Construction Of Evaluation Index Of Discharge Planning For Senile Patients

Objective To build a set of index system including the risk screening and the comprehensive evaluation of discharge planning for senile patients,with the aim of early identifying the high-risk groups with discharge difficulties and evaluating patients' discharge needs during the time of hospitalization to provide the basis for determining the service object of the discharge planning and formulating a comprehensive discharge planning service,thus to improve the efficiency and quality of the nursing service.Methods1.The method of literature review was applied to analyze and collate the literature data.With combination of expert consultation and research team seminar,an item pool of risk screening index of discharge planning for senile patients and comprehensive evaluation index of discharge planning for senile patients were made,and an index draft was preliminarily constructed.In accordance with the principle of index screening,Delphi method was adopted to carry out additions,deletions and amendments to the preliminarily-proposed indexes to determine a complete index frame and compute the Delphi evaluation parameter and validity and reliability.2.According to the judgment matrix built by experts for the mean value of the importance assignment of the index,an analytic hierarchy process and yaahp 7.5 software were applied to compute the initial weight coefficient and its large characteristic value,complete single hierarchical arrangement and total hierarchical arrangement and pass the consistency test,thus to determine the index weight of each hierarchy and the combined weight,and then sort by weight to determine the relative importance of each index in subjective assessment and objective reflection.3.Based on index weight,ABC classification method was used to grade the risk factors of the risk screening index of discharge planning for senile patients and evaluate the risk grade.And then,the different grades of the obtained risk indexes were analyzed to provide plans and references to develop discharge planning schemes with different intervention models.Results1.A total of 15 experts were invited for two rounds of expert consultation in this paper.And the positive coefficient of the two rounds of expert consultation was 100%,while the authority core was 0.848 and 0.850 respectively.The finally determined risk screening index of discharge planning for senile patients included 3 first-class indexes and 12 second-class indexes,and the Kendall coefficient of concordance of the two rounds of expert consultation was 0.158 and 0.245 respectively(P?0.01);the comprehensive evaluation index of discharge planning for senile patients included 3 first-class indexes,9 second-class indexes and 33 third-class indexes,and the Kendall coefficient of concordance of the two rounds of expert consultation was 0.165 and 0.167 respectively(P?0.01).2.After the two rounds of consultation,Cronbach's ?,I-CVI range and S-CVI/Ave of the risk screening index of discharge planning for senile patients was 0.674,0.733~1.000 and 0.947 respectively,while Cronbach's ?,I-CVI range and S-CVI/Ave of the comprehensive evaluation index of discharge planning for senile patients was 0.869,0.667~1.000 and 0.935 respectively,with good internal consistency reliability and content validity.3.CR value of indexes at each level in the built evaluation system in this paper was <0.1,which indicated that the consistency of the judgment matrix was acceptable.After the calculation,the first-class' s weight of the risk screening index of discharge planning for senile patients was 0.1199(life factor),0.6080(physiological factor)and 0.2721(medical factor)respectively;and the first-class' s weight of the comprehensive evaluation index of discharge planning for senile patients was 0.2000(evaluation of fundamental state)0.4000(physical and mental evaluation)and 0.4000(discharge management).4.After evaluating the index risk grades of discharge planning for senile patients,it could be concluded that there were 4 high-risk indexes in all,which accounted for 65.10% of the total number of risks;there were 4 middle-risk indexes in all,which accounted for 22.70% of the total number of risks;and there were 4 mild-risk indexes,which accounted for 12.20% of the total numbers of risks.Conclusion1.Through literature review expert consultation and research team seminar,and according to the principle of index construction,the preliminarily-proposed evaluation index of discharge planning for senile patients is consistent with the characteristics of senile patients and reflects the discharge needs of senile patients,with a quite comprehensive content.2.The consultant experts selected in this research are very concerned about this research and very familiar with the content of evaluation index of discharge planning for senile patients,and their suggestions and commendations are of quite high authority,so the data analysis results are reliable.3.The index system is developed using qualitative and quantitative Delphi-AHP method in this paper to make weight setting results of indexes at each level in the evaluation index of discharge planning for senile patients are more objective and correct.4.ABC classification method is used in this paper as a major method for evaluating the risk grades of discharge planning for senile patients.It can reasonably classify the risk indexes of discharge planning for senile patients according to the objective weight,so as to provide the basis for determining the scope of service objects of discharge planning.