摘要
Abstract
Objective Based on the Donabedian model,the nursing quality evaluation system of emergency cerebral hemorrhage patients was constructed,and applied to clinical practice,providing an objective and scientific reference basis for realizing the nursing quality management,monitoring and evaluation of emergency cerebral hemorrhage patients.Methods Through literature review,screening and evaluation,the feasibility data was extracted,and the framework of the nursing quality evaluation system for patients with emergency cerebral hemorrhage was constructed based on the Donabedian model,and the Delphi method was adopted to complete two rounds of expert letter inquiry to determine the final index system.The study selected 230 patients with acute cerebral hemorrhage admitted to our hospital from January 2021 to January 2024 as the research subjects.The period from January 2021 to June 2022 was used as the pre-intervention monitoring period,during which 165 patients were in the traditional group,receiving routine nursing quality management.The period from July 2022 to January 2024 was used as the post-intervention monitoring period,during which 165 patients were in the observation group,implementing nursing quality monitoring and management based on evaluation indicators for the care of patients with acute cerebral hemorrhage.Results In the two rounds of letter inquiry,the positive coefficient of experts was 95%and 100%,respectively,and the rate of suggestions was 56.25%and 35.54%,respectively;the authority coefficient of experts in the two rounds of letter inquiry was 0.945 and 0.893.In the first round the mean value of coefficient of variation(CV)of each index was 0～0.136,and the coordination coefficient of Kendall's W was 0.065;in the second round the mean value of variation coefficient(CV)was 0-0.110,and the coordination coefficient of Kendall's W was 0.186.The final nursing quality evaluation system for emergency cerebral hemorrhage patients covers 11 first-level indicators,11 second-level indicators and 55 third-level indicators.The results showed that the pass rate of admission-medication time,dynamic assessment rate of dysphagia patients,airway management rate,and early passive/active activity implementation rate of the observation group were statistically significant different from those in the traditional group(χ2=14.850,12.261,8.183,37.420,P＜0.05),and the patient satisfaction in the observation group was significantly higher than that in the traditional group(χ2=14.049,P＜0.001).Conclusions The nursing quality evaluation system for emergency cerebral hemorrhage patients constructed in this study is scientific,reliable and practical,and can be used as an important evaluation tool to achieve continuous improvement of nursing quality in clinical practice.关键词
Donabedian环节模型/脑出血/护理质量/评价体系Key words
Donabedian model/cerebral hemorrhage/quality of care/evaluation system
