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Developing and testing a matrix to achieve ready-everyday nursing standards (RENS): an observational study protocol.

ABSTRACT: INTRODUCTION:The Australian Council on Healthcare Standards (ACHS) set criteria for the delivery of healthcare services in Australia. While a voluntary process, continual accreditation with ACHS is an expectation of, and for, Australian healthcare providers. Juxtapositioned with the ACHS, the Nursing and Midwifery Board of Australia (NMBA) set the mandatory practice requirements of, and for, Australian nurses. Despite these overarching quality and governance directives, a regional Queensland Hospital and Health Service (HHS) demonstrated deficits in the quality of nursing care. Accordingly, a HHS project was commissioned with the aim of producing a quantum shift in the quality of nursing services such that the service was ready-everyday for accreditation assessment, and nursing practice exemplified the NMBA standards.Several barriers to achieving the aim were identified and it was considered that the implementation of critical system changes would structurally and operationally support the achievement of the aim. The system changes are pivoted around an interactive matrix that links nursing care services to the array of nursing professional and practice standards and provides real-time quantitative output measures. This paper outlines the protocol that will be used to establish, implement and evaluate the matrix. METHODS AND ANALYSIS:A participatory action research design with a modified Delphi methodology will be used for the development the matrix. The organisational change management around the matrix implementation will be informed by Kotter's model and supported by the use of the McKinsey 7S. The matrix implementation phase will be conducted using a modified Promoting Action on Research Implementation in Health Services model. Quantitative and qualitative data will be collected over a 12 month pre-test/post-test design to measure the statistical significance of the matrix in supporting compliance with nursing standards and the achievement of quality nursing care. Quantitative data from quality of care assessments will be analysed using descriptive and comparative statistics. Qualitative data from staff surveys will be analysed by content analysis of the major themes (n~200). ETHICS AND DISSEMINATION:The project has ethics approval from a Queensland Health Human Research Ethics Committee. Results will be reported to participants and other stakeholders at seminars and conferences and through peer-reviewed publications.

SUBMITTER: Ratsch A

PROVIDER: S-EPMC6719822 | biostudies-other | 2019 Aug

REPOSITORIES: biostudies-other

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Developing and testing a matrix to achieve <i>ready-everyday nursing standards</i> (RENS): an observational study protocol.

Ratsch Angela A Sewell Fiona F Pennington Adrian A

BMJ open 20190824 8

<h4>Introduction</h4>The Australian Council on Healthcare Standards (ACHS) set criteria for the delivery of healthcare services in Australia. While a voluntary process, continual accreditation with ACHS is an expectation of, and for, Australian healthcare providers. Juxtapositioned with the ACHS, the Nursing and Midwifery Board of Australia (NMBA) set the mandatory practice requirements of, and for, Australian nurses. Despite these overarching quality and governance directives, a regional Queens ...[more]

PMID: 31446420

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Project description:BackgroundEffective standardisation of methodologies to analyse the microbiome is essential to the entire microbiome community. Despite the microbiome field being established for over a decade, there are no accredited or certified reference materials available to the wider community. In this study, we describe the development of the first reference reagents produced by the National Institute for Biological Standards and Control (NIBSC) for microbiome analysis by next-generation sequencing. These can act as global working standards and will be evaluated as candidate World Health Organization International Reference Reagents.ResultsWe developed the NIBSC DNA reference reagents Gut-Mix-RR and Gut-HiLo-RR and a four-measure framework for evaluation of bioinformatics tool and pipeline bias. Using these reagents and reporting system, we performed an independent evaluation of a variety of bioinformatics tools by analysing shotgun sequencing and 16S rRNA sequencing data generated from the Gut-Mix-RR and Gut-HiLo-RR. We demonstrate that key measures of microbiome health, such as diversity estimates, are largely inflated by the majority of bioinformatics tools. Across all tested tools, biases were present, with a clear trade-off occurring between sensitivity and the relative abundance of false positives in the final dataset. Using commercially available mock communities, we investigated how the composition of reference reagents may impact benchmarking studies. Reporting measures consistently changed when the same bioinformatics tools were used on different community compositions. This was influenced by both community complexity and taxonomy of species present. Both NIBSC reference reagents, which consisted of gut commensal species, proved to be the most challenging for the majority of bioinformatics tools tested. Going forward, we recommend the field uses site-specific reagents of a high complexity to ensure pipeline benchmarking is fit for purpose.ConclusionsIf a consensus of acceptable levels of error can be agreed on, widespread adoption of these reference reagents will standardise downstream gut microbiome analyses. We propose to do this through a large open-invite collaborative study for multiple laboratories in 2020. Video Abstract.

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Dataset Information

Developing and testing a matrix to achieve ready-everyday nursing standards (RENS): an observational study protocol.

Publications

Developing and testing a matrix to achieve <i>ready-everyday nursing standards</i> (RENS): an observational study protocol.

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