摘要
目的构建科学规范的连续性肾脏替代治疗(Continuous Renal Replacement Therapy,CRRT)装置维护质量评价指标体系,为CRRT装置全周期维护质量的系统评估提供可靠依据。方法以Donabedian“结构-过程-结果”模型为理论框架,采用循证方法系统检索中英文数据库(检索时间2017年10月至2024年10月),结合行业标准与临床实践筛选证据,初步构建指标体系初稿;采用德尔菲法开展2轮专家函询,评价专家意见的积极性、权威性与一致性;最终确定指标体系各层级条目,采用层次分析法明确指标权重。结果共遴选24名专家进行函询,2轮德尔菲法专家函询的有效回收率分别为85.71%、100%,专家权威系数分别为0.871和0.900,各层级指标的肯德尔协调系数分别为0.160、0.166,表明专家积极性、权威性及意见一致性良好;经指标筛选(删除7项、修改10项、新增6项),最终形成包含3项一级指标、12项二级指标、52项三级指标的CRRT装置维护质量评价指标体系;采用层次分析法确定各指标权重,一致性检验结果均满足CR<0.1,权重分配合理。结论本研究构建的CRRT装置维护质量评价指标体系具有良好的科学性、可靠性与实用性,可为CRRT装置全周期维护质量的规范化评估与持续改进提供科学依据。后续需通过多中心大样本临床验证,进一步优化指标体系的适用性与有效性。
Objective To construct a scientific and standardized maintenance quality evaluation index system for continuous renal replacement therapy(CRRT)devices,and to provide a reliable basis for the systematic assessment of the whole-cycle maintenance quality of CRRT devices.Methods Based on Donabedian’s“structure-process-outcome”model as the theoretical framework,evidence-based methods were used to systematically search Chinese and English databases(search period:October 2017 to October 2024).Evidence was screened by combining industry standards and clinical practice to initially establish a draft index system.Two rounds of expert consultation were conducted using the Delphi method to evaluate the enthusiasm,authority,and consistency of expert opinions.Finally,the entries at all levels of the index system were determined,and the analytic hierarchy process was adopted to clarify the index weights.Results A total of 24 experts were selected for consultation.The effective recovery rates of the two rounds of Delphi expert consultation were 85.71%and 100%,respectively,the expert authority coefficients(Cr)were 0.871 and 0.900.The Kendall’s concordance coefficients of indicators at all levels were 0.160 and 0.166,indicating good expert enthusiasm,authority,and opinion consistency.Through index screening(7 items deleted,10 items modified,and 6 items added),a CRRT device maintenance quality evaluation index system consisting of 3 first-level indicators,12 second-level indicators,and 52 third-level indicators was finally formed.The analytic hierarchy process was used to determine the weight of each indicator,and the consistency test results all met CR<0.1,indicating a reasonable weight distribution.Conclusion The constructed CRRT device maintenance quality evaluation index system has good scientificity,reliability,and practicality,and can provide a scientific basis for the standardized assessment and continuous improvement of the whole-cycle maintenance quality of CRRT devices.Subsequent multi-center large-sample clinical validation is required to further optimize the applicability and effectiveness of the index system.
作者
王明霞
杨凌
胡兰苹
罗庆
焦红
WANG Mingxia;YANG Ling;HU Lanping;LUO Qing;JIAO Hong(Hemodialysis Center,Mianyang Hospital Affiliated to the School of Medicine,University of Electronic Science and Technology of China/Mianyang Central Hospital,Mianyang Sichuan 621000,China)
出处
《中国医疗设备》
2025年第12期122-128,共7页
China Medical Devices
基金
四川省自然科学基金(2023NSFSC0603)。
关键词
连续性肾脏替代治疗(CRRT)
装置维护
评价指标体系
三维质量评价模型
德尔菲法
层次分析法
continuous renal replacement therapy(CRRT)
device maintenance
evaluation index system
three-dimensional quality evaluation model
Delphi method
analytic hierarchy process
