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The article discusses the development of core outcome sets (COS) for skin diseases, which are standardized sets of outcomes and measures to be collected in research studies. The lack of uniformity in outcomes for skin diseases hinders the comparison of research findings and optimal patient care. Historically, COS have had limited stakeholder involvement and lacked geographic diversity. However, recent projects have expanded stakeholder involvement and incorporated novel methodologies to ensure more representative COS. The article emphasizes the importance of training materials for patients and patient representatives. Overall, the move towards methodological innovation and broader stakeholder involvement in COS development aims to standardize outcomes and improve their uptake in clinical practice. [Extracted from the article]

Background: The impact of social media, with its speed, reach and accessibility, in interventions aimed to improve adherence to guidelines such as assessment of Pain, Agitation/Sedation and Delirium (PAD) in intensive care is not described. Therefore, the primary objective of this quality improvement study was to evaluate the impact of a multifaceted intervention including audit and feedback of quality indicators (QI) via Facebook-groups, educational events and engagement of opinion leaders on adherence to PAD-guidelines in four ICUs.Methods: A quasi-experimental interrupted time series study with eight monthly data points in the two phases Before and Intervention was designed. Proportion of nursing shifts with documented PAD-assessment (PAD-QIs) were retrieved from the electronical medical chart from included adult ICU patient-stays in four participating ICUs. Difference between the two time periods was assessed using generalised mixed model for repeated measures with unstructured covariance matrix, and presented as Beta (B) with 95% confidence interval (CI).Results: Finally, 1049 ICU patient-stays were analysed; 534 in Before and 515 in Intervention. All three PAD-QIs significantly increased in Intervention by 31% (B = 30.7, 95%CI [25.7 to 35.8]), 26% (B = 25.8, 95%CI [19.4 to 32.2]) and 34% (B = 33.9, 95%CI [28.4 to 39.4]) in pain, agitation/sedation and delirium, respectively.Conclusion: A multifaceted intervention including use of Facebook-groups was associated with improved guideline-adherence in four ICUs, as measured with process PAD-QIs of PAD assessment. Further research on use of social media to improve guideline adherence is warranted, particularly as social distancing impacts clinical education and training and new approaches are needed. [ABSTRACT FROM AUTHOR]

