Construction Of Evaluation Index For Pre-hospital Treatment Skills Of Nurses With Severe Trauma In Yunnan Province

Objective(s):The purpose of this study is to construct the evaluation index of pre-hospital first aid skills of nurses with severe trauma in Yunnan province,and to verify its reliability and validity,so as to provide scientific and objective reference evaluation criteria for evaluating pre-hospital first aid skills of nurses with severe trauma in Yunnan province,and make the evaluation evidence-based;To provide the basis for standardizing the pre-hospital first aid skills training of nurses in the provincial medical units,and to promote the improvement of the trauma treatment ability of nurses in Yunnan province.Methods:1.Preliminary construction of evaluation indicators:(1)Literature review method:search the relevant literature and policy documents of pre-hospital treatment skills of severe trauma in recent 5 years,and lay the foundation for defining the research direction and constructing evaluation index for this study;(2)Semi-structured interview method: interview the experts from the expert committee on the construction of trauma centers in Yunnan Province,discuss the present situation of nurses’ pre-hospital treatment skills for severe trauma in Yunnan Province and suggestions on evaluation indicators,and analyze the results by using Nvivo 11.0 plus software to make up for the lack of quantitative research on the present situation of nurses’ pre-hospital treatment skills for severe trauma in Yunnan Province,so as to provide a basis for the localization of evaluation indicators;(3)Based on the results of literature review and semi-structured interviews,an evaluation index for nurses’ skills in pre hospital treatment of severe trauma in Yunnan Province was initially constructed.2.Determine the evaluation indicators: according to the preliminary evaluation index,an expert consultation form is formulated and expert consultation is conducted.SPSS 25.0 software is used to count the positive coefficient,authoritative coefficient and expert coordination coefficient of experts,etc.To verify the scientificity and reliability of the consultation results,the final draft of pre-hospital treatment skills evaluation index of nurses with severe trauma in Yunnan Province is formed.3.To test the reliability and validity of evaluation indicators indicators: A a cluster sampling method was used to conduct a questionnaire survey of nurses in trauma centers of medical units that have passed the certification of Yunnan Trauma Center,and the three-level items of the evaluation index were transformed into a self-evaluation questionnaire to obtain relevant data.The data were analyzed by SPSS25.0,and the authenticity,reliability and consistency of the questionnaire were evaluated by calculating Cronbach α coefficient,content validity and structure validity.Results:1.The interview extracted 4 themes and 11 sub-themes.The main contents of the themes include:(1)There is no clear standard for the construction of trauma care;(2)Nurses’ ability of pre-hospital treatment is weak;(3)Lack of evaluation index of nurses’ rescue skills;(4)the evaluation index should highlight the characteristics of pre-hospital trauma care.Combined with the results of literature review,a primary evaluation index including 3 first-level items,13 second-level items and 37 third-level items was formed.2.There are 15 experts in this consultation.After two rounds of expert consultation,the experts’ opinions are consistent.According to the statistics of the consultation results,the positive coefficient of both rounds is 1.0,the expert authority coefficient is 0.85 and 0.89,and the overall Kendall’s W of both rounds is 0.171 and0.175,all of which are P<0.001.After the first round of expert consultation,one second-level item and five third-level items were deleted;Amend 1 item of Level 2entry and 13 items of Level 3 entry;Three new second-level entries and four new third-level entries are added.After the second round of expert consultation,the first-level items and the second-level items have not been modified or deleted;Level3 entries have not been deleted,and four level 3 entries have been modified.Finally,the final draft of evaluation index of pre-hospital treatment skills of nurses with severe trauma in Yunnan Province was formed,including 3 first-level items,15second-level items and 36 third-level items.3.A total of 276 questionnaires were distributed and 270 valid questionnaires were collected,with an effective recovery rate of 97.83%.After statistical analysis,the total Cronbach’s α coefficient of questionnaire reliability evaluation index is 0.984 and Spearman-Brown coefficient is 0.955.The content validity of the questionnaire I-CVI is 0.83-1.00,and the S-CVI is 0.96;The structural validity was extracted from three common factors by exploratory factor analysis,with the cumulative variance contribution rate of 65.852%,the variance contribution rate of common factors of each item > 66.202%,the absolute value of each item’s load on the corresponding common factor > 0.4,and the range of 0.686-0.843.The structure was concise and clear,and the above data showed that the questionnaire was reliable and valid.Conclusion(s):This study is based on literature review and semi-structured interviews,and the evaluation index initially constructed according to scientific steps is scientific.It is proved that the evaluation index is scientific and reliable by calculating the statistical results such as expert authority coefficient and variation coefficient.The test of reliability and validity proves that the structure of the evaluation index is concise and clear,and the reliability and validity are good.In this study,the semi-structured interview,expert consultation and reliability and validity test all selected trauma emergency professionals in Yunnan Province,so the final evaluation index is scientific,operable and localized,which can provide scientific and objective reference for standardizing the evaluation and training of nurses’ pre-hospital treatment skills for severe trauma in medical institutions in Yunnan Province,and make the training and evaluation systematic and standardized,thus promoting the improvement of nurses’ trauma treatment ability in Yunnan Province.