The Elavuation Index System Research On Nursing Quality Of Surge Hospitals In Mass Casualty Incidents

ObjectiveAs there were no criteria for evaluating the nursing quality of surge hospitals around theworld, this study was designed to establish a comprehensive index system for evaluatingthe quality of nursing care during medical response period of mass casualty incidents.Adopting a conceptual framework of surge capacity, we applied several methods such asqualitative method and Delphi method to conduct the study. A nursing material preparationlist for surge hospitals was also developed. This study can provide a reference and a basictool for addressing such kind of problem.MethodsThe study can be divided into three stages.Stage I: Research on the current situation of nursing quality in surge hospitals. Adopting aqualitative method using the phenomenographic design where9specialists in the field ofhospital management, nursing management or health service were approached forsemi-structured interviews, we learned the evaluation method and status quo of nursingquality in surge hospitals. Core elements of nursing quality in surge hospitals were alsoextracted by analyzing the audiotapes. The findings can provide a reference forestablishing evaluation index system in the following stage.Stage II: Establishment of nursing quality evaluation index system for surge hospitals. Thedraft of evaluation index system was firstly developed using literature review andsemi-structured interviews. Twelve specialists were then invited to participate in2roundsof surveys aimed at developing consensus. After two rounds of Delphi procedure, thecontents and dimension weight coefficient of nursing quality evaluation index system weredetermined by using analysis hierarchy process and experts marking. Therepresentativeness and credibility of the Delphi method were also tested by the positivecoefficient, authoritative coefficient, coordination coefficient and the concentration ofexpert advice.Stage III: Formulation of nursing material preparation list for surge hospitals. The draft ofnursing material list was built through literature review, expert interview and Delphimethod. We didn’t end the expert consultation until the agreement rate of each term exceeded80%.ResultsStage I: Research on the current situation of nursing quality in surge hospitals. Twocategories and seven subcategories emerged. The principal categories includedorganization and management, and expertise level while the subcategories were protocolsand responsibilities, staffing, material management, drills, patient severity evaluation,nursing safety, disease prevention and control.Stage II: Establishment of nursing quality evaluation index system for surge hospitals.The evaluation index system consisted of two modules. One was specific nursingquality evaluation system, which included three level-1dimensions i.e. human resourcemanagement, material management and institutional management,12level-2dimensionsand47level-3dimensions. And the other one was basic nursing quality evaluation system,including three level-1dimensions i.e. routine nursing quality, infection control andnursing risk management,10level-2dimensions and27level-3dimensions.The three-round Delphi method had a positive coefficient of1.0, authoritativecoefficient of0.75. In addition, the first module had a coordination coefficient of0.588,while that of the second module was0.501. The whole evaluation index system hadcoordination coefficient of0.544, with P value lower than0.01using chi-square test.For the first module, the weight coefficient of three level-1dimensions was0.4,0.3,0.3, while that of the second ones was0.3,0.4,0.3, respectively.Stage III: Formulation of nursing material preparation list for surge hospitals. An86-termmaterial list was formulated, which included four parts, that is ventilatory devices,auxiliary material, bandage and splint, devices to support circulation and drug deliverydevices, and the others. The agreement rate of the expert consultation for each termexceeded90%.ConclusionThis research studied the current evaluation method and status quo of nursing quality insurge hospitals in China by using qualitative study and Delphi method. Firstly, twocategories and seven subcategories emerged after the semi-structured interviews. The categories for organization and management were: protocols and responsibilities, staffing,material management, drills. The categories for expertise level were: patient severityevaluation, nursing safety, disease prevention and control. Secondly, a nursing qualityevaluation index system with two modules was established through Delphi method. Thefirst module had three level-1dimensions i.e. human resource management, materialmanagement and institutional management,12level-2dimensions and47level-3dimensions. And the second module had three level-1dimensions i.e. routine nursingquality, infection control and nursing risk management,10level-2dimensions and27level-3dimensions. Finally an85-term nursing material list was formulated. All of thesefindings can provide a reference for the nursing quality evaluation during medical responseperiod of mass casualty incidents.