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Great project, and nice work on simplifying your consent to the appropriate reading level! My only suggestion would be to consider rephrasing the explaination section on nursing missing signals or inappropriately calling a RRT. I feel as though it might make patients question the competence of the RNs caring for them. Perhaps the purpose could be to optimize and make the RRT process more efficient in order to provide you (the patient) the best care.
~Fiona

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thanks for your comments. I plan to use the Problem Areas In Diabetes (PAID) tool that measures self efficacy in diabetes, then also measure A1c results at varied intervals. I think the themes of a meeting would be interesting, but want to keep it simple.
thanks
Marianne

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thanks for your comments regarding my IRB. I think the sessions will be evolving as I plan with the practice. I will let you know how it all goes. My plan is to try to create a model, we will see.
thanks
Marianne

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I also developed a PPT but Twitter does not like that, or the windows media file. So, I am going to try and post it here. See if that works. Not according to the instructions (so sorry Dr.Owens!) but at least everyone has a chance to see it. My apologies to everyone for it being a LOT more boring than the Adobe spark. I'm still excited about the project though!
Please let me know if you can see/hear it.
Lia
PS. The Windows Media file did not load but the PPT did. From what I see you have to open it and start the presentation. Again, so sorry it is not a simple click and play.

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Deb,Billy,Lia and Joy, thank you for your comments and recommendations. As far as money, I did not receive a formal grant but rather support from a local county. More info to come in next week's Twitter. I opted to do a voice over ppt since I have so much detail already surrounding my proposed capstone that hopefully will be approved. I apologize in advance that it won't look as tecnologically savvy as the Adobe spark. Now I just have to figure out how to load it. Maybe through you tube.

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Deb,Billy,Lia and Joy, thank you for your comments and recommendations. As far as money, I did not receive a formal grant but rather support from a local county. More info to come in next week's Twitter. I opted to do a voice over ppt since I have so much detail already surrounding my proposed capstone that hopefully will be approved. I apologize in advance that it won't look as tecnologically savvy as the Adobe spark. Now I just have to figure out how to load it. Maybe through you tube.

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Rita

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Your consent was very well written. It was thorough, yet concise and simple to follow. The only suggestion I would have is that I would consider access to journal articles to be a benefit to the participants. Otherwise I would not change a thing... Sounds like a great project!
~Fiona

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I'm so grateful for tut thoughtful feedback. I just checked my reading level again and it is 8.6. Are you using the flesh Kincaid score?
Thanks , rita

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Such a great and needed project. As I read, I couldn't help but to think of your study's potential impact on prevention. Organizations that don't have an ongoing awareness and focus on drug diversion may make it easier, in a potential diverter's eyes, to take that first step that can lead them down that rabbit's hole. Organizational vigilance could potentially save nurses from making that move due to not only fear but support from peers.

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You had to cover a lot of ground in your consent form. No wonder it was hard to do! Are you going to use a standardized form (e.g., SF 36 for persons with DM) as an outcome? Also wondering about the value of qualitative data with respect to the group discussions. Which themes emerge when the group gets together? Could you start each meeting with two or three standard questions and record what happens? Fascinating stuff!
Lia

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Just remembered the wording I have seen for randomize in consent forms. "By chance" or "by flipping a coin" (depending on randomization method). Hope that helps a bit.
Lia

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For the life of me I cannot find your comment again but, if I recall, you made a good point about folks repeating the survey. From what I understand this is addressed in the software through some unique code or other. Even so, there would be no incentive for anyone to spend another 15 minutes to do it again. Apparently that type of software is a lot more sophisticated and secure than the system we use to vote for president! Still, I am definitely going to read up on it some more. Yes, basic demographics / education is part of the survey. Thank you so much for your feedback. Really appreciate it.
Lia

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Thanks for the feedback. I also reviewed your consent and you did a really great job with making your consent concise and easy to follow. I am not sure why but I thought that we were not allowed to alter the WCU wording of the consent. I think this is why I struggled so much with getting the reading level down. However, if we are able to change the WCU wording I will definitely be using your suggestions! Thanks, and nice job on yours!!
~Fiona

