基于HFMEA模式构建ICU成人气管插管非计划拔管风险评估量表及信效度检验  

Construction of a risk assessment scale for unplanned extubation of tracheal intubation in ICU adults based on HFMEA model and testing of validity and reliability

作　　者：刘明超 于安山 钟艳 谢艳梅[2] LIU Mingchao;YU Anshan;ZHONG Yan;XIE Yanmei(Gannan Medical College,Jiangxi 341000 China)

机构地区：[1]赣南医学院,341000 [2]赣南医学院第一附属医院,341000 [3]赣州市第三人民医院,341000

出　　处：《全科护理》2024年第6期997-1001,共5页Chinese General Practice Nursing

基　　金：江西省卫生健康委科技计划项目,编号:202210850。

摘　　要：目的:以HFMEA理论为指导,构建重症监护室(ICU)成人气管插管非计划拔管风险评估量表,并检验其信效度。方法:以HFMEA理论为指导通过文献回顾,临床资料剖析、HFMEA小组成员筛选和决策树分析、临床预调查,形成《ICU成人气管插管非计划拔管风险评估量表》;采用便利抽样法,选取2022年4月—10月江西省某三级甲等医院ICU的526例气管插管病人进行量表调查并进行信效度检验。结果:正式量表共包括病人因素、导管因素、缺乏有效监督、其他因素4个维度,共13个一级条目,41个二级指标。Cronbach′sα系数为0.745,评价者间Spearman相关系数为0.936(P<0.001),本量表条目水平的内容效度指数(I-CVI)为0.80~1.00,量表水平的内容效度指数(S-CVI)为0.91。KMO=0.666,χ^(2)=1191.556,自由度(df)=78,P<0.01,共提取4个公因子,累计方差贡献率为53.23%。结论:构建的ICU成人气管插管非计划拔管风险评估量表信效度良好,护理人员可有效识别气管插管病人发生非计划拔管的风险。Objective:Based on HFMEA theory,to construct a risk assessment scale for unplanned extubation of tracheal intubation in ICU adults based on HFMEA model and to test the validity and reliability.Methods:Through literature review,clinical data analysis,HFMEA team members screening,decision tree analysis,and clinical pre-investigation,the“Risk Assessment Scale of Unplanned Extubation for Adult Tracheal Intubation in ICU”was formed.Using convenient sampling method,a total of 526 patients with tracheal intubation in ICU in a tertiary grade A hospital in Jiangxi province were selected for scale investigation and reliability and validity test from April to October 2022.Results:The formal scale included patient factor,catheter factor,lack of effective supervision and other factors,with 13 first-level items and 41 second-level indicators.The Cronbach′s alpha coefficient was 0.745,the inter-rater Spearman correlation coefficient was 0.936(P<0.001),the I-CVI was in the range of 0.80~1.00,and the S-CVI was 0.91.KMO=0.666,χ^(2)=1191.556,df=78,P<0.01,a total of 4 common factors were extracted,with a cumulative variance contribution of 53.23%.Conclusions:The reliability and validity of the constructed Risk Assessment Scale of Unplanned Extubation for Adult Tracheal Intubation in ICU were good,and nursing staff could effectively identify the risk of unplanned extubation in tracheal intubation patients.

关 键 词：信效度检验 非计划性拔管 HFMEA 量表 德尔菲法 

分 类 号：R472[医药卫生—护理学]