基于三维质量结构模型构建围手术期低体温预防护理质量指标体系

Construction of nursing quality evaluation index system for prevention of perioperative hypothermia based on Structure-process-outcome model

目的基于三维质量结构模型构建围手术期低体温预防护理质量指标评价体系,旨在为预防术中患者低体温提供科学、适用和可行性的质量管理依据。方法在课题组前期循证研究基础上,基于三维质量结构模型编制围手术期患者低体温预防护理质量指标条目池,经过循证小组按照FAME方法进行逐条证据评价,形成专家函询表,并在2轮专家函询与小组讨论后进行指标调整、修改和确认,最终形成围手术期低体温预防护理质量指标评价体系。结果围手术期低体温预防护理质量指标评价体系包含结构指标14项,过程指标18项,结果指标4项,共计36项。在本研究2轮专家函询中,2轮问卷回收有效率为100%,判断系数均值为0.955、熟悉程度均值为0.758、权威系数均值为0.857;肯德尔和谐系数分别为0.208和0.157,P均<0.001。结论基于三维质量结构模型构建围手术期低体温预防护理质量指标评价体系,源于证据,终于临床,具有可行性、适宜性、实用性和重要性的特点,可在临床推广使用。

Objective To construct a nursing quality evaluation index system for the prevention of perioperative hypothermia based on structure-process-outcome model,and to provide reference for preventing hypothermia during operation.Method With Donabedian structure-process-outcome model and previous evidence-based research,the item pool of nursing quality evaluation index system for the prevention of perioperative hypothermia was formed.After the evidence-based team evaluated the evidence item by item according to FAME method,the expert consultation table was formed,and the indicators were adjusted,modified and confirmed after two rounds of expert consultation and group discussion.The final nursing quality evaluation index system for prevention of perioperative hypothermia was developed.Results The nursing quality evaluation index system for prevention of perioperative hypothermia contained 36 items of 14 structural indicators,18 process indicators,and 4 outcome indicators.The recovery rate of two rounds of questionnaire was 100%;average judgment coefficient 0.955,average familiarity 0.758,and average authority coefficient 0.857.Kendall’s harmony coefficient was 0.208 and 0.157,respectively(all P<0.001).Conclusion The nursing quality evaluation index system for the prevention of perioperative hypothermia based on Donabedian structure-process-outcome model is scientific and practical,which is worth to be popularized in clinical practice.