Aims Design Methods Results Conclusion Implications for the profession Impact Reporting method Patient or public contribution The aim of the study was to develop a comprehensive competency framework for advanced practice nurses in Belgium.A co‐design development process was conducted.This study consisted of two consecutive stages (November 2020–December 2021): (1) developing a competency framework for advanced practice nurses in Belgium by the research team, based on literature and (2) group discussions or interviews with and written feedback from key stakeholders. 11 group discussions and seven individual interviews were conducted with various stakeholder groups with a total of 117 participants.A comprehensive competency framework containing 31 key competencies and 120 enabling competencies was developed based on the Canadian Medical Education Directions for Specialists Competency Framework. These competencies were grouped into seven roles: clinical expert and therapist, organizer of quality care and leader in innovation, professional and clinical leader, collaborator, researcher, communicator and health promoter.The developed competency framework has resemblance to other international frameworks. This framework emphasized the independent role of the advanced practice nurse and provided guidance in a clear task division and delegation to other professionals. It can provide a solid foundation for delivering high‐quality, patient‐centred care by advanced practice nurses in the years to come.This competency framework can guide further development of advanced practice nursing education in Belgium and represents a starting point for future evaluation of its feasibility and usability in education and clinical practice. Advanced practice nurses and healthcare managers can also use the framework as an instrument for personal and professional development, performance appraisal, and further alignment of these function profiles in clinical practice. Finally, this framework can inform and guide policymakers towards legal recognition of advanced practice nursing in Belgium and inspire the development of advanced practice nursing profiles in countries where these profiles are still emerging.What problem did the study address? The absence of a detailed competency framework for advanced practice nurses complicates legal recognition, role clarification and implementation in practice in Belgium. A rigorously developed competency framework could clarify which competencies to integrate in future advanced practice nursing education, mentorship programs and practice. What were the main findings? The competency framework outlined seven roles for advanced practice nurses: clinical expert and therapist, organizer of quality care and leader in innovation, professional and clinical leader, collaborator, researcher, communicator, and health promoter. Differentiation from other expert nursing profiles and clinical autonomy of advanced practice nurses were pivotal. Where and on whom will the research have impact? The comprehensive competency framework for advanced practice nurses and the collaborative methodology used can inspire other countries where these profiles are still emerging. The competency framework can be used as an instrument for role clarification, performance appraisals, continuous professional development, and professional (e‐)portfolios. The competency framework can guide policymakers when establishing Belgian’s legal framework for advanced practice nurses. The authors have adhered to CONFERD‐HP: recommendations for reporting COmpeteNcy FramEwoRk Development in health professions.No patient or public contribution in the design of the study. A patient advisory panel commented on the developed competency framework. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is already known?: The nurse–patient relationship in mental health care is an important focus of mental health nursing theories and research.There is limited evidence about which factors influence nurse‐sensitive patient outcomes of the nurse–patient relationship. This hinders the development, planning, delivering, and quality assurance of the nurse–patient relationship in nursing practice and nursing education. What this paper adds to existing knowledge?: To our best knowledge, this is the first study to examine associations between nurse‐sensitive patient outcomes of the nurse–patient relationship and a range of patient characteristics and relationship‐contextual factors.In this study, we found that gender, age, hospital characteristics, nurse availability when needed, nurse contact, and nurse stimulation were associated with the scores on the nurse‐sensitive patient outcome scale. What are the implications for practice?: Having insight into the factors associated with nurse‐sensitive patient outcomes of the nurse–patient relationship can help nurses, nursing students, nursing management and also patients to enhance the nurse–patient relationship, trying to influence outcomes of nursing care. Introduction: The lack of evidence on patient characteristics and relational‐contextual factors influencing nurse‐sensitive patient outcomes of a nurse–patient relationship is a possible threat to the quality and education of the nurse–patient relationship. Aim: To measure nurse‐sensitive patient outcomes of the nurse–patient relationship and to explore the associations between nurse‐sensitive patient outcomes and a range of patient characteristics and relational‐contextual factors. Method: In a multicenter cross‐sectional study, 340 inpatients from 30 units in five psychiatric hospitals completed the Mental Health Nurse‐Sensitive Patient Outcome Scale. Descriptive, univariate and Linear Mixed Model analyses were conducted. Results: Overall, patient‐reported outcomes were moderate to good. Female participants, nurse availability when needed, more nurse contact and nurse stimulation were associated with higher outcomes. Age differences were observed for some of the outcomes. Outcomes also varied across hospitals but were not related to the number of times patients were hospitalized or to their current length of stay in the hospital. Discussion: The results may help nurses to become more sensitive and responsive to factors associated with nurse‐sensitive patient outcomes of the nurse–patient relationship. Implications: The nurse‐sensitive results can support nurses in designing future nurse–patient relationships. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Psychiatric and/or mental health nurses are struggling to measure the outcomes of the nurse–patient relationship.Collecting nurse‐sensitive patient outcomes is a strategy to provide outcomes of a nurse–patient relationship from patients' perspectives.Because there was no validated scale, the Mental Health Nurse‐Sensitive Patient Outcome‐Scale (six‐point Likert‐scale) was recently developed and psychometrically evaluated. What the paper adds to existing knowledge?: This is the first study using the Mental Health Nurse‐Sensitive Patient Outcome‐scale to measure nurse‐sensitive patient outcomes of the nurse–patient relationship in psychiatric hospitals. Moderate to good average scores for the MH‐NURSE‐POS total (4.42) and domains scores (≥4.09). are observed. Especially outcomes related to 'motivation' to follow and stay committed to the treatment received high average scores (≥4.60).Our results are consistent with the patient‐reported effect(s) of relation‐based nursing in qualitative research.The scores generate evidence to support the outcomes of the nurse–patient relationship and implicates that further investment in (re)defining and elaborating nurse–patient relationships in mental healthcare is meaningful and justified.More comparative patient‐reported data can determine how nurse‐sensitive patient outcomes are affected by the patient, nurse, and context. What are the implications for practice?: Demonstrating patient‐reported outcomes of the nurse–patient relationship can be important to enhance the therapeutic alliance between nurses and patients, organize responsive nursing care, and create nursing visibility in mental healthcare. Further nursing staff training on interpersonal competencies, such as self‐awareness and cultural sensitivity, can be pivotal to achieving the patient‐reported outcomes for inpatients with mental health problems. Introduction: Identifying patient‐reported outcomes of the nurse–patient relationship is a priority in inpatient mental healthcare to guide clinical decision‐making and quality improvement initiatives. Moreover, demonstrating nurse‐sensitive patient outcomes can be a strategy to avoid further erosion of the specialism of psychiatric and/or mental health nursing. Aim/Question To measure nurse‐sensitive patient outcomes of the nurse–patient relationship. Method: In a multicentred cross‐sectional study, 296 inpatients admitted to five psychiatric hospitals completed the recently developed and validated Mental Health Nurse‐Sensitive Patient Outcome‐Scale (MH‐NURSE‐POS). The MH‐NURSE‐POS consists of 21 items (six‐point Likert‐scale) in four domains: 'growth', 'expression', 'control', and 'motivation'. Results: Participants displayed moderate to good average scores for the MH‐NURSE‐POS total (4.42) and domain scores (≥4.09). Especially outcomes related to 'motivation' to follow and stay committed to the treatment received high average scores (≥4.60). Discussion The results demonstrate that patients perceive the nurse–patient relationship and the care given by psychiatric and/or mental health nurses as contributing to their treatment. Implications for Practices: Patient‐reported outcomes can guide nurses and managers to provide and organize nursing care and to build a nurse–patient relationship that has a positive impact on these outcomes. Additionally, outcomes can create nursing visibility as a profession in‐ and outside mental healthcare. [ABSTRACT FROM AUTHOR]

