成年气管插管患者非计划性拔管风险评价指标体系的构建

目的构建系统科学的成年气管插管患者非计划性拔管风险评价指标体系。方法通过文献研究、半结构式访谈和专家会议,初步构建成年气管插管患者非计划性拔管风险评价指标体系框架;运用德尔菲法对初步拟定的风险评价指标进行筛选、修订、完善,并结合运用层次分析法对各风险评价指标进行权重值测算。结果专家判断系数为0.89,专家熟悉程度为0.77,专家权威程度为0.83;两轮专家函询中的一级指标、二级指标、三级指标及所有指标的协调系数分别为0.57、0.36、0.40、0.41和0.59、0.42、0.46、0.47,其显著性检验均具有统计学意义(P<0.01)。最终确定的成年气管插管患者非计划性拔管风险评价指标体系包含5个一级指标、13个二级指标、51个三级指标,其中一级指标权重值分别为患者因素0.405、家属因素0.042、医护人员因素0.307、导管因素0.099和系统因素0.147。结论构建的成年气管插管患者非计划性拔管风险评价指标体系科学可靠,各风险评价指标权重值设置合理。

Establishment of a risk assessment index system for unplanned endotracheal extubation in adult patients

Objective To establish a systematic and scientific risk assessment index system for unplanned endotracheal extubation in adult patients.Methods By means of the literature research method,the semi-structured interview method and the expert meeting method,the framework of the risk assessment index system for unplanned endotracheal extubation in adult patients was constructed premilinarily.Secondly the preliminary risk assessment indexes were screened,revised and improved through Delphi method.And then the weight value calculation and consistency test of each risk assessment index were carried out by Analytic Hierarchy Process.Results In this study,the expert judgment coefficient was 0.89,the degree of expert familiarity was 0.77,and the degree of expert authority was 0.83.In two rounds of expert correspondence,the coordination coefficients of the first-level indicators,second-level indicators,third-level indicators and all indicators were 0.57,0.36,0.40,0.41 and 0.59,0.42,0.46,0.47,respectively.The significance test was statistically significant(P<0.01).Ultimately,the risk assessment index system for unplanned endotracheal extubation in adult patients contained 5 first-level indicators,13 second-level indicators and 51 third-level indicators.And the weight values of 5 first-level indicators were that patient factors 0.405,family factors 0.042,medical staff factors 0.307,endotracheal tube factors 0.099 and system factors 0.147.Conclusion The risk assessment index system for unplanned endotracheal extubation in adult patients was scientific and reasonable,and the weight value of each risk assessment index was reasonable and scientific.