Xiong Weixin, Xie Fenglan, Li Qin, Chen Ying, Yang Hongmei, Wu Jieli, Li Jianying, Chen Zhihao, Hu Xiaoqin, Hu Lijing
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, GuangZhou, 510080, China.
Department of Nursing, The First Affiliated Hospital of Sun Yat-sen University, GuangZhou, 510080, China.
BMC Nurs. 2025 Jul 1;24(1):691. doi: 10.1186/s12912-025-03449-3.
This study aimed to develop an indicator system for early warning of clinical nursing critical values for implementation in general wards.
By simultaneously assessing multiple physiological parameters, subtle changes in a patient's clinical status can be more readily identified. However, the literature indicates that current early warning systems (EWS) are primarily utilized in in critical care units (ICU), prehospital first aid and hospital emergency cases. There remains a lack of consensus regarding early warning systems for critical nursing values in general wards, along with a shortage of effective and practical quantitative indicators for nursing risk prevention.
This study employed an integrative research approach combining literature review, theoretical analysis, and qualitative methodology. Through systematic screening, a critical nursing value warning indicators draft was identified. two-round Delphi survey was conducted involving 148 experts from clinical nursing, nursing education, and professional associations. The entire research process strictly adhered to the modified Conducting and Reporting of Delphi Studies (CREDES) guidelines and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist to ensure methodological rigor and transparency.
In the two Delphi survey rounds, the response rates for the two questionnaires were 96.62% and 99.32%, respectively. The authority coefficients were 0.854 and 0.871, respectively, with coefficients of variation ranging from 0.08 to 0.23. The final early warning system for clinical nursing critical values in general wards was composed of 10 primary indicators and 23 secondary indicators.
The developed indicator system for clinical nursing critical value early warning in general wards demonstrates both scientific reliability and practical applicability. It provides clear guidance to clinical nurses, enabling timely detection of patient condition changes, prevention of adverse events, and assurance of clinical nursing safety.
The development and establishment of indicator system for early warning of clinical nursing critical values in general wards will help to identify changes in patient conditions, avoidance of adverse events, and the assurance of clinical nursing safety.
本研究旨在建立一个普通病房临床护理危急值预警指标体系。
通过同时评估多个生理参数，可以更容易地识别患者临床状态的细微变化。然而，文献表明，目前的早期预警系统（EWS）主要应用于重症监护病房（ICU）、院前急救和医院急诊病例。对于普通病房护理危急值的早期预警系统，目前仍缺乏共识，同时也缺乏有效的、实用的护理风险预防定量指标。
本研究采用文献回顾、理论分析和定性研究相结合的综合研究方法。通过系统筛选，确定了一份护理危急值预警指标草案。对来自临床护理、护理教育和专业协会的148名专家进行了两轮德尔菲调查。整个研究过程严格遵循修改后的《德尔菲研究实施与报告》（CREDES）指南和《加强流行病学观察性研究报告》（STROBE）清单，以确保方法的严谨性和透明度。
在两轮德尔菲调查中，两份问卷的回复率分别为96.62%和99.32%。权威系数分别为0.854和0.871，变异系数范围为0.08至0.23。普通病房临床护理危急值的最终预警系统由10个一级指标和23个二级指标组成。
所建立的普通病房临床护理危急值预警指标体系具有科学可靠性和实际适用性。它为临床护士提供了明确的指导，能够及时发现患者病情变化，预防不良事件，确保临床护理安全。
普通病房临床护理危急值预警指标体系的建立将有助于识别患者病情变化，避免不良事件，确保临床护理安全。
