Formal selection of measures for a composite index of NICU quality of care: Baby-MONITOR.
Formal selection of measures for a composite index of NICU quality of care: Baby-MONITOR.
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DOI：
10.1038/jp.2011.12
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发表时间：
2011-11
影响因子：
2.9
通讯作者：
Petersen, L. A.
中科院分区：
文献类型：
--
作者：
Profit, J.;Gould, J. B.;Zupancic, J. A. F.;Stark, A. R.;Wall, K. M.;Kowalkowski, M. A.;Mei, M.;Pietz, K.;Thomas, E. J.;Petersen, L. A.
系统地对极低出生体重儿的护理质量措施进行评级，将其纳入婴儿监测，这是一种综合质量指标。修改德尔福专家小组成员流程，包括电子调查和电话会议。小组成员考虑了28项标准新生儿重症监护病房(NICU)质量指标，并考虑到预定义的指标特征，对每项指标进行了9分制的评分。此外，专家小组成员将衡量标准分为六个质量领域。我们通过使用公认的方法测试评分者的一致性来选择衡量标准。在考虑的28项指标中，13项的中位数评级在较高范围(7至9)。其中9例符合纳入标准：产前类固醇(中位数(四分位数范围))9例(0)，早产儿及时视网膜病变9例(0例)，迟发性败血症9例(1例)，入院时体温过低8例(1例)，气胸8例(2例)，生长速度8例(2例)，月经后36周血氧7例(2例)，出院时是否喂奶7例(2例)，住院死亡率7例(2例)。在为该化合物选择的衡量标准中，最常见的质量领域包括有效性(40%)和安全性(30%)。一个专家小组从28项例行报告的质量指标中选择了9项纳入综合指标。小组成员还为未来的研究制定了议程，以弥合未被选为婴儿监护仪的质量指标的知识差距。
To systematically rate measures of care quality for very low birth weight infants for inclusion into Baby-MONITOR, a composite indicator of quality. Modified Delphi expert panelist process including electronic surveys and telephone conferences. Panelists considered 28 standard neonatal intensive care unit (NICU) quality measures and rated each on a 9-point scale taking into account pre-defined measure characteristics. In addition, panelists grouped measures into six domains of quality. We selected measures by testing for rater agreement using an accepted method. Of 28 measures considered, 13 had median ratings in the high range (7 to 9). Of these, 9 met the criteria for inclusion in the composite: antenatal steroids (median (interquartile range)) 9(0), timely retinopathy of prematurity exam 9(0), late onset sepsis 9(1), hypothermia on admission 8(1), pneumothorax 8(2), growth velocity 8(2), oxygen at 36 weeks postmenstrual age 7(2), any human milk feeding at discharge 7(2) and in-hospital mortality 7(2). Among the measures selected for the composite, the domains of quality most frequently represented included effectiveness (40%) and safety (30%). A panel of experts selected 9 of 28 routinely reported quality measures for inclusion in a composite indicator. Panelists also set an agenda for future research to close knowledge gaps for quality measures not selected for the Baby-MONITOR.
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