| ObjectivesBased on the De Lone and Mc Lean Model of Clinical Information Systems Success,combined with the development requirements of nursing informatization in our country and the actual situation in the field of clinical nursing information,the comprehensive evaluation index system of clinical nursing information system was constructed by qualitative interview,Delphi method and Analytic hierarchy process,and it is reliability and validity were tested,which provided evidence support for comprehensive,systematic and objective evaluation of clinical nursing information system.Methods（1）Literature review method:Systematic retrieval of domestic and foreign literature,books and research reports on nursing information system,integration of relevant information system evaluation theory/tools/methods,as well as policy requirements and documents,to obtain relevant evaluation indicators.（2）Semi-structured interview method:From June to July 2021,seven nursing staff and one hospital information technology staff were included to conduct semi-structured interviews.Graneheim＆Lundman content analysis method was used to extract and supplement evaluation indicators,the comprehensive evaluation index system of clinical nursing information system was initially built up.（3）Delphi method:From October 2021 to January 2022,two rounds of letter consultation.The enthusiasm and authority of experts as well as the degree of coordination and concentration of their opinions were statistically analyzed.The evaluation indexes were modified according to the expert opinions and strictly according to the screening standards,and the comprehensive evaluation index system of clinical nursing information system was determined.（4）Analytic hierarchy process:According to the results of letter consultation,Yaahp12.8 software as used to establish the hierarchical structure analysis model,construct pairwise index comparis on judgment,check the consistency of matris,and determine the weight of each index.（5）Questionnaire survey method:In February 2022,a questionnaire survey was conducted on nurses who met the inclusion criteria in a Grade 3A hospital in Lanzhou.The content validity of the evaluation index system was analyzed,Cronbach’sαcoefficient and correlation coefficient were calculated by SPSS25.0,and the reliability and structural validity of the evaluation index system were tested respectively.Results（1）Results of semi-structured interview:Through semi-structured interview,the following four themes were extracted:The relevant characteristics of data information in clinical nursing information system;The characteristics/functions of the clinical nursing information system;The help and service provided by external environment such as network center/information center for nurses to use clinical nursing information system;Application effect of clinical nursing information system.Combined with the related indicators obtained in the previous literature review,the comprehensive evaluation index system of clinical nursing information system was preliminarily developed,including 6 first-level indicators and 50 second-level indicators.（2）Results of delphi method:18 epperts participated in the Delphi consultation,and the effective recovery rate of the two rounds of questionnaires was 100%,indicating high enthusiasm of the experts.First round expert authority coefficient（Cr）=0.920,expert coordination coefficient（Kendall’W）=0.165（X~2=163.345,P<0.001）,Cr=0.925,Kendall’W=0.220（X~2=146.454,P<0.001）,after consultation with experts,opinions on evaluation indicators tended to be consistent.Finally,the comprehensive evaluation index system of clinical nursing information system including 6 first-level indicators and 31 second-level indicators was determined.（3）Results of analytic hierarchy process:The weights of system quality,information quality,external support,usage,user satisfaction and use benefit of the 6first-level indicators were 0.227,0.227,0.129,0.129,0.062 and 0.227,respectively.The weight coefficients of the secondary indexes ranged from 0.010 to 0.068（CR<0.10）,that is,the consistency of judgment matrix is good,and the weight of each indicator is reasonably assigned.（4）Results of reliability and validity evaluation:The comprehensive evaluation index system of clinical nursing information system had good reliability and validity:the total Cronbach’sαcoefficient of evaluation index system was 0.984,and the Cronbach’sαof each level index ranged from 0.891 to 0.963.The correlation coefficients between each level of indicators ranged from 0.757 to 0.910（P<0.01）.Delphi expert letter consultation has a high coordination of expert opinions,and the weight coefficient of hierarchy analysis results is logical,which ensures the content validity of the evaluation system.ConclusionThis study constructs the comprehensive evaluation index system of clinical nursing information system,and the research results are scientific and reliable.The comprehensive evaluation index system is composed of system quality,information quality,external support,use situation,user satisfaction and use benefit.The evaluation content is comprehensive and the structure is reasonable,which provides a reference for the systematic and objective evaluation of clinical nursing information system. |
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