基于DRGs理念的腹腔镜全子宫切除术病人围术期护理质量敏感指标的构建  

Construction of perioperative nursing quality sensitive indicator for patients undergoing laparoscopic hysterectomy based on DRGs concept

作　　者：马倩[1] 毛辰蓉 蒋玲[1] MA Qian;MAO Chenrong;JIANG Ling(Suzhou Municipal Hospital,Jiangsu 215000 China)

机构地区：[1]苏州市立医院,江苏215000

出　　处：《护理研究》2023年第22期4009-4014,共6页Chinese Nursing Research

基　　金：苏州市护理学会姑苏护理人才“青苗”计划项目,编号:SHQM202109;苏州市医学重点扶持学科建设——临床护理学项目,编号:SZFCXK202101。

摘　　要：目的:构建基于疾病诊断相关分组(DRGs)理念的腹腔镜全子宫切除术病人围术期护理质量敏感指标。方法:基于DRGs理念,以三维质量结构模型为理论指导,通过查阅文献、专家函询构建腹腔镜全子宫切除术病人围术期护理质量敏感指标,采用层次分析法确定指标权重。结果:构建的基于DRGs理念的腹腔镜全子宫切除术病人围术期护理质量敏感指标包括3项一级指标(结构指标、过程指标、结果指标)、10项二级指标、40项三级指标,2轮专家函询问卷回收有效率分别为93.75%和100.00%,专家权威系数分别为0.87和0.89,肯德尔和谐系数分别为0.23和0.15。一级指标中,结果指标权重最高(33.99%),过程指标次之(33.65%),结构指标权重最低(32.36%)。结论:本研究构建的基于DRGs理念的腹腔镜全子宫切除术病人围术期护理质量敏感指标具有一定的时代特色,符合科学性、实用性原则,对量化腹腔镜全子宫切除术病人围术期护理质量有一定指导意义。Objective:To construct perioperative nursing quality sensitive indicator for patients undergoing laparoscopic hysterectomy based on diagnosis related groups(DRGs)concept.Methods:Based on the concept of DRGs and guided by three⁃dimensional quality structure model,perioperative nursing quality sensitive indicator for patients undergoing laparoscopic hysterectomy was constructed by literature review and expert consultation.The weights of the indicators were determined by analytic hierarchy process.Results:The perioperative nursing quality sensitive indicator for patients undergoing laparoscopic hysterectomy based on DRGs concept were constructed,including 3 first⁃level indicators(structural indicators,process indicators,and outcome indicators),10 second-level indicators,and 40 third⁃level indicators.The effective rates of 2 rounds of expert inquiry questionnaires were 93.75%and 100.00%,respectively.The expert authority coefficients were 0.87 and 0.89,respectively.And Kendall harmony coefficients were 0.23 and 0.15,respectively.Among the first-level indicators,outcome indicators had the highest weight(33.99%),followed by process indicators(33.65%),and structural indicators had lowest weight(32.36%).Conclusions:The perioperative nursing quality sensitive indicator for patients undergoing laparoscopic hysterectomy based on DRGs concept constructed in this study have certain characteristics of the times.It conforms to the principles of scientificity and practicality,and have certain guiding significance for quantifying the perioperative nursing quality of patients undergoing laparoscopic hysterectomy.

关 键 词：疾病诊断相关分组(DRGs) 腹腔镜 全子宫切除术 围术期 敏感指标 指标构建 德尔菲法 护理 

分 类 号：R473.71[医药卫生—护理学]