基于德尔菲法构建ICU患者中心静脉导管血流相关性感染风险评估工具

A risk assessment tool for central venous catheter infection in intensive care unit patients was established based on the Delphi method

目的构建适用于我国重症监护治疗病房(ICU)患者中心静脉导管血流相关性感染风险评估工具。方法采用德尔菲法,以《中心静脉导管相关性血流感染风险评分系统》为参考,以瑞士奶酪模型和护理风险管理理论为基本框架,在回顾相关文献的基础上,形成了专家咨询问卷;选取25名专家进行两轮专家咨询,对量表的条目进行筛选,形成最终的ICU患者中心静脉置管感染风险评估工具。结果专家的积极性较高,两轮问卷的有效回收率分别为83.3%和100%;两轮问卷的专家权威系数分别为0.89和0.88。两轮咨询后,总体条目的肯德尔协调系数W为0.331(P<0.001);形成了包括一级指标4个条目,二级指标共19个条目的ICU患者中心静脉置管感染风险评估量表。结论基于德尔菲法构建的ICU患者中心静脉导管血流相关性感染风险评估工具有较高的可靠性和权威性,可以为临床护士评估ICU患者中心静脉置管感染风险提供参考依据,为下一步检测该量表的信度、效度和评估量表的预测能力做铺垫。

Objective To establish central venous catheter infection risk assessment tool for measuring of Chinese intensive care unit(ICU)patients with central venous catheter infection risk.Methods Using the Delphi method,Risk Scoring System for Central Venous Catheterization Associated Bloodstream Infections for reference,with nursing safety and risk management theory as the framework,the expert consultation questionnaire was formed on the basis of review relevant literature.Twenty-five experts were selected for two rounds of expert consultation,and the items of the scale were screened to form the final risk assessment tool for the patients in ICU.Results The expert′s positivity was high and the response rates of the two-round consultation were 83.3%and 100%,the coefficient of the expert′s authorities Cr were 0.89 and 0.88,after the two-round consultation,Kendall′s W was 0.331(P<0.001).Finally,ICU patients central venous catheter infection risk assessment tool included 4 first-level indicators,19 second-level indicators.Conclusion The reliability and authority of ICU patients central venous catheter infection risk assessment tool established based on the Delphi method is relatively high.It can provide a reference for clinical nurses to evaluate ICU patients central venous catheter infection risk and lays a foundation for testing the reliability and validity and evaluating the predictive ability of the scale.