Construction of nursing-sensitive quality indicators for hemodialysis using Delphi method.

Aims and objectivesTo provide a set of nursing-sensitive quality indicators (NSQIs) for the evaluation of clinical nursing quality in haemodialysis unit. BackgroundThere are no established objective indicators for evaluation of the quality of nursing care in haemodialysis units in China. Design and methodsWe performed a literature search for eligible studies published from 2006-2016. A total of six studies were screened out from which 13 potential NSQIs were identified. Two rounds of Delphi surveys were conducted with the purpose of collecting opinions from a panel of independent experts. At last, 11 NSQIs were selected by consensus after exclusion of 8 NSQIs and addition of another 6 NSQIs. ResultsTwo rounds of expert inquiry were conducted; the questionnaire recovery rate was 100%. The average authoritative coefficients Cr for the two rounds were 0.79 and 0.90, respectively. The Kendall W values ranged from 0.273-0.388 (p<0.001). Eleven NSQIs were identified: nurse-to-patient ratio, dialysis ultrafiltration rate compliance rate, KT/V compliance rate, incidence of emergency during haemodialysis, person-time incidence rate of haemodialysis catheter-related bloodstream infections, incidence of coagulation in extracorporeal circulation, incidence of blood loss in extracorporeal circulation, incidence of pseudoaneurysm induced by fistula puncture, incidence of falls among haemodialysis patients, emergency dialysis rate of outpatients and incidence of fistula complications. ConclusionThe identified NSQIs reflect three aspects of haemodialysis nursing quality: importance, rationality of calculation formula and applicability of data collection methods. Relevance to clinical practiceThe study provides a reference for the evaluation of clinical nursing quality in haemodialysis units.