目的:构建眼科日间病房护理质量指标,为眼科日间病房的护理质量管理提供理论依据。方法:以Donabedian三维质量结构模式为理论框架,通过查阅文献、小组讨论,初步拟定眼科专科护理质量评价指标。通过专家函询,对指标进行筛选和修订,确定了眼科日间病房护理质量指标。结果:经过2轮函询,专家意见趋向一致,2轮问卷回收率均为100%,协调系数分别为0.129、0.342(P<0.01)。构建的眼科专科护理质量指标包括3项一级指标,分别为结构指标(二级指标2项)、过程指标(二级指标8项)和结果指标(二级指标3项)。结论:该指标具有较高的科学性、可靠性、可行性以及专科特色,可为眼科日间病房护理质量的评价提供良好的方法。
Objective: To set up nursing quality indicators for ophthalmic intra-day ward, providing theoretical basis for nursing quality management in ophthalmic intra-day ward. Methods: Based on the "Donabedian three dimensional quality structure model" as the theoretical framework, the preliminary ophthalmic specialized nursing quality assessment indicators were designed by literature review and group discussion. The ophthalmic nursing quality indicators for intraday ward were finalized by expers consultated, indicators screened and revised. Results: After two rounds of inquration by letters, the opinions from the experts were consistent. Questionnaire response rates were both 100% in two rounds, with coordination coefficients of 0.129 and 0.342 respectively (P< 0.01). The nursing quality indicators for ophthalmic intra-day ward were established, including 3 primary indicators, which are structual indicators (2 secondary indicators), process indicators (8 secondary indicators) and outcome indicatiors(3 secondary indicators). Conclusion: The indicators are scientific, reliable, feasible with specialized characteristics, which can provide a good reference for evaluating the nursing quality in ophthalmic intra-day wards.
目的:评价并汇总眼科成人日间手术患者病区护理管理的最佳证据,提高临床护理质量。方法:检索国内外数据库建库至2022年6月的日间手术患者病区护理管理的相关证据,包括系统评价、临床决策、证据总结、指南及专家共识。由2名研究人员独立对文献进行质量评价后,根据主题对证据进行提取和汇总。结果:根据纳入标准,共筛选出13篇文献,包括5篇专家共识、3篇证据总结、1篇循证实践、2篇系统评价、1篇指南。通过文献阅读、证据提取和归类,从日间手术护士准入资质、制定临床护理路径、院前管理、病历标准化、手术当日术前管理、术后管理、出院评估、康复及随访指导8个方面形成17条最佳证据。结论:该项目总结了眼科成人日间手术患者病区护理管理的最佳证据,可为护理管理者制定眼科日间手术病区流程方案、实践标准提供循证依据。
Objective: To evaluate and summarize the evidences of nursing management of ophthalmic postoperative adult patients intra-day ward, and improve the quality of clinical nursing. Methods: The related databases were searched from the establishment to June 2022. The searching contents include systematic review, clinical decision-making, evidence summary, guidelines and expert consensus on nursing management in postoperative patients intra-day wards at home and aboard. Based on the theme, the evidences were extracted and summarized after independent literature quality evaluation was conducted by 2 researchers. Results: Base on the inclusion criteria, a total of 13 pieces of literature were selected, including 5 expert consensus, 3 evidence summaries, 1 evidence-based practice, 2 systematic reviews and 1 guideline. Through literature review, evidence extraction and classification, a total of 17 pieces of evidence on 8 aspects were summarized, including admission qualifications for daytime surgical nurses, development of clinical nursing path, pre-hospital management, medical record standardization, preoperative management on the day of surgery, postoperative management, discharge assessment, rehabilitation and follow-up guidance. Conclusion: This article summarized the best evidence of nursing management for ophthalmic adult day surgery patients in intra-day ward,to provide scientific evidences for nursing managers to develop ophthalmic intra-day ward guidelines and practical standards.