Background: Patient‐centred care has been recognised as vital for today's healthcare quality. This type of care puts patients at the centre, contributing to positive patient outcomes such as patient autonomy. Empirical research comparing nurses' and patients' perceptions of the support and provision of patient‐centred care is limited and focuses solely on nurses and patients working and staying on surgical wards. Aims and objectives: Comparing patients' and nurses' perceptions of patient‐centred care on different types of hospital wards, and exploring if patient empowerment, health literacy, and certain sociodemographic and context‐related variables are associated with these perceptions. Design: Cross‐sectional design. Methods: Data were collected in ten Flemish (February–June 2016) and two Dutch (December 2014–May 2015) hospitals using the Individualised Care Scale (ICS). A linear mixed model was fitted. Data from 845 patients and 569 nurses were analysed. As the ICS was used to measure the concept of patient‐centred care, it is described using the term 'individualised care.' Results: Nurses perceived that they supported and provided individualised care more compared with patients as they scored significantly higher on the ICS compared with patients. Patients with higher empowerment scores, higher health literacy, a degree lower than bachelor, a longer hospital stay, and patients who were employed and who were admitted to Dutch hospitals scored significantly higher on some of the ICS subscales/subsections. Nurses who were older and more experienced and those working in Dutch hospitals, regional hospitals and maternity wards scored significantly higher on some of the ICS subscales/subsections. Conclusion: Nurses perceived that they supported and provided individualised care more compared with patients. Relevance to clinical practice: Creating a shared understanding towards the support and provision of individualised care should be a priority as this could generate more effective nursing care that takes into account the individuality of the patient. [ABSTRACT FROM AUTHOR]

Background: The prevalence of pressure injuries among community-dwelling older adults in countries worldwide is still a serious problem. In Indonesia, older adults mostly rely on family members for (medical) care. Therefore, involving family members in the prevention and treatment of pressure injuries (PIs) could potentially decrease its prevalence rates. However, family members are usually not trained for such tasks. Hence, it is essential to first get more insight into the current state of affairs on family members' knowledge, attitude and actual practice of preventing PIs. Due to the lack of an existing instrument to measure knowledge, attitude and practice of family caregivers in preventing PIs, this study focuses on the development and evaluation of psychometric properties of such an instrument. Methods: Three phases of instrument development and evaluation were used, including item generation, instrument construction and psychometric testing of the instrument. A total of 372 family caregivers of community-dwelling older adults who randomly selected participated in this study. Principal factor analysis, confirmatory factor analysis and Cronbach's alpha were performed to evaluate factor structure and internal consistency of the Knowledge, Attitude and Practice of Family Caregivers at Preventing Pressure Injuries (KAP-PI) instrument. Results: The final version of the KAP-PI-instrument consists of a 12-item knowledge domain, a 9-item attitude domain, and a 12-item practice domain with Cronbach's Alpha values of 0.83, 0.93 and 0.89, respectively. The instrument appeared to be both reliable and valid. Conclusion: The KAP-PI instrument can be used in family nursing or community nursing practice, education, and research to assess knowledge, attitude and practice of pressure injury prevention of family caregivers. [ABSTRACT FROM AUTHOR]

