ABSTRACT
OBJECTIVE: Variations in wound assessment and documentation remain an issue for clinicians despite efforts to standardise practices using national guidelines such as the Wound Care Assessment Minimum Data Set (WCA-MDS). As little is known about the quality of the wound assessment tools (WATs) used in Singapore, this study aimed to determine whether the existing WATs used meet the WCA-MDS criteria and clinicians' needs. METHOD: The study adopted an action evaluation methodology to evaluate seven well-established WATs, such as the Applied Wound Management (AWM) and National Wound Assessment Form (NWAF), and eight locally-designed WATs against the 34-item WCA-MDS criteria. Two clinicians reviewed the WATs using a self-developed audit form between June and July 2020. RESULTS: The results show that only five WATs met at least 50% of the 34 criteria indicators, with the MEASURE assessment framework achieving the most at 68%, followed by TIME-CDST at 65%, Hospital C WAT at 56%, NWAF at 53%, and AWM form at 50%. The five most common criteria indicators included wound type/classification, date and time of wound, wound size, wound bed tissue type, and exudate information. Most criteria indicators under the 'patient information' and 'specialist's referral' subdomains were omitted, reflecting the lack of focus on these areas in the local WATs. CONCLUSION: Despite advances in WAT development in the literature, the current state of wound assessment and documentation across healthcare institutions remains inconsistent. There is a need to focus on clinician training and establishing a nationally-validated WAT in Singapore.
Subject(s)
Documentation , Physical Examination , Humans , SingaporeABSTRACT
BACKGROUND: The Objective Structured Clinical Examination (OSCE) is widely used in nursing education, but its implementation is costly and resource intensive, potentially limiting its feasibility. A five-station OSCE was designed to replace a previously validated 12-station OSCE but was not evaluated for its psychometric properties. PURPOSE: This study aimed to evaluate the validity, reliability, acceptability, educational impact, and cost of a five-station OSCE using Van der Vleuten's utility formula. METHODS: This study was based on a cross-sectional, nonexperimental design involving psychometric testing, a survey, and a cost analysis. RESULTS: The five-station OSCE showed high content and predictive validity and inter-rater reliability among examiners. The OSCE format was well accepted by participants and achieved a cost saving of 45.2% compared with the 12-station format. CONCLUSIONS: The five-station OSCE provides an authentic and objective assessment of competence among newly graduated nurses.
Subject(s)
Clinical Competence , Educational Measurement , Cross-Sectional Studies , Humans , Psychometrics , Reproducibility of ResultsABSTRACT
Nurses working in palliative care settings encounter death and dying regularly and face a greater risk of developing death anxiety and negative attitudes than their counterparts. Such distress and apprehension can cause care fatigue and affect patients' quality of life. Death anxiety remains an underresearched area in Asia, where death and dying are still considered taboo. This study explored death anxiety and its impact on community palliative nurses in Singapore and was conducted at a community hospital in Singapore from January to June 2018. Purposive sampling was used to recruit 16 nurses of different job grades for the face-to-face interviews, which were transcribed verbatim and analyzed using the data analytical approach of Miles et al. Four overarching themes were generated: (1) intrinsic factors influencing death anxiety, (2) extrinsic factors influencing death anxiety, (3) emotional struggles and coping, and (4) need for death education and psychological support. Gaps in palliative care education and death education need to be contextualized to increase the community palliative nurses' awareness and acceptance of death and enhance their death literacy in a multicultural setting.
