Elsevier

Australian Critical Care

Volume 25, Issue 1, February 2012, Pages 41-57
Australian Critical Care

A Delphi study on National PICU nursing research priorities in Australia and New Zealand

https://doi.org/10.1016/j.aucc.2011.08.003Get rights and content

Summary

Background

There is a lack of evidence to direct and support nursing practice in the specialty of paediatric intensive care (PIC). The development of national PIC nursing research priorities may facilitate the process of undertaking clinical research and translating evidence into practice.

Purpose

To (a) identify research priorities for the care of patients and their family as well as for the professional needs of PIC nurses, (b) foster nursing research collaboration, (c) develop a research agenda for PIC nurses.

Methods

Over 13 months in 2007–2008, a three-round questionnaire, using the Delphi technique, was sent to all specialist level registered nurses working in Australian and New Zealand PICUs. This method was used to identify and prioritise nursing research topics. Content analysis was used to analyse Round I data and descriptive statistics for Round II and III data.

Results

In Round I, 132 research topics were identified, with 77 research priorities (mdn > 6, mean MADmedian 0.68 ± 0.01) identified in subsequent rounds. The top nine priorities (mean > 6 and median > 6) included patient issues related to neurological care (n = 2), pain/sedation/comfort (n = 3), best practice at the end of life (n = 1), and ventilation strategies (n = 1), as well as two priorities related to professional issues about nurses’ stress/burnout and professional development needs.

Conclusion

The research priorities identified reflect important issues related to critically ill patients and their family as well as to the nurses caring for them. These priorities can be used for the development of a research agenda for PIC nursing in Australia and New Zealand.

Introduction

Research is the cornerstone of generation of new knowledge and evidence to support improved practice and optimal patient outcomes.1 However barriers to both undertaking clinical research and implementing evidence into practice still exist.2 Nursing research is relatively young compared to other professions particularly in subspecialties such as paediatric intensive care (PIC). The systematic development of a knowledge base to direct and support PIC nursing is essential and the development of national PIC nursing research priorities may facilitate the process of undertaking clinical research and translating evidence into clinical practice.

Section snippets

Background

The available evidence to guide PIC nursing practice is limited. A search of the Cumulative Index of Nursing and Allied Health Literature (EBSCO) database from January 1992 to March 2011 using paediatric critical care as subject heading, revealed 756 research articles, 47 of which were from Australia and/or New Zealand. The topics addressed in this small number of Australian studies included parenting, decision-making, communication, nurses’ education, weaning from ventilation, feeding, pain

Design

The classic Delphi technique was used as a practical and valid approach to identify and prioritise clinical nursing research questions.4, 6, 7, 8, 9, 13 The structured process for collecting and condensing knowledge from a group of experts by means of a series of questionnaires interspersed with controlled opinion feedback was described by the RAND Corporation in the 1950s.14, 15 The process consists of response–analysis–feedback–response repeated two or three times16, 17. Advantages of the

Demographic profile

Nearly half (46%) of the participants were aged between 41 and 50 years. The median of professional experience was 15 years for general nursing and 9.5 years for paediatric intensive care nursing. Just over a third of the nurses who participated in the study had completed a postgraduate qualification and another third completed graduate studies (bachelor level). The majority (55%) were employed on a full time, permanent basis. Table 1 presents the demographic characteristics of participants in

Discussion

This study reports on research priorities as identified by specialist level registered nurses working in PIC units in Australia and New Zealand at the time of the study. The response rate in this study indicates a good representativeness of the study population and that the findings reflect the views of PIC nurses. Because the panel of respondents was constituted of nurses working in PIC at specialist level at the time study, it is likely that the results are truly relevant to their clinical

Conclusion

This study reports on research priorities as identified by specialist level registered nurses working in PIC units in Australia and New Zealand at the time of the study. The results reflect important current issues related to critically ill children and their families as well as the nurses caring for them. More specifically, these issues include assessment and management of patient comfort and pain, neurological protection following cerebral insult, weaning from mechanical ventilation and two

Recommendations

ACCCN established a Paediatric Advisory Panel in 2009. The research priorities highlighted in this study can now inform the Advisory Panel in guiding ACCCN's paediatric research agenda and to use the research priorities as a guide for future funding of nursing research. ACCCN may also take a leadership role by recommending in a position statement that all PICUs provide a Nurse Researcher position to facilitate nursing research. To really move forward with PIC nursing research in Australia and

Acknowledgements

We wish to thank the PIC nurse coordinators for their sustained interest and support of this study over the three rounds of data collection, namely Debbie Long, Amanda Ullman, Di McKinley, Marion Dempster, Elaine McCall, and Tina Kendrick, as well as all nurses who participated in this study. We also acknowledge the study endorsement by the ACCCN National Board on behalf of the ACCCN Paediatric Special Interest Group.

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