Using the Delphi Method to Identify Risk Factors Contributing to Adverse Events in Residential Aged Care Facilities

Figures & data

Figure 1 Adaptation of a theoretical framework on risk management for Chinese organizations.

Table 1 Participants’ General Characteristics (N = 24)

Variables	n (f)	Percentage (%)
Age (years)
30–39	9	37.50
40–49	7	29.17
≥50	8	33.33
Gender
Male	4	16.67
Female	20	83.33
Years of professional experience
10–19	11	45.83
20–29	5	20.83
≥30	8	33.33
Educational attainment
Undergraduate	14	58.33
Master’s	6	25.00
Doctorate	4	16.67
Profession
Nursing	18	75.00
Other profession (social work, human resources, medicine)	6	25.00
Title
Intermediate	11	45.83
Deputy senior staff	8	33.33
Senior staff	5	20.83
Graduate tutor
Yes	8	33.33
No	16	66.67

Table 2 Three Rounds of Expert Positive Coefficients

Round	Questionnaires Issued	Questionnaires Retrieved	Return Ratio (%)	Number of Effective Questionnaire	Effective Return Ratio (%)
First	29	24	82.76	24	82.76
Second	24	22	91.67	22	91.67
Third	22	22	100	21	95.45

Table 3 Coordination Level of Experts’ Opinions

Rounds	Kendall’s (ω)	χ^2 value	df	p-value
First	0.154	240.289	65	0.000
Second	0.297	534.708	106	0.000
Third	0.313	605.004	92	0.000

Table 4 Weight Assignment of the Index System on Risk Factors

First-Level Indicators (Weight)	Second-Level Indicators (Weight)	Third-Level Indicators (Weight)
1. Environmental facility (0.1610)	1.1 Environment (0.2500)	1.1.1 Architectural planning (0.2748)
		1.1.2 Physical conditions (0.1981)
		1.1.3 Layout design (0.3873)
		1.1.4 Identification system (0.1397)
	1.2 Facilities and equipment (0.7500)	1.2.1 Catering (0.2644)
		1.2.2 Furniture (0.0922)
		1.2.3 Auxiliary equipment (0.1781)
		1.2.4 Sports and fitness (0.0686)
		1.2.5 Medical and nursing (0.1322)
		1.2.6 Safety facilities (0.2644)
2. Nursing staff (0.3950)	2.1 Basic quality (0.2500)	2.1.1 Professional ethics (0.1623)
		2.1.2 General knowledge of regulations (0.0787)
		2.1.3 Safety consciousness (0.2309)
		2.1.4 Code of conduct (0.1145)
		2.1.5 Emergency capacity (0.1900)
		2.1.6 Communication and coordination ability (0.0787)
		2.1.7 Learning ability (0.0304)
		2.1.8 Physical quality (0.0672)
		2.1.9 Psychological quality (0.0473)
	2.2 Professional nursing skills (0.7500)	2.2.1 Basic knowledge of geriatric nursing (0.1139)
		2.2.2 Occupational safety and health knowledge (0.0599)
		2.2.3 Basic nursing skills (0.1971)
		2.2.4 First aid skills (0.1441)
		2.2.5 Security guard (0.1971)
		2.2.6 Disease nursing (0.0868)
		2.2.7 Psychological nursing (0.0452)
		2.2.8 Rehabilitation nursing (0.0346)
		2.2.9 Health education (0.0346)
		2.2.10 Nursing records (0.0868)
3. Older adults’ characteristics (0.1947)	3.1 Physiological factors (0.7500)	3.1.1 Age (0.0371)
		3.1.2 Disease (0.0860)
		3.1.3 Medication (0.1520)
		3.1.4 Ability in daily activities (0.2240)
		3.1.5 Language expression (0.0371)
		3.1.6 Sensory ability (0.0519)
		3.1.7 Balance ability (0.1092)
		3.1.8 Cognitive function (0.1092)
		3.1.9 Swallowing function (0.0762)
		3.1.10 Nutrition (0.0655)
		3.1.11 Skin (0.0519)
	3.2 Psychosocial factors (0.2500)	3.2.1 Character (0.1951)
		3.2.2 Emotion (0.4915)
		3.2.3 Social support (0.1951)
		3.2.4 Income (0.1184)
4. Management factors (0.2493)	4.1 Rules and regulations (0.3092)	4.1.1 Responsibility and authority (0.0810)
		4.1.2 Workflow (0.1343)
		4.1.3 Technical specifications (0.2601)
		4.1.4 Security check (0.2024)
		4.1.5 Training and assessment (0.1343)
		4.1.6 Accident reporting and handling system (0.1343)
		4.1.7 Management system of nursing documentation (0.0538)
	4.2 Organization and implementation (0.4351)	4.2.1 Staffing (0.1171)
		4.2.2 Certificates and Licenses for Nursing Staff (0.1171)
		4.2.3 Division of labor (0.0693)
		4.2.4 Pre-admission assessments (0.2341)
		4.2.5 Risk notification (0.1590)
		4.2.6 Functional partitions (0.0693)
		4.2.7 Quality control (0.2341)
	4.3 Emergency plan management (0.1501)	4.3.1 Emergency plan preparation (0.1817)
		4.3.2 Emergency plan review (0.0622)
		4.3.3 Emergency plan implementation (0.1164)
		4.3.4 Publicity and education (0.0794)
		4.3.5 Emergency drills (0.3337)
		4.3.6 Monitoring and warning (0.2266)
	4.4 Support system (0.1056)	4.4.1 Medical support (0.5485)
		4.4.2 Logistical support (0.2106)
		4.4.3 Accident insurance (0.2409)

Table 5 Risk Assessment Grade

Risk Grading	Risk Assessment Score
Extremely high risk	<40
High risk	40–59
Moderate risk	60–79
Low risk	80 and above