急诊经皮冠状动脉介入术后患者出院准备服务质量评价指标的构建及应用

doi:10.3761/j.issn.2096-7446.2025.01.006

摘要/Abstract

摘要：

目的构建并应用急诊经皮冠状动脉介入术（percutaneous coronary intervention，PCI）后患者出院准备服务护理质量评价指标，为患者出院准备服务护理质量评价提供依据。方法以“结构-过程-结果”三维质量模式为理论依据，通过系统检索文献、半结构化访谈并整合临床实践及患者个体需求，构建护理质量评价指标初稿，采用德尔菲专家函询法和层次分析法确定最终指标及其权重。将建立的护理质量评价指标应用于临床，比较应用前后的出院前评估执行达标率、护理实践执行达标率、院内外衔接执行达标率、随访管理执行达标率、患者与家属对出院准备服务的满意率。结果最终构建的急诊PCI术后患者出院准备服务护理质量评价指标包括3个一级指标、11个二级指标和50个三级指标。评价指标实施前后，出院前评估执行达标率分别为57.8%和92.8%，护理实践执行达标率分别为85.6%和95.0%，院内外衔接执行达标率分别为45.6%和75.0%，随访管理执行达标率分别为89.4%和95.6%，患者与家属对出院准备服务的满意率分别为89.4%和93.3%。结论该研究构建的急诊PCI术后患者出院准备服务护理质量评价指标科学、可靠，具有全面性及实用性，应用该评价指标有助于规范出院准备服务，促进专病护理质量的提升。

关键词: 急性心肌梗死, 经皮冠状动脉介入术, 出院准备服务, 护理质量评价指标, 德尔菲法

Abstract:

Objective To establish and apply the nursing quality evaluation indexes of hospital discharge preparation service for patients after emergency PCI，so as to provide the basis for the nursing quality evaluation of hospital discharge preparation service. Methods Based on the "structure-process-result" three-dimensional quality model，literature was systematically searched，and semi-structured interviews were conducted to integrate clinical practice and individual needs of patients to construct the preliminary draft of nursing quality evaluation indicators. Delphi expert consultation method and analytic hierarchy process were used to determine the final index system and the weights. The established nursing quality evaluation index was applied，and the compliance rate of pre-discharge evaluation implementation，the compliance rate of nursing practice implementation，the compliance rate of in-hospital and out-of-hospital transition implementation，the compliance rate of follow-up management implementation，patients and their families’ satisfaction with discharge preparation service were compared before and after the application. Results The evaluation indexes of nursing quality of hospital discharge preparation service for patients after emergency PCI were established，including 3 primary indexes，11 secondary indexes and 50 tertiary indexes. Before and after the implementation of the evaluation indexes，the compliance rate of pre-discharge evaluation implementation was 57.8% and 92.8%，the compliance rate of nursing practice implementation was 85.6% and 95.0%，the compliance rate of in-hospital and out-of-hospital transition implementation was 45.6% and 75.0%，and the compliance rate of follow-up management implementation was 89.4% and 95.6%，respectively. The satisfaction rate of patients and their families on discharge preparation service was 89.4% and 93.3%，respectively. Conclusion The evaluation indexes of nursing quality of discharge preparation service for patients after emergency PCI established in this study is scientific，reliable，comprehensive and practical，and the application of this evaluation index system is conducive to standardizing discharge preparation service and promoting the improvement of nursing quality for specific diseases.

Key words: Acute Myocardial Infarction, Percutaneous Coronary Intervention, Discharge Preparation Service, Quality Evaluation Index, Delphi Method

穆文方, 汤诗恒, 顾玉华, 王喜益, 许莉. 急诊经皮冠状动脉介入术后患者出院准备服务质量评价指标的构建及应用[J]. 中华急危重症护理杂志, 2025, 6(1): 43-49.

MU Wenfang, TANG Shiheng, GU Yuhua, WANG Xiyi, XU Li. The construction and application of quality evaluation indexes of hospital discharge preparation service for patients after emergency PCI[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(1): 43-49.

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