基于德尔菲法构建脑卒中机械取栓治疗患者延续护理质量评价指标体系

A Delphi based index system to assess the quality of continued nursing for stroke patients after mechanical cerebral thrombectomy

目的构建科学的脑卒中机械取栓治疗患者延续护理质量评价指标体系,为护理质量管理者及其护理人员客观评价脑卒中机械取栓治疗患者延续护理质量提供参考依据。方法2020年11月-2021年4月通过文献回顾和德尔菲法进行2轮专家函询,确定脑卒中机械取栓治疗患者延续护理质量评价指标体系的内容及各指标权重。结果2轮专家函询问卷有效回收率分别为94.12%、100.0%,2轮专家权威系数分别为0.878、0.888,2轮Kendall’s W系数均>0.70(P<0.05)。该评价指标体系内容包括延续护理的延续性信息平台建设、延续性护理知识获取、人员配备、管理方案的延续、医患关系的延续以及术后的康复指导、健康教育、随访、依从性、满意度、临床结局等,共包括4个一级指标、13个二级指标、37个三级指标。结论构建的脑卒中机械取栓治疗患者延续护理质量评价指标体系具科学性和实用性,可为脑卒中机械取栓治疗患者延续护理质量评价与持续改进提供依据。

Objective To establish a scientific and systematic indexed assessment system for evaluation of the quality of continued nursing in patients with cerebral apoplexy after mechanical cerebral thrombectomy so as to provide a reference for nursing quality managers and the nursing staff to objectively evaluate the quality of continued nursing for stroke patients after mechanical cerebral thrombectomy.Methods From November 2020 to April 2021,literature reviews were conducted and Delphi method was employed in two rounds of mail expert consultation to determine the contents and weights of the indexed assessment system of the quality of continued nursing for stroke patients after mechanical cerebral thrombectomy.Results Recovery rates of the two rounds of expert consultation were 94.12%and 100%,respectively.Expert authority coefficients of the two rounds of consultation were 0.878 and 0.888,respectively.Kendall's W coefficients of the two rounds of consultation were both>0.70(P<0.05).An indexed assessment system was developed including establishment of an information platform on continued nursing,access to knowledge of continued nursing,allocation of staff,continuity of management plans,continuity of doctor-patient relationship,instruction for postoperative rehabilitation,health education,follow-up,compliance,level of satisfaction and clinical outcomes.The system was composed with four primary indicators,13 secondary indicators and 37 tertiary indicators.Conclusions The indexed assessment system for quality of continued nursing for stroke patients treated by mechanical cerebral thrombectomy is scientific and reliable.It provides a basis for the evaluation of quality of continued nursing and continuous in improvement for stroke patients who are treated by mechanical cerebral thrombectomy.