POPULATION AND NUTRITION 2024年第1期43卷 1页

作者： Chen, Leying Huang, Zhongyan Tian, Qiuju Zha, Qinghua Zhang, Shiyu Chen, Zhe Dong, Ziyun Zhou, Yuqing Zhang, Ming Wei, Xiaoyan Shanghai Jiao Tong Univ Ruijin Hosp Dept Pancreat Surg 197 Ruijin 2 St Shanghai 200025 Peoples R China Shanghai Jiao Tong Univ Ruijin Hosp Dept Nurse Management Shanghai 200025 Peoples R China

BackgroundAt present, clinical nutritional care for patients with pancreatic cancer focuses more on the observation of the effect of enteral parenteral nutrition, and there is a lack of personalised care plans for weight-loss control. We used the delphi method to construct a set of personalised nursing programmes to effectively control the rate of postoperative weight loss in patients with pancreatic *** study was a cross-sectional investigation. Through literature analysis, literature review and data review, a personalised nursing plan for the postoperative weight-loss control in patients with pancreatic cancer was preliminarily developed. From October to December 2022, the delphi method was adopted to conduct two questionnaires for 32 experts working in fields related to pancreatic diseases in Grade-A tertiary hospitals from four different departments. After statistical processing, the personalised nursing plan was determined according to the perceived level of importance, coefficient of variation, full score rate and recognition rate of the *** recovery rates of the two rounds of consultation were 93.75% and 100%, respectively, and the overall authority coefficient of the experts was 0.918, which represented 'authoritative'. In terms of importance, the coefficient of variation was 0-0.137;in terms of feasibility, the coefficient of variation ranged from 0.09 to 0.194. Finally, a scheme consisting of 36 entries in 8 dimensions was built. This programme is comprehensive in content, meets the nutritional diagnosis and treatment needs of patients in the stage of postoperative rehabilitation, provides relatively comprehensive nutritional assessment and support and has a robust system and *** individualised nursing plan for patients with pancreatic cancer with postoperative weight-loss control based on the delphi method is highly scientific and reliable and has positive significance.

关键词： Pancreatic cancer Weight loss Personalisation Scheme construction delphi method

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Developing a questionnaire to evaluate an automated audit & feedback intervention: a Rand-modified delphi method

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BMC HEALTH SERVICES RESEARCH 2024年第1期24卷 433页

作者： van den Wyngaert, Ine Van Pottelbergh, Gijs Coteur, Kristien Vaes, Bert van den Bulck, Steve Univ Leuven Acad Ctr Gen Practice Dept Publ Hlth & Primary Care Leuven Belgium UHasselt Fac Med & Life Sci Res Grp Healthcare & Eth Diepenbeek Belgium

Background Audit and feedback (A&F) is a widely used implementation strategy to evaluate and improve medical practice. The optimal design of an A&F system is uncertain and structured process evaluations are currently lacking. This study aimed to develop and validate a questionnaire to evaluate the use of automated A&F *** Based on the Clinical Performance Feedback Intervention Theory (CP-FIT) and the REFLECT-52 (REassessing audit & Feedback interventions: a tooL for Evaluating Compliance with suggested besT practices) evaluation tool a questionnaire was designed for the purpose of evaluating automated A&F systems. A Rand-modified delphi method was used to develop the process evaluation and obtain validation. Fourteen experts from different domains in primary care consented to participate and individually scored the questions on a 9-point Likert scale. Afterwards, the questions were discussed in a consensus meeting. After approval, the final questionnaire was *** A 34-question questionnaire composed of 57 items was developed and presented to the expert panel. The consensus meeting resulted in a selection of 31 questions, subdivided into 43 items. A final list of 30 questions consisting of 42 items was *** A questionnaire consisting of 30 questions was drawn up for the assessment and improvement of automated A&F systems, based on CP-FIT and REFLECT-52 theory and approved by experts. Next steps will be piloting and implementation of the questionnaire.

关键词： Medical audit Quality of health care Audit and feedback Process evaluation delphi method Questionnaire

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A framework to assess and report social, environmental, and economic post-disaster damages based on Z-numbers and the delphi method

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NATURAL HAZARDS 2024年第15期120卷 14459-14494页

作者： Moghadam, Mahdi Anbari Bagherpour, Morteza Iran Univ Sci & Technol Dept Ind Engn Univ Ave Narmak Tehran *** Iran Antalya Bilim Univ Dept Ind Engn Antalya Turkiye

Natural disasters inflict significant damage on social, environmental, and economic fronts, complicating recovery efforts. Accurately assessing and reporting this damage is challenging due to the complex, multifaceted nature of post-disaster impacts and the inherent uncertainty and unreliability of initial data, often represented through linguistic terms. This paper presents a comprehensive approach to evaluating the damages caused by natural disasters on sustainability pillars by utilizing Z-numbers and the delphi method. Through expert opinion and literature review, key attributes within each domain are identified. The delphi method is then utilized to assign weights to these domains and attributes, ensuring an unbiased procedure. The Z-numbers-based approach helps mitigate the uncertainty and unreliability inherent in expert evaluations. The study introduces and computes an Overall Z Post-disaster Damage Index, and then identifies and ranks critical factors for immediate attention by disaster managers, thereby optimizing resource allocation and decision-making. The comparison of different approaches highlights the superiority of the adopted delphi-based Trapezoidal Z-number method, resulting in a more comprehensive and nuanced damage assessment. The integration of Z-numbers with trapezoidal membership functions effectively captures the complexity and uncertainty inherent in post-disaster situations. This research empowers disaster managers with a practical tool for post-disaster assessment, aiding decision-making and facilitating recovery and reconstruction efforts.

