骨科康复护理质量评价指标的构建

Establishment of a nursing quality evaluation indicator system for orthopedic rehabilitation

目的构建骨科康复护理评价指标,旨在为临床评价骨科康复护理质量提供参考。方法2020年6月—8月,课题组以"结构-过程-结果"三维质量模型为框架,通过文献回顾、半结构式访谈制订骨科康复护理质量评价指标初稿,采用德尔菲专家函询法对全国10个省市的23名专家进行问卷函询,并通过层次分析法,确定骨科康复护理质量评价指标及其权重。结果共开展2轮函询,问卷回收率分别为92.60%、92.00%,专家权威系数为0.909和0.917,肯德尔和谐系数分别为0.272和0.318。各级指标的重要性赋值均数为3.65~5.00,变异系数为0~0.22,最终构建的骨科康复护理质量评价指标包括3个一级指标(结构指标、过程指标、结果指标)、9个二级指标(人力资源配置、管理制度、设施设备、护理评估、护理实践、健康教育、随访管理、护士结局、患者结局)和56个三级指标。结论构建的骨科康复护理质量评价指标内容科学、合理、全面且具有针对性,对评价骨科康复护理质量具有指导意义。

Objective To establish an evaluation indicator system of nursing quality for orthopedic rehabilitation,and to provide references for related clinical evaluation.Methods From June to August 2020,the research group established the first draft of orthopedic rehabilitation nursing quality evaluation index system based on the frame-work of the three-dimensional"structure-process-outcome"quality model,literature review and semi-structured interviews,and then 23 experts from 10 provinces in China were consulted through Delphi technique.The final nursing quality evaluation system and index weight for orthopedic rehabilitation were analyzed by analytic hierarchy process.Results The recovery rates of 2 rounds of expert consultations were 92.60%and 92.00%.The authority coefficients were 0.909 and 0.917.The Kendall harmony coefficients were 0.272 and 0.318,respectively.The average importance value of indexes ranged from 3.65 to 5.00,and variation coefficients of each item ranged from 0 to0.22.The final nursing quality evaluation indicator system for orthopedic rehabilitation consisted of 3 first-level indicators(structure indicators,process indicators,outcome indicators),9 second-level indicators(human resources,management system,facilities and equipment,nursing evaluation,nursing practice,health education,follow-up management,nurse outcomes,patient outcomes),and 56 third-level indicators.Conclusion The nursing quality evaluation indicator system for orthopedic rehabilitation was scientific and reliable,which can provide scientific references for evaluating nursing quality for orthopedic rehabilitation.