本文選題：新生兒　切入點(diǎn)：危重癥護(hù)理　出處：《中國(guó)循證兒科雜志》2016年04期

【摘要】：目的構(gòu)建NICU護(hù)理質(zhì)量評(píng)價(jià)指標(biāo)體系,促進(jìn)NICU全面質(zhì)量的持續(xù)改進(jìn),提升危重新生兒救治成功率和生命質(zhì)量。方法基于"結(jié)構(gòu)-過(guò)程-結(jié)果"理論模型搭建NICU護(hù)理質(zhì)量評(píng)價(jià)指標(biāo)邏輯關(guān)系,結(jié)合我國(guó)醫(yī)院管理的相關(guān)政策法規(guī)和NICU建設(shè)管理標(biāo)準(zhǔn),參考兒童、成人和危重癥護(hù)理質(zhì)量評(píng)價(jià)指標(biāo)并結(jié)合新生兒疾病特點(diǎn),初步建立NICU護(hù)理質(zhì)量評(píng)價(jià)指標(biāo)并進(jìn)行定義,咨詢專家以咨詢計(jì)分法采取不記名2輪護(hù)理質(zhì)量評(píng)價(jià)指標(biāo)問(wèn)卷咨詢,提出刪除、拆分、添加、修改和合并的意見(jiàn),取第2輪問(wèn)卷咨詢指標(biāo)賦分值,構(gòu)建判斷矩陣,確定護(hù)理質(zhì)量評(píng)價(jià)指標(biāo)的權(quán)重關(guān)系。結(jié)果來(lái)自中國(guó)9省市12所三級(jí)甲等婦幼保健院或兒童�？漆t(yī)院48名專家應(yīng)邀參與了問(wèn)卷咨詢,2輪問(wèn)卷咨詢均得到了100%的回復(fù)。根據(jù)"結(jié)構(gòu)-過(guò)程-結(jié)果"理論模型建立并定義了67個(gè)評(píng)價(jià)指標(biāo)(結(jié)構(gòu)19個(gè),過(guò)程18個(gè),結(jié)果 30個(gè)),第1輪問(wèn)卷咨詢中,刪除8個(gè)、拆分1個(gè)、添加4個(gè)、修改4個(gè)、合并2個(gè)指標(biāo);第2輪問(wèn)卷咨詢中,刪除5個(gè)指標(biāo),無(wú)拆分、添加、修改和合并指標(biāo),對(duì)3個(gè)一級(jí)、14個(gè)二級(jí)、58個(gè)評(píng)價(jià)指標(biāo)(結(jié)構(gòu)16個(gè),過(guò)程18個(gè),結(jié)果 24個(gè))權(quán)重和組合權(quán)重計(jì)算結(jié)果顯示,一、二和三級(jí)指標(biāo)重要性賦值均數(shù)分別為4.6~4.9、4.1~4.9和3.7~5.0,滿分頻率分別為60.4%~88.6%、25.6%~90.7%和6.3%~97.9%,呈現(xiàn)一、二和三級(jí)指標(biāo)重要性賦值均數(shù)和滿分頻率范圍值逐漸寬泛的趨勢(shì)。一、二和三級(jí)指標(biāo)一致性系數(shù)均0.1,均具有滿意的一致性。結(jié)論以"結(jié)構(gòu)-過(guò)程-結(jié)果"為理論基礎(chǔ)搭建的58個(gè)三級(jí)NICU護(hù)理質(zhì)量評(píng)價(jià)指標(biāo),取得了咨詢專家一致的認(rèn)同,為更深入的相關(guān)研究鑒定了重要基礎(chǔ)。
[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.
【作者單位】： 復(fù)旦大學(xué)附屬兒科醫(yī)院護(hù)理部;上海健康醫(yī)學(xué)院;
【分類號(hào)】：R473.72

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