Abstract:

Objective To establish an evaluation index system of nursing quality in neurosurgery ICU in accordance with China’s conditions,in order to provide a scientific reference for the evaluation and monitoring of nursing quality in neurosurgery ICU. Methods Based on the three-dimensional quality model of “structure-process-outcome”,the domestic and foreign literatures were retrieved;clinical practice and individual needs of patients were integrated;the index entry pool was set;the inquiry content was determined by semi-structured interview method. Finally,the index system and its weight were determined by Delphi method and analytic hierarchy process. Results The recovery rates of two rounds of expert consultation were 96.67% and 100%;the authority coefficients were 0.8975 and 0.900;the judgment coefficients were 0.956 and 0.962;the familiarity coefficients were 0.838 and 0.837,and the Kendall harmony coefficients were 0.219 and 0.226,respectively. The final evaluation index system of nursing quality in neurosurgery ICU included three first-level indicators,namely,structure indicators,process indicators and outcome indicators,17 second-level indicators and 104 third-level indicators. Conclusion The evaluation index system of nursing quality in neurosurgery ICU established in this study is comprehensive and practical,which can provide objective and quantitative quality evaluation tools for nursing managers,guide the clinical practice of nurses,and promote continuous nursing quality improvement in neurosurgery ICU.

Key words: Neurosurgery, Intensive Care Units, Nursing Quality, Appraisal Indicators, Delphi Method, Nursing Administration Research

摘要：

目的 建立符合中国国情的神经外科ICU护理质量评价指标,旨在为神经外科ICU护理质量评价与监测提供科学依据。方法 以“结构-过程-结果”三维质量模式为框架,检索国内外文献,整合临床实践和患者个体需求,设定指标条目池,结合半结构访谈法确定咨询内容,最终通过德尔菲法和层次分析法确定指标及其权重。结果 2轮咨询问卷回收率分别为96.67%和100%,权威系数为0.897和0.900,判断系数为0.956和0.962,熟悉系数为0.838和0.837,肯德尔和谐系数为0.219和0.226。最终构建的神经外科ICU护理质量评价指标包括3项一级指标即结构指标、过程指标和结果指标,17项二级指标和104项三级指标。结论 神经外科ICU护理质量评价指标内容全面、实用,可作为客观和量化的质量评价工具,有效指导护士的临床实践,促进神经外科ICU护理质量持续改进。

关键词: 神经外科, 重症监护病房, 护理质量, 评价指标, 德尔菲法, 护理管理研究