Constructing Of An Effectiveness Evaluation System Of Closed Thoracic Drainage System And Empirical Study

Objective:1. By means of physical experiments and Delphi expert consultation, this thesis is to establish effectiveness evaluation of closed thoracic drainage system.2. By clinical empirical study , this thesis is to describe the current situation of clinical closed thoracic drainage system explore its influential factors.Methods:1. Based on ADC effectiveness assessment theory famewok , effectiveness evaluation of closed thoracic drainage system was developed from three dimensions including availability (A), Dependability (D), Capacity (C). The physical fluid dynamics experiments with hypotheses were made by a physical model of closed thoracic drainage. Experts were consulted to evaluate content validity and indicator weights were got with Analytic Hierarchy Process (AHP), then obtained closed thoracic drainage system effectiveness evaluation form.2. 201 patients were facilitated selected from 8 hospitals in Fujian Province and received on-site assessment from October 2010 to January 2011. The descriptive statistics, Analysis of variance and t test were adopted to describe status and analyze influential factors.Results:1.The physical experimental model of closed thoracic drainage was established, and attained the ideal physical conditions. Three fluid experimental hypotheses were ompleted. The first experiment demonstrated that large bore chest tubes for drain high liquid viscosity was better than the small diameter tube, but the inner diameter of drainage tub got a certain size (28F and above), the drainage volume of unit time in different diameter tubes had no significant difference. The second experiment proved that the ideal length of clinical chest tube should be 140-160cm. The third experiment demonstrated that the hydrostatic pressure was required at the beginning between vertical state and curled state of drainage tubes had statistical difference.2. The effectiveness evaluation of closed thoracic drainage system included 3 dimensions, 13 indicators and 39 indexes, which was clear and reflected Systematic thinking. 3. The closed thoracic drainage system effectiveness evaluation form.①Content validity: the assessment form was developed based on the ADC theoretical framework, literature review, Delphi expert consultation and pre- survey, its content validity index(CVI) was 0.941.②Reliability: the Cronbach'sαCoefficient of internal consistency reliability for overall assessment form was 0.949, the three dimensions were 0.906,0.837 and 0.797.③Construct validity: the result of factor analysis showed that there factors which cumulatively explained 63.61%.4. The survey results showed that effectiveness of closed thoracic drainage scored 65-94, an average of 83.3, median 85.50(80-88). It is above the middle level.5. The score in different gender patients were no statistically difference (P>0.05). But different diseases, different drainage tube size had difference (P <0.01).Conclusions:1. The effectiveness evaluation system of closed thoracic drainage system had comprehensive content and good correlation with the theme, and could fully reflects the conceptual framework and had good reliability and validity.2. The effectiveness evaluation system of closed thoracic drainage system could be used as guidelines for clinical practical care, provided nurses with evidence during the operation and prevent blindness and randomness, effectively guaranteed the patient's safety. Meanwhile, the establishment of evaluation index system could promote improvement of the care quality and indicated the direction of nursing services.