Objective To establish an evaluation index system for the quality and safety of the specialized nursing care in cardiovascular medicine. Methods To screen and evaluate the safety quality evaluation index via a group discussion with Delphi method and analytic hierarchy process referenced to the literatures from the evaluation index of domestic nursing safety quality (NSQ)and on the base of"the factor quality- quality of links-final quality"3-dimensional quality structure theory by Donabedian. Results The first and second round of expert consultation and the recovery rate were 97.05% (33/34) and 94.12% (32/34) respectibely, the effective rate was 100%;The authoritative coefficient of expert of the safety quality evaluation index of the specialized nursing care is 0.867 and 0.879 respectively. In the first round, the average of the importance rating is 3.50-5.00, the standard deviation is 0-0.042 and full mark rate is 34.10%-100%. In the second round, the average of the importance rating is 3.80-4.70, the standard deviation is 0~0.047 and full mark rate is 31.60%-100%. The fluctuation degree of the first round is more than 0.10 with a low coordination degree. However, the fluctuation degree of the second round result is less than 0.10. The coordination coefficients from all qustionnair scores by experts in the two roudns are 0.169 and 0.286. The difference was statistically significant according to the chi-square analysis (X2=6.842, P=0.002). The NSQ evaluatin index included 3 first degree indexes (weight coefficient including 0.2684,link qualing 0.6144,and quality 0.1172),16 second degree indicators (weight coefficient 0.034~0.0859) and 61 third degree indexes ( weight coefficient 0.034~0.0859) and 61 third degree indexes (weight coefficient 0.0052~0.0412). Conclusions This paper preliminary established a specialied NSQ evaluation index with factor quality- quality of links-final quality 3-dimensional quality structure in the field of cardiovascular medicine, which is based on Delphi method and analytic hierarchy process. NSQ provides a measurement tool for nurses in CME.%目的 初步构建心血管内科(cardiovascular medicine,CME)专科护理安全质量评价指标体系.方法 参考国内护理安全质量(nursing safety quality,NSQ)评价指标的相关文献和Donabedian提出"要素质量—环节质量—终末质量"三维质量结构理论基础,通过小组讨论、德尔菲法及层次分析法(analytic hierarchy process,AHP)对CME专科护理安全质量(nursing safety quality,NSQ)评价指标体系进行筛选和评价.结果 第一轮专家函询的回收率为97.06%(33/34),第二轮专家函询的回收率为94.12%(32/34),有效率均为100.00%;心血管内科专科护理安全质量评价指标体系专家权威系数分别为0.867与0.879,第一轮专家函询重要性均数为3.50~5.00,标准差为0~0.042,满分频率为34.10%~100.00%;第二轮专家函询重要性均数为3.80~4.70,标准差为0~0.047,满分频率为31.60%~100.00%.第一轮评分结果波动程度大于0.10,存在较低的协调程度,第二轮评分结果波动程度均小于0.10,两轮问卷调查中专家对所有条目评分的协调系数分别为0.169与0.286,经卡方分析(χ2=6.842,P=0.002),差异具有统计学意义;CME专科NSQ评价指标体系包括一级指标3个(权重系数分别为要素质量0.2684,环节质量0.6144,终末质量0.1172)、二级指标16个(权重范围0.0340~0.0859)、三级指标61个(权重范围0.0052~0.0412).结论 本文通过小组讨论、德尔菲法和AHP法,初步构建了一套要素质量、环节质量、终末质量的三维结构CME专科NSQ评价指标体系,为CME护理人员提供NSQ的评价工具.
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