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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Construction of nursing-sensitive quality indicator system for cardiac rehabilitation of patients undergoing
Lei Kang1, Min-Hui Wang1, Sheng-Jia Wu2
1Cardiovascular Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
Insights
A new indicator system was developed to evaluate the nursing-sensitive quality of cardiac rehabilitation (CR) after percutaneous coronary intervention (PCI). This system offers a reliable framework for assessing CR quality and improving patient outcomes.
Area of Science:
- Cardiovascular Nursing
- Quality Improvement Science
- Health Services Research
Background:
- Coronary heart disease (CHD) necessitates effective treatments like percutaneous coronary intervention (PCI).
- Cardiac rehabilitation (CR) is crucial post-PCI but lacks comprehensive quality evaluation systems.
- Current CR quality assessments focus on outcomes, neglecting a balanced approach to nursing management.
Purpose of the Study:
- To construct a scientific, sensitive, comprehensive, and practical indicator system for nursing-sensitive quality in CR after PCI.
- To establish a reliable framework for evaluating the quality of nursing care within CR programs.
- To provide a reference for improving CR quality and patient care post-PCI.
Main Methods:
- Literature analysis and semi-structured interviews to identify potential indicators.
- Development of the indicator system framework and initial draft.
- Application of the Delphi method and Analytic Hierarchy Process (AHP) for refinement and weighting.
Main Results:
- Two rounds of expert consultations achieved a 100% response rate with high authority (0.865-0.888) and coordination (0.491-0.522).
- The established system comprises 3 first-level indicators (structure, process, outcome), 11 second-level indicators, and 29 third-level indicators.
- The final system is deemed scientific, reliable, and comprehensive for evaluating nursing-sensitive quality in CR post-PCI.
Conclusions:
- A complete and reliable nursing-sensitive quality indicator system for CR after PCI has been successfully developed.
- The system provides a scientific and dependable tool for assessing the quality of nursing care in CR.
- This indicator system serves as a valuable reference for evaluating and enhancing clinical teaching quality in CR programs.
Background:
Coronary heart disease (CHD) is a cardiovascular disease with high mortality. At present, percutaneous coronary intervention (PCI) is considered as the main effective treatment for CHD due to less trauma, shorter course of treatment, and better curative effect. However, PCI alone is not a permanent cure, so cardiac rehabilitation (CR) is needed for a supplement. Nowadays, the evaluation of the nursing-sensitive quality of CR after PCI focuses on the outcomes of patients, lacks a complete evaluation indicator system, and is prone to problems such as nursing management imbalance.
Objective:
A scientific, sensitive, comprehensive and practical nursing-sensitive quality indicator system based on the structure-process-outcome model was constructed to provide a reference for evaluating nursing-sensitive quality of CR after PCI.
Methods:
Firstly, through literature analysis and semi-structured interview, the indicator system was collected, screened and determined. Then, the framework of the indicator system was established, and the draft of nursing-sensitive quality indicator system of CR after PCI was formed. Subsequently, the nursing-sensitive quality indicator system of CR after PCI was initially established using Delphi method. Finally, the specific weight was determined by analytic hierarchy process (AHP), and the nursing-sensitive quality indicator system of CR after PCI was established and perfected.
Results:
Two rounds of expert consultations were separately given 15 questionnaires, and all these questionnaires were returned, with a questionnaire response rate of 100%. Such result indicated that experts were highly motivated. Besides, the authoritative coefficients for two rounds of expert consultations were 0.865 and 0.888, and the coordination coefficients were 0.491 and 0.522, respectively. Hence, the experts' authority and coordination were high and the results were reliable. After the second round of expert consultation, the nursing-sensitive quality indicator system of CR after PCI was established, eventually. This system consisted of 3 first-level indicators (structural indicator, process indicator and outcome indicator), 11 s-level indicators and 29 third-level indicators.
Conclusion:
A relatively complete and reliable nursing-sensitive quality indicator system of CR after PCI has been established in this study. Such system is scientific and reliable and can provide a reference for the evaluation of clinical teaching quality of CR after PCI.
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