三级甲等综合医院护士临床服务能力评价指标的构建及验证 [中文引用][英文引用]

目的  构建三级甲等综合医院护士临床服务能力评价指标并进行初步验证。方法  以系统论和结构 - 过程 - 结果三维质量模型为框架，通过文献及政策性文件检索与分析、三级甲等综合医院护士质性访谈，初步构建三级甲等综合医院护士临床服务能力评价指标；于 2024 年 9 月— 11 月通过两轮德尔菲函询完成指标筛选与修改，采用层次分析法确定指标权重；于 2025年 1月—2月采用便利抽样法，选取广东省 4家三级甲等综合医院 391名护士作为研究对象，对该指标进行适用性调查，以验证护士对指标的满意度。结果  专家权威系数为 0.96，两轮专家函询的积极程度分别为 90.00% 和 100.00%，Kendall 协调系数 W 分别为 0.303 和 0.513。最终形成的三级甲等综合医院护士临床服务能力评价指标包括结构性服务能力、过程性服务能力、结果性服务能力 3 项一级指标，9 项二级指标和 57 项三级指标。指标的全面性、科学性、可行性、实用性、整体满意度得分分别为（4.65±0.44）分、（4.46±0.56）分、（4.43±0.72）分、（4.47±0.54）分、（4.53±0.67）分。结论  构建的三级甲等综合医院护士临床服务能力评价指标结构合理，覆盖范围广，内容完整，未来可进一步推广使用。

Objective To construct and preliminarily validate an evaluation index system for the clinical serviceability of nurses in Tier-IIIA hospitals，to provide a reference for the training and assessment of nurses in such settings. Methods Guided by system theory and utilizing the structure-process-outcome（SPO）model as the framework，an initial evaluation index system for nurses’ clinical serviceability in Tier-IIIA hospitals was constructed through literature and policy document review，data analysis，and qualitative interviews of nurses in Tier-IIIA hospitals. From September to November 2024，two rounds of Delphi expert consultations were conducted to select and refine the indicators. The weights of these indicators were determined using the analytic hierarchy process（AHP）. In January and February 2025，a survey was conducted with 391 nurses from four Tier-IIIA hospitals in Guangdong Province to assess their recognition of the index system and preliminarily evaluate its applicability and nurses’satisfaction of the indicators. Results The authority coefficients were 0.96. The response rates for the two rounds of expert consultations were 90.00% and 100.00%，respectively. and the Kendall’s W coefficients were 0.303 and 0.513. The final evaluation index system consists of three primary indicators（including structural service capability，process-based service capability and outcome-based service capability），nine secondary indicators，and fifty-seven tertiary indicators. The comprehensiveness，scientific rigor，feasibility，practicality，and overall satisfaction scores of the indicators were（4.65±0.44），（4.46±0.56），（4.43±0.72），（4.47±0.54），and（4.53±0.67）respectively. Conclusion The evaluation index system for nurses’clinical service ability in Tier-IIIA hospitals is well-structured with wide coverage and complete content，which can be further popularized and applied in the future.