Development Of Nursing Risk Assessment Form For Venous Thromboembolism In Hospitalized Patients

Objective:Venous thromboembolism(VTE)as a common clinical preventable fatal complication,its early risk assessment and prevention research has become the focus of clinical and scientific research personnel at home and abroad in recent years.Currently,there is a general concern about the prevention of VTE in patients undergoing surgery or post-traumatic treatment.The prevention of VTE in hospitalized patients is not given enough attention.However,in clinical practice,hospitalized patients have higher VTE prevalence and mortality.This study starts from the point of view of inpatients in internal medicine,and uses literature analysis methods,Delphi expert consultation methods,etc.to study and develop an assessment scale that is suitable for VTE risk screening of internal hospitalized patients,providing a simple,convenient and easy operation for nursing workers.The VTE risk screening tool is intended to help health care personnel make early assessments of VTE risk in newly admitted hospitalized patients and reduce the incidence of VTE.Methods:The study is divided into two parts.The first part: The application of Delphi expert consultation method.Through the previous literature study,we constructed a VTE risk factor evaluation index entry pool for inpatients in internal medicine.Based on this,an expert consultation form was formed to conduct 26 rounds of questionnaire consultations with 26 experts from various hospitals in Shanxi Province,and collected feedback information for statistical analysis.After two rounds of consultations,the opinions of the experts tend to be consistent,and the items of the assessment scales are screened out to form preliminary evaluation forms.Through the analysis of the selected experts' positive coefficient,coordination coefficient and authority coefficient,the reliability of the Delphi expert consultation method's research results was judged.The second part: The reliability and validity of the initial scale of VTE risk assessment in hospitalized patients.Using the initial evaluation form as a research tool,160 patients who met the inclusion exclusion criteria were surveyed and assessed.Based on the clinical data,the reliability and validity of the scale were analyzed to form the final?Veterinary Inpatient VTE Risk Assessment Scale?.Results:1.Through literature studies,VTE risk factors related to hospitalized patients were extracted: 10 first-level indicators and 38 second-level indicators.After two rounds of expert consultations,the importance of the primary and secondary indicators is assigned to3.63-4.93,and the coefficient of variation is 8.80-22.49%.In the end,there are 3 first-level indicators,9 second-level indicators and 28 third-level indicators.The recovery rate of the first round of expert consultation questionnaires was 86.67%,the recovery rate of the second round of expert consultation questionnaires was 100%,and the authority coefficients of the two rounds of experts were 0.875 and 0.893 respectively;the Kendall coefficients of the two rounds were statistically different.((P<0.01)).2.The initial scale of VTE risk assessment for inpatients in internal medicine consists of three primary indicators,nine secondary indicators,and 28 third-level indicators.The total Cronbach's alpha coefficient of the scale was 0.936.The three dimensions of Cronbach's alpha coefficient were: patient's own factor 0.721,disease/condition factor0.953,treatment-related factor 0.880;total test's test-retest reliability was 0.869,each dimension Inter-rater Pearson correlation coefficient: 0.658-0.925;inter-rater reliability:0.689-0.914,total table inter-rater reliability was 0.879.After factor analysis maximum orthogonality rotation,the principal component analysis shows that there are 3 common factors with eigenvalue ? 1 and the cumulative variance contribution rate is 87.904%,which is consistent with the initially constructed framework.The dimensions of the scale and the structure of the items are relatively Reasonable,with good structural validity.Finally,the risk of thrombosis in patients is divided into three levels: 1-2 is divided into low-risk,3-4 is divided into moderate-risk,?5 is divided into high-risk.Conclusion:1.After two rounds of expert consultations,a preliminary VTE risk assessment index system for inpatients in internal medicine was established: including three first-level indicators,nine second-level indicators,and 28 third-level indicators;experts' enthusiasm and authority were higher,and expert opinions Concentration,with good coordination and consistency,the preparation of the scale of the item is reliable and representative.2.The VTE risk assessment scale for inpatients prepared by literature analysis,expertconsultation,and quantitative analysis has a good reliability and validity and can be applied in clinical practice.