基于德尔菲法门诊血液透析感染事件监测指标体系的构建

Construction of monitoring indicators system for infection events in outpatient hemodialysis based on Delphi method

  • 摘要:
    目的  为降低门诊血液透析患者感染风险,构建门诊血液透析感染事件监测指标体系,继而为总结适用于门诊环境的防控措施提供依据。
    方法  结合国内血液透析中心相关文件、文献研究及医院感染监测现状,应用德尔菲法对全国的血液透析、医院感染管理及护理专家进行咨询,最终确定门诊血液透析感染事件监测指标体系。
    结果  两轮专家函询问卷回收率均为100.00%;专家权威程度分别为0.91、0.94;对一轮专家函询意见进行整理修改后,第二轮专家函询监测指标的重要性均值为4.55~5.00,监测指标的可行性均值为4.65~5.00,重要性、可行性的满分比分别为60.00%~100.00%和70.00%~100.00%,其变异系数分别在0.000~0.153、0.000~0.156,Kendall′s W值有统计学意义(P<0.05);最终形成了包含8项一级指标、31项二级条目、41项三级条目的门诊血液透析感染事件监测指标体系。
    结论  本监测指标体系具有科学性、合理性,有推广意义,可有助于门诊血液透析患者降低感染风险,保障医疗安全。

     

    Abstract:
    OBJECTIVE  To construct an event monitoring indicators system for outpatient hemodialysis infection to reduce the risk of infection for outpatient hemodialysis, and provide a basis for summarizing applicable prevention and control measures for outpatient environment.
    METHODS  Based on the relevant documents and literatures from domestic hemodialysis centers and the present status of hospital-acquired infection management and surveillance, the Delphi method was used to consult national experts in hemodialysis, management of hospital-acquired infection and nursing, and finally the monitoring index system for outpatient hemodialysis dialysis events was constructed.
    RESULTS  The response rate of experts for both rounds inquiry questionnaires was 100.00%. The coefficient of expert authority was 0.91 and 0.94, respectively. After organizing and modifying the inquiry opinions of the first round, the average importance and feasibility of monitoring indicators in the second round of correspondence was 4.55-5.00 and 4.65-5.00, respectively, and the full score ratio of importance and feasibility was at the intervals of 60.00%-100.00% and 70.00%-100.00%, respectively. The coefficient of variation was 0.000-0.153 and 0.000-0.156, respectively, and Kendall′s W value had statistical significance (P < 0.05). Finally, the monitoring indicators system for infection events in outpatient hemodialysis was constructed including 8 first-level, 31 second-level and 41 third-level indicators.
    CONCLUSION  This monitoring indicators system is scientific and rational, and has popularization significance, which can help reducing infection risks and guarantee medical safety for outpatient hemodialysis.

     

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