Establishment of Shanghai community nursing quality indicators system: Based on Donabedian's structure-process-outcome approach theory

Objective To construct Shanghai community nursing quality evaluation indicators system in order to provide an evaluation tool for comprehensively improving the quality of community nursing. Methods According to Donabedian's structure-process-outcome approach theory, an expert consultation questionnaire about evaluation of community nursing quality indicators system was prepared. Two rounds of Delphi consultation were conducted by purposive sampling and selecting experts such as primary medical management personnel, administrative personnel of primary health institutions, community nursing managers and professors of community nursing major in colleges and universities. Results Data analysis showed that expert positive coefficient was 94% and coefficient of authority was 0.85. Two rounds of enquiry for Kendall coefficient results were 0.253 (χ²=311.285, P<0.01) and 0.401 (χ²=498.971, P<0.01). The structural indicators included organizational structure, staff composition, rules and regulations, nursing training and 6 corresponding three-level indicators; Process indicators include resources, environment management, community care quality management, participation in community key population management, participation in Family doctor service team, hospice care, home care and 15 corresponding third-level indicators; The outcome indicators include nursing safety events, satisfaction rate of service objects, compliance rate of nursing quality control, training rate of community nurses, assessment qualified rate of community nurses, work innovation and achievement promotion and corresponding 27 three-level indicators. Conclusion The community nursing quality evaluation system based on the "structure-process-result" model has good reliability, operability and prospective, which can reflect the community nursing operation, nursing quality, nursing service and other conditions, and can also help community nursing managers to comprehensively develop nurse teams.