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I plan to target either all 4 ER departments across the health system or possibly all ICU/PCU departments? Still unsure as both areas are hot button areas for potential diversion activity. I do anticipate some hesitancy in possibly answering the surveys as well as resistance in wast witness compliance. I think we have to start some where. I felt if I started small for the project purposes and ended big as in continued efforts over next 5 years, this would benefit the organization at large and improve patient and staff safety.
Deb

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The IRB process will a time filled with asking the experts many questions. We will support each other for sure, one step at a time. We can do it!!
deb

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Yes, I will identify particular departments such as ER and utilize all 4 ER staff groups across Main Line Health (MLH) system. The pre-survey evaluating the current state will be numbered. Yes, I would plan to provide a thorough report to each MLH campus as I would expect them to be different.Great questions Marianne. You gave me food for thought,
deb

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I enjoyed learning about your project.  I hope you get great participation, it is a worthy cause for sure.  I thought that your consent form was definitely easy to read and contained the appropriate information at a middle school reading level.
I was wondering if you have a target number of nurses that you would like to participate.  Do you anticipate any conflict if there is a nurse who is participating and wants to ask a nurse who is not participating in the waste witness project?
Danielle

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I really love the idea of your project.  I think it is very manageable and will , hopefully, provide some meaningful results for the practice.  I have found that my SMAs are not well attended so am anxious to see how yours go. I try to do them in the evenings, provide a healthy snack, try to include interesting topics, etc.  Just can't ever get more than 5 to come!  They are very efficient and can be cost effective, as well as beneficial for the patients.  I will be excited to see where your research takes you!  I also wanted to comment on your possible risks section, I was impressed with the potential risks you mentioned, especially the part about wanting to speak with your provider to discuss private issues.

Danielle

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Fiona, I really like the format of your consent form.  Night shift nurses have felt like the "step-children" for years! It is great that you are taking some initiative to address the needs of these nurses.  I do think that the vocabulary is a bit complicated.  It was really hard to "dummy down" the terms.  

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Fiona, I really like the format of your consent form.  Night shift nurses have felt like the "step-children" for years! It is great that you are taking some initiative to address the needs of these nurses.  I do think that the vocabulary is a bit complicated.  It was really hard to "dummy down" the terms.  

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Words like participate can be changed to "take part in".  Frequency and duration, can be number and  period of time.  Also, engagement surveys... not sure how to change that one, but would think that a 7th grader would not know what that means.  It really did feel like nails down a chalkboard changing the terms but, apparently, it must be done!

Danielle

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Lia, Joy, and Marianne, thank you for taking the time to read my consent and provide feedback.  (Lia)You asked me how one knows if they are going to be in group A or B.  It is a randomized selection.  However, when I tried to explain that in the consent form, the reading level was too advanced so I decided to leave it out.  Joy, I agree that the first line should include advanced practice nursing student but when I considered the reading level, thought this may be confusing to the intended audience so I left it at nursing student.  Also, I will consider the beginning of those two areas.  Thank you!  Marianne, you asked me about literacy.  Subjects will have to meet criteria, one of the criteria is that patients have access to a computer and internet for at least 1 hour per week and have at least an 8th grade education.  Subjects will be able to complete the modules on their own time but must spend at least 1 hour per week on the program.  I thought that this will keep subjects engaged in the program and also, hold them accountable.  

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Lia, Joy, and Marianne, thank you for taking the time to read my consent and provide feedback.  (Lia)You asked me how one knows if they are going to be in group A or B.  It is a randomized selection.  However, when I tried to explain that in the consent form, the reading level was too advanced so I decided to leave it out.  Joy, I agree that the first line should include advanced practice nursing student but when I considered the reading level, thought this may be confusing to the intended audience so I left it at nursing student.  Also, I will consider the beginning of those two areas.  Thank you!  Marianne, you asked me about literacy.  Subjects will have to meet criteria, one of the criteria is that patients have access to a computer and internet for at least 1 hour per week and have at least an 8th grade education.  Subjects will be able to complete the modules on their own time but must spend at least 1 hour per week on the program.  I thought that this will keep subjects engaged in the program and also, hold them accountable.  

