成人气管插管非计划性拔管风险评估量表的构建  

Development of unplanned extubation risk assessment scale for adult tracheal intubation patients

作　　者：鲁志卉 王颖[1] 黄子菁 王蕾[1] LU Zhihui;WANG Ying;HUANG Zijing;WANG Lei(Nursing Department,Tongji Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan,430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院护理部,武汉市430030

出　　处：《中国护理管理》2022年第6期893-898,共6页Chinese Nursing Management

基　　金：华中科技大学自主创新研究基金资助项目(2015TS084)。

摘　　要：目的:构建成人气管插管非计划性拔管风险评估量表,为预防气管插管非计划性拔管,提高护理安全管理质量提供科学、可靠的量化评估工具。方法:基于循证理论初步构建量表的条目池;通过专家咨询、层次分析法确定量表条目的权重,形成测试量表;使用测试量表对成人气管插管患者进行非计划性拔管的风险评估,检验量表的信度和效度。结果:最终构建了包括9项条目、28个分类项的成人气管插管非计划性拔管风险评估量表。3轮专家的积极系数为88.24%、100.00%、100.00%;专家权威系数为0.91;肯德尔协调系数为0.329~0.759。在条目重要性的咨询上,I-CVI为0.8~1.0,S-CVI为0.96;在条目分类合理性咨询上,I-CVI为0.8~1.0,S-CVI为0.94。量表9项条目与总分的Spearman相关系数为0.630~0.834,P值均<0.05;量表验证性因子分析中,RMSEA为0.074,SRMR为0.03,CFI为0.983,TFI为0.922。量表的Cronbach’sα系数为0.841。结论:基于循证分析的结果,采用德尔菲专家咨询与层次分析法相结合的方法构建的成人气管插管非计划性拔管风险评估量表可为有效提高临床对气管插管患者的护理质量提供科学、有效的评估工具。Objective:To develop a risk assessment scale for unplanned extubation of adult tracheal intubation patients,providing a reliable and quantitative assessment tool for preventing unplanned extubation of tracheal intubation and improve the quality of nursing safety management.Methods:Guided by the evidence-based theory of Hopkins,we conducted evidence synthesis and panel discussion,and initially constructed the item pool of the scale.The content system of the scale was determined through 3 rounds of expert consultation.The weight of the items were determined through the analytic hierarchy process,forming a test version.The test version of the scale was used to assess the risk of unplanned extubation of adult patients with tracheal intubation,and the reliability and validity of the scale were analyzed.Results:The risk assessment scale for unplanned extubation of adult tracheal intubation included 9 items and 28 classification items.The active coefficients of the three rounds of expert consultation were 88.24%,100.00%,and 100.00%.The expert authority coefficient was 0.91.The expert coordination coefficient was 0.329-0.759.The reliability and validity of the scale met the standard,indicating that the reliability and validity were good.Conclusion:Based on the results of evidence-based analysis,the Delphi expert consultation and analytic hierarchy process were used to construct the risk assessment scale for unplanned extubation of adult tracheal intubation,in order to effectively improve clinical care quality for patients with tracheal intubation.

关 键 词：非计划性拔管 气管插管 成人 风险评估 循证 层次分析法 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]