Résumé
Objective:To construct a nursing grading evaluation indicator system for patients with stroke at home to provide a basis for graded care. Methods:Based on literature analysis, qualitative interviews and panel meeting, an evaluation indicator system was preliminarily drafted. June to September, 2018, the indicator system was consulted to experts three times. It was used to evaluate 210 patients with stroke at home from September to December, 2018 to test its reliability and validity. Results:The effective recovery rates of the three times of consultation were 85.00%, 89.47% and 100%, and the authority coefficient were 0.878, 0.879 and 0.879. The indicator system included four first-level indicators, 30 second-level indicators and 120 items. The scale-level content validity index (CVI) universal agreement was 0.733, average CVI was 0.927; the item-level CVIs were 0.83 to 1.00. For the overall level, the Cronbach's α coefficient was 0.928, and the Guttman Spilt half-factor coefficient was 0.794. For the dimensions, the Cronbach's α coefficient and the Guttman Spilt half-factor coefficients were all above 0.700. The correlated coefficients inter-evaluator of each indicators were 0.492 to 0.963 (P< 0.05). Conclusion:The nursing grading evaluation indicator system for patients with stroke at home is simple and operable, with satisfactory reliability and validity to grade the level of care for patients with stroke at home.
Résumé
Objective To investigate the training effect and application development of the health industry standard of Nursing Grading, and to explore it'sclinical applicability. Methods An electronic questionnaire survey was conducted among nurses in 30 three general hospitals of Shandong Province from November 10 to December 10 in 2015. The questionnaire mainly included four parts: basic information, training status, application status and the clinical applicability. All the questionnaires were automatically submitted by the nurse′s cell phone or computer, 3386 valid questionnaires were recovered. Results The status of standard training:93.92%(3180/3386) nurses received a comprehensive training about the standard. The answer rates of 4 theoretical examination questions was 88.95%(3012/3386), 84.49%(2861/3386), 85.17%(2884/3386), 65.71%(2225/3386)respectively. 77.26%of the nurses needed to continue training. Application status: 97.67% (3307/3386) nurses in the hospital has begun to apply Nursing Grading standard, and 97.01% (3208/3307) and 97.76% (3231/3307) of the hospital revised the standard of care systems and work processes; 78.23% (2649/3386) nurses divide the level of care based on both the patient's condition and self-care ability presently. 74.45%(2521/3386) nurses did it as follows,the doctor determine the patient′s condition level, the nurse determine the level of patient′s self-care ability, then the nursing grading was determined according to the both. In the clinical applicability survey, the choice proportion of very agree and agreeofHelping nurses to determine the patient′s level of care and It is beneficial to improve the efficiency of nursing management was 86.30% (2922/3386) and 82.66%(2799/3386);The choice proportion of very agree and agree ofHelp nurses to improve the quality of nursing services, reflecting the value of the nursing work, to meet the needs of patients was 79.36% (2687/3386), 76.56% (2592/3386), 80.98% (2742/3386) respectively. Conclusions The hospital attaches great importance to the standard of Nursing Grading, but the training effect needs to be improved;standard has been widely used in Shandong Province Physician-nurse collaboration has become the decision-making main body of nursing grading;the standard application can not only help the nurses to do decision-making correctly and improve the efficiency. It also can help nurses to improve the quality of nursing service, and enhance patients′satisfaction. So it is very suitable for clinical practice.