气管切开患者围手术期护理质量评价指标体系的构建

Development of an evaluation system measuring pre-and post-tracheotomy care quality

目的建立气管切开围手术期护理质量评价指标体系,以提高其护理质量。方法基于文献回顾,初步拟定气管切开围手术期护理质量评价指标体系一套,形成专家咨询问卷,应用德尔菲法对15名重症监护、耳鼻咽喉头颈外科护理等相关专家进行两轮咨询。结果遴选专家积极系数为100%,平均权威系数为0.877,专家对所有指标意见的协调系数Kendall′s W分别为0.483、0.833(均P<0.01)。经过两轮咨询,构建了气管切开护理质量的评价指标体系,包括要素质量、环节质量及终末质量3项一级指标、10项二级指标、38项三级指标并设置了不同的权重。结论两轮专家咨询的结果具有一定可靠性,所构建的评价指标能够科学有效地对气管切开围手术期的护理质量予以评价,对提高其护理质量、患者及家属的满意度具有较好作用。

Objective To develop an evaluation system measuring pre- and post-tracheotomy care quality. Methods Based on literature review, indicators measuring pre and post-tracheotomy care quality were developed, then 15 experts in intensive care and otorhino laryngology head and neck surgery care were invited to provide their opinions using the Delphi technique. Results The response rate of questionnaire was 100%, the mean authority coefficient of expert was 0. 877, and the coefficient of concordance （W） was 0. 483 for round 1 and 0. 833 for round 2 （P〈0.01 for both）. After two rounds of consultation, the tracheotomy care quality evaluation system was composed of such 3 primary indicators as structure, process and outcome, 10 secondary indicators and 38 tertiary indicators. The weights of indicators were also determined. Conclusion The consensus of two-round consultation is reliable, and the evaluation system can scientifically and effectively measure traeheotomy care quality, thus to improve nursing quality and satisfaction of patients and their families.