Nurses' Priorities for Perioperative Research in Africa.

BACKGROUND: Mortality rates among surgical patients in Africa are double those of surgical patients in high-income countries. Internationally, there is a call to improve access to and safety of surgical and perioperative care. Perioperative research needs to be coordinated across Africa to positively impact perioperative mortality. METHODS: The aim of this study was to determine the top 10 perioperative research priorities for perioperative nurses in Africa, using a research priority-setting process. A Delphi technique with 4 rounds was used to establish consensus on the top 10 perioperative research priorities. In the first round, respondents submitted research priorities. Similar research priorities were amalgamated into single priorities when possible. In round 2, respondents ranked the priorities using a scale from 1 to 10 (of which 1 is the first/highest priority, and 10 is the last/lowest priority). The top 20 (of 31) were determined after round 2. In round 3, respondents ranked their top 10 priorities. The final round was an online discussion to reach consensus on the top 10 perioperative research priorities. RESULTS: A total of 17 perioperative nurses representing 12 African countries determined the top research priorities, which were: (1) strategies to translate and implement perioperative research into clinical practice in Africa, (2) creating a perioperative research culture and the tools, resources, and funding needed to conduct perioperative nursing research in Africa, (3) optimizing nurse-led postoperative pain management, (4) survey of operating theater and critical care resources, (5) perception of, and adherence to sterile field and aseptic techniques among surgeons in Africa (6) surgical staff burnout, (7) broad principles of infection control in surgical wards, (8) the role of interprofessional communication to promote clinical teamwork when caring for surgical patients, (9) effective implementation of the surgical safety checklist and measures of its impact, and (10) constituents of quality nursing care. CONCLUSIONS: These research priorities provide the structure for an intermediate-term research agenda for perioperative research in Africa.

Development of a graphic blood glucose monitoring chart for glycaemic control in diabetes mellitus: a modified Delphi method study.

BACKGROUND: In Kenya 30% of patients admitted with ketoacidosis due to hyperglycaemia die within 48 hours of hospitalisation. Effective monitoring of blood glucose levels is critical for glycaemic control and prevention of mortality. Kenya public hospitals lack a graphic blood glucose monitoring tool. AIMS: To develop a graphic blood glucose monitoring tool. METHODS: Modified Delphi technique was used for consensus-building among nurses on the features of an appropriate blood glucose monitoring tool. A total of 150 nurses selected by purposive sampling participated in the study. Data were collected for 24 months through sequential interactive rounds and workshops using a questionnaire. At every round, consensus was reached if ≥75% of the nurses agreed or disagreed on a feature. RESULTS: A graphic blood glucose monitoring chart was developed with the following features: time on the x-axis, blood glucose values on the y-axis, colour codes corresponding to blood glucose levels, existing conditions during blood glucose measurement. SIGNIFICANCE: The chart may improve glycaemic control while stimulating further research on its effectiveness. CONCLUSION: Modified Delphi method is useful for successive collation of judgments of nurse experts in the development of a graphic blood glucose monitoring chart.