Aim: To gain insight into which elements of the interpersonal care relationship (IPCR) are perceived as occurring (less) frequently and as (not) disturbing from the perspective of hospitalized older patients. Design A cross‐sectional study in three Belgian hospitals. Methods: A convenience sample of patients aged 75 years or older admitted to a non‐geriatric ward were recruited between May 2017 and April 2019. The Interpersonal Geriatric care relationship (InteGer) tool was used to identify elements of the IPCR and was completed by the researchers through structured patient interviews. Results: The mean total scale score for frequency was 3.74 (SD 1.51) [range 0–12]. On subscale level, the highest mean score was in the accessibility and the lowest mean score in the humanization subscale. Statistically significant differences between the hypothesized and experienced disturbance were observed in 18 of the 30 items. Ten items score in the category 'no action needed' (not occurring, not disturbing), nine items in the category 'remain attentive for patient experiences' (occurring, not disturbing), 10 items in the category 'further analyses or monitoring needed' (not occurring, disturbing) and one item in the category 'urgent action needed' (occurring and disturbing). Conclusion: Participants report mostly positive experiences related to the four subscales of the InteGer, that is, humanization, attentiveness, interest and accessibility. Insights from this study provide important opportunities in the context of care optimization for each category with the main focus on items with high experienced disturbance. Impact The InteGer can be used for monitoring IPCR and formulating action points at ward and hospital level to further improve the IPCR and quality of care. [ABSTRACT FROM AUTHOR]

Background: In‐hospital cardiac arrest is a medical emergency that occurs on a regular basis. As patients most at risk for an in‐hospital cardiac arrest are usually positioned on a dynamic mattress, it is important to measure the effect of mattress compressibility on chest compression quality during cardiopulmonary resuscitation (CPR). High‐quality CPR is essential for patient survival and good neurological outcome. Aims and objectives: To examine the effect of an inflated dynamic overlay mattress on chest compression quality during CPR and to explore the predictive effect of health care providers' anthropometric factors, hand positioning and mattress type on chest compression frequency and depth. Design: Manikin‐based single‐blinded randomised controlled trial. Methods: Nursing students (N = 70) were randomised to a control (viscoelastic foam mattress) or intervention group (inflated dynamic overlay mattress on top of a viscoelastic foam mattress) and had to perform chest compressions over a 2‐minute period. Compression rate, depth and hand positioning were registered. The 2015 European Resuscitation Council (ERC) guidelines were used as a reference. Results: The mean difference in chest compression depth between control and intervention groups was 2.86 mm (P =.043). Both groups met the guidelines for adequate chest compression quality, as recommended by the ERC. A predictive effect of health care providers' body height and weight, mattress type and hand positioning on compression depth could be demonstrated (P =.004). Conclusions: CPR in bedridden patients on a dynamic overlay mattress has a negative effect on the quality of chest compressions. Mean chest compression depth decreases significantly. However, clinical significance of the results may be debatable. Mattress type, body weight and hand positioning appear to be significant predictors for adequate chest compression depth. Relevance to clinical practice: A firm surface under the patient is needed during CPR. Special attention must be paid to correct hand positioning during CPR. [ABSTRACT FROM AUTHOR]

Aim: To develop and psychometrically test the Interpersonal Geriatric care relationship tool. Background: The quality of nursing care is highly influenced by the quality of the interpersonal care relationship, yet there are no tools available that capture the conceptual breadth of the interpersonal care relationship. Design: Instrument development and psychometric testing of the content and construct validity, factor structure and reliability. Methods: A four-phased validation procedure was conducted (January 2016-April 2019): defining the construct measured by the tool, tool development, content validation and psychometric evaluation. Results: The 30-item Interpersonal Geriatric care relationship tool was subjected to exploratory factor analysis. Four components (humanization, attentiveness, interest and accessibility) were extracted. The tool demonstrated discriminating power and good internal consistency. Cronbach's alphas for the components ranged between 0.69 and 0.84. Conclusion: The Interpersonal Geriatric care relationship tool is a valuable measure that can be used by scientists, educators and healthcare professionals to benchmark the interpersonal care relationship culture in hospitals and optimize the quality of care. [ABSTRACT FROM AUTHOR]

