应用德尔菲法构建社区护理质量评价指标体系

Application of Delphi in Constructing Community Nursing Quality Evaluating System

目的构建社区护理质量评价指标体系,为客观评价并切实提高社区护理质量提供依据和对策。方法采用目的抽样的方法选取上海市18个区县的社区卫生中心和质量控制中心从事护理管理工作10年以上、具有主管护师以上职称的社区护理管理专家16名作为函询对象,应用德尔菲法对社区护理质量评价指标进行2轮函询。结果专家的权威程度(Cr)系数为0.86,专家意见协调系数为0.18～0.35(P<0.01);建立的社区护理质量评价指标包括社区护理中心护理质量、社区护理站点护理质量、家庭医生签约及上门服务护理质量、服务团队的满意率、社区护理质量创新等5个一级指标(其权重分别为0.51,0.15,0.19,0.09,0.06)和24个二级指标、33个三级指标。结论专家的积极性、权威程度及专家意见的集中程度均较高;社区护理质量评价指标应体现社区护理"六位一体"的功能及区域性特征和持续优质服务的理念。

Objective To construct a community nursing quality evaluating system, and provide the evidence and strategy of high nursing quality of community health system. Methods Using Delphi method, 16 specialists with the professional titles of supervisor nurse or higher and over ten years of nursing experience on community nursing quality management were consulted in two rounds from 18 district community health centers and quality control centers in Shanghai. Results Specialists were quite active while specialists~ Cr was 0. 86 and coefficient of coordi- nation was 0.18--0. 35（P〈0. 01）. The community nursing quality evaluating indictors consisted 5 first-level in- dictors： nursing quality of community nursing center, nursing quality of community nursing station, contract of family doctor and nursing quality of door- to- door service, satisfaction of nursing team, and innovation of communi- ty nursing quality （the portion were 0. 51,0.15,0. 19,0.09,0.06） ,24 second-level indicators,and 33 third-level in- dicators. Conclusion The specialists~ activity, authority, and concentration of their opinions are quite high. Community nursing quality evaluation indicators should reflect the community nursing function （6 in 1）, the re- gional characteristics and the concept of continued high quality service.