Abstract:

Objective　To construct a nutritional nursing quality evaluation system for patients at department of gastroenterology by the 3D quality structure mode, and to provide some standardized and guiding references for improving nutritional nursing quality. Methods　The databases of the European Society for Endenteric Nutrition, the China Guide Network, the American Society for Endenteric Nutrition, CNKI, Wanfang, VIP, and JBI were systematically searched. The literatures were systematically screened and evaluated, and the comprehensive evidences were obtained. Combined with the actual situation of the patients in Department of Gastroenterology, Ansai District People's Hospital, the initial nutritional nursing quality questionnaire was made. The Delphi method was used to carry out 2 rounds of correspondence on 27 experts from Beijing, Shanghai, Guangzhou, and Zhengzhou. All the experts were female. They were (47.28±5.79) years old. The experts' degree of authority was expressed by the authority coefficient. The experts' coordination degree was described by coefficient of variation and Kendall's concordance coefficient. The importance of each index was clarified. The weight level of each item was established by the analytic hierarchy process. Results　The judgment coefficient of the first round expert correspondence was 0.97; the degree of familiarity with the research content was 0.89; the degree of authority was 0.93. The judgment coefficient of the second round was 0.89; the degree of familiarity with the research content was 0.87; the degree of authority was 0.88. Finally, 3 primary indicators (construction indicators, process indicators, and outcome indicators), 6 secondary indicators (environment and equipment, human resource, clinical service, nutritional nursing procedure, risk management, and service results), and 21 tertiary indicators were formed. Conclusions　It is scientific to construct the nutritional nursing quality evaluation system for patients at department of gastroenterology. It can reflect the clinical nursing needs and provide reference basis for improving nursing quality, and have guiding effect on continuously improving the nursing quality of department of gastroenterology.

Key words:

Department of gastroenterology, Nutritional nursing quality, Sensitive indicators

摘要：

目的　运用三维质量结构模式构建消化内科患者营养护理质量评估体系，为提高营养护理质量提供标准化、导向性依据。方法　2019年2月至3月系统检索欧洲肠内肠外营养学会、中国指南网、美国肠外肠内营养学会、知网、万方、维普、JBI数据库，经系统筛选、评价文献、综合证据，并结合安塞区人民医院消化内科患者实际情况形成初始营养护理质量问卷。运用德尔菲法对北京市、上海市、广州市、郑州市27名专家进行2轮次函询。专家均为女性，年龄（47.28±5.79）岁。专家权威程度以权威程度系数表示，专家的协调系数用变异系数和肯德尔和谐系数描述。明确各指标内容的重要性，并采用层次分析法确立各条目的权重水平。结果　首轮专家函询的判断系数为0.97，专家对研究内容熟悉程度系数为0.89，权威程度系数为0.93；第2轮专家函询的判断系数为0.89，专家对研究内容熟悉程度系数为0.87，权威程度系数为0.88。最终形成3项一级指标（结构指标、过程指标、结果指标）、6项二级指标（环境设备、人力资源、临床服务、营养护理流程、风险管理、服务结果）、21项三级指标。结论　构建消化内科患者营养护理质量评估体系具有一定的科学性，能够反映临床护理需求，为提高护理质量提供参考依据，对持续提高消化内科护理质量具有导向性作用。

关键词:

消化内科, 营养护理质量, 敏感指标