Consensus methods such as the Delphi survey technique are being employed to help enhance effective decision-making in health and social care. The Delphi survey is a group facilitation technique, which is an iterative multistage process, designed to transform opinion into group consensus. It is a flexible approach, that is used commonly within the health and social sciences, yet little guidance exists to help researchers undertake this method of data collection. This paper aims to provide an understanding of the preparation, action steps and difficulties that are inherent within the Delphi. Used systematically and rigorously, the Delphi can contribute significantly to broadening knowledge within the nursing profession. However, careful thought must be given before using the method; there are key issues surrounding problem identification, researcher skills and data presentation that must be addressed. The paper does not claim to be definitive; it purports to act as a guide for those researchers who wish to exploit the Delphi methodology.

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Many challenges and questions are raised when using the Delphi technique, but there is no doubt that it is an important method for achieving consensus on issues where none previously existed. Researchers need to adapt the method to suit their particular study.

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Identifying barriers is just the first step to addressing issues surrounding the use of evidence-based practice. Extra resources will be needed if these barriers are to be tackled. However, if the resultant change improves the health and wellbeing of people and communities, then the extra costs would be offset by more efficient use of services.

This study identified the core components of cultural competence important to nurses practising within a multicultural society such as Sweden. Acquisition of the knowledge, skills and attitudes identified should enable nurses to meet the needs of patients from different cultural backgrounds. The components of cultural competence can form the basis of nursing curricula.

The desire to reduce the length of waiting lists in the modern health service means that strategies for decreasing the length of hospital stay are exercising the minds of service planners. This has led to renewed emphasis on well planned discharge policies and procedures. The aim of this study was to analyse all discharge policies and procedures currently in use in one large integrated NHS trust in Northern Ireland and formulate a Corporate Discharge Policy for general use in NHS trusts. Objectives of the study included examining the current process of discharge, reviewing the interface between ward staff and district nursing services and examining the quality and standard of documentation in use. Findings indicate the need for standardization of the discharge planning process and sufficient notice of discharge, and for clarification and education regarding staff roles, the importance of multidisciplinary working, and the lack of quality communication between acute and community services.