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Construction of a Follow-up Evaluation Index System for Patients with Venous Thromboembolism Based on the Donabedian
Qian Zhang1, Qingmei Niu1, Yihua Zhang2
1Department of Nursing, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, Shanxi, 030032, People's Republic of China.
Background:
Follow-up care for patients with venous thromboembolism lacks standardization and a comprehensive quality assessment system. There is an urgent need to improve management measures to enhance the quality of care.
Objective:
This study developed a comprehensive evaluation index system to standardize and guide clinical nursing practice in the follow-up management of patients with venous thromboembolism, aiming to enhance long-term care quality.
Methods:
Based on the Donabedian model, we created a preliminary questionnaire through literature review and group discussions. The study employed a modified Delphi method with 20 multidisciplinary experts over two consultation rounds, combining expert feedback with the analytic hierarchy process (AHP) to determine indicators and their weights.
Results:
The consultation achieved a 100% response rate in both rounds. Statistical analysis showed satisfactory consensus with Kendall's harmony coefficients of 0.32 and 0.33, and high expert authority coefficients of 0.91 and 0.95. The final system comprises 3 primary indicators, 8 secondary indicators, and 37 tertiary indicators.
Conclusion:
In this study, we developed a comprehensive evaluation index system for the follow-up management of patients with venous thromboembolism based on the Donabedian model. This system provides a structured framework to help standardize follow-up management; however, its feasibility, reliability, and clinical effectiveness require further prospective validation in clinical practice.
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Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above the...