基于流程再造与德尔菲法的达芬奇机器人手术护理标准方案构建

摘要

Objective To construct the Da Vinci surgical nursing standard scheme and to provide standardized guidelines and indicators forclinicuse.Methods We drew the flow chart on the basis of Process Reengineering,used group discussion circle to select thek ey link to preliminarily form the standard items,and then used Delphy(Delphi)method to modify and determinethe items.Results The-coefficients (Cr)for two rounds of experts enquirywere 0.869 and 0.86,respectively.Kendall coordination coefficients (W)were 0.083~0.324,andthe test of significance P<0.001,whichindicated statistical significance.The satisfaction degree ofthe patients,doc-tors and nurses after the business process reengineering (BPR),thestart of operation,the interval between operationsand theoperation time had been improved.Itwasfinally determined that the Da Vinci surgical nursing standard scheme was constituted by 3 dimensions and20items.Conclusions The Da Vinci surgical nursing standard based on the process reengineering and Delphi methodis of high re-liability with standardability and practicability,which can be applied to all kinds of Da Vinci surgeries.%目的 构建达芬奇机器人手术护理标准方案,为临床提供规范指引及衡量指标.方法 基于流程再造绘制出现行流程图,使用小组讨论圈选重点环节,初步构成标准条目,然后运用德尔菲(Delphi)法进行修正及确定.结果 两轮专家函询两轮权威系数(Cr)分别为0.869与0.86,Kendall协调系数(W)为0.083~0.324,显著性检验P<0.001,差异有统计学意义.流程改造前后病人、医生及护士满意度,手术开台时间、连台间隔时间及手术时间均有改善.最终确定由3个维度,20个条目构成的达芬奇机器人手术护理标准方案.结论 基于流程再造与德尔菲法的达芬奇机器人手术护理标准方案可信度高、具有规范性及实用性,适用于各类达芬奇机器人手术.