The Construction Of Nursing-sensitive Quality Indicators In Patients With Acute Traumatic Brain Injury

Objective:To construct the nursing-sensitive quality indicators for acute traumatic brain injury based on the Evidence-Based Medicine methods and Delphi method.In order to provide a basis for the quantitative management of acute traumatic brain injury care,and a reference tool for nursing staffs to evaluate,monitor and improve the quality of care for patients with acute traumatic brain injury.Method:This study determined the retrieval words and strategy in both English and Chinese by Evidence-Based Medicine methods,evaluated the grade and quality of target literatures using evaluation tools of Australia Joanna Briggs Institute(JBI).A research team is established including 15 clinical nurses experts,team members extracted 23 primary sensitive nursing-sensitive quality indicators for acute traumatic brain injury based on systematic review methods of Evidence-Based Medicine,and determine the content of each index with the target literatures.Then based on these primary sensitive nursing-sensitive quality indicators,a questionnaire for Delphi method was developed.The Delphi method was conducted two rounds to confirm the expected indicators on its importance and connotation with 47 consultant experts from six provinces,and the Likert rating category was used to evaluate.The statistical calculation uses positive coefficient of experts,expert authority coefficient(Cr),Kendall's W and coefficient of variation(CV)to evaluate the consulting results and the Means,Standard deviation can display the results to determine the sensitive nursing-sensitive quality indicators for acute traumatic brain injury.Results:Finally,11 nursing-sensitive indexes of acute trauma brain injury were constructed,including index names,meanings,calculation formulas,numerator and denominator interpretation,and data collection methods.Experts' positive coefficient was expressed by the questionnaire recovery rate,and the two rounds of questionnaire consulting recovery rates were 100% and 97.87%,both greater than 90.0%;expert authority coefficients were 0.85 and 0.88,both greater than 0.7;the consistency evaluation of the results of the two rounds of questionnaire consulting was expressedby Kendall's W and coefficient of variation.And Kendall's W were 0.37 and 0.50,P<0.05,and the coefficients of variation of the final indicators were between 0.09 and0.18,all less than 0.20.Conclusion:Based on the Evidence-Based Medicine methods and Delphi method,11 sensitive nursing-sensitive quality indicators for acute traumatic brain injury in emergency department were established.Delphi expert consultation has high positive and authority coefficient,the experts' authority and representativeness results is well,so well as the Kendall's W and coefficient of variation.Above results showed that the Delphi results have high reliability and consistency and the obtained sensitive nursing-sensitive quality indicators can provide a reference for emergency nursing staff to improve the quality of care of patients with acute traumatic brain injury.