Framework for Nursing Quality Assessment in Tracheotomy Dysphagia Following Craniocerebral Trauma Using the Structure-Process-Outcome Model.

IF 3.2 3区 医学 Q1 NURSING Journal of Clinical Nursing Pub Date : 2024-10-16 DOI:10.1111/jocn.17446
Delian An, Yanfeng Li, Yingjie Zhang, Youli Jiang, Ping Fan, Hengfang Ruan, Xingyue Hou, Miaoxia Chen, Huijuan Li
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Abstract

Aim: This study aimed to establish a comprehensive set of nursing-sensitive quality indicators (NSQIs) for patients with dysphagia following tracheotomy due to acquired brain injury (ABI), based on the 'structure-process-outcome' model.

Design: A Delphi survey.

Methods: The research utilised a mixed-methods approach, including systematic literature reviews, qualitative interviews and two rounds of Delphi expert consultations. A diverse team comprising specialists in dysphagia rehabilitation and nursing management conducted the research, which involved defining and refining NSQIs through extensive evaluations and consensus among recruited experts.

Results: The finalised NSQI includes 4 structural indicators, 13 process indicators and 4 outcome indicators, covering key aspects such as resource allocation, patient assessment and clinical outcomes. The expert consensus provides verification. Kendall's harmony coefficients are 0.304 and 0.138 (p < 0.001), respectively, and the mean importance assignments of indicators at all levels are 3.90-5.00. The final care of patients with tracheotomy and dysphagia after brain injury was constructed. The evaluation indicators include a total of 4 first-level indicators, 23 second-level indicators and 52 third-level indicators.

Conclusion: The established NSQIs offer a systematic framework to enhance the quality of nursing care for ABI patients with posttracheotomy dysphagia. This model facilitates precise monitoring and proactive management of nursing practices, promising better patient outcomes and streamlined care processes.

Implication for the profession and patient care: This study develops targeted NSQIs to improve dysphagia management in ABI patients' posttracheotomy, fostering better patient outcomes and advancing nursing education through essential specialised training.

Patient or public contribution: Expert-driven insights from experienced clinicians informed the NSQIs, ensuring their relevance and effectiveness in enhancing patient-centred care.

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使用结构-过程-结果模型对颅脑创伤后气管切开术吞咽困难进行护理质量评估的框架。
目的:本研究旨在根据 "结构-过程-结果 "模型,为后天性脑损伤(ABI)气管切开术后出现吞咽困难的患者建立一套全面的护理敏感质量指标(NSQIs):设计:德尔菲调查:研究采用混合方法,包括系统文献回顾、定性访谈和两轮德尔菲专家咨询。一个由吞咽困难康复和护理管理专家组成的多元化团队开展了这项研究,其中包括通过广泛评估和招募专家达成共识来定义和完善 NSQI:最终确定的 NSQI 包括 4 个结构指标、13 个过程指标和 4 个结果指标,涵盖资源分配、患者评估和临床结果等关键方面。专家共识提供了验证。肯德尔和谐系数分别为 0.304 和 0.138(p 结论:已确立的 NSQI 提供了一个系统性的指标体系:已建立的 NSQI 为提高气管切开术后吞咽困难的 ABI 患者的护理质量提供了一个系统框架。该模型有助于对护理实践进行精确监测和主动管理,有望改善患者预后并简化护理流程:这项研究开发了有针对性的 NSQIs,以改善 ABI 患者气管切开术后吞咽困难的管理,促进改善患者预后,并通过必要的专业培训推进护理教育:患者或公众的贡献:来自经验丰富的临床医生的专家见解为 NSQIs 提供了依据,确保其在加强以患者为中心的护理方面的相关性和有效性。
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来源期刊
CiteScore
6.40
自引率
2.40%
发文量
0
审稿时长
2 months
期刊介绍: The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice. JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice. We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.
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