Construction Of Nursing Quality Evaluation Index System For Acute Leukemia

BackgroundAcute leukemia is one of the most common hematological malignancies.The morbidity and mortality in China are 6.70/10 and 4.05/10 million respectively.It is reported that acute leukemia patients can have 4~11 clinical symptoms such as infection,and 16 nursing problems,such as activity intolerance.The nursing is difficult and the nursing needs are complex.The current situation of nursing quality is not optimistic and needs to be improved.The establishment of nursing quality evaluation index system for specialist diseases has been recognized as a scientific method to ensure the quality of nursing profession.However,there is no study on the evaluation index system of acute leukemia nursing quality.Therefore,based on the framework of Donabedian's "structure process results" three-dimensional quality structure model,the evaluation index system of acute leukemia nursing quality is constructed by literature review,qualitative interview,expert meeting,delphi method and analytic hierarchy process,so as to evaluate and improve the nursing quality of acute leukemia in the future.ObjectiveTaking Donabedian's "structure process result" three-dimensional quality structure model as the theoretical framework,through a variety of methods,construct the evaluation index system of acute leukemia(non transplant)nursing quality including structural level,process level and result level,which conforms to the requirements of index definition and the whole process of nursing.Methods1.The relevant literature related to the quality evaluation of acute leukemia at home and abroad was retrieved,and the evaluation indexes related to the quality of acute leukemia nursing were extracted,and the evaluation index pool of acute leukemia nursing quality was formed.2.Through the semi structure and depth interview to the medical and nursing staff of the hematology department,the idea of the medical and nursing staff to evaluate the quality of acute leukemia nursing quality was understood,and the evaluation index pool of acute leukemia nursing quality was supplemented.3.Combined with the results of literature retrieval and qualitative interview,from the process of acute leukemia nursing quality formation: structural level,process level and result level,it analyzed the indicators that can reflect the quality of acute leukemia nursing quality,and drew up the evaluation index system of acute leukemia nursing quality.Then through expert meeting,delphi method and analytic hierarchy process(AHP),the index system and weight of acute leukemia nursing quality evaluation were determined,and the definition of acute leukemia nursing quality index was defined: name,category,calculation formula and collection method.Results1.In this study,two rounds of expert consultation were conducted,and 2 rounds of expert consultation were 100% and 94.74% respectively.The expert authority coefficient Cr is 0.848 and 0.854 respectively,and the Kendall coordination coefficient W is 0.273 and 0.420,respectively(P < 0.01).2.The final evaluation index system of acute leukemia nursing quality includes 3 first grade index,8 two grade index,24 three grade index(3 structural index,7 process index,14 result index),and each three level index contains index name,calculation method and data collection method.3.The analytic hierarchy process(AHP)shows that CR of all levels is less than 0.1,indicating that the index system has a high degree of consistency.In the first level index,the weight value of the structural index is 0.117,the weight of the process index is 0.268,and the weight of the result index is 0.614.Among the two level indicators,the top 3 indicators of combination weight were: nursing measures,hospital infection and patient complications.Among the three level indicators,the index of the top 3 of the combined weights was the incidence of respiratory infection in acute leukemia patients,the incidence of central catheter related blood flow infection in acute leukemia patients,and the complete implementation of protective isolation measures in patients with acute leukemia.Conclusion Based on the "structure process result" three-dimensional quality structure model of Donabedian,a set of evaluation index system for acute leukemia nursing quality was constructed with qualitative and quantitative research methods,which included 3 first grade index,8 two grade index,24 three grade index(3 structural index,7 process index,14 result index)and the three level indicators are clearly defined.The highest grade one,two and three indicators were outcome indicators,nosocomial infection and incidence of respiratory tract infections in AL inpatients.The construction of the index system is more scientific and reliable.The indicators at all levels are closely related to the characteristics of acute leukemia and nursing.It can comprehensively measure the nursing quality of acute leukemia,and provide the basis for clinical evaluation and improvement of the quality of acute leukemia nursing.