清醒患者俯卧位通气护理质量评价指标的构建

Establishment of nursing quality evaluation index of awake prone position ventilation

目的构建清醒患者俯卧位通气护理质量评价指标,为评价清醒患者俯卧位通气护理质量提供一定的理论参考依据。方法以“结构-过程-结果”三维质量结构模型为指导,通过文献分析法、半结构化访谈法,经课题组分析,逐步形成清醒患者俯卧位通气护理质量评价指标条目,2022年11月—2023年1月采用目的抽样法,对25名分别来自山西、陕西、河南5所三甲医院具有呼吸、急危重症等相关经验的护理以及公共卫生领域的专家进行2轮德尔菲专家函询,经统计学处理,根据指标的重要性得分和变异系数,最终确立清醒患者俯卧位通气护理质量评价指标。结果2轮专家函询咨询问卷回收率均为100%,专家权威系数为0.960,2轮肯德尔和谐系数为0.136、0.160(P<0.01),最终形成的评价指标包含3项一级指标、9项二级指标、51项三级指标三项指标。结论本研究构建的清醒患者俯卧位通气护理质量评价指标具有较高可靠性、科学性和实用性,指标权重设置合理,可为护理管理者评价临床护士实施清醒患者俯卧位通气的护理质量提供理论参考依据,也可以为全面提升临床护士实施清醒患者俯卧位通气护理质量提供操作指引和决策依据。

Objective To construct a scientific and feasible nursing quality evaluation index for prone ventilation in awake patients,and to provide a comprehensive,standardized and quantifiable theoretical framework for evaluating the nursing quality of prone ventilation in awake patients.Methods Guided by Donabedian's"structure-process-result"three-dimensional quality structure model,the research group conducted literature analysis and semi-structured interview to gradually formulate the evaluation indexes for nursing quality during prone ventilation in awake patients.Objective sampling was adopted from November 2022 to January 2023.Two rounds of Delphi expert consultation were conducted on 25 nursing and public health experts with respiratory,acute and critical care experience from 5 tertiary hospitals in Shanxi,Shaanxi and Henan.After statistical processing,the evaluation indexes of nursing quality of prone ventilation for awake patients were finally established according to the importance scores and coefficient of variation of the indexes.Results The recovery rates for both rounds of expert correspondence consultation questionnaires were 100%.The expert authority coefficient was 0.960,and the Kendall harmony coefficient were 0.136 and 0.160(P<0.01).The final evaluation index of prone ventilation nursing quality for conscious patients was composed of 3 primary indexes,9 secondary indexes and 51 tertiary indexes.Conclusion The evaluation index of prone ventilation nursing quality for awake patients established in this study is highly reliable,scientific and practical.The weight of the index is set reasonably to provide a theoretical reference for nursing managers to evaluate the nursing quality of clinical nurses implementing prone ventilation for awake patients.It also provide operational guidance and decision-making basis for comprehensively improving the nursing quality of clinical nurses implementing prone ventilation for awake patients.