Sensory processing disorder: perceptions on the clinical role of advanced psychiatric nurses

Background: No description of the clinical role of the advanced psychiatric nurse in the management of children with sensory processing disorder could be found for the South African context. This is a loss in clinical nursing practice with regard to diagnosis, treatment and research. Aim: To explore and clarify the perceptions of healthcare professionals in South Africa on the clinical role of the advanced psychiatric nurse in sensory processing disorder to provide a description of this role. Setting: The research was conducted by inviting registered healthcare professionals practicing in South Africa to complete several rounds of an on-line survey. Methods: An explorative and descriptive design was used. Purposive sampling was used to identify an initial sample of healthcare professionals, followed by snowball sampling. The Delphi technique was implemented with three sequential rounds, gathering data on the perceptions of the healthcare professionals regarding the clinical role of the advanced psychiatric nurse in sensory processing disorder. Results: The following main themes crystallised from the data ­ (1) Specialised training of the advanced psychiatric nurse (APN) on sensory processing disorder; (2) Interventions carried out by the APN with regard to sensory processing disorder; (3) Adequate support to the family with regard to sensory processing disorder; and (4) Referral of a child with sensory processing disorder. Conclusion: The study indicates that the healthcare professionals who are experts in delivering healthcare to children with sensory processing disorder agree that the APN with additional training in this condition has a clinical role to play in rendering healthcare to these healthcare users. A preliminary clinical role description could be formulated. Recommendations for nursing practice, nursing education and further research were formulated

Building consensus on identifying research mentoring gaps and finding ways of addressing the gap in a Kenyan college of health sciences

Background: The concept of mentoring in clinical practice has traditionally focused on moving graduates from novice to more respectable positions within the clinical practice hierarchy. With the growing emphasis on evidence-based practice, the role of research in generating evidence for practice cannot be overemphasised. Mentoring in clinical operational research for both students and junior members of academic staff in health professionals' training colleges is as important as mentoring for clinical skills. Aim: This study aimed at building consensus on possible ways of enhancing research mentoring for graduate students and members of academic staff in a college of health sciences. Setting: The study was conducted within Moi University College of Health Sciences (MUCHS) in Eldoret, Kenya. Methods: The study population was composed of academic staff members and registered graduate students by the end of 2015. All academic staff and graduate students were eligible to participate. The Delphi technique was used to not only collect individual opinions but also build consensus. During the first iteration, questions were sent for which open-ended responses were needed. Responses from the first round were grouped into patterns and themes that guided the writing of questions for the subsequent rounds.Results: The response rate was 78%. There was consensus in appreciating that mentoring was fundamental for career growth in clinical practice and research and needed for improving and developing formal structure for effective mentoring. It was crucial to establish training programmes for mentors and for accrediting them. Conclusion: Enhancing of current research mentoring in MUCHS was needed and expected by graduate students and academic staff

Determination of visual portfolio for surgeons overseas assessment of surgical needs Nigeria study: Consensus generation through an e-Delphi process

Background: Surgery as a public health priority has received little attention until recently. There is a significant unmeasured and unmet burden of surgical illness in low- and middle-income countries (LMICs). Our aim was to generate a consensus among expert pediatric surgeons practicing in LMICs regarding the spectrum of pediatric surgical conditions that we should look out for in a community-based survey for Surgeons OverSeas Assessment of Surgical Needs Nigeria study. Materials and Methods: The Delphi methodology was utilized to identify sets of variables from among a panel of experts. Each variable was scored on a 5-point Likert scale. The experts were provided with an anonymous summary of the results after the first round. A consensus was achieved after two rounds, defined by an improvement in the standard deviation (SD) of scores for a particular variable over that of the previous round. We invited 76 pediatric surgeons through e-mail across Africa but predominantly from Nigeria. Results: Twenty-one pediatric surgeons gave consent to participate through return of mail. Thirteen (62%) answered the first round statements and 8 (38%) the second round. In general, the strength of agreement to all statements of the questionnaire improved between the first and second rounds. Overall consensus, as expressed by the decrease in the mean SD from 0.84 in the first round to 0.68 in the second round, also improved over time. The strength of consensus improved for 23 (74%) of the statements. The strength of consensus decreased for the remaining 8 (26%) of statements. Out of the 31 consensus-generating statements, 16 (51%) scored high agreement, 13 (42%) scored low agreement, and 2 (15%) scored perfect disagreement. Conclusion: We have successfully identified the pediatric surgical conditions to be included in any community survey of pediatric surgical need in an LMIC setting

