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PubMed2000

A consensus statement on critical thinking in nursing.

The purpose of this study was to define critical thinking in nursing. A Delphi technique with 5 rounds of input was used to achieve this purpose. An international panel of expert nurses from nine countries: Brazil, Canada, England, Iceland, Japan, Korea, Netherlands, Thailand, and 23 states in the U.S. participated in this study between 1995 and 1998. A consensus definition (statement) of critical thinking in nursing was achieved. The panel also identified and defined 10 habits of the mind (affective components) and 7 skills (cognitive components) of critical thinking in nursing. The habits of the mind of critical thinking in nursing included: confidence, contextual perspective, creativity, flexibility, inquisitiveness, intellectual integrity, intuition, open-mindedness, perseverance, and reflection. Skills of critical thinking in nursing included: analyzing, applying standards, discriminating, information seeking, logical reasoning, predicting and transforming knowledge. These findings can be used by practitioners, educators and researchers to advance understanding of the essential role of critical thinking in nursing.

Affect↗
PubMed2004

Hospital management of diabetes: beyond the sliding scale.

A growing body of evidence suggests that there is a close correlation between good glucose control and improved clinical outcomes in hospitalized diabetic patients. Until recently, however, no established standards have existed for caring for people with diabetes in the hospital. At a recent consensus conference, experts from around the world studied the evidence and recommended new glycemic targets for hospitalized patients (Endocr Pract 2004; 10:77-82). The challenge now is to implement these targets.

Algorithms↗
PubMed2000

Testing a consensus conference method by discussing the management of traumatic dental injuries in Tanzania.

OBJECTIVES: To test the recommended consensus conference methods in Tanzania by discussing the management of traumatic dental injuries, and to reach consensus on the feasibility of the treatment modalities of traumatic dental injuries recommended in western countries in the Tanzanian situation. STUDY PARTICIPANTS: Fifteen dentists as representatives of the profession and two lay people as representative of potential consumers. INTERVENTIONS: Presentation of treatment modalities for traumatic dental injuries recommended in western countries. MAIN OUTCOME MEASURE: Consensus on the feasibility of the recommended treatment modalities of traumatic dental injuries in the Tanzanian situation. RESULTS: For most types of injuries, consensus on the feasibility of the recommended treatment methods for Tanzania was reached immediately. More time was spent to discuss management of some injuries where the members felt that the recommended management regimes for these injuries are not feasible in the current Tanzanian situation. Panel members made three recommendations. First, parents and teachers should be provided with guidelines or instructions about self-care following trauma. Second, teaching on the management of traumatic dental injuries at training institutions should be emphasised and third, dental practitioners at dental clinics in the country should get continuing education about the management of traumatic dental injuries. CONCLUSION: The methods for achieving consensus were useful in the Tanzanian dental situation, therefore it is recommended that the methods be adopted to reach consensus on other oral health issues.

Attitude of Health Personnel↗
PubMed2002

The road to consensus: considerations for the safe use and prescribing of COX-2-specific inhibitors.

We describe a process which aimed to achieve consensus on evidence-based considerations for the safe prescribing and use of the COX-2-specific inhibitors available in Australia among a group of 31 clinicians and other health professionals, drawn from practice, academia and industry. Difficulties were encountered at several points: the composition of the working group was contentious; the evidence, drawn from large clinical studies, was criticised by some for problems of study design, data analysis and reporting; interpretation of study results was influenced by the interpreter's knowledge, skills and biases; and the formulation of the "Considerations" became more controversial as summary statements were contracted and simplified. Agreement on the final draft was achieved among 23 of 31 participants. Evidence-based practice guidelines are a welcome development in modern medicine, but the consensus required to produce them can mask important diversity of opinion.

Consensus Statements as Topic↗
PubMed2001

Preventing medical errors in point-of-care testing: security, validation, safeguards, and connectivity..

