Development Of Nursing Rounds Checklist For Patients With Severe Abdominal Trauma

Objective:This study focused on the particularity of severe abdominal trauma,through literature review,semi-structured interview and clinical observation methods to obtain the best evidence of medical care for severe abdominal trauma and construct a nursing round checklist for patients with severe abdominal trauma.Aiming at innovating the nursing rounds mode,reducing nursing omissions and errors,providing scientific management tool for nursing round practice of patients with severe abdominal trauma,improving the nursing staff’s compliance to evidence-based measures and clinical guidelines,and improving the quality of care for patients with severe abdominal trauma.Methods:1.Literature review: According to the retrieval strategies,literature\guideline\expert consensus related to the treatment and nursing of severe abdominal trauma were retrieved.The English literature databases including PubMed,Embase,Web of Science,Cochrane Library.The Chinese literature databases including CNKI,Wanfang Database and Chinese Biomedical Literature Service System.2.Semi-structured interview: Thirteen medical staff were selected for semi-structured interviews.After the interview,the interview information was sorted out,the interview topics were extracted and the existing literature items were supplemented.3.Clinical observation: The medical staff and patients with severe abdominal trauma in emergency medicine department,general surgery(trauma surgery)and Intensive care unit were selected as clinical observation objects.The treatment and nursing behaviors were recorded by the way of on-site tracking combined with browsing the diagnosis and treatment record sheet.After the observation,organize the content in time and add it to the checklist items.4.Perfection by experts : Seek expert opinion on existing checklist items.The suitability of items and nursing rounds was evaluated according to the clinical practice.To put forward necessary suggestions on addition,deletion and modification.The structure,framework,and language of the checklist are repeatedly discussed and revised.Adjust and modify the consultation items according to the expert opinions to form the final expert letter questionnaire.5.Delphi method: Questionnaires were distributed by We Chat,email and direct delivery.Invite experts to evaluate the importance and operability of each item,and put forward professional suggestions for modification or adjustment.6.statistical analysis: Use expert positive coefficient,authority coefficient,variation coefficient and coordination coefficient to analyze and evaluate the quality of the questionnaire.Results:On the basis of literature review,semi-structured interview,clinical observation and perfection by experts,this study constructed the basic framework of the nursing ward round checklist for patients with severe abdominal trauma preliminarily.The checklist framework including 3 level-I items,10 level-II items and 43 level-III items.After two rounds of expert consultation,the checklist framework was finally adjusted to 3 first-level items,11 second-level items and 42 third-level items.According to the statistical results,the effective recovery rate of the two rounds of expert inquiry was90% and 100%,respectively;expert authority coefficients were 0.918 and 0.916,respectively.After the second round of consultation,the importance value of each item ranged from 0 to 0.189 and the coefficient of variation from 0 to 0.192,and the Kendall’s W coefficient was 0.356 and 0.358,P<0.001,the difference was statistically significant.Conclusion:This study was guided by the nursing procedure and the inventory management theory.Through focused on the particularity of severe abdominal trauma,a nursing round checklist for patients with severe abdominal trauma was constructed.The final checklist consists of 3 first-level items,11 second-level items and 42 third-level items.The result of statistical analysis is reliable.The positive degree,authority degree and coordination degree of experts are all high.The contents of this checklist are scientific and practical in clinical practice,which can be used for reference in nursing rounds of patients with severe abdominal trauma.