Construction and Application of Nursing Quality-Sensitive Indicators for Preventing Respiratory Therapy Device-Related Pressure Injuries
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Ronglian Dang1, Haonan Wang2, Tian Zhang1
1Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010000, People's Republic of China.
Objective:
To construct quality-sensitive indicators for preventing respiratory therapy device-related pressure injuries (DRPI) and provide a basis for evaluating and improving nursing quality.
Methods:
A quality-sensitive indicator framework was developed through literature review, group discussion, the Delphi method, and analytic hierarchy process (AHP). A convenience sample of 325 patients using respiratory therapy devices in the Department of Respiratory and Critical Care Medicine was enrolled from July 2025 to January 2026. Patients admitted from July to September 2025 comprised the pre-intervention group, while those admitted from November 2025 to January 2026 comprised the post-intervention group. Baseline deficiencies were analyzed during the pre-intervention period, followed by standardized procedure development and staff training in October 2025 and three months of continuous quality improvement.
Results:
The effective response rates of the two Delphi rounds were 91.67% and 100%, respectively. Expert authority coefficients were 0.89 and 0.87, and Kendall's W ranged from 0.121 to 0.244 in the first round and from 0.159 to 0.209 in the second round. All AHP consistency ratios were <0.1. After implementation, the rates of all ten monitored process indicators were significantly higher than those during the pre-intervention period (all P<0.05), with implementation rates ranging from 78.06% to 94.84%.
Conclusion:
The quality-sensitive indicator framework provided a structured approach for evaluating and improving nursing processes for DRPI prevention. Its implementation was associated with improved adherence to selected preventive nursing processes. Further studies are needed to evaluate its reliability, validity, and effects on direct patient outcomes.
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