急性缺血性脑卒中患者rt-PA静脉溶栓系统护理质量评价指标体系构建OA

Objective To explore the construction of a systematic nursing quality evaluation index system during intravenous thrombolysis with recombinant tissue-type plasminogen activator(rt-PA)in patients with acute ischemic stroke.Methods The structure-process-outcome quality model served as the theoretical basis of this study.Combined with relevant health policies and clinical nursing practices on the basis of literature review and field investigation,a systematic nursing quality evaluation index system was initially established for patients with acute ischemic stroke during rt-PA intravenous thrombolysis.Six experts from the Second Affiliated Hospital of Guangdong Medical University were selected for the pre-survey.The expert consultation questionnaire was compiled according to the pre-survey findings.Two rounds of expert inquiries were carried out using the Delphi method,and the analytic hierarchy process was adopted to calculate the weight of each indicator.Results A total of 20 experts were enrolled.Twenty questionnaires were distributed and retrieved in each round,with a response rate of 100％for both rounds.The expert authority coefficients were 0.885 and 0.904.Kendall's concordance coefficients of the two rounds of expert inquiry questionnaires conducted were 0.220(χ2=463.563,P<0.001)and 0.314(χ2=527.586,P<0.001),respectively.The final evaluation system for nursing quality consisted of 3 first-level indicators,which are further divided into 13 second-level indicators and further refined into 53 third-level indicators.The consistency ratio(CR)of all indicators was less than 0.1.Conclusion The established evaluation index system for systematic nursing quality during rt-PA intravenous thrombolysis in patients with acute ischemic stroke is reliable,scientific,practical,and has significant nursing characteristics.