Development Of Evaluation Table For Urinary Catheter Removal In Patients Undergoing Orthopedic Surgery Under The Concept Of Enhanced Recovery After Surgery

Objective:The purpose of this study is to compile the evaluation table for urinary catheter removal in patients undergoing orthopedic surgery,then apply the evaluation table to orthopedic clinic,conduct reliability and validity test and clinical effect verification,and help orthopedic nurses accurately grasp the timing of urinary catheter removal in patients undergoing orthopedic surgery,shorten the catheter indwelling time,and reduce the incidence of related complications.Methods:1.Combined with literature review,group discussion method and clinical practice to find relevant factors affecting urinary catheter indwelling time of patients undergoing orthopaedic surgery,then use the Delphi method to construct index items of evaluation table for urinary catheter removal of patients undergoing orthopaedic surgery.2.Methods of literature review and expert meeting were used to grade and assign each index item in the evaluation table.The analytic hierarchy process is used to calculate the weight value of the index.The convenience sampling method was used to select 60 patients with elective orthopaedic surgery for small sample pre-test,and the indexes of the evaluation table were selected to form the evaluation table of urinary catheter removal in patients with orthopaedic surgery.3.Convenience sampling method was used to select 300 orthopaedic elective surgery patients who were admitted to a 3a grade hospital.The developed evaluationtable was used for evaluation.Reliability and validity test of the evaluation table was conducted with the score results.4.In order to determine the optimal threshold value of the evaluation form,the sensitivity and specificity test of the evaluation form was conducted in a third-grade grade a hospital.The study subjects selected 100 elective surgery patients admitted to the department of orthopedics through convenient sampling.Results:1.The recovery rate of the first round of the questionnaire was 100%,and that of the second round was 97.44%.The expert authority coefficients were 0.943 and 0.934,both greater than 0.80.The Kendall coordination coefficient of the first round of Delphi expert correspondence was 0.203,and that of the second round of Delphi expert correspondence was 0.158.At the end of the two rounds of consultation,the mean value of each item was 3.79-4.71,and the coefficient of variation was 9.76%-26.85%.After the preliminary test of 60 patients with elective orthopaedic surgery,the evaluation table of urinary catheter removal in patients with orthopaedic surgery was finally formed with 3primary indexes and 16 secondary indexes.2.The evaluation table was applied to 300 patients undergoing elective ortho paedic surgery for reliability and validity test.Cronbach’s α coefficient,fractional half-reliability and interevaluator reliability Kendall’s W coefficient represent the re liability of the evaluation form,which were 0.548,0.430 and 0.998,respectively.V alidity was expressed by content validity and structure validity.The overall conten t validity index(S-CVI)of the table was 0.938,and the content validity index(ICVI)of each index was between 0.67 and 1.00.Six common factors were extract ed by exploratory factor analysis,with a cumulative contribution rate of 60.796%and a load factor range of 0.524-0.880.3.The area under the ROC curve of the evaluation table was 0.963,and the 95%confidence interval was between 0.928 and 0.998.When the patient score was 35.85,itwas the best threshold for the evaluation target.Meanwhile,the sensitivity,specificity and Jordan index of the evaluation table were the highest,which were 0.909,0.971 and0.88,respectively.When the score > 35.85,the patient could not remove the catheter;when the score ≤35.85,the patient could remove the catheter.Conclusion:1.The evaluation table of urinary catheter removal for patients undergoing orthopedic surgery was prepared in this study,which included three dimensions: general condition of patients,history of orthopedic surgery,and postoperative condition of patients,with a total of 16 items.The reliability and validity test indicated that the scale had good reliability and validity and could be used as an objective evaluation tool for the removal of urinary catheter in patients after orthopaedic surgery.2.After clinical verification,the sensitivity and specificity of the evaluation table were good in patients with indwelling urinary catheter after elective orthopedic surgery,and the timing of urinary catheter removal in patients with orthopedic surgery could be judged more accurately.