非计划拔管风险评估工具的研究  

Development of Risk Assessment Tool for Unplanned Extubation

作　　者：王欣[1] 贺婷[2] 李云[3] 颜国慧[4] 陈静[5] 梁义[6] 

机构地区：[1]中山市人民医院护理部,广东中山528403 [2]中山市人民医院老年科,广东中山528403 [3]中山市人民医院重症治疗科,广东中山528403 [4]中山市人民医院神经内科,广东中山528403 [5]中山市人民医院神经外科,广东中山528403 [6]中山市人民医院普外科,广东中山528403

出　　处：《护理学报》2016年第5期1-5,共5页Journal of Nursing（China）

基　　金：中山市科技局项目(2015B1098)

摘　　要：目的研制非计划拔管的风险评估工具,识别高风险患者,减少非计划拔管的发生。方法采用德尔菲法研制非计划拔管的风险评估工具,并采用此工具对684例留置管道的住院患者进行评估,分析信度、效度、灵敏度、特异性、ROC曲线下面积,结合约登指数分析最佳临界值。结果经过2轮专家咨询形成非计划拔管的风险评估工具,包括8个评价条目。专家的权威程度(Cr)为0.71,内部一致性信度Cronbach’sα系数为0.818;条目平均内容效度比为0.94,各条目与总分的相关性分析均P<0.01;ROC曲线下面积为0.902,P<0.01;当临界值取为15.5,灵敏度为0.853,特异度为0.824,此时约登指数最大为0.677。结论本研究所研制的非计划拔管评估工具信度、效度较好,特异性和灵敏度较高,筛选非计划拔管高风险患者的准确性较高。本研究为护士评估非计划拔管风险提供了科学工具。Objective To develop a risk assessment tool for unplanned extubation for the identification of high-risk patients and reduce the incidence of unplanned extubation. Methods With Delphi method, a risk assessment tool for unplanned extubation was developed and then it was applied in 684 patients for the assessment of the incidence of unplanned extubation. The reliability, validity, sensitivity, specificity and area under the ROC curve were analyzed and the best threshold was analyzed with Youden Index. Results The risk assessment tool developed after two-round expert consultation included 8 items. Cr value of experts ’ authority was 0.71, Cronbach’s αof internal consistency reliability 0.818 and content validity index 0.94. The relationships among the total score and each items all indicated statistical significance （all P〈0.01）. The area under ROC curve was 0.902 （P〈0.01）. With threshold value of 15.5, sensitivity of 0.853, and specificity of 0.824, Youden Index reached the highest of 0.677. Conclusion With good reliability and validity, high sensitivity and specificity, the developed risk assessment tool for unplanned extubation is effective for the identification of patients with high risk of unplanned extubation and it is a scientific tool for the assessment of unplanned extubation.

关 键 词：非计划拔管 评估工具 高危风险 

分 类 号：R471[医药卫生—护理学] C931.3[医药卫生—临床医学]