Research On The Construction Of Nursing Quality Evaluation Index System For Kidney Transplant Patients Based On Structure-Process-Outcome Model

Objective: Based on the three-dimensional mass structure model of "structure-processresult",this study constructs a set of comprehensive,scientific,operable and reasonably weighted nursing quality evaluation indicators for kidney transplant patients,which provides scientific and effective tools for improving the overall nursing quality of kidney transplant patients,and also provides a basis for horizontal or longitudinal comparison of nursing quality of kidney transplant patients.Methods: Based on the three-dimensional quality model of "structure-processoutcome",this study included the nursing quality evaluation indicators for renal transplant patients through literature review,and conducted semi-structured interviews from November 2021 to February 2022 to supplement the previous research results,and formulated the first draft of the nursing quality evaluation index system for kidney transplant patients.From March to May 2022,two rounds of Delphi expert consultation were conducted,and finally the importance scoring results of these indicators were applied to the analytic hierarchy method to obtain an authoritative indicator system and the weights of each level of indicators.Results: This study included a total of 30 experts from 11 provinces and cities to conduct semi-structured interviews and two rounds of Delphi expert consultations.The questionnaire recovery rates of the two rounds of Delphi method were 100% and 95.8%,indicating that the enthusiasm of experts was high.The expert authority coefficients were 0.846 and 0.852,indicating that experts mostly relied on personal practical experience and advanced theories at home and abroad in the process of index evaluation.The Kendall coordination coefficient is 0.281,0.296,and the Kendall coordination coefficient has improved in the second round.The P value of the above data significance test is less than 0.001,which indicates the credibility and scientificity of the expert inquiry results.In the end,3 first-level indicators,11 second-level indicators and 65 third-level indicators were obtained.On the basis of the expert’s index importance score,the weight calculation of each level of indicators and the consistency test are carried out in combination with the analytic hierarchy method.The CR value of the consistency test of all levels of indicators was less than 0.1,and the weight calculation results showed that the index ‘Ⅲ-7 Qualification rate of skills and knowledge training related to renal transplantation’(0.0926)was the highest,followed by ‘Ⅲ-40 Implementation rate of medication guidance’(0.0655),‘Ⅲ-5 Development and update of specific training program for renal transplantation’(0.0589),‘Ⅲ-38 Implementation rate of postoperative dietary guidance’(0.0496),and ‘Ⅲ-10 Qualified rate of hand hygiene monitoring’(0.0404).Conclusion: Through the constructed nursing quality evaluation index system for kidney transplant patients,specific and targeted nursing quality evaluation standards for specialized kidney transplant patients are proposed,which is easier to find the problems of nursing staff in their work,and has certain promotion value.The findings suggest that process indicators are the most important of the three first-level indicators,suggesting that future care efforts should focus on the care process.This index system can comprehensively evaluate the nursing quality of kidney transplant patients,and play an important role in improving the nursing quality of kidney transplant patients.