基于加速康复外科理念的围手术期护理质量评价标准体系构建

Development of a perioperative nursing quality evaluation standard system base on Enhanced Recovery After Surgery concept

目的:构建基于加速康复外科的围手术期护理质量评价标准体系,为科学评价围手术期护理质量提供客观工具,为加速康复外科护理实践持续改进提供科学参考。方法:以结构-过程-结果三维质量结构模型为理论框架,通过检索文献、小组讨论并采用德尔菲函询法进行2轮专家函询,通过计算专家积极系数、变异系数、专家权威系数和肯德尔和谐系数等条目来验证函询结果的可靠性。结果:共进行了2轮专家函询,2轮函询的问卷回收率均为100.0%,专家的权威系数分别为0.900、0.892。肯德尔和谐系数分别为0.119、0.173,经显著性检验具有统计学意义(P<0.001)。经过2轮函询,最终确定包括3个一级条目、17个二级条目、48个三级条目的ERAS理念下围手术期护理质量评价标准体系。结论:构建的加速康复外科理念下围手术期护理质量评价标准体系科学、可靠,适用范围广,可作为围手术期护理质量评价的客观工具。

Objective:To develop a scientific,reliable and operable perioperative nursing quality evaluation standard system under the Enhanced Recovery After Surgery concept.Methods:The theoretical framework of this study is the Structure-Process-Result three-dimension quality evaluation model.The system was developed based on literature review and group discussion.Two rounds of expert consultation were conducted by Delphi correspondence method.The reliability of the correspondence was verified by calculating the expert positive coefficient,coefficient of variation,expert authority coefficient,and Kendall harmony coefficient.Results:The recovery rates of the effective questionnaires were 100.0%.The authority coefficients of the experts were 0.900 and 0.892,respectively.Kendall concordant coefficients were 0.119 and 0.173,respectively(P<0.001).After two rounds of correspondence,the perioperative nursing quality evaluation standard system was finally determined.The system included 3 primary items,17 secondary items and 48 tertiary items.Conclusion:The perioperative nursing quality evaluation standard system is scientific,reliable and widely applicable,which can be used as an objective tool for perioperative nursing quality assessment.