手术室压力性损伤护理质量评价指标体系的构建

目的基于Donabedian结构-过程-结果三维质量评价模式构建手术室压力性损伤护理质量评价指标体系,为手术室护理管理者进行手术室护理质量评价提供参考标准。方法2018年3—7月采用目的抽样法,选取上海市护理学会手术室专业委员会主任委员、上海市三级甲等综合性医院手术室科护士长、压力性损伤管理小组专科护士等18名专家作为咨询对象。在检索手术相关压力性损伤国内外文献的基础上,基于Donabedian结构-过程-结果三维质量评价模式制订函询表。采用德尔菲(Delphi)法进行2轮专家咨询,根据专家意见对各级条目进行删除、合并、修改,确定手术室压力性损伤护理质量各级评价指标及权重。结果本研究共进行2轮专家咨询,其中专家判断系数为0.989,专家熟悉系数为0.956,专家权威系数为0.973。2轮函询结果中,二级和三级指标的变异系数为0.109~0.138。最终构建的手术室压力性损伤护理质量评价体系包含3项一级指标、9项二级指标和28项三级指标。结论本研究通过Delphi法构建了科学、合理的手术室压力性损伤护理质量评价体系,可用于手术室压力性损伤护理质量的评价,有利于手术室护理质量的持续改进。

Construction of an evaluation index system of nursing quality for pressure injury in Operating Room

Objective To construct an evaluation index system of nursing quality for pressure injury in Operating Room based on Donabedian structure-process-outcome three-dimensional quality assessment model to provide a reference for nursing quality assessment by nursing managers in Operating Room.Methods From March to July 2018,we selected 18 experts such as chairman of Committee of Operating Room of Shanghai Nursing Association,head nurses of Operating Room at ClassⅢGrade A general hospitals in Shanghai,nurse specialist of pressure injury management team,by purposive sampling as subjects.The consultation form was designed based on search of operation related pressure injury at home and abroad as well as Donabedian structure-process-outcome three-dimensional quality assessment model.Delphi method was used to 2 rounds of expert consultation.Items in all levels were deleted,merged and revised according to expert opinions and to define the evaluation indexes in all levels of nursing quality for pressure injury in Operating Room as well as the weight.Results This study carried out 2 rounds of expert consultation,with 0.989 for the expert judgment coefficient,0.956 for the expert familiarity coefficient and 0.973 for the expert authority coefficient.The variation coefficients of second-level indexes and third-level indexes ranged from 0.109 to 0.138 in 2 rounds of expert consultation.The evaluation index system of nursing quality for pressure injury in Operating Room included 3 first-level indexes,9 second-level indexes and 28 third-level indexes.Conclusions This study constructs a scientific and reasonable evaluation index system of nursing quality for pressure injury in Operating Room with the method of Delphi which can be used to nursing quality assessment for pressure injury in Operating Room and is in favor of continuous quality improvement of nursing in Operating Room.