住院病人非计划性拔管风险评估体系的构建.pdfVIP

·2404·CHINESENURSINGRESEARCHJuly,2019Vol.33No.14

住院病人非计划性拔管风险评估体系的

构建

陈煌，邓小玲，李秋燕，谢红珍

Constructionofriskassessmentsystemonunplannedextubationforinpatients

CHENHuang,DENGXiaoling,LIQiuyan,XIEHongzhen(GeneralHospitalofSouthernTheatreCommand,

Guangdong510010China)

摘要：［目的］构建住院病人非计划性拔管风险评估体系，为制定科学有效的护理干预措施提供依据。［方法］运用文献分析法、案例分

析法、问卷调查法以及头脑风暴法获得非计划性拔管的相关风险因素，邀请18名临床护理专家进行2轮咨询，形成住院病人非计划

性拔管风险评估体系。［结果］专家积极性为100%，权威程度系数为0.788，通过两轮专家咨询，形成了“病人因素”“导管因素”“管理

因素”3个一级指标、34个（使用镇静剂的病人）/39个（未使用镇静剂的病人）二级指标的住院病人非计划性拔管风险评估体系。经

过两轮专家咨询，变异系数为0~19.77%，Kendall协调系数分别为0.313和0.374（P0.001）。［结论］应用德尔菲法构建的住院病

人非计划性拔管风险评估体系具有较高的科学性，对于指导临床护理工作具有重要意义。

关键词：非计划性拔管；风险评估；德尔菲法；专家咨询；非计划性拔管风险评估体系；住院病人

AbstractObjective:Toconstructunplannedextubation(UEX)riskassessmentsystemforinpatients,andtoprovideabasisforthe

developmentofscientificandeffectivenursinginterventions.Methods:Byusingliteratureanalysis,caseanalysis,questionnairesurvey,

andbrainstormingmethod,theriskfactorsrelatedtoUEXwereobtained.Atotalof18clinicalnursingexpertswereinvitedtoconduct2

roundsofconsultationtoformaUEXriskassessmentsystemforinpatient.Results:Theenthusiasmoftheexpertswas100%,andthe

coefficientofauthoritywas0.788.Throughtworoundsofexpertconsultation,theUEXriskassessmentsystemforinpatientwas

constructedinvolving3first⁃levelindicators(patientfactors,catheterfactorsandmanagementfactors),and34(patientsusing

sedatives)/39(patientswithoutsedatives)secondaryindicators.After2roundsofexpertconsultation,thecoefficientofvariationwas0⁃19.77%,

theKendallcoordinationcoefficientwas0.313and0.374,respectively,andthesignificancetestwasP0.001.Conclusions:The

constructedUEXriskassessmentsystemforinpatientbytheDelphimethodwasofhighscientificity,whichmadegreatsignificance

effortsinguidingclinicalnursingwork.

Keywordsunplannedextubation;riskassessment;Delphimethod;expertconsultation;unplannedextubationriskassessmentsystem;

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