Construction Of Nursing Quality Evaluation Index System Of Neonatal Intensive Care Unit

Background As a result of increasing scientific and technological advances in perinatal medicine, the survival rate of newborns with severe diseases has significantly increased. This new reality makes the quality improvement of neonatal critical care become the core content of nursing quality management of newborns. The first step of the quality management is to scientifically evaluate current nursing quality. Though, many countries have developed they own nursing quality indicators, these indicators are predominantly for adult care which is not suitable for neonatal critical care. The development of such evluation system in neonatal intensive care will contribute to a sustaining improvement of the nursing quality for newborns.Objective This study is conducted to develop an scientific and effective index system to evaluate the quality of neonatal nursing care, based on literature research, theoretical analysis, Delphi method and Analytic Hierarchy Process; to provide efficient tools for comprehensive comparison of nursing quality of neonatal intensive care unit for the nurse managers; to lay the foundation for establishing a national database of nursing quality of neonatal intensive care unit; to provide an empirical basis for developing nursing quality evaluation index system in other specialist areas.Methods The study established premilinarily evaluation index system through literature research and theoretical analysis, which based on Donabedian’s model and development status of neonatal intensive care units in China. Delphi method was adopted in organizing two rounds of questionnaire consultations among 48 experts, Analytic Hierarchy Process was adopted to calculate weights coefficients of each indicator in the system and to test its logical consistency, and then the nursing quality evaluation index system of neonatal intensive care unit was developed.Results1、This study used Delphi method to develop an evaluation index system based on Donabedian’s model, which consisted of structure quality, process quality and outcome quality 3 first-level indicators,14 second-level indicators and 58 third-level indicators. The percentage of questionnaires received in two-round expert consultations is 100%, indicating that the experts had a high degree of enthusiasm on this study; the authoritative coefficient were 0.88 and 0.89, indicating that the expert group had a good authority; the experts’ coordinate coefficients were 0.204 and 0.283 (P<0.05), indicating that the experts’ views were consonant. Therefore, expert forecasts were based on practical experience and theoretical basis, the credibility was higher and the survey result was desirable.2, The weights of the indicators were set up by using Analytic Hierarchy Process on the basis of the mean importance of indicator. The results showed that indicators on all levels met the requirements of consistency, and the weight values of the first-level indicators were 0.3108,0.4934,0.1958. The high-ranking weight values of the second-level indicators included nursing skill, nursing assessment and nursing measures, nursing staff education and training, nursing quality management, etc.Conclusion This study jointly use Delphi method and the Analytic Hierarchy Process to determine the nursing quality evaluation index system of neonatal intensive care unit to ensure the scientificalness and reliability of the evaluation index system. The evaluation index system has many characteristics, such as:distinct special feature, clear layer, high operability and rationality of indicator weight, which can make us capable to comprehensively measure the nursing quality of neonatal intensive care unit and provide the basis for the improvement of nursing quality of neonatal intensive care unit.