急诊心肌梗死患者抢救护理质量评价指标体系的构建及应用

Construction and application of evaluation index system for emergency myocardial infarction patients'rescue and nursing quality

目的基于德尔菲法构建急诊心肌梗死患者抢救护理质量评价指标体系,并探究其应用效果。方法通过文献检索、文献筛选、指标提取构建护理敏感指标初级条目池,遴选函询专家,经德尔菲法专家函询对护理质量评价指标进行评价,结合评价结果对指标进行筛选,并根据专家意见修订、完善指标,最终形成护理质量评价指标体系。选择医院急诊科2020年10月—2021年9月收治的心肌梗死患者共200例为研究对象,按照组间基本特征具有可比性的原则将患者分为观察组与对照组,每组100例,对照组采取常规护理管理,观察组在对照组基础上应用急诊心肌梗死患者抢救护理质量评价指标体系,比较两组分诊抢救时间及救治成功率。结果研究第1、2轮函询问卷回收率分别为88.89%、100.00%,第1、2轮函询专家权威度分别为0.867、0.886,第1、2轮函询肯德尔和谐系数W分别为0.338(χ2=83.493,P=0.000)、0.364(χ2=102.637,P=0.000),差异有统计学意义;研究经专家函询、筛选得到急诊AMI抢救护理敏感指标共54个,一级指标3个,二级指标15个,三级指标36个,指标变异系数为0.068~0.154。观察组分诊评估时间、抢救时间均小于对照组(P<0.05);观察组救治成功率为98.00%大于对照组的89.00%(P<0.05)。结论研究基于德尔菲法构建的急诊心肌梗死患者抢救护理质量评价指标体系具有可靠性,其在急诊心肌梗死患者抢救护理中的应用,能改善分诊抢救效果,有助于提高救治成功率。

Objective To construct an evaluation index system for emergency myocardial infarction patients'rescue and nursing quality based on the Delphi method,and explore its application effect.Methods Through literature search,literature screening,and index extraction,a primary entry pool of nursing sensitive indicators was constructed,and experts were selected for consultation.After consultation with experts through Delphi method,nursing quality evaluation indicators were evaluated.The indicators were selected based on the evaluation results,and the indicators were revised and improved based on expert opinions.Finally,a nursing quality evaluation indicator system was formed.A total of 200 patients with myocardial infarction admitted to the emergency department of the hospital from October 2020 to September 2021 were selected as the study subjects.According to the principle of comparability of basic characteristics between groups,the patients were divided into an observation group and a control group,with 100 patients in each group.The control group adopted routine nursing management.The observation group applied the emergency myocardial infarction patient rescue nursing quality evaluation index system on the basis of the control group,and compared the rescue time and rescue success rate of the two groups.Results The recovery rates of the questionnaire in the first and second rounds of the study were 88.89%and 100.00%,respectively.The authority of experts in the first and second rounds of the study was 0.867 and 0.886,respectively.The Kendall harmony coefficients W in the first and second rounds of the study were 0.338(χ2=83.493,P=0.000)and 0.364(χ2=102.637,P=0.000),respectively,with a statistically significant difference;through expert consultation and screening,a total of 54 sensitive indicators for emergency AMI rescue nursing were obtained,including 3 primary indicators,15 secondary indicators,and 36 tertiary indicators,with a coefficient of variation of 0.068 to 0.154. The evaluation time and rescue time of the observation group wereshorter than those of the control group(P<0.05);the success rate of treatment in the observation group was 98.00%higher than 89.00% in the control group(P<0.05). Conclusion The research on the evaluation index system ofemergency myocardial infarction patients' rescue and nursing quality based on the Delphi method was reliable,and its application in emergency myocardial infarction patients' rescue and nursing can improve the triage andrescue effect, and contribute to improving the rescue success rate.