Abstract 70: Finalizing a Core Set of Pediatric Cancer Nursing-Sensitive Quality Indicators for Use in Resource- Diverse Settings and Countries: A Mixed Methods Modified-Delphi Study

Abstract Purpose: Nursing-sensitive quality indicators (NSIs) measure improvements in patient care quality and safety that nurses directly or indirectly influence. Existing standardized NSIs are often general, developed in high-resource countries, and may not reflect aspects of care most relevant to pediatric cancer in resource-diverse settings and countries. Our previous multiphase research established a preliminary core set of pediatric cancer NSIs based on Delphi expert consensus and peer-reviewed literature. This study aims to finalize a core set of NSIs to measure improvements in the quality of nursing care delivered to children and adolescents with cancer in resource-diverse settings and countries. Methods: A sequential mixed methods research design, intersected with a modified-Delphi method was utilized. A purposive sample of 43 multidisciplinary pediatric cancer experts from 24 countries participated. Round 1 (web-based survey): Panelists rated 12 potential NSIs by importance, use/usability, perceived feasibility, and face validity (1=lowest, 9=highest). Median and interquartile range scores were calculated. Next, panelists selected their top 10 NSIs and ranked them by importance (1=most important, 10=least important) for inclusion in a final core set of NSIs. Mean importance scores were calculated through reverse scoring. Round 2 (virtual panel meetings): Meeting 1: A subgroup of 11 panelists discussed Round 1 survey results and refined the list of NSIs and their specifications. Meeting 2: A separate subgroup of 10 panelists reviewed Meeting 1 findings and finalized NSI specifications. Results: Expert panelists prioritized 9 NSIs for inclusion in the final core set. These include NSIs that are novel to pediatric cancer (n=3): chemotherapy/biotherapy administration, patient/family discharge education, and Pediatric Early Warning Score assessment; NSIs that have been modified from existing NSIs (n=4): hand hygiene, intravenous infiltration and extravasation, pain assessment/management, and vascular access device maintenance; and existing NSIs (n=2): central line-associated bloodstream infections and nurse staffing. Expert panelists excluded 3 NSIs: oral care, psychosocial screening, and nausea assessment/management. Conclusion: Findings underscore the need for tailoring NSIs to measure improvements in pediatric cancer care delivery globally. The next steps include pilot testing NSIs in 3 resource-diverse countries. Citation Format: Courtney E. Sullivan, Wendy Landier, Julie Buser, Lauri Linder, Jack Needleman, Paola Friedrich, Patricia A. Patrician. Finalizing a Core Set of Pediatric Cancer Nursing-Sensitive Quality Indicators for Use in Resource- Diverse Settings and Countries: A Mixed Methods Modified-Delphi Study [abstract]. In: Proceedings of the 13th Annual Symposium on Global Cancer Research; 2025 Sep 16. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(12_Suppl):Abstract nr 70.