综合医院胃肠外科护理质量评价指标体系的构建  

Construction of nursing quality evaluation indexes system of gastrointestinal surgery in general hospitals

作　　者：汪欢[1] 乐革芬[1] 喻姣花[1] 张学辉[1] 刘兴红[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院

出　　处：《护理研究（下旬版）》2015年第9期3359-3363,共5页Chinese Nursing Researsh

摘　　要：[目的]构建综合医院胃肠外科具有专科特异性的护理质量评价指标,并确定各级指标权重,为建立专科护理质量评价体系提供参考依据。[方法]采用查阅文献资料及专家访谈法,借鉴Donabedian提出的"结构-过程-结果"理论框架初步建立综合医院胃肠外科护理质量评价指标后,应用德尔菲法就建立的各级评价指标进行函询,结合重要性赋值采用层次分析法确定各级指标权重。[结果]综合医院胃肠外科护理质量评价指标包含3个一级指标、8个二级指标和34个三级指标。专家对构建的指标意见协调性好,一致性水平较高。各级指标权重中一级指标中突出过程质量;二级指标中权重排名前3位的分别是制度流程、人力资源、不良事件;三级指标中排名前5位的分别为上消化道大出血应急预案知晓率、专科常见并发症的护理制度及流程执行率、专科操作技能培训考核合格率、血管导管相关血流感染发生率、留置导尿管相关泌尿系感染发生率。[结论]本研究中采用质性和量性相结合的方法建立护理质量评价指标可信度较高,可初步在临床上探讨其适用性,为进一步探讨构建各专科特色的护理质量评价指标提供参考依据。在评价过程中突出过程质量,兼顾结构和结果质量,可促进临床护理质量持续改进。Objective:To construct the nursing quality evaluation index of gastrointestinal surgery with specialist specificity in general hospitals,and to determine the weight of all levels of indexes,so as to provide the evidences for establishing the specialist care quality evaluation systems and carrying out the specialist care quality evaluation.Methods:After accessing to literatures and expert interviews,learning from the theoretical framework of'structure-process-outcome'raised by Donabedian and initially establishing the nursing quality evaluation indexes of gastrointestinal surgery in general hospitals.The Delphi method was applied for letter consult on the established all levels of evaluation indexes,combined with the importance of assignment and using analytic hierarchy process(AHP)to determine the weights of all levels of indexes.Results:Nursing quality evaluation indexes of gastrointestinal surgery in general hospitals included 3 primary indicators,8 secondary indicators and 34 third indicators.Experts had good coordination and higher consistency on the indicators.In weight of all levels of indexes,in the first level indicators in the process quality was outstanding in primary indicators;the top 3 in secondary indicators were in turn the system process,human resources and adverse events;the top 5 in third indicators were respectively emergency plan awareness rate of upper digestive tract bleeding,execution rate of nursing system and process of specialist common complications,pass rate of specialist skills training assessment,incidence of catheter related bloodstream infection and incidence of indwelling catheter-related urinary tract infection.Conclusion:The established nursing quality evaluation indexes based on qualitative and quantitative methods had the better credibility,and can be used in clinical practice to probe into the applicability,to provide a reference basis for further building the special feature of nursing quality evaluation indexes.In the process of evaluation,it can promote the continuous impr

关 键 词：胃肠外科 护理质量 三维质量结构 德尔菲法 评价指标 

分 类 号：R47[医药卫生—护理学]