手外科血管危象预防护理质量评价指标的构建及应用

Construction and application of a nursing quality evaluation index system for preventing vascular crisis in hand surgery department

目的构建手外科血管危象预防护理质量评价指标,并评价应用效果。方法以三维质量结构模式为理论框架,通过文献分析、半结构访谈及专家函询构建手外科血管危象预防护理质量评价指标。将200例单指断指再植或皮瓣移植患者按照入院时间分为对照组和观察组各100例,对照组给予常规护理,观察组根据构建的手外科血管危象预防护理质量评价指标进行护理。结果构建的手外科血管危象预防护理质量评价指标体系包含结构质量、过程质量、结果质量3项一级指标,10项二级指标及47项三级指标。质量评价指标应用后,观察组血管危象及时发现率、断指再植或移植皮瓣成活率及患者满意度评分显著高于对照组,患者血管危象发生率显著低于对照组(均P<0.05)。结论构建并应用手外科血管危象预防护理质量指标有利于及时发现血管危象,降低血管危象发生率,提高再植手指或移植皮瓣成活率及患者满意度。

Objective To develop a nursing quality evaluation index system for preventing vascular crisis in hand surgery department,and to evaluate its application effect.Methods The three-dimensional quality structure model was taken as the theoretical framework,a nursing quality evaluation index system for preventing vascular crisis in hand surgery department was constructed through literature analysis,semi-structured interviews and Delphi expert consultation.Then a total of 200 patients who underwent single finger amputation replantation or flap transplantation were divided into a control group and an experimental group chronologically,with 100 cases in each group,the control group received routine nursing,while the experimental group received nursing based on the constructed nursing quality evaluation index system.Results The constructed nursing quality evaluation index system consisted of 3 primary indicators(structure quality,process quality,outcome quality),10 secondary indicators,and 47 tertiary indicators.After application of the index system,the rates of timely detection of vascular crisis,survival rates of reimplanted fingers or flaps,and patient satisfaction scores in the experimental group were significantly higher than those of the control group,while its incidence of vascular crisis was significantly lower than that of the control group(all P<0.05).Conclusion Construction and application of a nursing quality evaluation index system for preventing vascular crisis in hand surgery department,is conducive to detecting vascular crisis timely,reducing the incidence of vascular crisis,improving the survival rates of reimplanted fingers or flaps,and enhancing patient satisfaction.