新生儿危重症护理管理质量评价指标体系的初步构建

发布时间：2018-04-08 16:23

本文选题：新生儿　切入点：危重症护理　出处：《中国循证儿科杂志》2016年04期

【摘要】：目的构建NICU护理质量评价指标体系,促进NICU全面质量的持续改进,提升危重新生儿救治成功率和生命质量。方法基于"结构-过程-结果"理论模型搭建NICU护理质量评价指标逻辑关系,结合我国医院管理的相关政策法规和NICU建设管理标准,参考儿童、成人和危重症护理质量评价指标并结合新生儿疾病特点,初步建立NICU护理质量评价指标并进行定义,咨询专家以咨询计分法采取不记名2轮护理质量评价指标问卷咨询,提出删除、拆分、添加、修改和合并的意见,取第2轮问卷咨询指标赋分值,构建判断矩阵,确定护理质量评价指标的权重关系。结果来自中国9省市12所三级甲等妇幼保健院或儿童专科医院48名专家应邀参与了问卷咨询,2轮问卷咨询均得到了100%的回复。根据"结构-过程-结果"理论模型建立并定义了67个评价指标(结构19个,过程18个,结果 30个),第1轮问卷咨询中,删除8个、拆分1个、添加4个、修改4个、合并2个指标;第2轮问卷咨询中,删除5个指标,无拆分、添加、修改和合并指标,对3个一级、14个二级、58个评价指标(结构16个,过程18个,结果 24个)权重和组合权重计算结果显示,一、二和三级指标重要性赋值均数分别为4.6~4.9、4.1~4.9和3.7~5.0,满分频率分别为60.4%~88.6%、25.6%~90.7%和6.3%~97.9%,呈现一、二和三级指标重要性赋值均数和满分频率范围值逐渐宽泛的趋势。一、二和三级指标一致性系数均0.1,均具有满意的一致性。结论以"结构-过程-结果"为理论基础搭建的58个三级NICU护理质量评价指标,取得了咨询专家一致的认同,为更深入的相关研究鉴定了重要基础。
[Abstract]:Objective to construct the evaluation index system of NICU nursing quality, to promote the continuous improvement of NICU total quality, and to improve the success rate and quality of life of critically ill newborns.Methods based on the "structure-process-result" theory model, the logical relationship of NICU nursing quality evaluation index was established, and the related policies and regulations of hospital management and the standard of NICU construction management were combined to refer to children.The evaluation indexes of nursing quality of adults and critically ill patients, combined with the characteristics of neonatal diseases, were preliminarily established and defined by NICU nursing quality evaluation index. The consultation experts adopted anonymous two rounds of nursing quality evaluation index questionnaire by consulting scorecard.The opinions of deleting, splitting, adding, modifying and merging were put forward. The second round of questionnaire was used to assign the score of consultation index, to construct the judgment matrix and to determine the weight relation of nursing quality evaluation index.Results 48 experts from 12 Grade 3A Maternal and Child Health Hospitals or Children's specialized Hospitals from 9 provinces and cities in China were invited to participate in the questionnaire consultation.According to the "structure-process-result" theoretical model, 67 evaluation indexes (19 structures, 18 processes, 30 results) were established and defined. In the first round of the questionnaire, 8 were deleted, 1 was split, 4 were added and 4 were modified.In the second round of questionnaire consultation, 5 indicators were deleted, and no split, added, modified and combined indicators were added, modified and merged, for 3 first level, 14 second level, 58 evaluation indicators (structure 16, process 18),Results 24) the results of weight and combination weight calculation showed that the mean values of the importance of the first, second and third grade indexes were 4.64.9U 4.1g 4.4.9 and 3.7N 5.0respectively, and the full score frequencies were 60.4% and 88.625.6g / 25.6% and 6.3n 97.9%, respectively.The trend that the importance of the second and third degree indicators assign the mean and the full frequency range gradually broad.The consistency coefficients of the first, second and third indexes are both 0.1, which are satisfactory.Conclusion based on the theory of "structure-process-result", 58 evaluation indexes of nursing quality of tertiary NICU have been agreed with by consulting experts, which is an important basis for further related research.
【作者单位】：复旦大学附属儿科医院护理部;上海健康医学院;
【分类号】：R473.72

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