Validation of evidence-based clinical practice guideline: nursing intervention for newly diagnosed pulmonary tuberculosis patients at community setting

Tuberculosis is a major contributor to disease burden in the developing countries. It is considered the second fatal disease all over the world and the third most important public health problem in Egypt. The direct causes of increasing the burden of tuberculosis are the inconsistent and fragmented health services. The nursing interventions of tuberculosis in community settings require a system of recommendations that ensure the consistency of care. The present study aimed at providing a valid evidence-based clinical guideline that assists nurses to intervene consistently to the newly diagnosed patient with pulmonary tuberculosis. The intended guideline was developed according to the criteria of the Scottish Intercollegiate Guidelines Network [SIGN] and the American Academy of Neurology. This guideline was developed based on the need for assessments of the intended users [nurses] and the end-point beneficiaries [newly diagnosed patients with pulmonary tuberculosis]. The development process of the guideline consisted of seven main steps. The SIGN appraisal tools were used for the critical appraisal phase of the retrieved studies, and the ''Appraisal of Guidelines for Research and Evaluation [AGREE] Instrument'', that was used for appraising the internal validity of the developed guideline. The developed guideline included thirty recommendations categorized into four main themes, which are assessment, nursing diagnosis, nursing care plan and implementation of care plan. The overall assessment of the guideline revealed that two-thirds of academic appraisers strongly recommended the guideline to be used in practice and most of practitioner nurses and practitioner physicians recommended the guideline to be in practice. The development of this guideline was based on the needs of the targeted users [nurses] and end-point beneficiaries [patients]. It was strongly recommended by the appraisers to be used in the outpatients chest clinics. The study recommended that this developed guideline should be disseminated to the policy makers to be approved for application

Application of objective structured clinical examination in community health nursing course: experience of staff members and students

Objective Structured Clinical Examination [OSCE] is the most valid and reliable tool for evaluation of performance competency. There are different formats of OSCE to assess the cognitive and psychomotor skills as well as the knowledge recall and communication skills in an objective and consistent manner. It is important to involve students and examiners in changing or innovating of evaluation pattern. The present study aimed to investigate the perception and experience of staff members and students toward introducing OSCE as a new approach of assessment in community health nursing course. In addition to compare the applicability of using three different structured methods of simulated patient [Lay person with staff members, Staff members play double roles and two staff members], in order to find out the most appropriate simulated patient method. The study is a mix of quantitative and qualitative design. It was carried out at the fourth year community health-nursing students, totaling 160 students. All examiners [n= 16] and only 60 students participated at the focus group sessions. Results revealed that most of students and examiners were satisfied with the objectivity of OSCE and the variety of questions that increase the chance of gaining marks. The students' level of performance ranged from good to excellent in all stations for most of students. The study recommends introducing OSCE into the curriculum of community health nursing course and holding comprehensive training for staff members on being a simulated patient and examiner at the same time

validated clinical practice guideline for community health nurse working in tuberculosis out-patient clinics

Tuberculosis is a major contributor to disease burden in developing countries; it is considered the second fatal disease all over the world and the third most important public health problem in Egypt. The direct causes of increasing the burden of tuberculosis are the inconsistent and fragmented health services, The nursing interventions of tuberculosis in community settings require system of recommendation that ensures the consistency of care. The present study aimed at providing a valid clinical guideline that assist nurses to intervene consistently to the newly diagnosed pulmonary tuberculosis patient. The needs analysis of community health nurses working in out patient chest clinics in addition to the expectation of newly diagnosed pulmonary tuberculosis patient regarding nursing interventions. The guideline development process established according to the criteria of experts of guideline development organizations. The Scottish Intercollegiate Guidelines Network [Sign] research appraisal tools were used for the critical appraisal phase of the obtained evidence. AGREE instrument was used for assessing the internal validity of the guideline. The guideline and apprised for internal validity by academic nursing and medical staff, nursing, and medical practitioners. The scores of all appraisers in relation to scope and Purpose, stakeholder involvement, rigour of development ranged from [62.9-77.7%, 53.5-77.7%, and 66.6-76.2%], respectively. While the scores for the clarity and presentation were 50-76.4, applicability were 61.9-68.5, and editorial independence were 88-93. The four groups of revision strongly recommended the application of the guideline