基于医护人员视角急诊抢救室护理质量评价的质性研究

Qualitative study on the evaluation of nursing quality in emergency resuscitation room based on the perspective of medical staff

目的了解急诊医护人员对抢救室护理质量评价的认知及建议,为构建抢救室护理质量评价指标提供参考。方法采用质性研究中的现象学研究方法,于2020年8—10月采用目的抽样法对上海市4所医院15名医生、护理人员进行半结构式个人深度访谈,采用Colaizzi 7步分析法对访谈结果进行整理、提炼主题。结果提炼出与抢救室结构类护理质量评价指标相关的3个主题,即护理管理制度、护理人力资源、环境与设施;提炼出与抢救室过程类护理质量评价相关的3个主题,即消毒隔离/院内感染、专科护理质量、护理文件书写规范;提炼出与抢救室结果类护理质量评价指标相关的3个主题,即患者健康结局、满意度、不良事件发生率。结论目前急诊抢救室护理质量评价有待进一步规范,基于医护人员视角提取的抢救室护理质量评价相关主题,能够为构建合理、科学、全面的抢救室护理质量评价指标体系提供参考依据。

Objective To understand the perceptions and suggestions of emergency medical staff on the evaluation of nursing quality in the resuscitation room,and to provide reference for the construction of nursing quality evaluation standards in the resuscitation room.Methods Phenomenological research methods in qualitative research were used to conduct semi-structured personal in-depth interviews with 15 physicians and nursing staff from August to October 2020 using a purposive sampling method,and the results of the interviews were organized and themes were refined using the Colaizzi 7-step analysis.Results Three themes related to the evaluation criteria of nursing quality in the structure category of the resuscitation room were extracted,namely,nursing management system,nursing human resources,and environment and facilities;three themes related to the evaluation criteria of nursing quality in the process category of the resuscitation room were extracted,namely,sterile isolation/nosocomial infection,quality of specialty care,and standard of nursing documentation;and three themes related to the evaluation criteria of nursing quality in the outcome category of the resuscitation room were extracted,namely,patient health outcome,satisfaction,and incidence of adverse events.Conclusions At present,the evaluation of the quality of emergency room care needs to be further standardized,and the themes related to the evaluation of the quality of emergency room care extracted based on the perspective of medical and nursing staff can provide a reference basis for the construction of a reasonable,scientific and comprehensive evaluation standard of nursing quality of emergency room.