The Art of the Delphi Technique : Highlighting its Scientific Merit

The initial use of the Delphi technique was forecasting in order to be able to plan ahead. More recently the Delphi technique has been used as a constructive method in facilitating controlled; rationale group communication to develop knowledge for decision-making. Although the Delphi technique is widely used; its scientific merit is questioned. This article illuminates the application; limitations; value and scientific merit of the Delphi technique. The subsequent articles illustrate the application of the Delphi technique

Opinions on a Strategy to Promote Nurses' Health Research Contribution in South Africa

This is the second article in a series of three articles on a strategy to promote nurses' health research contribution in South Africa. This article describes a Delphi study that was conducted to explore the panel of experts' opinions on nurses' health research contribution and to develop a strategy to promote this contribution. A qualitative and quantitative; descriptive design was used. A Delphi study consisting of three successive rounds was conducted from January 2005 to February 2006. A panel of experts (round one: n=28; round two: n=31; round three: n=18); selected from multiple health-related and health research-related clusters; participated. Professional nurses in academic/educational positions were the main participants. Multi-disciplinary team members; other than nurses; at international as well as national level; also made valuable contributions as part of the panel. Data were gathered by circulating a list of open-ended questions (round one) as well as questionnaires (rounds two and three). Analysis was done using open coding and descriptive statistics. Findings were processed and; in an anonymous way; fed back to panellists to re-assess and change if necessary. In this way; outcomes in the various rounds resulted in a move towards consensus in opinions between the panelists. Elements essential to a strategy to improve research done by nurses; could be identified; name -ly research capacity building; collaboration; dissemination and utilisation of research results; quality of research conducted by nurses; leadership; resources and research priorities. These elements are seen as a framework for a strategy; and this framework was explored further in a subsequent article

Building consensus on clinical procedural skills for South African family medicine training using the Delphi technique

Background: The development of registrar training as part of the newly created speciality of family medicine in South Africa requires the development of a national consensus on the clinical procedural skills outcomes that should be expected of training programmes.Methods This study utilized a Delphi technique to establish a national consensus between 35 experts from training institutions; those already in family practice and managers who might be employing family physicians in both private and public sector contexts. Results: Consensus was reached on 214 core skills at different levels of desired competency and 23 elective skills. The core skills were divided into 58 that should be taught by family physicians; 101 that should be performed independently and 55 that should be performed during training under supervision. The panel were unable to reach consensus on a further 21 skills.ConclusionThis is the first study that has proposed a set of essential clinical procedural skills for the training of family physicians in South Africa. The findings will act as a benchmark for programmes in South Africa and through the new initiative of `FaMEC in Africa' may influence curriculum development in other African countries. They may be used as a guide for curriculum planning; as a way of monitoring skills development and as an indication to registrars of the skills they need to achieve for assessment purposes. The findings may also inform the planning of training programmes for the proposed mid-level health worker (clinical associate) in South Africa as their skills will be a sub-set of these skills and will be taught by family physicians within district hospitals. Training programmes for undergraduates and interns in family medicine may also want to position themselves as stepping stones in line with these final outcomes of postgraduate training

Building Consensus on Clinical Procedural Skills for South African Family Medicine Training Using the Delphi Technique

Background: The development of registrar training as part of the newly created speciality. Methods: This study utilized a Delphi technique to establish a national consensus between 35 experts from training institutions; those already in family practice and managers who might be employing family physicians in both private and public sector contexts of family medicine in South Africa requires the development of a national consensus on the clinical procedural skills outcomes that should be expected of training programmes.Results: Consensus was reached on 214 core skills at different levels of desired competency and 23 elective skills. The core skills were divided into 58 that should be taught by family physicians; 101 that should be performed independently and 55 that should be performed during training under supervision. The panel were unable to reach consensus on a further 21 skills.Conclusion: This is the first study that has proposed a set of essential clinical procedural skills for the training of family physicians in South Africa. The findings will act as a benchmark for programmes in South Africa and through the new initiative of 'FaMEC in Africa' may influence curriculum development in other African countries. They may be used as a guide for curriculum planning; as a way of monitoring skills development and as an indication to registrars of the skills they need to achieve for assessment purposes. The findings may also inform the planning of training programmes for the proposed mid-level health worker (clinical associate) in South Africa as their skills will be a sub-set of these skills and will be taught by family physicians within district hospitals. Training programmes for undergraduates and interns in family medicine may also want to position themselves as stepping stones in line with these final outcomes of postgraduate training