中华现代护理杂志2024,Vol.30Issue(13) :1713-1719.DOI:10.3760/cma.j.cn115682-20230825-00691

手术室眼耳鼻喉专科护理质量敏感指标体系的构建及应用

Construction and application evaluation of a quality sensitive indicator system for eye,ear,nose and throat specialized nursing in Operating Rooms

陈捷茹 华玮 庞艳秋 杨怡雯
中华现代护理杂志2024,Vol.30Issue(13) :1713-1719.DOI:10.3760/cma.j.cn115682-20230825-00691

手术室眼耳鼻喉专科护理质量敏感指标体系的构建及应用

Construction and application evaluation of a quality sensitive indicator system for eye,ear,nose and throat specialized nursing in Operating Rooms

陈捷茹 1华玮 2庞艳秋 1杨怡雯1
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作者信息

  • 1. 复旦大学附属眼耳鼻喉科医院手术室,上海 200031
  • 2. 复旦大学附属眼耳鼻喉科医院护理部,上海 200031
  • 折叠

摘要

目的 构建并应用手术室眼耳鼻咽喉专科护理质量敏感指标体系,为评价专科手术室护理工作质量提供依据.方法 以"结构-过程-结果"三维质量评价模式为模型,采用文献检索、专家访谈法初步拟定手术室眼耳鼻咽喉专科护理质量敏感指标体系框架,通过2轮德尔菲专家函询法确定最终的指标体系及指标权重.于2023年1月在复旦大学附属眼耳鼻喉科医院手术室基于已构建的质量指标体系开展针对性培训.比较2022年12月(培训前)与2023年2月(培训后)我院手术室护理质量敏感指标体系中结局指标的差异.结果 构建的终版手术室眼耳鼻咽喉专科护理质量敏感指标体系包含3个一级指标、10个二级指标、36个三级指标;2轮函询专家积极系数均为100.00%,权威系数为0.917、0.931.应用质量指标体系后,眼耳鼻咽喉科手术室护理人员对于困难气道相关应急演练不合格率由4.86%下降到0.54%(P<0.05);专科理论、操作技能考核的不合格率由6.49%下降到1.08%(P<0.01);两组患者的护理质量不合格例数有不同程度降低(P<0.05);两组患者不良事件发生情况中,术中清点意外发生率由1.85%下降到0(P<0.05),手术患者头面部医源性压力性损伤发生率由2.47%下降到0.31%(P<0.05).结论 本研究构建的手术室眼耳鼻咽喉专科护理质量敏感指标体系科学性和适用性较好,可有效降低专科手术室的护理风险,有利于专科手术室护理工作质量的提高.

Abstract

Objective To construct and apply the quality sensitive indicator system for eye,ear,nose and throat specialized nursing in Operating Rooms,in order to provide a basis for evaluating the quality of nursing work in specialized Operating Rooms.Methods Using the three-dimensional quality evaluation model of"structure-process-result",a preliminary framework for quality sensitive indicators of eye,ear,nose,and throat specialty nursing in the Operating Room was developed using literature search and expert interviews.The final indicator system and weight were determined through two rounds of Delphi expert inquiry.In January 2023,targeted training was conducted in the Operating Room of Eye & ENT Hospital of Fudan University based on the established quality indicator system.The difference of outcome indicators in the sensitive index system of nursing quality in Operating Room of our hospital in December 2022(before training)and February 2023(after training)were compared.Results The final version of the quality sensitive indicator system for eye,ear,nose and throat specialty nursing in the Operating Room included three primary indicators,10 secondary indicators and 36 tertiary indicators.The positive coefficients of the two rounds of consultation with experts were both 100.00%,and the authoritative coefficients were 0.917 and 0.931.After applying the quality indicator system,the failure rate of emergency drills related to difficult airways among nursing staff in the Operating Room of the Eye,Ear,Nose and Throat Department decreased from 4.86%to 0.54%(P<0.05).The failure rate of specialized theoretical and operational skills assessment decreased from 6.49%to 1.08%(P<0.01).The number of unqualified nursing quality cases in the two groups decreased to different degrees(P<0.05).Among the occurrence of adverse events in the two groups,the incidence of intraoperative counting accidents decreased from 1.85%to 0(P<0.05),and the incidence of iatrogenic head and face stress injuries of surgical patients decreased from 2.47%to 0.31%(P<0.05).Conclusions The sensitive indicator system for the quality of eye,ear,nose and throat specialized nursing in the Operating Room constructed in this study is scientifically sound and applicable,which can effectively reduce nursing risks in specialized Operating Rooms and improve the quality of nursing work in specialized Operating Rooms.

关键词

手术室/眼耳鼻咽喉科/护理敏感指标/三维质量评价模式/德尔菲法/护理质量

Key words

Operating Room/Eye,Ear,Nose and Throat Department/Nursing sensitive indicators/Three dimensional quality evaluation mode/Delphi method/Nursing quality

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基金项目

复旦大学附属眼耳鼻喉科医院科研资助项目(FENF 202102)

出版年

2024
中华现代护理杂志
中华医学会

中华现代护理杂志

CSTPCD
影响因子:1.14
ISSN:1674-2907
参考文献量15
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