基于4R危机管理理论的综合性医院手术室突发急性传染病护理应急管理体系的构建

目的构建一套科学、系统、规范且适用于综合性医院手术室突发急性传染病护理应急管理的指标体系。方法于2020年6月—2021年3月以4R危机管理理论为指导,采用文献研究、专家访谈的科学方法初步拟定指标框架,对16名来自手术室护理、护理管理、医院感染、疾病预防控制及传染病领域的医疗、护理专家应用德尔菲专家咨询法进一步筛选和确定各级指标,并采用层次分析法和优序图法确定各级指标的权重值,最终形成综合性医院手术室突发急性传染病护理应急管理体系。结果2轮咨询专家积极系数均为100.00%,提出意见的专家分别占68.75%和31.25%,专家权威系数为0.9063,各级指标的变异系数均<0.25,2轮咨询一、二、三级指标的协调系数分别为0.228、0.322、0.288和0.252、0.406、0.326(均P<0.01)。最终形成包括4项一级指标、13项二级指标和64项三级指标的综合性医院手术室突发急性传染病护理应急管理体系,且指标权重分配合理。结论构建的综合性医院手术室突发急性传染病护理应急管理体系具备较高的科学性和可靠性,能够为手术室护理管理者应对突发急性传染病的护理应急管理提供科学参考依据。

Construction of nursing emergency management system for sudden acute infectious diseases in Operating Room of general hospital based on 4R crisis management theory

Objective To build a scientific,systematic and standardized index system suitable for emergency management of sudden acute infectious diseases in Operating Rooms of general hospitals.Methods From June 2020 to March 2021,guided by the 4R crisis management theory,the index framework was initially formulated by scientific methods of literature research and expert interviews.A total of 16 medical and nursing experts from the fields of Operating Room nursing,nursing management,nosocomial infection,disease prevention and control and infectious diseases were further screened and determined indicators at all levels by applying the Delphi expert consultation method.The weight values of indexes at all levels were determined by analytic hierarchy process(AHP)and priority map method,and the emergency management system of nursing for sudden acute infectious diseases in Operating Rooms of general hospitals was finally formed.Results The positive coefficients of experts in the two rounds of consultation were both 100.00%.The experts who provided opinions accounted for 68.75%and 31.25%respectively.The authoritative coefficient of experts was 0.9063.The coefficient of variation of indicators at all levels was less than 0.25.The coordination coefficients of the first-level,secondary and tertiary indexes were 0.228,0.322,0.288 and 0.252,0.406,0.326(all P<0.01),respectively.Finally,a nursing emergency management system for sudden acute infectious diseases in Operating Rooms of general hospitals was formed,including 4 first-level indicators,13 second-level indicators and 64 third-level indicators,and the weight distribution of indicators was reasonable.Conclusions The constructed nursing emergency management system for sudden acute infectious diseases in Operating Rooms of general hospitals is scientific and reliable,which can provide scientific references for Operating Room nursing managers to deal with emergency nursing management of acute infectious diseases.