基于三维质量模式缺血性脑卒中静脉溶栓护理质量评价指标体系的构建

Construction of an evaluation index system for nursing quality of ischemic stroke intravenous thrombolysis based on three-dimensional quality

目的建立一套较为科学的、实用的基于三维质量模式缺血性脑卒中静脉溶栓护理质量评价指标体系,以期科学地评价溶栓期护理质量。方法以三维质量结构模式为基础,阅读缺血性脑卒中静脉溶栓的相关文献,采用半结构式访谈,构建出缺血性脑卒中患者溶栓期护理质量评价指标体系框架,采用德尔菲法进行专家咨询,并对结果进行分析。结果2轮专家咨询积极系数均为100%,权威程度第1轮0.881、第2轮0.879。10项二级指标及51项三级指标,变异系数均小于0.15,第2轮协调系数分别为一级指标0.504、二级指标0.509、三级指标0.541,χ2检验均为P<0.001。结构质量、过程质量和结果质量指标权重值分别为0.189、0.601、0.210。构建了包含3项一级指标、10项二级指标及51项三级指标的缺血性脑卒中静脉溶栓护理质量评价指标体系。结论咨询专家的积极性、权威性、意见协调程度均较高。并为管理者提供标准的、实用性的缺血性脑卒中静脉溶栓护理质量评价工具。

Objective To establish a scientific and practical evaluation index system of nursing quality of intravenous thrombolysis for ischemic stroke based on three-dimensional quality model,so as to scientifically evaluate the nursing quality in thrombolytic period.Methods Based on the three-dimensional quality structure model,read the literature related to intravenous thrombolysis in ischemic stroke patients,and used semi-structured interview to construct the framework of nursing quality evaluation index system for patients with ischemic stroke during thrombolytic period.Delphi method was used for expert consultation,and the results were analyzed.Results The positive coefficient of the two rounds of expert consultation was 100%,and the degree of authority in the first round was 0.881,and that in the second round was 0.879.The coefficient of variation of 10 second level indexes and 51 third level indexes were all smaller than 0.15.The second round of coordination coefficients were 0.504 for the first-level index,0.509 for the second-level index,and 0.541 for the third-level index.The chi-square test was all P<0.001.The weight values of structural quality,process quality and result quality indicators were 0.189,0.601,0.210,respectively.The evaluation index system of nursing quality of intravenous thrombolysis for ischemic stroke was constructed,including 3 first level items(structure quality index,process quality index,result quality index),10 second level items and 51 third level items.Conclusions Consulting experts are highly motivated,authoritative,and coordinated.It also provides managers with standard and practical tools for evaluating the quality of intravenous thrombolytic care for ischemic stroke.