血液科护理敏感质量指标的构建

Development of Sensitive Quality Indicators for Nursing in Hematology Department

目的构建具有科学性、专科性、临床实用性的血液专科护理敏感质量指标。方法以Donabedian"结构-过程-结果"三维质量模式为理论依据,采用循证分析法、半结构式访谈法及Delphi专家函询法确立血液专科护理敏感质量指标。结果2轮函询问卷的有效回收率均为100%,权威系数Cr值分别为0.832、0.886,协调系数W值为0.307~0.447,P<0.001。最终构建出护患比、疼痛干预率、化疗患者口腔黏膜炎发生率、化疗患者肛周感染发生率、经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)相关性血流感染发生率、PICC导管血栓栓塞发生率及输血反应发生率等共7项血液专科护理敏感质量指标。结论建立血液专科护理敏感质量指标,对血液科护理质量管理具有较好的指导作用,且对持续动态地促进血液科护理质量改进具有较好的临床价值。

Objective To construct scientific,specific and applicable nursing-sensitive quality indicators in Hematology Department.Methods Based on Donabedian's"structure-process-outcome"theory,the sensitive quality indicators of hematological nursing were established by using evidence-based analysis,semi-structured interview and Delphi expert inquiry method.Results After two rounds of expert advisory,the effective response rates were all 100%;Cr coefficients were 0.832 and 0.886,respectively;W coefficients ranged from 0.307 to 0.447,the results were statistically significant(P<0.001).Finally,seven sensitive quality indicators of hematological nursing were constructed,including nurse-patient ratio,pain intervention rate,incidence of oral mucositis,incidence of perianal infection,incidence of PICC catheter-related infection,incidence of PICC catheter thromboembolism and incidence of transfusion reaction.Conclusions Establishing sensitive quality indicators of hematological nursing has a good guiding role in the nursing quality of Hematology department,and it also has a good clinical value for improving the nursing quality of Hematology Department continuedly and dynamically.