Constructing an evaluation index system for clinical nursing practice teaching quality using a Delphi method and analytic hierarchy process-based approach.

BACKGROUND: The key step in evaluating the quality of clinical nursing practice education lies in establishing a scientific, objective, and feasible index system. Current assessments of clinical teaching typically measure hospital learning environments, classroom teaching, teaching competency, or the internship quality of nursing students. As a result, clinical evaluations are often insufficient to provide focused feedback, guide faculty development, or identify specific areas for clinical teachers to implement change and improvement. Therefore, the purpose of our study was to to construct a scientific, systematic, and clinically applicable evaluation index system of clinical nursing practice teaching quality and determine each indicator's weight to provide references for the scientific and objective evaluation of clinical nursing practice teaching quality. METHODS: Based on the "Structure-Process-Outcome" theoretical model, a literature review and Delphi surveys were conducted to establish the evaluation index system of clinical nursing practice teaching quality. Analytic Hierarchy Process (AHP) was employed to determine the weight of each indicator. RESULTS: The effective response rate for the two rounds of expert surveys was 100%. The expert authority coefficients were 0.961 and 0.975, respectively. The coefficient of variation for the indicators at each level ranged from 0 to 0.25 and 0 to 0.21, and the Kendall harmony coefficients were 0.209 and 0.135, respectively, with statistically significant differences (P < 0.001). The final established index system included 3 first-level, 10 second-level, and 29 third-level indicators. According to the weights computed by the AHP, first-level indicators were ranked as "Process quality" (39.81%), "Structure quality" (36.67%), and "Outcome quality" (23.52%). Among the secondary indicators, experts paid the most attention to "Teaching staff" (23.68%), "Implementation of teaching rules and regulations (14.14%), and "Teaching plans" (13.20%). The top three third-level indicators were "Level of teaching staff" (12.62%), "Structure of teaching staff" (11.06%), and "Implementation of the management system for teaching objects" (7.54%). CONCLUSION: The constructed evaluation index system of clinical nursing practice teaching quality is scientific and reliable, with reasonable weight. The managers' focus has shifted from outcome-oriented to process-oriented approaches, and more focus on teaching team construction, teaching regulations implementation, and teaching design is needed to improve clinical teaching quality.

Trends in the prevalence and risk factors for peripherally inserted central catheter-related complications in cancer patients from 2016 to 2022: a multicenter study.

PURPOSE: To identify the trends in the prevalence of peripherally inserted central catheter (PICC) related complications in cancer patients and explore the risk factors for complications and occurrence speed. METHODS: A total of 3573 cancer patients with PICC were recruited at 17 hospitals from 2016 to 2022. Logistic and COX regression were performed to identify influencing factors of PICC-related complications and incidence speed, respectively. RESULTS: The proportion of symptomatic PICC-related thrombosis, phlebitis, and infections reported had decreased from 59.1% (in 2017), 11.9% (in 2016), and 11.1% (in 2016) to 15.3% (in 2022), 2.9% (in 2022), and 7.4% (in 2022), and adhesive-related skin injuries and bleeding/oozing reported had increased from 4.8% (in 2016) and 0.0% (in 2016) to 45.5% (in 2022) and 3.4% (in 2022), respectively. Catheter occlusion showed a trend of first increasing and then decreasing from 2.4 (in 2016) to 12.0 (in 2020) to 5.8% (in 2022). Logistic regression showed that hospital level, nature, the patient's gender, age, diagnosis, history of deep vein catheterization, chemotherapy drug administration, and type of PICC were influencing factors of complications. COX regression showed that the patient's gender, age, diagnosis, history of deep vein thrombosis and thrombophlebitis, history of deep vein catheterization, chemotherapy drug administration, type of PICC, type of connector, and StatLock used for fixation were influencing factors of incidence speed. CONCLUSION: The composition ratios of PICC-related complications in cancer patients in China have changed in recent years. Chemotherapy drug administration was a significant risk factor accelerating the occurrence of complications. Maintenance factors had the maximum weight on the COX model, followed by patient factors. It is suggested that patients with high-risk factors be closely monitored and proper maintenance be performed to prevent and delay the occurrence of PICC-related complications.

The Professional Identity of Nursing Students and Their Intention to Leave the Nursing Profession During the Coronavirus Disease (COVID-19) Pandemic.

BACKGROUND: The COVID-19 pandemic has affected China and other countries since December 2019. The effects of this pandemic on nursing students in terms of their professional identity, intention to leave the nursing profession, and perception of clinical nursing work remain unclear. PURPOSE: The aims of this study were, first, to investigate nursing students' professional identity, intention to leave the nursing profession, and perception of clinical nursing work during the COVID-19 pandemic and, second, to explore factors influencing professional identity to help develop effective strategies to enrich and strengthen this factor in the future. METHODS: This cross-sectional, descriptive survey study was conducted on 150 nursing students in China in February 2020. RESULTS: The 14 (9.3%) participants who reported intending to leave the nursing profession earned lower scores for professional identity than their peers who reported intending to remain. The participants who believed that the COVID-19 pandemic had made them "more passionate about clinical nursing work" earned the highest scores, followed by those who believed the pandemic had "no effect." The lowest scores were earned by those who believed clinical nursing work to be "too dangerous to engage in." COVID-19 knowledge scores, the perceived effectiveness of preventive and control measures, the number of cases seen on the day the study survey was taken, and time spent daily on COVID-19 events were the variables found to influence professional identity. CONCLUSIONS: COVID-19 outbreak is not merely a time of crisis but also an opportunity to reconstruct the professional identity of nursing students.