Establishment Of A Nursing Quality Indicator System For Institution That Integrating Pension With Medical Care

Objective:To explore the current situation and existing problems of nursing quality evaluation in the institution that integrating pension with medical care in China,and to establish a nursing quality indicator system of the institution that integrating pension with medical care.Methods:Descriptive phenomenological methodology was adopted in this study,a semi-structured interview was conducted with 8 nurse managers from 7 institutions that integrating pension with medical care,data were analyzed based on Colaizzi's phenomenological research method.The "structure-process-outcome" proposed by Donabedian is the theoretical framework.Based on the results of literature review and qualitative research,the first round of the consultation questionnaire on quality indicator system was established.According to the content of this study,18 experts who work in nursing management,clinical geriatric nursing and nursing research on geriatric nursing were enrolled in the questionnaire investigation by the Delphi Method,and Analytic hierarchy process(AHP)was used to determine the index weight,finally the quality indicator system of the institutions that integrating pension with medical care was established.Results:1.Two themes were extracted through qualitative interviews with 8 nurse managers,including:the status of care quality evaluation in the institution that integrating pension with medical care;key indicators of nursing quality in the institution that integrating pension with medical care.2.After two rounds of consultation,the experts advised to reach consensus,the recovery rate of two rounds of consultation was 81.8%and 83.3%respectively,the expert authority score of two rounds were 0.903and 0.904;and the coordination coefficients of the second round of consultation were 0.278,0.226 and 0.222,respectively.The quality indicator system of the institutions that integrating pension with medical care consisted of 3 first-level indicators,17 second-level indicators,and 67 third-level indicators.3.The analytic hierarchy process was used to determine the weights of the first-level and second-level indicators.The 3 first-level indicators and its index weights were structure quality evaluation(0.1429),process quality evaluation(0.4286),and outcome quality evaluation(0.4286).The 17 second-level indicators and its index weights were environment(0.0736),organization system(0.1923),institutional norms(0.2537),materials and equipment(0.1457),nursing human resources(0.3347),daily living care(0.1762),therapeutic care(0.1130),observation and treatment of the disease(0.1762),mental nursing(0.0713),rehabilitation nursing(0.0411),security management(0.2422),infection control(0.0880),palliative care(0.0310),nursing records(0.0610),satisfaction(0.6144),compliance(0.1172),adverse outcome(0.2684).Conclusions:1.In this study,qualitative research was used to find out that the quality of nursing care varies and the unified nursing quality evaluation standard absent,and nursing managers pay more attention on primary care and safety management,but overlook the humanistic care and rehabilitation nursing.Therefore,it is urgent to establish a unified and comprehensive nursing quality evaluation standard.2.This study established the quality indicator system of the institutions that integrating pension with medical care,its feasible method,reasonable content and reliable results can provide evidence for nursing quality evaluation.