Construction Of Nursing Quality Evaluation Index System For Bronchoscopic Diagnosis And Treatment

ObjectiveBased on the three-dimensional quality model,this study constructs a set of nursing quality evaluation index system of bronchoscopy diagnosis and treatment with scientificity,feasibility and clinical applicability to provide a theoretical and practical basis for nursing quality management of bronchoscopy diagnosis and treatment,in order to further improve the nursing quality of respiratory endoscopy.Methods1.literature review method: computerized search of relevant literature on bronchoscopy diagnosis and care quality evaluation and screening of literature.The Johns Hopkins evidence-based nursing practice model was used to extract and organize the contents of the included literature and form the framework of bronchoscopy diagnosis and treatment nursing quality evaluation indexes.2.Semi-structured interview method: Based on the results of the literature review,an interview outline was prepared,and bronchoscopy nursing staff and nursing managers in tertiary hospitals were selected for face-to-face interviews to initially form bronchoscopy diagnosis and treatment nursing quality evaluation indexes.3.Delphi method: 20 bronchoscopy nursing management,medical management and clinical nursing staffs were selected for 2 rounds of expert correspondence.Combining the results of statistical analysis and experts’ opinions,the final evaluation index of bronchoscopic care quality was formed.4.Hierarchical analysis method: The hierarchical model and judgment matrix were established by using yaahp 12.3 software,and the weights of indicators at all levels were calculated and tested for consistency.5.Questionnaire survey method: The questionnaire of bronchoscopic nursing care quality evaluation index was formed by standardizing the index weights and using purposive sampling,17 nursing managers of medical institutions were selected for the survey to test the reliability of the bronchoscopic diagnosis and care quality assessment tool.Results1.results of literature review: 19 articles were included after the initial and rescreening of the literature search.Four articles were evaluated by level of evidence and quality at IIB,four articles at IIIB,four articles at IVA,one article at VA,and six articles at VB.Initially,3 primary indicators of structure,process and outcome quality,13 secondary indicators of nursing staffing,professional knowledge and expertise,training and assessment,and 58 tertiary indicator frameworks such as nursing desk ratio,medical to nursing ratio,composition of nursing staff with different education,percentage of nurses with different titles,and knowledge of respiratory system anatomy and physiopathology were constructed.2.Results of semi-structured interview method: A total of 8 interviewees,including 2 nursing managers and 6 bronchoscopy nursing staff,were included in the interviews.Based on the clinical staff’s understanding and knowledge of nursing quality and the important influencing factors in bronchoscopic diagnosis and care,2 themes and 4 sub-themes were extracted,and the indicator framework was modified to form an expert correspondence questionnaire with 3 primary indicators,13 secondary indicators,and 57 tertiary indicators.3.Delphi method results: two rounds of expert correspondence were conducted,and the effective recovery rates of the first round and the second round of correspondence were 100% and 95% respectively;The expert’s judgment basis is 0.895 and 0.931 respectively;The familiarity levels are 0.940 and 0.968 respectively;The authority level is 0.917 and 0.949.The coefficient of variation of the two rounds of indicators ranges from 0.000 to 0.162 and from 0.000 to 0.132,respectively.The CV of the two rounds of correspondence indicators is less than 0.25.The Kendall’s W ranges for the importance,formula rationality,and operational feasibility of the two rounds of indicators were 0.335-0.498 and 0.316-0.510,respectively,with statistically significant differences(P<0.05).results of hierarchical analysis method: the weights of structural indicators,process indicators,and outcome indicators in the weight setting were 0.142,0.429,and 0.429,respectively,and the CR values of all indicators were <0.1,with good consistency.4.Results of questionnaire method: Cronbach’s α of bronchoscopy diagnosis and care quality evaluation tool was 0.902,among which Cronbach’s α of structural indicators was 0.711,Cronbach’s α of process indicators was 0.814,and outcome indicators Cronbach’s α was 0.824,with good internal consistency.The Spearman’s correlation coefficient for the two combined evaluations was 0.983(p < 0.001).Conclusions1.Based on the three-dimensional quality model,this study constructed a set of bronchoscopy diagnosis and treatment nursing quality evaluation index system,including three first level indicators of structure,process,and result quality,12 second level indicators,and 60 third level indicators.The index system is scientific,reliable,and clinically applicable.2.The index system can provide an objective reference basis for the evaluation of the quality of bronchoscopy diagnosis,treatment and nursing,so as to promote the continuous improvement of the quality of bronchoscopy diagnosis,treatment and nursing,and promote the development of scientific,standardized,standardized,refined and homogeneous nursing quality management.