以质量求发展,以服务铸品牌

护理学报 ›› 2022, Vol. 29 ›› Issue (8): 69-74.doi: 10.16460/j.issn1008-9969.2022.08.069

• 临床护理:儿科护理 • 上一篇    下一篇

基于结构-过程-结果模型儿童支气管镜围术期专科护理质量敏感指标的构建

王琪1a,1c,2, 刘腊梅1a,1c,2, 陈莉娜1b,1c, 阙晓玲1a,1c,2, 苏绍玉1b,1c,2   

  1. 1.四川大学华西第二医院 a.小儿呼吸免疫科护理单元; b.儿科; c.出生缺陷与相关妇儿疾病教育部重点实验室,四川 成都 610041;
    2.四川大学华西护理学院,四川 成都 610041
  • 收稿日期:2021-12-29 出版日期:2022-04-25 发布日期:2022-05-11
  • 通讯作者: 刘腊梅(1987-),女,四川中江人,本科学历,主管护师,护士长。E-mail:liulamei0110@126.com
  • 作者简介:王琪(1995-),女,甘肃天水人,硕士,护师。
  • 基金资助:
    四川省科技厅重点研发项目(2020YFS0105)

Construction of Sensitivity Indicators of Specialized Nursing Quality of Nursing Perioperative Period of Children's Bronchoscopy

WANG Qi1a,1c,2, LIU La-mei1a,1c,2, CHEN Li-na1b,1c, QUE Xiao-ling1a,1c,2, SU Shao-yu1b,1c,2   

  1. 1a. Dept. of Pediatric Respiratory and Immunology Nursing; 1b. Dept. of Pediatric; 1c. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education,West China Second University Hospital, Sichuan University,Chengdu 610041, China;
    2. West China School of Nursing, Sichuan University, Chengdu 610041, China
  • Received:2021-12-29 Online:2022-04-25 Published:2022-05-11

摘要: 目的 构建儿童支气管镜围术期专科护理质量敏感指标,为儿童呼吸专科护理质量管理提供参考依据。方法 以Donabedian结构-过程-结果模型为理论框架,采用焦点访谈、文献回顾及德尔菲法(Delphi)构建儿童支气管镜围术期专科护理质量敏感指标。结果 2轮函询专家积极系数为100%、94%,权威系数为0.880、0.910,指标重要性协调系数0.151、0.203(P<0.01),指标可行性协调系数0.222、0.232(P<0.01)。最终构建的专科护理质量敏感指标包含1个结构指标、6个过程指标和12个结果指标。结论 基于Donabedian结构-过程-结果理论基础和Delphi法构建的儿童支气管镜围术期专科护理质量敏感指标具有科学性、实用性和可行性,可以为儿童呼吸专科护理质量管理提供参考依据。

关键词: 儿童, 支气管镜, 围术期, 护理敏感指标, Delphi法

Abstract: Objective To construct a sensitive index of specialized nursing quality in perioperative period of children's bronchoscopy, so as to provide references for the quality management of specialized nursing in children's respiratory department. Methods Using Donabedian structure-process-result model as the theoretical framework, literature review and Delphi method were used to construct the sensitive indicators of perioperative nursing quality in children with bronchoscopy. Results The positive coefficient of experts was 100% and 94%, the authority coefficient was 0.880 and 0.910, the coordination coefficient of index importance was 0.151 and 0.203 (P<0.01), and the coordination coefficient of index feasibility was 0.222 and 0.232 (P<0.01). The final sensitive indicators of nursing quality include 1 structural indicator, 6 process indicators and 12 outcome indicators. Conclusion Based on Donabedian's theory and Delphi method, the sensitive index of nursing quality in children's bronchoscopy perioperative period is scientific, practical and feasible, which can provide references for nursing quality management in children's respiratory department.

Key words: pediatrics, bronchoscopy, perioperative period, nursing-sensitive indicators, Delphi method

中图分类号: 

