急诊护理质量敏感指标的构建研究

doi:10.16460/j.issn1008-9969.2021.13.013

摘要/Abstract

摘要： 目的通过科学的研究方法,构建急诊护理质量敏感指标,为急诊临床实践提供科学、可测量的质量监测工具。方法以文献循证为基础,通过专家访谈和Delphi法对46名专家进行2轮问卷咨询,确定符合临床实践的指标体系。结果专家咨询的权威系数为0.93,判断系数0.96,熟悉程度0.89。2轮专家咨询后抢救室、监护室和观察室敏感指标的协调系数分别为0.364、0.443和0.516,P<0.05,具有统计学意义,认为专家咨询的协调程度好。指标体系包括3个一级指标、5个二级指标和15个三级指标。结论急诊护理质量敏感指标体系各级指标的条目专家意见集中,研究结果可信度高,为急诊护理质量的考核、岗位设置、流程优化提供了客观的依据。

关键词: 急诊科, 护理质量, 敏感指标

Abstract: Objective To construct sensitive index system of emergency nursing quality, and provide a scientific quality monitoring tool for emergency clinical practice. Methods After review of evidence-based literature, the index system in line with clinical practice was identified and determined by expert interview and two rounds of Delphi expert consultation within 46 experts. Results Authority coefficient, judgment coefficient and familiarity degree of expert consultation was 0.93, 0.96 and 0.89 respectively; the coordination coefficient of the sensitivity index in emergency room, emergency intensive care unit and observation room was 0.364, 0.443 and 0.516 respectively; the P-value of the chi-square test was all less than 0.05. The results were statistically significant, which indicated good expert coordination. The index system consisted of 3 first-level, 5 second-level and 15 third-level indexes. Conclusion With concentrated expert opinions and being highly reliable, the constructed sensitive index system of emergency nursing quality provides evidence for quality assessment, post setting and process optimization in emergency nursing.

Key words: emergency, nursing quality, sensitive index

中图分类号:

R472.2

张丽秀, 樊落, 李琳, 王雪, 魏婧昀, 冯兰棱. 急诊护理质量敏感指标的构建研究[J]. 护理学报, 2021, 28(13): 13-18.

ZHANG Li-xiu, FAN Luo, LI Lin, WANG Xue, WEI Jing-yun, FENG Lan-ling. Construction of Sensitive Index System of Emergency Nursing Quality[J]. Journal of Nursing, 2021, 28(13): 13-18.

参考文献

[1] 简伟研,周宇奇,吴志军等.护理敏感质量指标的发展和应用[J].中国护理管理,2016,16(7):865. DOI:10.3969/j.issn.1672-1756.2016.07.001.
[2] Isis M.The National Database of Nursing Quality Indicators NDNQI[J]. Online J Issues Nurs,2007,3(12):3-7. DOI:10.3912/OJIN.Vol12No03Man02.
[3] 国家卫生计生委医院管理研究所护理中心.护理敏感质量指标实用手册[M].北京:人民卫生出版社,2016.
[4] 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.
[5] 张文彤,董伟. SPSS 统计分析高级教程[M]. 北京:高等教育出版社,2013.
[6] 张华芳,黄丽华.护理质量敏感性指标的研究进展[J].中华护理杂志, 2014,49(8):991-993. DOI:10.3761/j.issn.0254-1769.2014.08.024.
[7] Thomas-Hawkins C, Latham CE, Hain DJ.Emphasizing the Value of Nephrology Nursing Through Nursing-sensitive Indicators: A Call for Action[J]. Nephrol Nurs J, 2017,44(4):317-325.
[8] 王斌,王琳,李萍等.基于三维质量结构模式PICU护理敏感性质量指标体系的构建[J].护理学报,2019,26(1):17-21.DOI:0.16460/j.issn1008-9969.2019.01. 017.
[9] 戚雯雯,景峰,午敬华,等.优质护理服务在急诊科的实施与效果[J].解放军护理杂志,2018,35(18):69-71. DOI:10.3969/j.issn.1008-9993.2018.18.017.
[10] National Database of Nursing Quality Indicators.Turn Quality Data for Your Hospital into Solutions You Can Use[EB/OL]. [2020-08-16]. http://www.nursingquality.org/#intro.
[11] 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.issn.1008-9969.2020.09.027.
[12] 李东洋,吴世芬,莫新少,等.专升本与全日制本科护士核心能力的比较分析[J].中国实用护理杂志, 2014, 30(32):24-27. DOI:10.3760/cma.j.issn.1672-7088.2014.32.007.
[13] 国家卫生健康委员会. 2020中国卫生健康统计年鉴[EB/OL].[2021-04-12].https://www.yearbookchina.com/navibooklist-n3020013080-1.html?from=singlemessage,2021-04-09.
[14] 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.
[15] 郭红艳,谢红.美国护理质量评价体系对我国护理质量管理的启示[J].中国护理管理, 2014,14(5):459-462. DOI:10.3969/j.issn.1672-1756.2014.05.004.
[16] American Nurses Association.Nursing Quality Indicators: Definitions and Implications. Washington, DC: American Nurses Publishing[EB/OL]. [2020-08-25]. http://nursingworld.org/books/pdescr.cfm?cnum=11#NP-108.
[17] Taggu A, Murthy S, Krishna B, et al.Mishaps During Intrahospital Transport of Patients from Emergency Department-a mixed Bag of Patients[J]. Intensive care Medicine Experimental, 2015, 3(1):A69.DOI:10.1186/2197-425X-3-S1-A69.
[18] 马莉,王志稳,葛宝兰,等.急诊科危重病人院内转运过程中不良事件及风险因素分析[J].护理研究,2019,11(21):3676-3680. DOI:10.12102/j.issn.1009-6493. 2019.21.008.
[19] 赵泽华,孙琳,刘云,等.急诊创伤患者低体温管理方案的构建[J].中华护理杂志,2018,53(4):448-453. DOI:10.3761/j.issn.0254-1769.2018.04.014.
[20] American Nurses Association.NDNQI Transforming Data into Quality Care[EB/OL].[2020-08-16].https://www.nursingworld.org.
[21] Burstin H, Leatherman S, Goldmann D.The Evolution of Healthcare Quality Measurement in the United States[J]. J Intern Med,2016,279(2):154-159.DOI:10.1111/joim.12471.
[22] Lim MK.Quest for Quality Care and Patient Safety:the Case of Singapore[J].Qual Saf Health Care,2004,13:71-75. DOI:10.1136/qshc.2002.004994.

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