Bentall手术围术期护理质量敏感性指标体系的构建

Construction of sensitivity index system of perioperative nursing quality in Bentall operation

目的:构建带主动脉瓣人工血管升主动脉替换术(Bentall手术)围术期护理质量敏感性指标体系,为Bentall手术的专科护理质量评价与监测提供依据,以促进Bentall手术围术期护理质量的持续改进。方法:以Donabedian“结构-过程-结果”三维质量评价为模型,经过2轮德尔菲专家函询,由小组成员最终确定Bentall手术围术期护理质量敏感性指标体系。结果:2轮函询问卷回收率均为100%,第1轮和第2轮函询专家的权威系数均>0.80;2轮函询的结构、过程和结果指标专家意见的肯德尔协调系数比较,差异均有统计学意义(P<0.05)。第2轮函询专家对指标的重要性及满分率均高于第1轮函询,第2轮函询指标的变异系数为0.015~0.115。经过2轮专家函询,最终确定Bentall手术围术期护理质量敏感性指标体系包括3个一级指标、10个二级指标、52个三级指标,所有指标的重要性均>4.0分、变异系数均<0.25。结论:构建的Bentall手术围术期护理质量敏感性指标体系涵盖了Bentall手术围术期护理的关键内容,可准确、系统、全面地反映临床真实的护理工作质量,为医疗机构专科护理质量评价提供可靠依据,有助于促进Bentall手术围术期护理质量的持续改进。

Objective:To construct a scientific perioperative nursing quality sensitivity index system for aortic valve prosthesis ascending aorta replacement(Bentall operation),provide a basis for the evaluation and monitoring of specialized nursing quality of Bentall operation,and promote the continuous improvement of perioperative nursing quality of Bentall operation.Methods:With Donabedian's"structure process result"three⁃dimensional quality evaluation model as the model,the group members finally determined the Bentall perioperative nursing quality sensitivity index system through two rounds of expert correspondence through the Delphi method.Results:The recovery rate of the two rounds of correspondence questionnaires was 100%,and the authority coefficient(Cr)of experts in the first and second rounds of correspondence questionnaires all greater than 0.8;The Kendall's coordination coefficient W of structural indicators,process indicators and outcome indicators of the two rounds of correspondence showed significant difference(P<0.05).The full score rate of the second round of correspondence experts on the importance of indicators was higher than that of the first round of correspondence,and the variation coefficient range of the second round of correspondence was 0.015⁃0.115.The index system of perioperative nursing quality sensitivity of Bentall operation was finally determined after two rounds of expert correspondence,including 3 first level indicators,10 second level indicators and 52 third level indicators,the importance assignment of all indicators were greater than 4.0,and variation coefficient was greater than 0.25.Conclusion:The constructed perioperative nursing quality sensitivity index system of Bentall covers the key content of Bentall perioperative nursing,which can accurately,systematically and comprehensively reflect the real clinical nursing quality,provide a reliable basis for the evaluation of specialized nursing quality in medical institutions,and it is helpful to promote the continuous improvement of perioperative nursing quality of Bentall operation.