Constructing a Nursing Programme to Manage Intra-Abdominal Pressure in Neurocritical Care Patients: A Modified Delphi Study

IF 3.5 3区医学 Q1 NURSING Journal of Clinical Nursing Pub Date : 2025-03-03 DOI:10.1111/jocn.17703

Mingyu Yan, Lijun Xiang, Yansi Luo, Meng Cao, Lei Cheng, Peng Zhao, Lin Liao, Chaoran Xu, Li He, Xiaomei Zhang

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引用次数: 0

Abstract

Aim

To construct a nursing programme to manage intra-abdominal pressure (IAP) in neurocritical care patients.

Design

The consensus of 16 experts was collected using a two-round Delphi method.

Methods

First, we developed the early stages of the nursing programme for managing IAP in neurocritical care patients through preliminary study and relevant literature internationally. A questionnaire was then distributed to a panel of 16 experts, each with over 10 years of experience in respiratory critical care, neurocritical care or comprehensive intensive care unit treatment. Between April and May 2024, these experts reviewed the preliminary programme and provided feedback and recommendations for modifications.

Results

Two rounds of expert consultation were conducted. After the first round of expert feedback, 22 items were revised. In the second round, eight additional items were revised. The questionnaire recovery rates in both rounds of correspondence were 88.9% and 100%, and the authority coefficients were 0.869 and 0.888, respectively. The Kendall W values ranged from 0.127 to 0.336 (p < 0.001). Consensus was reached on six Level 1 entries, 17 Level 2 entries, and 50 Level 3 entries.

Conclusion

A panel of 16 experts approved the proposed nursing approach for managing IAP in neurocritical care.

Implications for the Profession and Patient Care

This nursing protocol offers a systematic approach for managing IAP throughout all stages of care in neurocritical settings. Moreover, this programme can guide neurocritical care nurses in maintaining optimal IAP at critical times. The protocol could potentially be used in training nurses on IAP regulation and enhancing their management skills in this specialised area of care, along with preventing IAP-related health issues.

Reporting Method

The study is reported in accordance with the Guidance on Conducting and Reporting DElphi Studies (CREDES) recommendations.

Patient or Public Contribution

No patient or public contribution.

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构建护理方案以管理神经危重症患者的腹内压：一项修正的德尔菲研究。

目的：建立神经危重症患者腹内压（IAP）的护理方案。设计：采用两轮德尔菲法，收集16位专家的意见。方法：首先，我们通过初步研究和国际上的相关文献，制定了神经危重症患者IAP管理的早期护理方案。然后向16位专家组成的小组分发了一份调查问卷，每位专家在呼吸重症监护、神经重症监护或综合重症监护病房治疗方面都有超过10年的经验。在2024年4月至5月期间，这些专家审查了初步计划，并提供了修改的反馈和建议。结果：进行了两轮专家会诊。经过第一轮专家反馈，修改了22个项目。在第二轮中，又修订了8个项目。两轮对应的问卷回收率分别为88.9%和100%，权威系数分别为0.869和0.888。肯德尔W值范围为0.127 ~ 0.336 (p)。结论：由16名专家组成的小组批准了在神经危重症护理中管理IAP的拟议护理方法。对专业和患者护理的启示：本护理方案提供了一种系统的方法，用于在神经危重症的所有护理阶段管理IAP。此外，该程序可以指导神经危重症护理护士在关键时刻保持最佳IAP。该议定书可能用于培训护士了解IAP规则，提高他们在这一专业护理领域的管理技能，同时预防与IAP相关的健康问题。报告方法：本研究按照德尔菲研究进行和报告指南（CREDES）的建议进行报告。患者或公众捐款：没有患者或公众捐款。

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来源期刊

Journal of Clinical Nursing 医学-护理

CiteScore

6.40

自引率

2.40%

发文量

审稿时长

2 months

期刊介绍： The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice. JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice. We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.