Quality-of-care indicators for pelvic organ prolapse: development of an infrastructure for quality assessment.
Quality-of-care indicators for pelvic organ prolapse: development of an infrastructure for quality assessment.
复制标题
盆腔器官脱垂的护理质量指标：开发质量评估基础设施。
DOI：
10.1007/s00192-013-2105-z
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发表时间：
2013
影响因子：
1.8
通讯作者：
Shekelle,PaulG
中科院分区：
文献类型：
--
作者：
Anger,JenniferT;Scott,VictoriaCS;Kiyosaki,Krista;Khan,AqsaA;Sevilla,Claudia;Connor,SarahE;Roth,CarolP;Litwin,MarkS;Wenger,NeilS;Shekelle,PaulG
介绍和假设一个缺乏的数据存在解决提供给女性盆腔器官脱垂（POP）的护理质量。我们试图开发一种方法来衡量这种质量，通过发展的质量的护理指标（QIs）。MethodsQIs是仿照那些以前描述的评估护理弱势长者（ACOVE）项目。这些指标随后提交给一个由九名专家组成的小组。使用兰德适当方法，我们分析了每个指标的初步排名。随后举行了一次论坛，小组成员作为一个小组对每项指标进行了深入讨论，之后小组成员单独对指标进行了重新评级。中位分数至少为7的QIs被认为是valid.ResultsQIs开发，解决筛选，诊断，工作，以及非手术和手术治疗。争议的领域包括是否应该进行筛查以识别脱垂，子宫托使用者是否应该每6个月接受一次卫生专业人员的阴道检查，而不是每年一次，以及是否应该为计划接受POP手术的老年妇女提供阴道闭合术。21个潜在指标中有14个被评为盆腔器官脱垂有效（中位数得分≥7）.ConclusionWe developed and rated 14 potential quality indicators for the care of women with POP.Once these QIs are tested for practical feasibility，they can be used on a large scale to measure and compared the care provided to women with prolapse in different clinical settings.
Introduction and hypothesisA paucity of data exists addressing the quality of care provided to women with pelvic organ prolapse (POP). We sought to develop a means of measuring this quality through the development of quality-of-care indicators (QIs).MethodsQIs were modeled after those previously described in the Assessing the Care of Vulnerable Elders (ACOVE) project. The indicators were then presented to a panel of nine experts. Using the RAND Appropriateness Method, we analyzed each indicator’s preliminary rankings. A forum was then held in which each indicator was thoroughly discussed by the panelists as a group, after which panelists individually re-rated the indicators. QIs with median scores of at least 7 were considered valid.ResultsQIs were developed that addressed screening, diagnosis, work-up, and both nonsurgical and surgical management. Areas of controversy included whether screening should be performed to identify prolapse, whether pessary users should undergo a vaginal examination by a health professional every 6 months versus annually, and whether a colpocleisis should be offered to older women planning to undergo surgery for POP. Fourteen out of 21 potential indicators were rated as valid for pelvic organ prolapse (median score ≥7).ConclusionWe developed and rated 14 potential quality indicators for the care of women with POP. Once these QIs are tested for feasibility they can be used on a larger scale to measure and compare the care provided to women with prolapse in different clinical settings.