基于病种分值付费的高龄股骨颈骨折患者临床护理路径的构建研究

Construction of clinical nursing pathway for femoral neck fracture in the elderly based on Diagnosis Intervention Packet

目的 构建基于病种分值付费的高龄股骨颈骨折患者的临床护理路径,为该类患者的临床护理工作提供路径表单,为评价其护理质量提供依据。方法 基于文献分析法和头脑风暴法构建路径表单,初步构建基于病种分值付费的高龄股骨颈骨折患者的临床护理路径,于2022年1月—3月采用德尔菲法对17名专家进行2轮专家函询,确立该临床护理路径。结果 2轮专家函询的有效问卷回收率均为100%,专家权威系数为0.879、0.918,肯德尔和谐系数为0.476、0.299,最终形成的临床护理路径包含6项一级指标、18项二级指标、107项三级指标。结论 该研究构建的基于病种分值付费的高龄股骨颈骨折患者临床护理路径具有较高的科学性、可靠性及实用性,可作为该类患者临床措施实施和护理质量评价的依据。

Objective To construct the evaluation index of clinical nursing path for elderly patients with femoral neck fracture under Diagnosis-Intervention Packet(DIP) payment,to provide the path form for the clinical nursing work of such patients,and to provide the basis for evaluating their nursing quality.Methods Based on the literature evidence-based and brainstorming methods,the path form was constructed,and the clinical nursing path of elderly patients with femoral neck fracture was initially constructed based on DIP payment.From January to March2022,17 experts were interviewed by Delphi method for 2 rounds of expert correspondence,and the operation form of their clinical nursing path indicators was established.Results The effective questionnaire recovery rates of the2 rounds of expert correspondence were 100%;the expert authority coefficients were 0.879,0.918;the Kendall harmony coefficient was 0.476,0.299.The final path indicators included 6 first-class indicators,18 second-class indicators,and 107 third-class indicators.Conclusion The index of clinical nursing pathway for elderly patients with femoral neck fracture based on DIP payment has high scientificity,reliability and practicality,and it can be used as the basis for clinical implementation and evaluation of such patients.