Establishment Of Difficulty-assessing Index System Of Nursing Operation Technique

Medical care is a service with high risk and advanced technique. Both doctors' surgical therapy and nurses' operation technique have corresponding technical criterion. Researches on difficulty assessment of nursing operation technique can facilitate the improvement of nursing performance evaluation system, provide reference for developing the nursing operation technique charging standard, and help carry out nursing ability and capacity corresponding, operate nursing techniques according to hierarchic sequence of nursing human resource. Meanwhile, it can provide basis for examining nursing techniques impartially, objectively and scientifically, which will promote the improvement of modem nursing administration system.Objective:To establish a scientific, reasonable, quantitative and comparable index system of difficulty assessment of nursing operation technique.Methods:Delphi Method was adopted to form a assessment system. Experts in three fields—clinical nursing, nursing administration and nursing education came from five provinces(cities) and took part in the three-round consultations. Synthetic index method and critical value were used to screening indexes. AHP method was adopted to determine weights of first class indexes; experts evaluation method was used to setting weights of second order indexes. Positive coefficient, Kendall coefficient and authoritative coefficient were adopted to test the credibility of this study.Fifty nursing experts were invited to evaluate the difficulty of ten representative basic nursing operation techniques, which is to measure the new index system practically. Weighted sum method and Fuzzy synthetic evaluation were employed for comprehensive evaluation. Cronbach's alpha coefficient and Kendall coefficient were adopted to assess the stability and advisability of the new index system.Results:The draft of index system was developed and perfected by integrating results of three-round consultations and professional characteristics. And an index system of difficulty assessment of nursing operation technique consisted of five items in first level and eleven items in second level was established. Weights of five items in first level set by AHP method were: W_{operation skill complexity degree}=0.3094, W_{operator standard}=0.3005, W_{operation condition}=0.0970, W_{operation intensity}=0.0675, W_{operation risk}=0.2255. Positive coefficient of three expert consultations were 100%, 100%, and 95.5%; Kendall coefficient were 0.2357(X²=62.2125, P＜0.05),0.2181(X²=62.3840, P＜0.05),0.2868(X²=60.2337, P＜0.05); authoritative coefficient was 0.89.The difficulty coefficient of ten basic nursing operation techniques measured by the fourth round survey were: blood transfusion 1.47, urinary catheterization for female patient 1.38, suctioning from oral cavity or nasal cavity 1.37, closed intravenous infusion 1.34; nasogastric gavage 1.27, intradermal injection 1.16, making an occupied bed 1.07, prepare sterile treatment tray 1.04, mouth care 1.03; measuring Vital Signs 0.98. Cronbach's alpha coefficient of ten departments were between 0.7739 and 0.8601; Kendall coefficient of "making an occupied bed" was 0.8745(x²=437.2436, P＜0.05).Conclusions:The index system constructed in this research is clearly arranged; the number of items is appropriate and comprehensive; weights of items are reasonable; results of three-round consultations are reliable according to experts'positive coefficient, Kendall coefficient and authoritative coefficient; consultations show good function of evaluation, too. In a word, the new system can reflect the difficulty of nursing operation technique in every dimensions and it can assess the goal impartially and objectively.