Development of a phased discharge planning for patients undergoing airway stenting: a Delphi study informed by the...

This study aimed to develop a dynamic, phased discharge planning intervention and optimize the nursing care pathway for patients with airway stenosis undergoing airway stenting, to address gaps in complication management and home care competencies following the procedure.

Employing the Timing It Right (TIR) as a theoretical basis, the initial program was developed through integrated literature review, semi-structured interviews with 7 physicians, 9 nurses and 8 patients, and expert panel group discussions. Subsequent refinement involved three iterative rounds of Delphi consultation with domain experts. Revisions were made based on aggregated feedback to finalize the program.

Three rounds of expert consultation were completed, with questionnaires distributed via email and WeChat. Response rates were 95.24, 100, and 100% across the respective rounds. The expert authority coefficient (Cr) exceeded 0.7 throughout; coefficient of variation ranged from 0.05 to 0.17, 0.06 to 0.23, and 0.06 to 0.19; Kendall's W values were 0.172, 0.166, and 0.187, respectively (p < 0.001). The final discharge plan comprised 5 primary domains: diagnosis phase (admission to pre-surgery), stabilization phase (postoperative to stable recovery), preparation phase (3 days pre-discharge), implementation phase (post-discharge to 1 month), adaptation phase (1-3 months post-discharge), plus 15 secondary categories and 57 tertiary items. All 57 tertiary indicators satisfied the retention criteria of mean importance score >4.00 and coefficient of variation <0.25 after three rounds of revision.

The discharge planning intervention, structured around the Timing It Right Framework, demonstrates scientific rigor and operational feasibility, offering a standardized and comprehensive roadmap for the post-stenting care of patients. Prospective clinical trials are required in future research to quantify its effects on complication incidence, unplanned readmission and patient quality of life.