Development Of Nursing-sensitive Quality Indicators For The Central Sterile Supply Department In Anhui

Objective:This study aims to construct scientific,sensitive and operable CSSD nursing quality sensitivity indicators based on evidence-based and qualitative interviews,with the help of Delphi expert inquiry method and analytic hierarchy method,so as to provide reference for nursing quality evaluation and monitoring of disinfection supply centers in Anhui Province.Methods:(1)Literature research: This research first went through a scientific and comprehensive literature search,and used the Hopkins evidence level and quality level to evaluate the level and quality of the retrieved literature.(2)Semi-structured interview: Based on the literature research,a quality sensitivity index system based on a qualitative interview will be preliminary prepared.(3)Expert consultation: Based on the theoretical basis of the three-dimensional quality model of "structure-process-result",two rounds of expert consultation were conducted with 25 experts from 16 prefectures and cities in Anhui Province.Finally,the nursing quality sensitive index system was established for use by the Anhui Provincial Disinfection Supply Center,including the name of each index,the calculation formula and the data collection method.(4)Analytic hierarchy: The analytic hierarchy method is used to analyze the weight of sensitive indicators of nursing quality in disinfection supply centers,and the consistency of the indicators is verified.Results:(1)Results of the literature review: A total of 1136 articles were found in the literature search,of which 18 articles were finally included in the removal of irrelevant and duplicated literature.The quality evaluation results of the included literature were: 1 I.B level literature,11 II.A level literature,1 II.B level literature,3III.A level papers,1 III.B level paper,and 1 IV.A level documents,forming a pool of42 CSSD nursing quality index entries.(2)Semi-structured interview results: three themes were extracted: hospital management,clinical practice,workload and quality monitoring;7 sub-themes:environmental layout,staffing,equipment and facilities,technical operation,standard protection,workload,quality monitoring.Combined with the results of literature research,the first draft of CSSD nursing quality sensitivity index was preliminary formed.(3)Expert consultation results: the positive coefficient of expert consultation rounds was 96.00% and 100%;The authoritative coefficients were 0.83 and 0.87,respectively,both greater than 0.7,indicating that the letter survey results were reliable;The Kendall harmonization coefficients were 0.221 and 0.234(P<0.001),respectively.The final CSSD nursing quality sensitive index in Anhui Province consisted of 3 first-level indicators,7 second-level indicators and 14 third-level indicators,and the importance of each index was greater than 4 points,and the coefficient of variation was < 0.25.(4)Hierarchy analysis results: The CR values of the first,second and third level indicators are all < 0.1,which shows that the weight distribution of the indicators is reasonable;the weight of the structural index in the primary index is 0.1429,and the weight of the process index is consistent with the weight of the structural index,both are 0.4286;the weight range of the combination of the secondary index is0.0357~0.3429,the highest is safety and quality monitoring(0.3429);the weight range of the combination of the third-level index is 0.0268~0.1241,and the highest is the unqualified rate of instrument cleaning quality(0.1241).ConclusionBased on the three-dimensional quality model,the content of CSSD nursing quality sensitivity index constructed by Delphi method is scientific,reliable and operable,which can provide guidance and basis for the quality management of CSSD in hospitals in the region.