Constructing ECMO Care Quality Evaluation Index System Based on "Structure-Process-Outcome" Three-Dimensional Theoretical Model

Abstract

Objective: To construct a set of objective, relatively perfect and clinically applicable ECMO nursing quality evaluation index system, and to provide practical basis and reference for clinical nurses to implement ECMO nursing. Methods: The literature was analyzed and semi-structured interviews were used, through systematic references and searching keywords. Based on the Structrue-Process-Outcome three-dimensional theoretical model, the prototype of the ECMO nursing quality evaluation index system was constructed. 28 experts were selected and 2-round Delphi study on ECMO nursing quality evaluation indicators was performed, to evaluate the enthusiasm, authoritativeness, concentration and coordination of opinion of the experts, and to test the reliability and validity of the evaluation index system. The AHP method was used to determine the mean importance ratings, the standard variation of importance ratings, the coefficient of variation (CV) and full-score frequency K (%) of indicators at all levels in the evaluation index system. Results: Through literature review and searching keywords, an questionnaire including 3 first-level indicators, 15 second-level indicators and 62 third-level indicators was initially formed. The positive coefficient of the experts was 100% (20/20) and 96.42% (19/20) respectively, and the authoritative coefficient was 0.926 and 0.934 respectively in the first and second round of expert consultation. The weights of the three first-level indicators were 0.34, 0.52, and 0.31, respectively. The ECMO nursing quality evaluation index system including three first-level indicators, 15 second-level indicators, and 66 third-level indicators was determined. The effective recycling rates of the two rounds of Delphi surveys were 80% and 90%, respectively. The authoritative coefficients of experts in the two rounds were 0.889 and 0.88, respectively. The Kendall coordination coefficients of the two rounds of surveys were 0.259 and 0.161, respectively (P<0.05). Finally, an ECMO nursing quality evaluation index system including three first-level indicators, 15 second-level indicators and 66 third-level indicators was constructed, based on the Structrue-Process-Outcome three-dimensional model. Conclusion:The ECMO nursing quality evaluation index system is constructed based on the Structrue-Process-Outcome three-dimensional theoretical model, which is provided as a practical and operational assessment tool for clinical nurses in the implementation of ECMO care.