急症病房急性心肌梗死患者护理质量评估体系构建

Construct a nursing quality evaluation system for patients with acute myocardial infarction in the emergency department

目的构建急症病房急性心肌梗死患者护理质量评估体系,为其临床护理提供有效参考依据。方法研究小组查阅国内外护理质量评价相关文献资料,针对急性心肌梗死护理要点,运用逐级分解目标要素法初步构建急症病房急性心肌梗死患者护理质量评估指标体系。采用德尔菲专家规定程序调查法(DM),对23名心血管内科医师专家及护理专家进行心肌梗死相关护理管理指标咨询,通过电子邮件及电话访谈方式进行两论专家咨询,并对咨询结果进行整理,最终构建急性心肌梗死患者护理质量评估体系。结果两轮专家咨询权威系数(Cr)分别为0.90,0.89;第二轮咨询结束后,一、二、三级指标的指标重要性肯德尔和谐系数(W)值分别为0.381,0.335,0.297,指标可操作性W值分别为0.298,0.235,0.206,两组W值经显著性检验(P<0.05);最终形成包含3个一级指标、6个二级指标、18个三级指标的急症病房急性心肌梗死患者护理质量评估体系。结论采用德尔菲专家规定程序调查法(DM)构建急性心肌梗死患者护理质量评估体系具有一定科学性、合理性,可作为护理理论基础模式应用于临床。

Objective To construct a nursing quality evaluation system for patients with acute myocardial infarction in the emergency department,and provide an effective reference for their clinical care.Methods The research team consulted relevant literature data of nursing quality evaluation at home and abroad,and aimed at the key points of nursing care of acute myocardial infarction,using the step-by-step decomposition of the target element method to initially construct an evaluation index system of nursing quality of patients with acute myocardial infarction in the emergency department.Delphi expert procedure survey method(DM)was adopted to consult 23 cardiovascular physician experts and nursing experts for myocardial infarction-related nursing management index,two-rounds expert consultation was implemented through email and telephone interviews,and tidied the results of consultation.Finally we built a care quality evaluation system for patients with acute myocardial infarction.Results The two rounds of expert consultation authority coefficients(Cr)were 0.90 and 0.89 respectively.After the second round of consultations,the index importance Kendall harmony coefficients(W)of the first,second,and third-level indicators were 0.381,0.335,and 0.297 respectively,W values of indicator operability were 0.298,0.235,and 0.206,and the two groups of W values were tested for significance(P<0.05);eventually,the nursing quality evaluation system for ward patients with acute myocardial infarction came into being,which included 3 primary indicators,6 secondary indicators,and 18 tertiary indicators.Conclusion It was scientific and reasonable to construct a nursing quality assessment system for patients with acute myocardial infarction using the Delphi expert procedure survey method.