Mental health nurses are struggling to describe their nursing identity as professional discipline in a changing mental health care. Measuring nurse‐sensitive patient outcomes and demonstrating nursing's effect(s) experienced by patients contribute to (re)discover the specific nursing identity. However, a valid and reliable scale is currently lacking. The aim of this study was the development and psychometric evaluation of the Mental Health Nurse‐Sensitive Patient Outcome Scale (MH‐NURSE‐POS) for inpatient psychiatric hospital settings. This three‐staged study resulted in a scale capturing how inpatients experience the contribution of nurses in their treatment in psychiatric hospitals. First, a draft questionnaire was developed based on a literature review, an independent expert's advice, and an experts panel. Second, the content validity was tested in a two‐round Delphi‐procedure and focus groups with patients. A pilot test, based on cognitive interviews, confirmed the feasibility of the questionnaire. Third, the psychometric properties of the mental health nurse‐sensitive patient outcomes were determined in a sample of 353 patients. The cross‐sectional study included a convenience sample of five psychiatric hospitals (Belgium). The factor structure (Kaiser–Meyer–Olkin measure of sampling adequacy 0.924; Bartlett's test of sphericity χ2 = 4162.537; df = 231; P < 0.001), convergent validity by the Individualized Care Scale (Pearson correlation 0.660; P < 0.001), and reliability (Cronbach's Alpha 0.854) were evaluated. The factor analysis resulted in a four‐factor solution representing growth, expression, control, and motivation. The Mental Health Nurse‐Sensitive Patient Outcome Scale is a valid and reliable tool to measure the effectiveness of mental health nurses from the patient perspective. [ABSTRACT FROM AUTHOR]

Chronic wounds are an increasing problem in the aging population, patients experience a lower health-related quality of life and the care for these patients is associated with high costs. Thorough wound assessments facilitate objective monitoring of wound status and progress. A wound assessment tool can guide clinicians in these wound assessments and in recording wound progress or deterioration. Systematically identify assessment tools for chronic wounds, investigate their measurement properties, and summarize the data per assessment tool. Systematic review The databases Medline (PubMed interface), Embase, CINAHL, and CENTRAL were systematically searched until May 2020 (updated in February 2021). Studies reporting the development and/or the evaluation of measurement properties of assessment tools for chronic wounds were included. The "Consensus-based Standards for the selection of health Measurement Instruments" risk of Bias checklist was applied to evaluate the methodological quality of the included studies. Each reported measurement property was rated against criteria for good measurement properties. The evidence was summarized and the quality of the evidence was graded using a modified Grades of Recommendation, Assessment, Development, and Evaluation approach. Study selection, data extraction and quality appraisal were conducted independently by two reviewers and double-checked by a third reviewer. Twenty-seven studies describing the measurement properties of fourteen assessment tools for chronic wounds were included. None of the studies reported a content validity evaluation by a relevance study or a comprehensiveness study in professionals. Six articles reported the development or revision of an existing assessment tool. The reported measurement properties included: structural validity (5 studies), reliability (18 studies), hypotheses testing for construct validity (18 studies) and responsiveness (7 studies). Internal consistency, cross-cultural validity / measurement invariance and measurement error were not reported. If criterion validity was assessed, the results were allocated to hypotheses testing for construct validity as no 'gold standard' is available. Fourteen assessment tools for chronic wounds were identified. Construct validity (by hypotheses testing) and responsiveness of the Pressure Ulcer Scale for Healing version 3.0 were supported by sufficient ratings based on moderate to high level quality of evidence. Reliability of the (Revised) Photographic Wound Assessment Tool had a sufficient rating based on moderate quality of evidence. The ratings of the measurement properties of the other wound assessment tools were either insufficient or indeterminate, or a sufficient result was supported by low to very low quality of evidence. Registration number in PROSPERO: CRD42020183920 Tweetable abstract: A systematic review giving a clear overview of the measurement properties of available assessment tools for chronic wounds. [ABSTRACT FROM AUTHOR]