小儿骨科护理质量评价指标体系的构建  

Construction of nursing quality evaluation index system for pediatric orthopedics

作　　者：王楠 金薇 胡雁真 黄洁 赵丹 邢娟 李长虹 胡亚楠 刘怡 鲁雪梅 杨征 Wang Nan;Jin Wei;Hu Yanzhen;Huang Jie;Zhao Dan;Xing Juan;Li Changhong;Hu Yanan;Liu Yi;Lu Xuemei;Yang Zheng(Department of Pediatric Orthopedic,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China;Department of Nursing,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China;Spinal Surgery Department of Spinal Surgery,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)

机构地区：[1]首都医科大学附属北京积水潭医院小儿骨科,北京100035 [2]首都医科大学附属北京积水潭医院护理部,北京100035 [3]首都医科大学附属北京积水潭医院脊柱外科,北京100035

出　　处：《中国实用护理杂志》2024年第9期655-664,共10页Chinese Journal of Practical Nursing

基　　金：北京市自然科学基金-海淀原始创新联合基金资助项目(L212041)。

摘　　要：目的构建具有代表性的小儿骨科护理质量敏感指标,为医院小儿骨科护理质量评价与监测提供依据。方法2023年4—7月,以结构-过程-结果三维质量结构模式为理论框架,通过检索国内外文献,拟订条目池,通过2轮德尔菲法专家函询,最后采用层次分析法确定各层次指标及其权重。结果2轮函询问卷的有效回收率均为100%(20/20);专家的权威系数分别为0.87和0.88;变异系数分别为0.00~0.27和0.00~0.24。2轮函询二、三级指标的Kendall协调系数分别为0.140、0.166和0.192、0.161(均P<0.05)。最终构建的小儿骨科护理质量评价指标体系包括3项一级指标、21项二级指标、83项三级指标。一级指标中,过程质量指标权重最大为0.4934,其次为结果质量指标,权重为0.3108,结构质量指标权重最小,为0.1958。在二级指标中,肢体血循环评估标准的组合权重最大,为0.0998。结论本研究构建的小儿骨科护理质量评价指标体系涵盖关键内容,可操作性更强,能更好地指导护理干预和质量控制。Objective To construct a representative index system for evaluating pediatric orthopedic nursing quality,providing a basis for hospital pediatric orthopedic nursing quality assessment and monitoring.Methods From April to July 2023,using the"structure-process-outcome"three-dimensional quality structure model as the theoretical framework,a literature review was conducted,and an item pool was formulated.Through two rounds of Delphi method expert consultations,the hierarchical analysis method was finally employed to determine the indicators and their weights at each level.Results The effective recovery rates of the questionnaire of the two rounds of expert consultations were 100%(20/20),the authority coefficients of experts were 0.87 and 0.88,the coefficients of variation were 0.00 to 0.27 and 0.00 to 0.24.The Kendell harmony coefficients of the second and third indicators in the two rounds of inquiry were 0.140,0.166 and 0.192,0.161(all P<0.05).The final pediatric orthopedic nursing quality evaluation index system included 3 primary indicators,21 secondary indicators and 83 tertiary indicators.Among the primary indicators,the weight of process quality was the highest at 0.4934,followed by outcome quality at 0.3108,and the lowest was structural quality at 0.1958.In the secondary indicators,"assessment criteria of limb blood circulation"had the highest weight at 0.0998.Conclusions The constructed pediatric orthopedic nursing quality evaluation index system covers key aspects and is more operationally feasible.It provides better guidance for nursing interventions and quality control.

关 键 词：德尔菲技术 儿科护理 骨科 护理质量 评价指标 

分 类 号：R473.72[医药卫生—护理学]