肿瘤专科护理敏感质量指标的构建

Developmentof Nursing-sensitive Quality Indicators in the Oncology Department

目的构建具有科学性、专科性、临床适用性的肿瘤专科护理敏感质量指标,提高专科护理质量。方法以"结构-过程-结果"质量管理模式为理论依据,采用循证分析法、Delphi专家函询法,确立肿瘤专科护理敏感质量指标。结果 2轮函询问卷的有效回收率分别为100%、93.7%,权威系数Cr值分别为0.820、0.865,协调系数W值波动于0.109～0.162之间,结果具有统计学意义(P<0.001)。构建出化疗患者口腔黏膜炎发生率、疼痛干预率、化疗药物经中心静脉导管输注率、PICC导管相关性感染发生率、化疗外渗发生率、化疗相关性恶心呕吐发生率等6项肿瘤专科护理敏感质量指标。结论建立肿瘤专科护理敏感质量指标,可以对肿瘤专科护理质量管理发挥较好的指导作用,且对持续动态地促进肿瘤科护理质量的改进具有较好的临床意义。

Objective To construct a scientific,specific and applicable nursing-sensitive quality indicators in the oncology department,in order to improve the specific nursing quality.Methods Based on the“structure-process-outcome”theory,we adopted evidence-based analysis and Delphi method to determine the nursing-sensitive quality indicators in oncology department.Results After two rounds expert advisory,the effective response rates were 100%,93.7%;Cr coefficients were 0.820 and 0.865;W coefficients ranged from 0.109 to 0.162(P<0.001).The 6 nursing-sensitive quality indicators were the incidence of oral mucositis in patients with chemotherapy,the intervention rate in patients with pain,the infusion rate of chemotherapeutic drugs through the central venous catheter,the incidence of catheter-related infections in patients with PICC,the extravasation incidence with chemotherapy,and the chemotherapy-induced nausea and vomiting.Conclusions The nursing-sensitive quality indicators in oncology department is a good guidance for the management of nursing quality,and it also has a better clinical value for improving the quality of nursing care continuedly and dynamically.