摘要
目的建立并应用主动脉夹层护理质量评价指标体系.方法以Donabedian的结构-过程-结果三维质量评价模式为理论框架,查阅相关文献,初步拟定护理质量评价指标体系.采用Delphi专家函询法对20名专家进行咨询,构建评价指标体系.运用主动脉夹层护理质量评价指标制订查检表,对主动脉夹层护理质量进行检查监督,比较评价指标应用前(2018年7月-2019年1月)与应用后(2019年3月-9月)主动脉夹层专科技术操作规范达标率、护理措施执行达标率、病情评估达标率的情况及患者满意度.结果共进行2轮咨询,有效回收率均为100%,专家权威系数Cr值分别为0.86和0.88,肯德尔系数值为0.319~0.555,P<0.001.构建的主动脉夹层护理质量评价指标体系包含3个一级指标、8个二级指标、32个三级指标.评价指标实施前后比较:专科技术操作规范达标率分别为90.4%和96.9%,主动脉夹层护理措施执行达标率分别为87.2%和95.4%,病情评估达标率分别为88.0%和96.2%,患者满意度分别为88.3%和98.3%,差异均有统计学意义(P<0.05).结论本研究构建的主动脉夹层护理质量评价指标体系具有较强的科学性与可靠性,体现专病特点.应用该评价指标体系有助于规范专业护理行为,促进专病护理质量的提升.
Objective To establish and implement the quality indicator system of nursing services for patients with aortic dissection.Methods The Donabedian’s structure-process-result three-dimensional quality evaluation model was used as the theoretical framework and the quality indicator system of nursing services for patients with aortic dissection was preliminarily formulated on the basis of the relative literature.Delphi method was used to consult twenty experts,the quality indicator system of nursing services was established.A checklist was formulated according to the aortic dissection nursing quality evaluation index,to inspect and supervise the aortic dissection nursing quality.The standization rate of aortic dissection specialized skill performance,compliance rate of nursing measures implementation,condition assessment compliance rate and patient’s satisfaction were compared before implementation(July 2018 to January 2019)and after implementation(March to September 2019).Results Two rounds of expert consultation were conducted.The effective response rates were both 100%,authority coefficients(Cr)were 0.86 and 0.88,the Kendall’s W ranged from 0.319~0.555(P<0.001).The quality indicator system of nursing services for patients with aortic dissection consisted of 3 first-level indicators,8 second-level indicators and 32 third-level indicators.After application of quality indicator system,the standization rate of aortic dissection specialized skill performance increased from 90.4%to 96.9%,the implementation rate of aortic dissection nursing measures increased from 87.2%to 95.4%,and the condition assessment compliance rate increased from 88.0%to 96.2%,and patient’s satisfaction increased from 88.3%to 98.3%.The differences were statistically significant(P<0.05).Conclusion The constructed quality indicator system of nursing services for patients with aortic dissection is scientific and reliable,and reflects the characteristics of special disease.The application of this evaluation index system can help standardize professional nursing behaviors and promote the improvement of the quality of specialized nursing care.
作者
刘翠
魏丽丽
朱福香
尚全伟
张丛丛
孔娜
崔晓岭
LIU Cui;WEI Lili;ZHU Fuxiang;SHANG Quanwei;ZHANG Congcong;KONG Na;CUI Xiaoling(Intensive Care Unit of Cardivascular Surgery,the Affiliated Hospital of Qingdao University,Qingdao,266000,China;不详)
出处
《中华急危重症护理杂志》
2020年第4期313-317,共5页
Chinese Journal of Emergency and Critical Care Nursing