Construction Of Nursing Quality Evaluation Index System For ECMO

Research Purpose:To establish a set of clinically applicable ECMO nursing quality evaluation index system considering the whole process of ECMO nursing on the basis of evidence-based,accelerate the standardized and scientific management of ECMO nursing,and provide standardized reference for the implementation of ECMO nursing.Research Methods:Firstly,Through the evidence-based nusing method was used to read relevant domestic and foreign literature by developing a rigorous search strategy.Secondly using the Johns Hopkins evidence rating and quality assessment method to assess quality of literatures.Based on the "structure-process – outcome" three-dimensional theoretical model and group discussion the preliminary draft of ECMO nursing quality evaluation indexes was developed.Two rounds of letter consultation were conducted with 17 experts from four regions in Zhejiang province by Delphi method,and the indicators were screened and modified.Finally,the analytic hierarchy process(AHP)is adopted to determine all levels of indicators and their weights.Research Results:1.A total of 20 literature studies were included,including 2 systematic evaluations,3experimental studies,3 observational studies,2 literature reviews,7 expert opinions,and 1 clinical guideline.2.In the two rounds of expert letter inquiries,the positive coefficients of experts were 100%.Index importance assignment mean differences between 4.65 ～ 5.00,the authority of experts coefficient is 0.853 and 0.894 respectively(> 0.7),after two rounds of expert enquiry for all levels of the importance of fluctuation of variation coefficient is 0.00 ～ 0.13,finally construct the ECMO nursing quality evaluation index system includes three level index,10 secondary index and 41 threelevel indicators of quality evaluation index system.3.The analytic hierarchy shows that the process index(0.5936)has the highest weight value.Among the first-level indexes.Among the secondary indicators,the top three were ECMO computer preparation,ECMO operation management and clinical complications.Among the three indicators,the top three are the probability of successful withdrawal,the implementation rate of ECMO parameter monitoring,and the accuracy rate of capacity monitoring.Research Conclusion:The ECMO nursing quality evaluation index system was established based on Donabedian quality management model by combining Delphi and Analytic Hierarchy Process(AHP).The evaluation index system is more scientific,systematic and reasonable weight distribution,which can reflect the process of ECMO nursing work and can be used as a tool for ECMO nursing quality evaluation.