OBJECTIVES: o prevent medical errors, improve user performance, and enhance the quality, safety, and connectivity (bidirectional communication) of point-of-care testing. PARTICIPANTS: Group A included 37 multidisciplinary experts in point-of-care testing programs in critical care and other hospital disciplines. Group B included 175 professional point-of-care managers, specialists, clinicians, and researchers. The total number of participants equaled 212. EVIDENCE: This study followed a systems approach. Expert specifications for prevention of medical errors were incorporated into the designs of security, validation, performance, and emergency systems. Additional safeguards need to be implemented through instrument software options and point-of-care coordinators. Connectivity will be facilitated by standards that eliminate deficiencies in instrument communication and device compatibility. Assessment of control features on handheld, portable, and transportable point-of-care instruments shows that current error reduction features lag behind needs. CONCENSUS PROCESS: Step 1: United States national survey and collation of group A expert requirements for security, validation, and performance. Step 2: Design of parallel systems for these functions. Step 3: Written critique and improvement of the error-prevention systems during 4 successive presentations to group B participants over 9 months until system designs stabilized into final consensus form. CONCLUSIONS: The consensus process produced 6 conclusions for preventing medical errors in point-of-care testing: (1) adopt operator certification and validation in point-of-care testing programs; (2) implement security, validation, performance, and emergency systems on existing and new devices; (3) require flexible, user-defined error-prevention system options on instruments as a prerequisite to federal licensing of new diagnostic tests and devices; (4) integrate connectivity standards for bidirectional information exchange; (5) preserve fast therapeutic turnaround time of point-of-care test results; and (6) monitor invalid use, operator competence, quality compliance, and other performance improvement indices to reduce errors, thereby focusing on patient outcomes.(Arch Pathol Lab Med. 2001;1307-1315)

Consensus Statements as Topic↗
PubMed1994

NIH conference. HIV vaccine development: a progress report.

The development of a safe, effective preventive vaccine for human immunodeficiency virus (HIV) infection remains an area of vigorous research. Several highly innovative vaccine candidates are being developed, and more than 13 vaccine candidates have been tested in human phase I or II trials. All have produced antibody and several have produced modest neutralizing titers, but to date no reproducible evidence has suggested prolonged, high-titer neutralization across a diversity of HIV strains. Furthermore, only the live recombinant vector approaches have produced some evidence of cytotoxic T-cell responses. The principal obstacle to progress is the lack of definitive information on what constitutes a protective immune response. There is no animal model for HIV-induced disease. Hence, the identification of the correlates of immunity and more useful animal models is among the highest priorities for HIV vaccine research. Large-scale efficacy trials raise daunting scientific, ethical, and resource issues. Nonetheless, preparation in such trials is underway in order to be in a position to evaluate the most promising vaccine candidate.

AIDS Vaccines↗
PubMedDate not supplied

Development of core competencies for infection prevention and control.

The Infection Control Nurses Association (ICNA) has developed a robust framework for infection prevention and control practitioners to demonstrate their competence. This article describes the process of developing these competencies from the first edition (in two parts) to the integrated competencies and assessment framework, which may be useful to other specialist groups considering the development of competencies relevant to their area of interest. It describes how the competencies have been used and how they may be used in the future to accredit ICNA members.

Career Mobility↗
PubMed2003

[New cases of melanoma as documented in the National Cancer Registry].

The authors briefly survey general aspects of crucial importance for the proper functioning of the National Cancer Registry, such as legislation, collected data, identification of patients, the completeness and validity of its content in relation to the results and conclusions of a comprehensive, national supervision performed after the Melanoma Consensus Conference. Compared to earlier national controlling attempts, the present supervision was highly successful: doctors of various hospitals did perform the detailed control of diagnosis in 95.81% of 1361 melanoma patients announced in 2001. They checked whether patients given the C43 BNO code had melanoma indeed, searched for those who received a different BNO code and identified those not announced for any reason to the Registry. After correction the Registry included 1117 new cases of melanoma in 2001. The authors state that the conclusions from this supervision may enhance the reliability not only of the data base of the Registry but that of the hospitals as well.

Adolescent↗
PubMed1999

[Asbestosis].

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Asbestos↗