  • R473.72
[1] 赵诗雨,喻姣花.专科护理质量敏感性指标研究进展[J].护理研究,2019,33(8):1342-1346. DOI:10.12102/j.issn.1009-6493.2019.08.014.
[2] Heslop L, Lu S, Xu X.Nursing-sensitive Indicators:A Concept Analysis[J].J Adv Nurs,2014,70(11):2469-2482. DOI:10.1111/jan.12503.
[3] 刘鑫鑫. 以Donabedian结构—过程—结果理论构建儿科护理敏感性质量指标评价体系[D].杭州:浙江大学,2017.
[4] Brenner M, Browne C, Gallen A, et al.Development of a Suite of Metrics and Indicators for Children’s Nursing Using Consensus Methodology[J]. J Clin Nurs,2019, 28(13-14):2589-2598. DOI:10.1111/jocn.14845
[5] 国家卫生健康委办公厅.国家卫生健康委办公厅关于印发药事管理和护理专业医疗质量控制指标(2020年版)[EB/OL]. (2020-08-05)[2021-4-27].http://www.gov.cn/zhengce/zhengceku/2020-08/05/5532636/files/f196b2d536ec4180a33
830944e1b0a0b.pdf .
[6] Donabedian A.Quality of Care: Problems of Measurement. Ⅱ.Some Issues in Evaluating the Quality of Nursing Care[J]. Am J Public Health Nations Health,1969,59(10):1833-1836. DOI:10.2105/ajph.59.10.1833.
[7] 管咏梅,楼建华.儿科护理敏感性质量指标的发展及应用[J].中国护理管理, 2014, 14(12):1345-1346. DOI:10.3969/j.issn.1672-1756.2014.12.033.
[8] Rybojad B, Aftyka A, Rudnicka-Drozak E.Nursing Activities in the Prevention and Treatment of Perioperative Complications after Airway Foreign Body Removal in Pediatric Patients[J]. J Perianesth Nurs,2016,31(1):49-55. DOI:10.1016/j.jopan.2014.07.013.
[9] Carlens J, Fuge J, Price T, et al.Complications and Risk Factors in Pediatric Bronchoscopy in a Tertiary Pediatric Respiratory Center[J]. Pediatr Pulmonol,2018,53(5):619-627. DOI:10.1002/ppul.23957.
[10] Jacomelli M, Margotto SS, Demarzo SE, et al.Early Complications in Flexible Bronchoscopy at a University Hospital[J]. J Bras Pneumol,2020,46(4):e20180125.DOI:10.36416/1806-3756/e20180125.
[11] Huang R, Lin W, Fan H, et al.Bronchoalveolar Lavage with Pediatric Flexible Fibreoptic Bronchoscope in Pediatric Haematopoietic Stem Cell Transplant Patients: Nursing Considerations for Operative Complication[J]. J Spec Pediatr Nurs,2019,24(2):e12236. DOI:10.1111/jspn.12236.
[12] Prager JD, Ruiz AG, Mooney K, et al.Improving Operative Flow During Pediatric Airway Evaluation: A Quality-improvement Initiative[J].JAMA Otolaryngol Head Neck Surg, 2015, 141(3):229-235. DOI:10.1001/jamaoto.2014.3279.
[13] José RJ, Shaefi S, Navani N.Sedation for Flexible Bronchoscopy: Current and Emerging Evidence[J]. Eur Respir Rev,2013,22(128):106-116.DOI:10.1183/09059180.00006412.
[14] Eber E, Antón-Pacheco JL, de Blic J, et al. ERS Statement: Interventional Bronchoscopy in Children[J]. Eur Respir J,2017,50(6):1700901. DOI: 10.1183/13993003.00901-2017.
[15] 中华医学会呼吸病学分会介入呼吸病学学组. 2019新型冠状病毒感染疫情防控期间开展支气管镜诊疗指引(试行)[J].中华结核和呼吸杂志,2020,43(3):199-202. DOI:10.3760/cma.j.issn.1001-0939.2020.03.012.
[16] Dexter F,Parra MC, Brown JR, et al.Perioperative COVID-19 Defense: An Evidence-based Approach for Optimization of Infection Control and Operating Room Management[J]. Anesth Analg, 2020,131(1):37-42.DOI:10.1213/ANE.0000000000004829.
[17] 国家卫生健康委员会人才交流服务中心儿科呼吸内镜诊疗技术专家组,中国医师协会儿科医师分会内镜专业委员会,中国医师协会内镜医师分会儿科呼吸内镜专业委员会,等.中国儿科可弯曲支气管镜术指南(2018年版)[J].中华实用儿科临床杂志,2018, 33(13):983-989. DOI:10.3760/cma.j.issn.2095-428X.2018.13.006.
[18] 董君. 层次分析法权重计算方法分析及其应用研究[J].科技资讯,2015,13(29):218-220. DOI:10.16661/j.cnki.1672-3791.2015.29.218.
[19] 马莹,叶君荣,黄昭君,等.基于循证构建精神科护理质量敏感性指标[J].护理学报,2020,27(9):27-32. DOI:10.16460/j.issn1008-9969.2020.09.027.
[20] 国家卫生计生委医院管理研究所护理中心护理质量指标研发小组.护理敏感质量指标实用手册(2016版)[M].北京:人民卫生出版社,2016:1-5.
[21] Vaismoradi M, Tella S, Logan PA, et al.Nurses’ Adherence to Patient Safety Principles: A Systematic Review[J]. Int J Environ Res Public Health,2020,17(6):2028.DOI: 10.3390/ijerph17062028.
[22] Leiten EO, Martinsen Einar MH, Bakke PS, et al.Complications and Discomfort of Bronchoscopy: A Systematic Review[J]. Eur Clin Respir J,2016,3(1):33324. DOI:10.3402/ecrj.v3.33324.
[23] Eber E,Antón-Pacheco Juan L,de BJ, et al. ERS Statement: Interventional Bronchoscopy in Children[J]. Eur Respir J,2017,50(6):1700901. DOI:10.1183/13993003.00901-2017.
[24] 刘敏杰,张兰凤,叶赟,等.结构-过程-结果模式在护理质量评价中的应用进展[J]. 中华护理杂志,2013,48(4):371-374. DOI:10.3761/j.issn.0254-1769.2013.04.030.
[25] Mouritsen JM, Ehlers L, Kovaleva J, et al.A Systematic Review and Cost Effectiveness Analysis of Reusable Vs. Single-use Flexible Bronchoscopes[J]. Anaesthesia,2020,75(4):529-540. DOI:10.1111/anae.14891.
[26] 徐秋香,马森,刘箐.麻醉恢复室护理质量敏感性指标的构建[J].护理学报,2021,28(3):6-9.DOI:10.16460/j.issn1008-9969.2021.03.006.
[27] 汤磊雯,叶志弘,潘红英.护理质量敏感指标体系的构建与实施[J].中华护理杂志,2013,48(9):801-803. DOI:10.3761/j.issn.0254-1769.2013.09.012.
[28] Diamond IR,Grant RC,Feldman BM,et al.Defining Consensus: A Systematic Review Recommends Methodologic Criteria for Reporting of Delphi Studies[J]. J Clin Epidemiol,2014,67(4):401-409. DOI:10.1016/j.jclinepi.2013.12.002.
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