关键词： Sustainability Linguistic variables Post-disaster Z-numbers Fuzzy logic delphi method

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An international consensus based on the delphi method to define failure of medical treatment in pyogenic spinal infections

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SPINE JOURNAL 2024年第2期24卷 250-255页

作者： Urrutia, Julio Camino-Willhuber, Gaston Guerrero, Alonso Diaz-Ledezma, Claudio Bono, Christopher M. Pontificia Univ Catolica Chile Sch Med Dept Orthopaed Surg Diagonal Paraguay 362 Santiago Chile Hosp Special Surg New York NY USA Clin Las Condes Dept Orthoped Surg Santiago Chile Harvard Med Sch Massachusetts Gen Hosp Dept Orthoped Surg Boston MA USA

BACKGROUND CONTEXT: Pyogenic spinal infections (PSIs) are severe conditions with high morbidity and mortality. If medical treatment fails, patients may require surgery, but there is no consensus regarding the definition of medical treatment failure. PURPOSE: To determine criteria for defining failure of medical treatment in PSI through an international consensus of experts. STUDY DESIGN: A two -round basic delphi method study. SAMPLE: One hundred and fifty experts from 22 countries (authors or co-authors of clinical guidelines or indexed publications on the topic) were invited to participate;33 answered both rounds defining the criteria. OUTCOME MEASURES: A scale of 1 to 9 (1: no relevance;9: highly relevant) applied to each criterion. methodS: We created an online survey with 10 criteria reported in the literature to define the failure of medical treatment in PSIs. We sent this survey via email to the experts. Agreement among the participants on relevant criteria (score >= 7) was determined. One month later, the second round of evaluations was sent. An extra criterion suggested by six responders in the first round was incorporated. The final version was reached with the criteria considered relevant and with high agreement. RESULTS: The consensus definition is: (1) There is an uncontrolled sepsis despite broad spectrum antibiotic treatment, and (2) There is an infection relapse, following a six -week period of antibiotics with clinical and laboratory improvement. CONCLUSIONS: Our definition of failure following nonsurgical treatment of PSI can offer a standardized approach to guide clinical decision -making. Furthermore, it has the potential to enhance scientific reporting within this field. (c) 2023 Elsevier Inc. All rights reserved.

关键词： delphi method International consensus Pyogenic spinal infections Vertebral osteomyelitis

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The era of business analytics: identifying and ranking the differences between business intelligence and data science from practitioners' perspective using the delphi method

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JOURNAL OF BUSINESS ANALYTICS 2024年第2期7卷 94-119页

作者： Al-Debei, Mutaz M. Univ Jordan Business Sch Dept Management Informat Syst Amman Jordan AL Ahliyya Amman Univ Hourani Ctr Appl Sci Res Amman Jordan Univ Jordan Dept Management Informat Syst Amman 11942 Jordan

The concepts associated with business analytics, such as business intelligence and data science, are generally murky. However, this misconception has a harmful impact on both academics and practitioners. This uncertainty may cause universities to develop misleading or incoherent curricula. This lack of clarity may also cause enterprises to choose an inappropriate analytical solution to a business problem, resulting in project failure and wasted resources. Despite its significance;it appears that only practitioners and major consulting firms are exerting significant effort to address this matter. Hence, this study aims to fill this void and uses the delphi method to indicate that business intelligence and data science may be classified using eight dimensions which are: types of analytics, analytics process, skill set, data sources, business value, the scope of analytics, methods & techniques, and finally, technological platforms & tools. Significant implications for theory and practice are offered.

关键词： Business analytics business intelligence data science data analytics delphi method business value

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A delphi method Comfort Status Scale for Patients With Lung Cancer After Thoracoscopic Surgery

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JOURNAL OF PERIANESTHESIA NURSING 2024年第6期39卷 958-963.e1页

作者： Yuan, Zheng You, Yali Song, Xiaofei Wu, Wenbo Zhang, Xiaopeng Duan, Guochen Hebei Gen Hosp Dept Nursing Shijiazhuang Peoples R China Hebei Gen Hosp Dept Cardiovasc Internal Med 3 Shijiazhuang Peoples R China Hebei Gen Hosp Dept ENT Shijiazhuang Peoples R China Hebei Gen Hosp Dept Thorac Surg 2 Shijiazhuang Peoples R China Childrens Hosp Hebei Prov Dept Thorac Surg 133 Jianhua South St Shijiazhuang 050000 Peoples R China

Purpose To construct the comfort status scale for patients with lung cancer after thoracoscopic surgery. Design delphi method inquiry to 15 clinical and nursing experts. methods On the basis of the comfort status scale and the subjective experience and objective symptoms of patients with lung cancer after thoracoscopic surgery, the relevant literature was consulted, semistructured interviews and group discussions were conducted, the pool of items of the postoperative comfort status scale for patients with lung cancer was initially formed, and the postoperative comfort status scale for patients with lung cancer was finally established. Findings The positive coefficient of experts was 100%, the coefficient of authority was 0.92 and 0.93, and the Kendal's W was 0.257 and 0.298, the degree of coordination of expert opinions was statistically significant (P < .05). Finally, a total of 28 items in four dimensions were formed to assess the postoperative comfort status of patients with lung cancer after thoracoscopic surgery. Conclusions The delphi method-based comfort status scale for patients with lung cancer after thoracoscopic surgery is scientific and reliable, and can provide a quantitative basis for the evaluation of the comfort status of patients after lung cancer thoracoscopic surgery, to further provide individual comfort care measures. (c) 2024 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://***/licenses/by-nc-nd/4.0/).

关键词： thoracoscopic surgery comfort status scale delphi method nursing care

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