关键词:

眼科, 门诊, 护理质量, 指标体系, 德尔菲法

Abstract:

Objective　To construct a localized, scientific, and reliable quality evaluation index system for ophthalmic outpatient care, and to provide a standardized tool for quality control of ophthalmic outpatient care. Method Using the literature evidence-based approach, relevant literature on ophthalmic outpatient nursing quality indicators was retrieved from databases such as China National Knowledge Infrastructure, Wanfang, PubMed, EmBase, and CINAHL. The search period was from the establishment of the database until August 2023, and 11 relevant articles were ultimately selected. Based on the Structure Process Outcome (SPO) indicator system framework, develop specific interview content items. Using purposive sampling method, interviews were conducted with ophthalmic nursing managers and clinical nurses from five tertiary hospitals in Guangdong Province. Colaizzi analysis method was used to summarize and organize the interview content. Based on literature evidence and interview results, a preliminary indicator system for the quality of ophthalmic outpatient nursing was constructed, including 3 primary indicators, 9 secondary indicators, and 41 tertiary indicators. Create an expert inquiry questionnaire and use the Delphi method to conduct two rounds of expert inquiries via email from December 2023 to May 2024. Based on the results of the first round of inquiry, a second round of inquiry questionnaire will be formed through discussion. Using the recovery rate to indicate the level of expert engagement; The authority coefficient represents the level of expert authority, which is equal to (familiarity+judgment basis)/2; The Kendall harmony coefficient represents the coordination situation among experts. Using Analytic Hierarchy Process (AHP), construct a judgment matrix, calculate the weights, weight ranking, and combination weights of each indicator, and obtain the consistency coefficient (CR value). When the CR value is ≤ 0.100, the judgment matrix has consistency. Results　This study included 17 ophthalmic nursing experts, including 9 with 15 to 30 years of work experience and 8 with over 30 years of work experience; Among them, 7 experts have less than 10 years of experience in outpatient work, 9 experts have 10 to 20 years of working experience, and 1 expert has 20 years or more of working experience; 5 candidates hold senior professional titles, and 12 candidates hold deputy senior titles or below; The distribution areas of expert work units are 10 in South China, 1 in North China, 2 in East China, 1 in Central China, and 3 in Southwest China. In the first round, a total of 18 inquiry questionnaires were distributed and 17 were collected. In the second round, a total of 17 inquiry questionnaires were distributed and 17 were collected. The positive coefficients for the two rounds of expert inquiry were 0.944 and 1.000, the authoritative coefficients were 0.885 and 0.977, and the Kendall harmony coefficients were 0.221 and 0.239, respectively (both P<0.001). In the first round of inquiry, 10 experts proposed 74 revision suggestions. In the second round of inquiry, 9 experts proposed 14 revision suggestions. The final system of ophthalmic outpatient nursing quality indicators includes 3 primary indicators, 8 secondary indicators, and 36 tertiary indicators. Conclusion　The quality evaluation index system of ophthalmic outpatient care constructed in this study has specialized characteristics on the basis of ensuring the scientificity and reliability of the research results, which is in line with the characteristics of clinical practice and nursing management of ophthalmology outpatient clinics, and can provide a reference for the scientific, refined, and standardized management of ophthalmic clinical nursing quality.

Key words:

Ophthalmology, Outpatient, Quality of care, Index system, Delphi method