Construction And Preliminary Application Of Continuous Nursing Quality Evaluation Index System For Patients With Cutaneous Ureterostomy

Objective:This study aimed to construct a comprehensive and quantifiable continuous nursing quality evaluation index system for cutaneous ureterostomy patients by taking the three-dimensional quality structure model as the theoretical framework.Besides,the index weights were set reasonably.The practicability and operability of the evaluation index system were analyzed through preliminary application,so as to provide an objective evaluation tool for the continuous nursing quality of cutaneous ureterostomy patients and provide standardized reference for continuous nursing practice and quality improvement.Methods:1.Qualitative interview method to draw up the evaluation index system items:through literature review,the key points of cutaneous ureterostomy continuous nursing quality evaluation and related factors affecting the development of quality evaluation were clarified.A semi-structured interview outline was formed,and a total of 10 nurses who carried out continuous nursing or quality management of cutaneous ureterostomy patients were selected for qualitative interview by objective sampling method.Taking the three-dimensional quality structure model as the theoretical framework,the items of continuous nursing quality evaluation index system for patients undergoing cutaneous ureterostomy were preliminarily drawn up.2.Delphi expert consultation method to form the quality evaluation index system: using objective sampling method,23 experts engaged in continuous nursing practice or quality management of cutaneous ureterostomy patients were selected for two rounds of experts consultation.Evaluate the enthusiasm,authority and coordination degree of experts to form a continuous nursing quality evaluation index system for cutaneous ureterostomy patients.3.The analytic hierarchy process sets the weight of the quality evaluation index system: establish the hierarchical structure model,construct the judgment matrix,and set the weight and combination weight of all levels indicators in the continuous nursing quality evaluation index system of cutaneous ureterostomy patients,and carry on the consistency test.4.Questionnaire analysis of the application effect of quality evaluation index system: according to the continuous nursing quality evaluation index system of patients with cutaneous ureterostomy formed in the early stage,the questionnaire was designed.The indexes were standardized and the scoring standard was set.The continuous nursing quality of 302 patients with cutaneous ureterostomy in a Grade3 A hospital in Jiangxi Province was evaluated,and the application effect of the evaluation index system was analyzed.Results:1.Results of the evaluation index system items: an evaluation index system of continuous nursing quality of cutaneous ureterostomy patients was formed,including3 first-level indexes,13 second-level indexes and 71 third-level indexes.2.Results of expert consultation: the effective recovery rates of questionnaires in the two rounds of expert consultation were 95.83% and 100% respectively.The submission rates of expert opinions were 60.87% and 4.35% respectively.The expert authority coefficients were 0.90 and 0.91 respectively,and Kendalls’ W ranged from0.16 to 0.22,the difference was statistically significant(P<0.05),and the coefficient of variation of each index was <0.25.After two rounds of expert consultation,the evaluation index system of continuous nursing quality for patients with cutaneous ureterostomy was established,including 3 first-level indexes,13 second-level indexes and 54 third-level indexes.3.Results of weight setting: the weights of the first level indicators are as follows: structural quality(0.200),process quality(0.400)and result quality(0.400).The consistency test coefficients of the weights for all indicators are less than 0.1.4.Results of the evaluation index system application: the scores of continuous nursing quality of patients with cutaneous ureterostomy ranged from 52.58 to 87.48,with an average score of 69.82.Conclusion:The continuous nursing quality evaluation index system for cutaneous ureterostomy patients constructed in this study is reliable,comprehensive in coverage,reasonable in weight setting,scientific,operable and specialized.It can provide an objective evaluation tool for continuous nursing quality of cutaneous ureterostomy patients.The application results of the evaluation index system of continuous nursing quality for cutaneous ureterostomy patients play a guiding role in the improvement of continuous nursing quality,and can provide standardized reference for accurate continuous nursing practice and nursing quality management of cutaneous ureterostomy patients.