ICU机械通气患者早期活动护理质量敏感指标的构建

doi:10.3761/j.issn.0254-1769.2020.01.002

摘要/Abstract

摘要：

目的构建ICU机械通气患者早期活动护理质量敏感指标,用于指导护理实践,为早期活动护理质量的评价提供依据。方法以三维质量结构模型为理论框架,应用约翰霍普金斯循证护理方法进行证据综合,同时结合半结构访谈形成包括3个一级指标、9个二级指标和31个三级指标的函询问卷初稿。通过2轮专家函询确定最终ICU机械通气患者早期活动护理质量敏感指标。结果 2轮专家函询的积极系数均为100%,专家权威系数分别为0.854和0.870,专家意见协调系数为0.312和0.394。最终形成的护理质量敏感指标包括3个一级指标、7个二级指标、28个三级指标。结论本研究构建的机械通气患者早期活动护理质量敏感指标是一套科学、可靠、可信度较高的评价指标,能够为制订针对机械通气患者早期活动的干预措施提供理论依据。

关键词: 危重症, 机械通气, 康复护理, 德尔菲技术, 质量指标

Abstract:

Objective To establish an evidence-based early activity nursing quality sensitive index system for ICU patients with mechanical ventilation,which is used to guide nursing practice and provide references for evaluation of early activity nursing quality. Methods With the Donabedian model as the theoretical framework,the Johns Hopkins evidence-based nursing method was used for evidence synthesis,and was combined with semi-structured interviews to form a consultation questionnaire consisting of 3 first-level indicators,9 second-level indicators and 31 third-level indicators. Through two rounds of expert consultation,the early activity nursing quality sensitive index system for patients with mechanical ventilation in ICU was determined. Results The positive coefficients of two rounds of expert consultation were both 100%;the expert authority coefficients were 0.854 and 0.870 respectively;the coordination coefficients were 0.312 and 0.394. The final nursing quality sensitive index system included 3 first-level indicators,7 second-level indicators and 28 third-level indicators. Conclusion The nursing quality sensitive index system for ICU patients with mechanical ventilation for early activity is a scientific,reliable and highly credible evaluation system,which can provide a theoretical basis for the development of interventions for early activities of patients with mechanical ventilation.

Key words: Critical Illnesses, Mechanical Ventilation, Rehabilitation Nursing, Delphi Technique, Quality Index

薛友儒, 郭丙秀, 邵慧慧, 张蔚. ICU机械通气患者早期活动护理质量敏感指标的构建[J]. 中华护理杂志, 2020, 55(1): 16-21.

XUE Youru, GUO Bingxiu, SHAO Huihui, ZHANG Wei. Evidence-based construction of early activity nursing quality sensitive index system for patients with mechanical ventilation in ICU[J]. Chinese Journal of Nursing, 2020, 55(1): 16-21.

图/表 4

表1 指标界值表

表2 专家意见协调程度的显著性检验

表3 ICU机械通气患者早期活动护理质量敏感指标一、二级指标第2轮函询结果

表4 ICU机械通气患者早期活动护理质量敏感指标三级指标第2轮函询结果

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