Department of Hemodialysis, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Department of Nursing, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
J Clin Nurs. 2018 Nov;27(21-22):3920-3930. doi: 10.1111/jocn.14607. Epub 2018 Aug 2.
To provide a set of nursing-sensitive quality indicators (NSQIs) for the evaluation of clinical nursing quality in haemodialysis unit.
There are no established objective indicators for evaluation of the quality of nursing care in haemodialysis units in China.
We performed a literature search for eligible studies published from 2006-2016. A total of six studies were screened out from which 13 potential NSQIs were identified. Two rounds of Delphi surveys were conducted with the purpose of collecting opinions from a panel of independent experts. At last, 11 NSQIs were selected by consensus after exclusion of 8 NSQIs and addition of another 6 NSQIs.
Two rounds of expert inquiry were conducted; the questionnaire recovery rate was 100%. The average authoritative coefficients Cr for the two rounds were 0.79 and 0.90, respectively. The Kendall W values ranged from 0.273-0.388 (p < 0.001). Eleven NSQIs were identified: nurse-to-patient ratio, dialysis ultrafiltration rate compliance rate, KT/V compliance rate, incidence of emergency during haemodialysis, person-time incidence rate of haemodialysis catheter-related bloodstream infections, incidence of coagulation in extracorporeal circulation, incidence of blood loss in extracorporeal circulation, incidence of pseudoaneurysm induced by fistula puncture, incidence of falls among haemodialysis patients, emergency dialysis rate of outpatients and incidence of fistula complications.
The identified NSQIs reflect three aspects of haemodialysis nursing quality: importance, rationality of calculation formula and applicability of data collection methods.
The study provides a reference for the evaluation of clinical nursing quality in haemodialysis units.
为评估血液透析病房的临床护理质量，提供一套护理敏感质量指标（NSQIs）。
中国尚未建立评估血液透析单位护理质量的既定客观指标。
我们对 2006 年至 2016 年发表的合格研究进行了文献检索。从这六篇研究中筛选出了六项研究，共确定了 13 项潜在的 NSQIs。进行了两轮 Delphi 调查，目的是从一组独立专家那里收集意见。最后，通过排除 8 项 NSQIs 和增加 6 项 NSQIs，共识后选择了 11 项 NSQIs。
进行了两轮专家咨询；问卷回收率为 100%。两轮的平均权威系数 Cr 分别为 0.79 和 0.90。Kendall W 值范围为 0.273-0.388（p<0.001）。确定了 11 项 NSQIs：护士与患者比例、透析超滤率达标率、KT/V 达标率、血液透析期间紧急情况发生率、人时血液透析导管相关血流感染发生率、体外循环凝血发生率、体外循环失血量发生率、瘘管穿刺引起的假性动脉瘤发生率、血液透析患者跌倒发生率、门诊急诊透析率和瘘管并发症发生率。
确定的 NSQIs 反映了血液透析护理质量的三个方面：重要性、计算公式的合理性和数据收集方法的适用性。
本研究为评估血液透析病房的临床护理质量提供了参考。
