Los animales: sus funciones, y adaptaciones al medio

Data collection entailed planning the nominal group, selecting participants, and conducting the group. Each process will be described below.

Planning the nominal group

Two things are essential before a nominal group can be held.

Firstly, the researcher must select a sample of people who have experience, expertise and insight into the problem being explored. Secondly, there is a need to develop appropriate questions for the nominal group to address. This may involve preliminary work such as interviewing potential experts or potential participants (Gallagher, Hares, Spencer, et al., 1993: 78).

The participants in the nominal group should qualify for selection based on their expertise on the matter under discussion or because they are representative of their profession and have the power to implement the findings (Potter, et al., 2004: 127).

Experts were handpicked to participate in the verification process based on their expertise and experience in the management of burns and wounds respectively. The nominal group verified the findings from this study and addressed the questions from the integrative review done in Chapter Four.

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Selecting participants (Sample)

A list of the multidisciplinary team involved in the management of burns was composed from admission to hospital until discharge. The clinical management team from which the nominal group was likely to be selected included trauma doctors, surgeons and nurses; plastic and general surgeons; intensives specialists; infection control nurses; intensive care nurses; wound care nurses; dieticians; a physiotherapist and an occupational therapist. The suggested size of a nominal group is five to nine participants according to Potter, et al., (2004:126). Nine experts were invited to participate in the group, however, one expert declined due to time constraints and the other was on leave at the time of the verification.Seven participants were recruited, three medical doctors and four nurses. The logic for this was to include one person from the different specialties in burn management.

Though nutrition and mobility are important in burn wound management, the researcher excluded representatives from these specialties as there was no direct accountability between nurses, physiotherapist, occupational therapist and dieticians as the South African Nursing Council (SANC), states that nurses are independent professionals (SANC, 1978: R2598, Act 50 of2005), that practise either independently or under prescription from a medical doctor as described in Section B of the Medical, Dental and Supplementary Health Service Professions Act, 1974 (Health Professions Act 56 of 1974).

The panel included specialist doctors and nurses, heads of departments, academics and opinion leaders in the management of burns, infection control and wound management. Table 2.6 is a list of experts. The panel wished to be acknowledged for their contribution in the development of the guidelines and have given permission for their names and specialties to be documented in the thesis.

Table 2.6 Panel of experts (alphabetical order)

Name Speciality Burn or wound

management

experience/ expertise

Professor Jaques Goosen Trauma surgeon 

Sister Phindi Lehabe Registered Nurse 

Sister Eva Lekwaba Private nurse practitioner (wound care) 

Doctor Adelin Muganza General surgeon 

Professor Elias Ndobe Plastic surgeon 

Sister Katinka Rheeder Nursing manager 

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Conducting the group

A nominal group pack was compiled and given to each member of the expert panel prior to the nominal group. The pack included a covering letter inviting them to participate in the study; the purpose of the study was stated, the methodology which was to be used as well as a description of the process of NGT and their contribution and involvement should they agree to participate. The pack also included an information sheet, consent letter, a user’s manual for the AGREE II instrument, the AGREE II (Brouwers, et al.,2010), instrument, a summary of the methodology of the integrative review as per (Whittemore & Knafl, 2005), which included the search methods, selection criteria, methods to assess the quality and strength of the evidence (DiCenso, Guyatt, & Ciliska, 2005: 34), the integrative review findings along with a table of recommendations for guidelines that were to be evaluated by them.

The process of guideline development required the researcher to include reference support to ensure guidelines are evidence based. This provided the experts with current information to use in the discussions and allowed the panel to draw on current knowledge in verifying the guidelines. Only one meeting was held in a pre-booked venue. Experts were not paid (Moule & Goodman, 2009: 234).

The researcher moderated the discussions and took notes. Moderation augmented facilitation of the discussion; this ensured the flow and guided process. The nominal group lasted approximately one hour and forty five minutes; the average recommended duration of a nominal group is up to two hours (Potter, Gordon & Hamer, 2004: 126; Gallagher, Hares, Spencer, et al.,1993: 80).

The nominal group technique process comprises number of stages. Table 2.7 depicts the recommended stages of NGT and the actual stages as implemented in this study.

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Table 2.7 Stages of NGT

Stages of the NGT (Varga-Atkins, et al., 2011:11)

Stages of NGT for this study

Welcoming statement Welcoming statement

Introduction: purpose of the session ,session structure, review of researchers packs and address queries or concerns

Stage 1 Silent generation of ideas Stage 1 – Individual responses from AGREE II Stage 2 Round robin recording of ideas Stage 2 – Clarification and consolidation: responses are

read out, clarified and discussed, consensus reached, recommendations for changes discussed.

Stage 3 Serial discussion and clarification Stage 3 – Ranking results are calculated and shared with the group as per AGREE II

Stage 4 Preliminary vote on item importance Stage 4- Each recommended guideline discussed to qualify, refine and further develop the guideline and to ensure it is applicable to the South African context. Stage 5 Discussion of preliminary vote (optional) Stage 5- Final vote

Stage 6 Final vote Stage 6- Revised guidelines send for review by experts Top five shared with the commissioners of the

research

„Technology‟ of recording ideas: pen and flipchart, facilitator writes on board as participants dictate. Ranking by paper.

Next the verification instrument is discussed.