骨肿瘤科专科护理质量标准的构建

Construction of nursing quality standard in bone oncology department

目的构建骨肿瘤科专科护理质量标准,为科学评价骨肿瘤科专科护理质量提供依据。方法2022年11月至2023年6月,以Donabedian的结构-过程-结果三维质量结构模式为理论依据,通过文献回顾、半结构式访谈法,初步拟订骨肿瘤科专科护理质量评价指标,采用德尔菲法选择来自全国27个省或直辖市的31所三级甲等医院和护理院校的31名专家进行2轮函询,对标准进行筛选和修改,确定骨肿瘤专科护理质量评价标准。结果2轮专家咨询的问卷回收率均为100.00%,2轮函询专家权威系数均为0.93,一、二、三级标准的变异系数均≤0.25。2轮函询,一级标准的Kendall协调系数均为0.088,二级标准的Kendall协调系数分别为0.103和0.140;三级标准的Kendall协调系数分别为0.119和0.110。通过2轮专家函询,确立骨肿瘤专科护理质量评价标准分为3级,包括3项一级标准(结构质量标准、过程质量标准及结果质量标准)、21项二级标准和80项三级标准。结论骨肿瘤科专科护理质量标准构建过程科学、可靠,体现专科特色,可为骨肿瘤科护理质量的评价提供科学依据,规范护理行为。

Objective To establish the standard of nursing quality in bone oncology department,and provide the basis for scientific evaluation of nursing quality in bone oncology department.Methods On the theoretical basis of Donabedian′s three-dimensional quality model of"structure-process-outcome",and through literature review and semi-structured interview method,the"evaluation index of nursing quality in bone oncology department"was preliminatively formulated from November 2022 to June 2023.The Delphi method was used to select 31 experts from 31 third-level A hospitals and nursing colleges in 27 provinces or municipalities across the country for two rounds of correspondence consultation.The criteria were screened and modified to determine the evaluation criteria of nursing quality in bone tumor specialty.Results The questionnaire recovery rate of 2 rounds of expert consultation was 100.00%,the authority coefficient of 2 rounds of expert consultation was 0.93,and the coefficient of variation of 1,2 and 3-grade standards were all less than or equal to 0.25.The Kendall′s coefficient of concordance of the primary standards of the two rounds of expert consultation were both 0.088,in the secondary standards were 0.103 and 0.140,in the tertiary standards were 0.119 and 0.110.Through 2 rounds of expert letter consultation,the evaluation criteria for the quality of care in bone tumor specialties were divided into three levels,including 3 primary standards(structural quality criteria,process quality criteria and outcome quality criteria),21 secondary standards and 80 tertiary standards.Conclusions The construction process of nursing quality standard in bone oncology department is scientific and reliable,reflecting specialty characteristics,and can provide scientific basis for the evaluation of nursing quality in bone oncology department and standardize nursing behavior.