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术后加速康复理念下脊柱外科护理敏感质量指标的构建

Construction of Nursing-Sensitive Quality Indicators for Spine Surgery Under the Concept of Enhanced Recovery After Surgery.

作者信息

Dong Zhenghui, Zhang Yatian, Qi Jinfang, Wu Xuanyi, Wang Zhiwei, Zhang Lipin, Ma Xian

机构信息

Department of Nursing, The Sixth Affiliated Hospital of Xinjiang Medical University, Health Care Research Center for Xinjiang Regional Population, Xinjiang, China.

School of Nursing, Xinjiang Medical University, Xinjiang, China.

出版信息

J Adv Nurs. 2025 Mar 25. doi: 10.1111/jan.16914.

Abstract

AIMS

The aim of the study was to develop a set of nursing-sensitive quality indicators for accelerating spine surgical rehabilitation.

DESIGN

This is a modified Delphi study. A two-round Delphi study was conducted from November to December 2023.

METHODS

Based on an evidence-based perspective and semi-structured interviews, an outline of nursing-sensitive quality indicators for accelerated rehabilitation in spine surgery patients was formulated. The Donabedian structure-process-outcome theory model was used as the theoretical framework to develop the indicator system; the indicators were improved and refined after two rounds of Delphi surveys, and the weights of the indicators were determined by the analytic hierarchy process. A total of 23 experts from 10 hospitals in 7 Chinese provinces completed the two rounds of the modified Delphi process.

RESULTS

The experts reached a consensus on the definition of the indicators, the calculation formula and the data collection method, and included a sensitive quality indicator system for accelerated rehabilitation care in spine surgery with 3 primary indicators, 9 secondary indicators and 26 tertiary indicators.

CONCLUSION

A set of indicators about accelerated rehabilitation care in spinal surgery covers the key aspects of patient education, assessment, measures, and rehabilitation, and its content is scientific, comprehensive, and targeted, which can provide a basis for objective evaluation of the quality of accelerated rehabilitation care in spinal surgery.

IMPACT

Medical institutions can routinely collect monthly data based on this indicator, conduct horizontal comparisons of the quality of accelerated rehabilitation care in spinal surgery among hospitals at the same level with the assistance of a national or even global networked auditing platform, and establish an internal safeguard mechanism for evaluating the quality of perioperative care.

REPORTING METHOD

This study follows the Conducting and REporting of DElphi studies (CREDE) guidance on Delphi studies.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution was made in this study.

摘要

目的

本研究旨在制定一套护理敏感质量指标,以加速脊柱手术康复。

设计

这是一项改良的德尔菲研究。于2023年11月至12月进行了两轮德尔菲研究。

方法

基于循证视角和半结构化访谈,制定了脊柱手术患者加速康复护理敏感质量指标大纲。采用Donabedian结构-过程-结果理论模型作为理论框架来构建指标体系;经过两轮德尔菲调查对指标进行改进和完善,并通过层次分析法确定指标权重。来自中国7个省份10家医院的23名专家完成了两轮改良德尔菲过程。

结果

专家们就指标定义、计算公式和数据收集方法达成共识,纳入了一个包含3个一级指标、9个二级指标和26个三级指标的脊柱手术加速康复护理敏感质量指标体系。

结论

一套关于脊柱手术加速康复护理的指标涵盖了患者教育、评估、措施及康复等关键方面,其内容科学、全面且具有针对性,可为客观评价脊柱手术加速康复护理质量提供依据。

影响

医疗机构可基于该指标定期每月收集数据,借助国家甚至全球联网审计平台,对同级医院脊柱手术加速康复护理质量进行横向比较,并建立围手术期护理质量评估的内部保障机制。

报告方法

本研究遵循德尔菲研究的《德尔菲研究的实施与报告》(CREDE)指南。

患者或公众贡献

本研究未涉及患者或公众贡献。

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