Consensus on Quality Indicators for Pediatric Oncology Nursing Care in Mainland China: A Delphi Method and Analytic Hierarchy Process.

Background: Because routine nursing quality indicators are not suitable to evaluate pediatric oncology nursing care, this study aimed to identify a set of quality indicators for pediatric oncology nursing care in mainland China. Method: This prospective investigation utilized a modified Delphi technique and an analytic hierarchy process. A survey questionnaire was developed using a literature review and semi-structured interviews. Fifteen invited experts evaluated the importance of potential indicators through three rounds of Delphi survey by email in 2018. The importance weight of each indicator was identified through analytic hierarchy process. Results: In the Delphi survey, the average authoritative coefficient was 0.93-0.96 for each round of the inquiry. After three rounds of survey, 29 quality indicators were identified as important nursing outcomes for assessing the quality of pediatric oncology nursing care in mainland China. The importance rating mean score of indicators ranged between 4.67 and 5.00 on a 5-point scale, and the variation coefficient ranged between 0 and 0.19. Expert-assigned indicator importance weight varied between 0.0040 and 0.0870. Conclusion: This study identified an indicator system with 29 nursing-sensitive quality indicators that may represent potential indicator candidates for quality assessment of pediatric oncology nursing practice in mainland China.

Application of bispectral index in assessing the level of sedation for young infants with congenital heart disease / 中国小儿急救医学

Objective To evaluate and analyze the degree of correlation between the bispectral index (BIS) and COMFORT behavior scale (COMFORT B scale) and to explore the usability of BIS in assessing the level of sedation for young infants from 6 months to 2 years old after surgical repairs of congenital heart disease.Methods A prospective observational study was designed to involve 50 young infants to assess their postoperative sedation depth.Two investigators evaluated the level of sedation simultaneously and independently by using BIS and COMFORT B scale at each fixed observational points.A total of 375 data sets were gathered by observations.Correlations between BIS value and COMFORT B scale were determined by using Spearman rank correlation test and prediction probability to evaluate the accuracy of the performance of BIS on various sedation depths.Results BIS values in correspondence with different level of sedation,which was divided into oversedation,adequate sedation,undersedation according to COMFORT B scale,were 57.0 ±11.0,69.9 ± 7.6 and 84.4 ± 9.0.There was a moderate correlation between BIS values aad COMFORT B scale ( rs =0.63,P ＜0.000 1 ).The Spearman correlation between BIS and COMFORT B was rs =0.66 and rs =0.59 for the age groups 6 months ～ 1 year old and 1 ～ 2 years old,respectively ( P ＜0.000 1 ).Prediction probability value which indicated BIS can correctly predict various levels of sedation was 0.85 ( P ＜0.000 1 ).Contusion BIS is an accurate and valid objective parameter to assess the level of sedation for young infants from 6 months to 2 years old.