伤口造口专科护理敏感质量指标体系的构建

doi:10.3761/j.issn.0254-1769.2022.21.001

摘要/Abstract

摘要：

目的构建本土化、科学可靠的伤口造口专科护理敏感质量指标体系，为护理质量评价提供标准化工具。方法 2021年6月—12月，以“结构-过程-结果”质量评价模型为理论依据，基于循证分析和半结构式访谈制订函询问卷，通过德尔菲法确立指标体系，采用层次分析法确定指标权重。结果 2轮函询问卷的有效回收率分别为94.1%、100%，专家权威系数分别为0.897、0.931，肯德尔和谐系数分别为0.110~0.156、0.162~0.196，最终形成了包含3项一级指标、8项二级指标和20项三级指标的伤口造口专科护理敏感质量指标体系。结论该指标体系具有较强的科学性、可靠性和临床适用性，符合伤口造口专科临床实践与护理管理特点，可为客观评价伤口造口专科护理质量提供参考依据。

关键词: 护理敏感质量指标, 伤口, 造口, 肠造口术, 膀胱造口术, 护理

Abstract:

Objective To construct a localized，scientific，and reliable nursing-sensitive quality indicator system，in order to provide standardized tools for evaluating the quality of wound and ostomy care. Methods This study is based on the theory of "structure-process-result" quality evaluation model，using evidence-based analysis and semi-structured interview to formulate the consultation questionnaire，and the Delphi method and Analytic Hierarchy Process are employed to determine the content of the system and the weight of each indicator. Results The effective recovery rates of the 2 rounds of questionnaires were 94.1% and 100%;the authority coefficients of experts were 0.897 and 0.931;the Kendall harmony coefficients of expert opinions were 0.110~0.156，0.162~0.196 respectively. Finally，a nursing-sensitive quality indicator system of wound and ostomy care was constructed，including 3 first-level indicators，8 second-level indicators，and 20 third-level indicators. Conclusion The system shows strong scientificity，as well as excellent reliability and clinical applicability，which is consistent with the characteristic of clinical practice and nursing management of wound and ostomy care，and it can provide references for objectively evaluating the quality of specialist care.

Key words: Nursing-Sensitive Quality Indicator, Wound, Ostomy, Enterostomy, Cystostomy, Nursing Care

王宁, 吕琳, 杨丽梅, 王晓平, 韩琳. 伤口造口专科护理敏感质量指标体系的构建[J]. 中华护理杂志, 2022, 57(21): 2565-2571.

WANG Ning, LÜ Lin, YANG Limei, WANG Xiaoping, HAN Lin. Construction of a nursing-sensitive quality indicator system in wound and ostomy care[J]. Chinese Journal of Nursing, 2022, 57(21): 2565-2571.

图/表 3

表1 专家意见协调程度及显著性检验

Table 1 The coordination degree of expert opinions and the significance test

表2 专家意见集中程度

Table 2 The concordance degree of the expert opinions

表3 伤口造口专科护理敏感质量指标体系

Table 3 Nursing-sensitive quality indicator system of wound and ostomy care

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