军队三级医院护理质量重点监测指标体系构建

Construction of a key monitoring indicator system for nursing quality in military tertiary hospitals

  • 摘要: 背景 现有护理质量指标体系无法满足军队三级医院双重职能下的管理需求。目的 构建军队三级医院护理质量重点监测指标体系,为平时监测护理薄弱环节及医院护理质量评价提供依据。方法 依据Donabedian 理论,采用文献研究、半结构式访谈拟定指标初稿,通过两轮专家函询、TOPSIS法构建军队三级医院护理质量重点监测指标体系。结果 构建的军队三级医院护理质量重点监测指标体系包含3 个一级指标(结构质量、过程质量、结果质量)、9 个二级指标(护理人员配置、护理工作负荷、护理人员培训、护理人员能力、患者护理、护理管理、不良事件、院内感染、团队稳定性)及26 个三级指标,各指标均附有相对近似度值。两轮专家函询问卷回收率均为100%,专家权威系数为0.914,肯德尔和谐系数分别为0.260、0.177(P<0.01)。TOPSIS法中关键性、可操作性、灵敏性指标评价依据权重分别为0.40、0.40、0.20。结论 本研究构建的军队三级医院护理质量重点监测指标体系实用性强,可为护理质量管理提供参考工具。

     

    Abstract: Background Existing nursing quality indicator systems cannot meet the management needs arising from the dual functions of military tertiary hospitals. Objective To construct a key monitoring indicator system for nursing quality in military tertiary hospitals, so as to provide reference for monitoring weak links in routine nursing care and evaluate hospital nursing quality. Methods Based on Donabedian's theory, a preliminary draft of the indicator system was constructed through literature review and semi-structured interviews. A two-round expert consultation and the TOPSIS were used to construct the key monitoring indicator system for nursing quality in military tertiary hospitals. Results The constructed key monitoring indicator system for nursing quality in military tertiary hospitals comprises 3 first-level indicators (structure quality, process quality, outcome quality), 9 secondlevel indicators (nursing staffing, nursing workload, nursing training, nursing competency, patient care, nursing management, adverse events, healthcare-associated infections, team stability), and 26 third-level indicators, and each indicator was assigned a relative closeness to the ideal solution. The response rates for both rounds of expert consultation questionnaires were 100%, the expert authority coefficient was 0.914. The Kendall's W were 0.260 and 0.177, respectively (P<0.01). In TOPSIS, the evaluation criteria weights for criticality, operability, and sensitivity were 0.40, 0.40, and 0.20. Conclusion The key monitoring indicator system for nursing quality in military tertiary hospitals constructed in this study is highly practical and can serve as a reference tool for nursing quality management.

     

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