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基于 Donabedian 理论构建血液透析护理敏感性质量指标:德尔菲法研究。

Construction of haemodialysis nursing-sensitive quality indicators based on Donabedian theory: A Delphi method study.

机构信息

West China School of Nursing, Sichuan University, Chengdu, China.

Hemodialysis Center, Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Nurs Open. 2023 Feb;10(2):807-816. doi: 10.1002/nop2.1349. Epub 2022 Aug 30.

Abstract

AIMS

To establish a sensitive, scientific and practical evaluation system for haemodialysis nursing and to provide a reference for the evaluation of haemodialysis nursing quality.

DESIGN

Through a literature review and Delphi method.

METHOD

According to the literature review, a preliminary nursing-sensitive quality indicators for haemodialysis were established, and an expert survey questionnaire was designed. Finally, the evaluation system for the nursing-sensitive quality indicators was determined using the Delphi method.

RESULTS

Thirteen nursing-sensitive quality indicators for haemodialysis were finally constructed, including two structural indicators, three process indicators and eight outcome indicators. The effective recovery rate of the two rounds of expert survey questionnaires was 100%, the coefficient of judgement basis is 0.956, the coefficient of familiarity is 0.833, the coefficient of authority is 0.895, and the Kendall's harmony coefficients of the two rounds of expert consultation were 0.158 ~ 0.307 and 0.170 ~ 0.315, respectively, with statistical significance (p < .05).

CLINICAL RELEVANCE

In this study, the nursing-sensitive quality indicators for haemodialysis were developed by the Delphi method and included structural indicators, outcome indicators and process indicators, which made up for some deficiencies noted in previous studies. The authors have provided a more reliable and comprehensive basis for evaluating the quality and safety of haemodialysis nursing in the future.

摘要

目的

建立一个敏感、科学和实用的血液透析护理评估体系,为血液透析护理质量的评估提供参考。

设计

通过文献回顾和 Delphi 法。

方法

根据文献回顾,初步建立血液透析护理敏感性质量指标,并设计专家调查问卷。最后,采用 Delphi 法确定护理敏感性质量指标的评价体系。

结果

最终构建了 13 项血液透析护理敏感性质量指标,包括 2 项结构指标、3 项过程指标和 8 项结果指标。两轮专家调查问卷的有效回收率均为 100%,判断依据系数为 0.956,熟悉系数为 0.833,权威系数为 0.895,两轮专家咨询的 Kendall 协调系数分别为 0.1580.307 和 0.1700.315,均有统计学意义(p<0.05)。

临床意义

本研究采用 Delphi 法制定血液透析护理敏感性质量指标,包括结构指标、结果指标和过程指标,弥补了以往研究的一些不足。为今后评估血液透析护理的质量和安全性提供了更可靠、更全面的依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89ac/9834505/b152772781cd/NOP2-10-807-g001.jpg

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