儿科护理质量指标构建与应用

Construction and Application of Nursing Quality Index for Pediatric Specialty

目的构建儿科护理质量指标,为我国儿科护理质量评价提供依据。方法基于文献回顾、小组讨论、专家咨询、国家护理专业质控中心儿科专科质控组审议等确定儿科护理质量指标。于2019年在全国8家儿童专科医院及综合医院儿科进行试应用。结果构建的儿科护理质量指标包括结构指标6项、过程指标2项、结果指标7项。8家医院每名住院患儿24 h平均护理时数、护士离职率、住院患儿身体约束率、新生儿院内尿布皮炎发生率、住院患儿外周静脉输液外渗/渗出发生率等总体呈下降趋势,6月龄内患儿母乳喂养维持率明显提升,但床护比和护患比有所下降。结论儿科护理质量指标具有实用性,体现了儿科特色,可用于住院患儿护理质量评价。

Objective To construct nursing quality index of pediatric specialty and provide evidence for evaluation of nursing quality in Pediatric Department in China.Methods Pediatric specialty nursing quality indicators were determined based on literature review,group discussion,expert consultation,and review by pediatric quality control group of National Nursing Quality Control Center.It was tested and applied in 8 children's specialized hospitals and the Pediatric Departments of general hospitals in 2019.Results The nursing quality indexes of pediatric specialty included 6 structural indexes,2 process indexes and 7 outcome indexes.The average 24-hour nursing hours per hospitalized child,the turnover rate of nurses,the physical restraint rate of hospitalized children,the incidence of pressure injury in hospitalized children,the incidence of neonatal in-hospital diaper dermatitis,and the incidence of peripheral intravenous infusion extravasation/exudation in hospitalized children showed a general downward trend in the 8 hospitals,and the breastfeeding maintenance rate of hospitalized children within 6 months of age increased significantly.However,the ratio of bed to nurse and the ratio of nurse to patient decreased.Conclusion Pediatric specialty nursing quality index is practical,reflects the characteristics of pediatrics,and can be used to evaluate the nursing quality of hospitalized children.