Protocol of the DENIM study: a Delphi-procedure on the identification of trauma patients in need of care by physician-staffed Mobile Medical Teams in the Netherlands

Harmsen, Annelieke M. K.; Geeraedts, L.M.G.; Giannakópoulos, Georgios F.; Terra, Maartje; Christiaans, H.M.T.; Mokkink, Lidwine B.; Bloemers, Frank W.

doi:10.1186/s13049-015-0089-z

Cited by 6 publications

(10 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nove dos 18 trabalhos avaliados não apresentaram desligamento dos médicos participantes no decorrer da aplicação da técnica 2,3,7,[15][16][17]19,25,26 , no restante, a média elevada da porcentagem de permanência de 71,99% dos participantes no decorrer do processo contribuiu para a confiabilidade das decisões de consenso, além de consolidar a estruturação no método. Ademais, entre todos os trabalhos que compõem essa revisão, dez deles usaram como taxa mínima citada estabelecida para consenso maior que 70% que consiste em valores já utilizados na literatura como em Harmsen 27 , que, portanto, garantem uma estruturação válida para o método.…”

Section: Discussionunclassified

A análise do uso da técnica Delphi na tomada de decisão em pacientes críticos

Santos

Andrade

Alves

et al. 2020

Rev. Med. (São Paulo)

View full text Add to dashboard Cite

Introdução: A técnica Delphi é um método utilizado para alcançar consenso entre especialistas sobre determinado assunto. Objetivos: realizar revisão sistemática sobre a contribuição e utilização do método Delphi exclusivamente por médicos, para tomada de decisões em pacientes críticos. Métodos: A pesquisa foi realizada nas bases de dados: PubMed, SciElo, Biblioteca Virtual em Saúde, Scopus, Periódicos CAPES e ClinicalTrials.gov, utilizando os descritores: “Delphi technique”, “Decision making”, “Critical care” e “Physicians”. Selecionou-se ensaios clínicos ou estudos observacionais para responder à pergunta norteadora: “Qual a contribuição da técnica Delphi na tomada de decisão pelos médicos em pacientes críticos?” Para avaliação do nível de evidência e grau de recomendação dos estudos incluídos, foi utilizado a escala do Centro de Medicina Baseada em Evidências de Oxford. Resultados: Foram incluídos dezoito referências para compor este estudo. As contribuições do método Delphi foram consideradas importantes para a tomada de decisões em quinze estudos analisados, para: definir estratégias de manejo, tratamento e recomendações; gerenciar e diagnosticar pacientes; definir consenso para exames; identificar ideias controversas e seus motivos subjacentes. Das limitações do método, a mais recorrente foi a seleção de especialistas de diferentes níveis de conhecimento. Conclusão: Este estudo mostra a aplicabilidade da técnica Delphi para manejo de pacientes críticos, tratamento medicamentoso, recomendações para sintomas específicos, diretrizes para gerenciar e diagnosticar pacientes, consenso para testes e exames e identificação de tópicos de ideias controversas e seus motivos subjacentes em situações onde não há consenso na literatura médica.

show abstract

Section: Discussionunclassified

A análise do uso da técnica Delphi na tomada de decisão em pacientes críticos

Santos

Andrade

Alves

et al. 2020

Rev. Med. (São Paulo)

View full text Add to dashboard Cite

show abstract

“…Avoiding an individual’s opinion to be biased by influential factors such as hierarchy and peer pressure. It is of scientific value because it can lead to an agreed set of recommendations to guidelines [ 8 , 15 , 16 ].…”

Section: Methodsmentioning

confidence: 99%

“…Emergency operators in the EMS dispatch centre dispatch either EMS alone or EMS and P-HEMS simultaneously (Fig. 1 shows the dispatch sequences [ 8 ]). This dispatch is based on information handed to the operator by a layperson, which can be incomplete or incorrect.…”

Section: Introductionmentioning

confidence: 99%

National consensus on communication in prehospital trauma care, the DENIM study

Harmsen

Geeraedts

Giannakópoulos

et al. 2017

Scand J Trauma Resusc Emerg Med

Self Cite

View full text Add to dashboard Cite

BackgroundIn the Netherlands prehospital trauma care is provided by emergency medical services (EMS) nurses. This care is extended by Physician staffed Helicopter Emergency Medical Services (P-HEMS) for the more severely injured patient. Prehospital communication is a factor of influence on the identification of these patients and the dispatch of P-HEMS. Though prehospital communication it is often perceived to be incomplete and unstructured. To elucidated factors of influence on prehospital triage and the identification of the severely injured patient a Delphi study was performed.MethodsA three round modified Delphi study was designed to explore concepts amongst experts in prehospital trauma care. P-HEMS physicians/nurses, trauma surgeons, EMS nurses and dispatch center operators where asked to state their opinion regarding identification of the poly trauma patient, trauma patient characteristics, prehospital communication and prehospital handover.ResultsSeventy-one panellist completed all three rounds. For the first round seven cases and 13 theses were presented. From the answers/argumentation the second round was build, in which 68 theses had to be ranked within four principle themes: factors that influence prehospital communication, critical information for proper handover, factors influencing collaboration and how training/education can influence this. Out of these answers the third survey was build, focussing on determining the exact content of a prehospital trauma handover. The majority of the panellists agreed to a set of parameters resulting in a new model of inter-professional hand over regarding prehospital trauma patients.DiscussionExact identification of the poly trauma patient in need of care by P-HEMS is difficult though prehospital communication and the prehospital handover may be improved.ConclusionThe respondents report that prehospital communication needs to be unambiguous to improve trauma care. Consensus was reached on a set of ten parameters that should minimally be handed over with regard to a prehospital trauma patient. This to facilitate prehospital communication between the Dispatch centre, EMS, P-HEMS and the receiving hospital.

show abstract

“…Delphi method does not use a random or general sample of the target population, nor is it intended to produce statistically significant and non-probability sampling (Álvarez, Calvo, & Mora, 2014;Harmsen et al, 2015;Iden & Langeland, 2010;Keeney, Hasson, & McKenna, 2011;Sitlington & Coetzer, 2013). The Delphi study process does not require a specific sample size (Magalhães-Sant'Ana et al, 2016).…”

Section: Participants Recruitmentmentioning

confidence: 99%

“…Shaikh and Khoja (2014) suggested that the consensus level is one of the fundamental elements in Delphi studies, and a sufficiently high consensus level should be utilised as a benchmark for retaining the factors that are preferred by participants in the first round. However, as there is no fixed measure to define the consensus level (Becuwe et al, 2017), variable statistics were used for consideration of the consensus level as suggested by various studies (Richardson, de Leeuw, & Dullaert, 2016;Gracht, 2012;Harmsen et al, 2015;Tharisara, Kanchana, & Turner, 2016;Williams, 2016;Hasson, Keeney, & McKenna, 2000;Hsu and Sandford,2007). Following (Bulger & Housner, 2007;Green, Jones, Hughes, & Williams, 1999;Lohuis, van Vuuren, & Bohlmeijer, 2014;Neuer Colburn, Grothaus, Hays, & Milliken, 2016), this study uses a consensus level of four for five-point Likert scale questions.…”

Section: Demographics Of Participantsmentioning

confidence: 99%