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Danielle

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Fiona,  what a great project. I'm excited to see your results as I think we are often our own worst enemies when it comes to self scheduling and trying to micro manage every minute of our lives. The one thing I personally did to drop the level some was to substitute keep secret for confidential. Doesn't sound nearly as professional but it did drop my literacy level some when I changed them. In addition, I didn't think about shredding the information after. That is a great addition.

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Fiona,  what a great project. I'm excited to see your results as I think we are often our own worst enemies when it comes to self scheduling and trying to micro manage every minute of our lives. The one thing I personally did to drop the level some was to substitute keep secret for confidential. Doesn't sound nearly as professional but it did drop my literacy level some when I changed them. In addition, I didn't think about shredding the information after. That is a great addition.

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Rita

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I'm not sure why mine came up so high for you as I did use word and check the full document several times trying to get it even lower, but thank you for the tips. Definitely a challenge and the hardest part of this assignment. That being said I would address this literacy requirement within my own organization because I do believe it can be a deservice for a target population in which you know has a higher literacy level. I do believe we have an obligation to conform but to also question.
Rita

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For the portion I wrote I was able to get my reading level to a 7.2, but for the document as a whole the reading level is 8.9. I tried using synonyms and more simple sentence structures, but I really struggled to get it any lower. I would welcome any suggestions. ~Fiona

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I agree with you in that I felt the IRB form was pretty straight forward. You changed a lot of the words that I did. Nicely done.
A couple things: 1) In your first line you say you are a "nursing student". I think you need to put in advanced practice nursing student or just leave it out. 2) To cut out the word beginning in #2 - use "at the start" and 3) Same with using beginning in #3 - you could use "when the study starts". Those two changes brings you down to an 8.8 reading level. Joy

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I see you changed your project like I did. Again, I seem to be getting a higher reading level than others are getting on theirs. For yours, I got a 9.32. What did you get?
I'm a little confused on why we need to have an 8th grade reading level when some of us are working with physicians and nurses (college educated)? Any body have an answer? Joy

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I don't know, but I think I may be doing the reading level wrong. On your's, I got a 9.16.
Oh well. Two things: 1) I don't think you need to state the research question in #1. It may be confusing to individuals not associated with research, and 2) I think you can drop the last sentence in #2. Confidentiality is covered in #6. I think we need to make our consents short and sweet for our participants. Joy

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I read your consent form. I liked your explanation of the nature of your project. It was concise and easy to read. When I did the reading level though, I got 9.08. Perhaps I'm not doing it correctly. With that said, I can see why we are starting the consent process now!! Joy

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I liked your idea of moving participants forward in your survey. Liked the idea of click of a button to answer. I thought you met the requirements listed by IRB.
How will you know if you get repeats on the survey ( could be caused by computer issues).
I was curious if participant level of education will be asked in the survey? It was difficult getting the reading level down. Marianne

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I found your IRB easy to understand. Is there a specific number of nurses to participate? How will information be shared after the study? Are the units coded? Will each facility receive a report? Good job.
Marianne

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I agree with your post and others, that I feel like I lost meaning to my consent just trying to take it down to an appropriate reading level. Despite that, I did feel like I had a good understanding of your project by reading your consent. Good Job!
Bridget

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I liked your consent form as it was simple. I was wondering how you will address issues of low literacy with computers. Will you limit your sample? Will patients be allowed to end the study or do the education on the computer at their own pace? Just curious
Marianne

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Marianne Informed Consent. I found this challenging with getting my consent to 8.4 as well. Here is mine. 

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Marianne Informed Consent. I found this challenging with getting my consent to 8.4 as well. Here is mine. 

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As said by others, getting the reading level down to a 7th or 8th grade level was difficult. The postings from Dr. Owens did help.

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Your form was easy to understand / read Billy. Very interested in learning more about what you are going to do. Cool project! Re. your hospital having trouble finding a wound care nurse. Yes, it is increasingly difficult in part because of emphasis on EBP. Average age of Certified Wound Care Nurses is early 50's or so and there are only about 7,000 in the country. Colleagues are retiring and desperately looking for replacements. Of course there are other types of certifications but we do not have a handle on that or what these nurses have learned / do. Hence, the idea behind my project. It is a Quality of Care/Workforce issue.

