| Objective1.Based on Nursing standard for adult stoma to construct a specialized nursing-sensitive quality indicators system in intestinal stoma,aiming to provide references for evaluating and improving of the quality of specialist nursing in intestinal stoma scientifically.2.Use the specialized nursing-sensitive quality indicators in intestinal stoma to evaluate quality of specialist nursing in intestinal stoma,analysis and summary of the actual situation in the application of indicators,to improve the quality evaluation system.Method1.Part one: Based on Nursing standard for adult stoma and ‘Structure-Process-Result’mode,according to literature review,group discussion,Delphi method,to construct the specialized nursing-sensitive quality indicators in intestinal stoma and use analytic hierarchy process(AHP)to determine the weight of indicators.2.Part two: In the basis of the specialized nursing-sensitive quality indicators in Part one,make questionnaire of the specialized nursing-sensitive quality indicators,to evaluate the quality of specialized nursing in intestinal stoma through field evaluation and questionnaire survey.Result1.Based on Nursing standard for adult stoma and ‘Structure-Process-Result’ mode and combine with Delphi method and AHP,to construct the specialized nursing-sensitive quality indicators,it has objectivity,rationality and practicability.2.In the basis of the specialized nursing-sensitive quality indicators in Part one,make questionnaire of the specialized nursing-sensitive quality indicators,it has good reliability and validity and to a certain extent,it can be used as a tool to evaluate the quality of specialized nursing in intestinal stoma.3.The Analytic Hierarchy Process shows that the weight of the first level indicators are the result indicator(0.4905),process indicator(0.3119),structural indicator(0.1976),Cr = 0.0517.The first three of the 9 secondary indicators are the outcome(0.2406),the occurrence of complications(0.1530),and the facility allocation(0.1317).The first three ranking of the three indicators are: patients or family members had the skills of pocket making replacement(0.1604),the incidence of skin injury around the stoma(0.1530).The necessary supplies and accessories(including bag making,stoma powder,skin protective film,leakage prevention paste / ring)were necessary(0.1317).CR value of all indexes was less than 0.1.4.Based on the specialized nursing-sensitive quality indicators in intestinal stoma to make questionnaire of the specialized nursing-sensitive quality indicators,nine three-level indicators with the weight of the top 1/2 were selected to form the "evaluation table of sensitive indicators of nursing quality of stoma specialty",and the Cronbach α coefficient was0.768.5.In clinical application,146 patients were evaluated on site,and 9 items in the evaluation questionnaire of quality sensitive indexes of intestinal stoma were evaluated.The two items with good evaluation results were: necessary nursing supplies and accessories(including making bags,mouth powder,skin protective film,leakage prevention paste,and sticking ring),and correctly evaluating the stoma after operation,with the score of 4.95-4.96,the coefficient of variation between 4% and 5%;the four items with good evaluation results were: the incidence of skin injury around the stoma,and timely detection of stoma.The scores of the patients and the peripheral skin complications,the correct implementation of the treatment process of the complications of skin injury around the stoma,the correct selection and use of the stoma care supplies and accessories products were scored between 4.05-4.94,the coefficient of variation was between 5% and 8%;the evaluation results were generally 3 items:the patients or their family members mastered the skills of pocket making replacement,the satisfaction of patients or family members to the overall nursing of stoma,the patients or their families’ satisfaction with the overall nursing of stoma,and the patients’ or their families’ mastering the The scores of the knowledge of the family members were 4.01-4.35,and the coefficient of variation was 12%-16%.Conclusion1.Part one: Based on Nursing standard for adult stoma and taking the "structure process result" three-dimensional quality model as the theoretical framework,using Delphi method and analytic hierarchy process to construct the specialized nursing-sensitive quality indicators in intestinal stoma,which is objective,rational and practical.2.Part two: Based on the specialized nursing-sensitive quality indicators in intestinal stoma,the evaluation form of sensitive indicators of nursing quality of stoma specialty has good reliability and validity,and can be used as an evaluation tool of nursing quality level of intestinal stoma specialty to a certain extent.In the " specialist nursing quality sensitive index evaluation form in intestinal stoma",the entries from nurses’ perspective were better,and the items evaluated from the perspective of patients or family members were generally effective,which may be related to the health education methods of nursing staff,patients’ nursing needs,and the compliance of patients and their families with intestinal stoma... |
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