Construction Of Use And Management System For ICU Clinical Nurse Specialist In Jiangsu Province And Testing Of Its Reliability And Validity

Objective:To investigate the status quo of clinical use and management for ICU clinical nurse specialists in Jiangsu province,to establish use and management system for ICU clinical nurse specialists in Jiangsu province and determine the weight of each level of the system,and construct to preliminary evaluation of reliability and validity for the system,so as to provide reference for promoting use and management development of ICU clinical nurse specialists in the future.Methods:1.Through searching and analyzing the literatures and soliciting expert opinions,a questionnaire on the status quo of use and management of the ICU clinical nurse specialists in Jiangsu province was designed from the point of view of nursing administrators and ICU clinical nurse specialists respectively,a convenience sampling method was used to select the respondents meeting the criteria for the questionnaire survey,in order to know the current use and management situation of the ICU clinical nurse specialists in Jiangsu province and analyze the existing problems,laying a foundation for the construction of the system framework.2.On the basis of the preliminary questionnaire survey and literature review,a draft of use management system was drew up for the ICU clinical nurse specialists in Jiangsu province,the expert consultation questionnaire was prepared,the Delphi expert consultation was carried out,determing the weight of each level of the system through the analytic hierarchy process.3.A sampling method was used to selecte a certain number of standardized the ICU clinical nurse specialists in Jiangsu province and a questionnaire survey on the use of the management system was conducted,to conduct a preliminary evaluation of the system quality through the reliability and validity and form the final use and management system for the ICU clinical nurse specialist in Jiangsu province.Results:1.Questionnaire survey:At the level of the the nursing management,the work place and work content of the ICU clinical nurse specialists were gradually expanded,managers attached importance to its development,but the team size of this group in the province was small,and the scientific research ability was generally low,the evaluation and post treatment of the ICU clinical nurse specialists needed to be improved.Some hospitals carried out professional qualification examination,but the system of evaluation system was imperfect.At the level of the ICU clinical nurse specialist,the clinical use was not sufficient,there were some phenomena such as vague orientation,low ICU clinical nurse specialists’ satisfaction on post treatment,and their scientific research ability was weak,specialist continuing education,re-certification and others needed to be established and improved.2.Delphi expert consultation:27 experts were invited and selected to participate in the consultation and complete two rounds of Delphi expert consultation work,and then the system of the ICU clinical nurse specialist in Jiangsu province was established,which included 5 first-level items,18 second-level items and 89 third-level items.The effective response rate of the two rounds of consultation were 90%and 100%,the authority coefficient was 0.89,the two rounds of the Kendall’s harmony coefficient were 0.189 and 0.205,the degree of expert coordination in the second round was higher than that in the first round,the difference of the Kendall’s harmony coefficient was statistically significant(P<0.001).3.Analytic hierarchy process:The weight value of the five first-level items from high to low was:job function(0.2826),evaluation(0.2826),post incentive(0.1628),specialty retraining(0.1092),and qualification recertification(0.1628).After consistency check,the consistency ratio of all levels of items was less than 0.1,which accorded with the requirement of consistency.4.Reliability and validity evaluation:The critical ratio of each item was 4.207～11.731(P<0.001),and the correlation coefficient between each item and its total score and its first-level item were all greater than 0.4.The correlation coefficient between the first-level items was 0.574～0.881(P<0.001),the correlation coefficient between the first-level items and the whole system was 0.763～0.901(P<0.001),the I-CVI was 0.833～1.000,the S-CVI/UA was 0.886,the S-CVI/Ave was 0.981.The total Cronbach’s α was 0.988,and the total Guttman Split-Half was 0.882.Finally,the use and management system of the ICU clinical nurse specialist was formed,which included 5 first-level items,18 second-level items and 88 third-level items.Conclusions:1.This study established a scientific and reliable use and management system for ICU clinical nurse specialist in Jiangsu province.2.The use and management system of the ICU clinical nurse specialist in Jiangsu province in this study has good reliability and validity,which can provide reference for managers to strengthen the clinical use and management development of ICU clinical nurse specialists and explore their sustainable development methods.