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Billy, your consent was well written and easy to understand.  I like your topic for your project. Nurses are often hesitant to call a rapid response for a number of reasons and it is something I have seen several times over the past year. Good luck with your project this next year!
Diane

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Deb, I totally agree with your comment that you are fearful of the IRB process.  I am, too!  Especially since we have to go through two IRB approvals and I have heard that others have had a difficult time.  Well, we can help each other through this!
Diane

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I spent a great deal of time working to get the reading level down to 8.4, which was the best that I could do. It was difficult to lower the level any further without losing the meaning.

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Hi Lia,
I am a little nervous about the IRB process as well. I agree in that it was difficult to obtain a 7-8 grade reading level. Word was very helpful! Your project sounds very interesting. My hospital is currently looking for a wound care nurse. I hear they are hard to come by. Education is key!
-Billy

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Rita, Congrats to obtaining a grant for your project! That is awesome! I love the fact that you are offering a gift card. I think this will be a fabulous way to get subjects to take part in your project.
-Billy

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Overall, I ended up with a 8.1 reading level. However, like most, I feel I lost a lot of value in the actual consent by needing to do this. Hopefully, there is enough information to understand what I am actually trying to accomplish! It took a while and multiple attempts to get get down to a grade 7-8 reading level.

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Struggled at the beginning. It was time consuming to reduce reading level. Ended up with a Fiesch-Kincaid reading level of 6.8, if my computer is correct. Overall, I am fearful of IRB process. I think mine lost some intent secondary to changing some many words,
deb

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Your informed consent was very good. Offering patients multiple ways to learn is brilliant. Very creative project, providing patients with choice as well as much needed education. Great job,
deb

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Rita, I really liked your consent and your project idea of palliative care. It brings such value to an already great organization, Main Line Health. Imagine the vallue it brings to patient care and peer to peer mentoring, as truly all of the knowledge can be easily shared.Trying to figure our how to post to padlet mysel, deb

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Rita, how awesome that you were able to get a grant for your project! I have looked at several grant opportunities but the time frame is just too short. No doubt in my mind that a generous gift certificate is going to get you a great participation rate. Not sure why you feel you lost value in the overall consent though. Reads fine to me :)
Lia

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I ended up with a 8.6 reading level but feel I lost value in my overall consent by doing this.

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My reading level

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Danielle, I love how you changed the last sentence on the consent form re.possible harm. Very clever! I have one question, how do I know if I am going to be in group A or group B? You know that is what everyone is going to ask. Having conducted several programs and studies with older adults the main issue was always: "am I getting everything he/she is getting?" Not whatever potential risks they just read about in the consent form. Just wanted to share this. We worry about the big stuff and it's the small stuff that always gets you.
Lia

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I thought the IRB consent form was relatively straight forward.  The most difficult part, by far, was getting it down to a 7-8th grade reading level.  I really had to change a lot of the vocabulary, which made it difficult.  I hope that it still makes sense and all of the points still come across.  I used the WCU IRB website and also thought that the JHU informed consent tips were helpful to re-word the form.
Danielle

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Hello Lia, obtaining any approval is intimidating these days!  I agree that MS word was great help in obtaining the grade level.  I also thought that the WCU template was great and easy to follow.  Hopefully, the earlier we get started, the less stress we will face later!  

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Hello Lia, obtaining any approval is intimidating these days!  I agree that MS word was great help in obtaining the grade level.  I also thought that the WCU template was great and easy to follow.  Hopefully, the earlier we get started, the less stress we will face later!  

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In terms of your form, I like how you implemented the "yes" "no" button idea.... I had not thought of that.
Danielle

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The entire process of obtaining IRB approval is intimidating to me. Nothing WCU related, they are all like that. Reading level of my consent form is 8.5. Not great but it is not for patients so that should be OK. I hope...Most helpful in the process was MS word.
Lia