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Estándares de calidad asistencial para las consultas de enfermería en reumatología
Authors:Santiago Muñoz Fernández  Pablo Lázaro y De Mercado  Javier Alegre López  Raquel Almodóvar González  Alberto Alonso Ruiz  Francisco Javier Ballina García  Ana María Bilbao Cantarero  Mercedes Cabañas Sáenz  Rosario García-Vicuña  Mauricio Mínguez Vega  Isabel Padró Blanch  José Andrés Román Ivorra  Encarnación Roncal Marqueta
Institution:1. Servicio de Reumatología, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, España;2. Técnicas Avanzadas de Investigación en Servicios de Salud (TAISS), Madrid, España;3. Sección de Reumatología, Hospital Universitario de Burgos, Burgos, España;4. Servicio de Reumatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España;5. Servicio de Reumatología, Hospital Universitario de Cruces, Barakaldo, Vizcaya, España;6. Servicio de Reumatología, Hospital Universitario Central de Asturias, Oviedo, España;7. Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España;8. Servicio de Reumatología, Hospital Universitario de la Princesa, Madrid, España;9. Servicio de Reumatología, Hospital Clínico Universitario San Juan de Alicante, Alicante, España;10. Servicio de Reumatología, Hospital del Mar, Barcelona, España;11. Servicio de Reumatología, Hospital Universitario y Politécnico La Fe, Valencia, España;12. Servicio de Reumatología, Hospital Universitario La Paz, Madrid, España
Abstract:BackgroundNursing clinics in rheumatology (NCR) are organizational models in the field of nursing care. There are various NCR models, but there is no consensus on its operational definition. Our objective is to develop quality standards to define and characterize a NCR.MethodTwo-round Delphi method. The panel consisted of 67 experts: Rheumatologists and nurses of the nursing working group of the Spanish Society of Rheumatology (SSR). The Delphi questionnaire was developed after a literature and experience review from previous SSR projects. The questionnaire consists of 7 sections: general considerations, standards of structure, process, treatment and monitoring, health education, training and research and quality of care. Each item was scored from 1 (least important) to 9 (most important) or by assigning a number (e.g., waiting days). The degree of agreement among the experts was categorized according to the coefficient of variation (CoV) between very high (CoV≤25%) and very low (CoV>100%).ResultsThe second round questionnaire (182 items) was answered by 46 panelists (34 rheumatologists and 12 nurses). A very important agreement was reached on the general standards of structure, process, treatment and monitoring, health education and quality of care. Less agreement was observed on standards related to training time, number of recommended nurses’ research projects and publications.ConclusionThe standards developed in this study would be useful for establishing desirable quality standards of structure and process, and criteria for clinical work, research and teaching that can be used to develop and evaluate the NCRs.
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