Construction of nursing-sensitive quality indicators for spine surgery under the concept of enhanced recovery after surgery

Abstract

Aims: The aim of the study was to develop a set of nursing‐sensitive quality indicators for accelerating spine surgical rehabilitation. Design: This is a modified Delphi study. A two‐round Delphi study was conducted from November to December 2023. Methods: Based on an evidence‐based perspective and semi‐structured interviews, an outline of nursing‐sensitive quality indicators for accelerated rehabilitation in spine surgery patients was formulated. The Donabedian structure‐process‐outcome theory model was used as the theoretical framework to develop the indicator system; the indicators were improved and refined after two rounds of Delphi surveys, and the weights of the indicators were determined by the analytic hierarchy process. A total of 23 experts from 10 hospitals in 7 Chinese provinces completed the two rounds of the modified Delphi process. Results: The experts reached a consensus on the definition of the indicators, the calculation formula and the data collection method, and included a sensitive quality indicator system for accelerated rehabilitation care in spine surgery with 3 primary indicators, 9 secondary indicators and 26 tertiary indicators. Conclusion: A set of indicators about accelerated rehabilitation care in spinal surgery covers the key aspects of patient education, assessment, measures, and rehabilitation, and its content is scientific, comprehensive, and targeted, which can provide a basis for objective evaluation of the quality of accelerated rehabilitation care in spinal surgery. Impact: Medical institutions can routinely collect monthly data based on this indicator, conduct horizontal comparisons of the quality of accelerated rehabilitation care in spinal surgery among hospitals at the same level with the assistance of a national or even global networked auditing platform, and establish an internal safeguard mechanism for evaluating the quality of perioperative care. Reporting Method: This study follows the Conducting and REporting of DElphi studies (CREDE) guidance on Delphi studies. Patient or Public Contribution: No patient or public contribution was made in this study.