Objective To establish standards, methods and processes for evidence-based evaluation and selection of essential medicine that meet the needs of the 8 pilot township health centers in China. Methods A descriptive analysis was conducted to compare the similarities/differences and the advantages/disadvantages of the standards, methods and processes between the World Health Organization (WHO) essential medicines evaluation and selection, and the GRADE evidence quality and recommend intensity. In combination with the former outcomes of this series of study, the standards, methods and processes of evidence-based evaluation and selection of essential medicines in the domestic pilot township health centers were optimized, restructured and improved. Softwares such as GRADEprofiler were used to assess the quality of evidence. Results a) Localized standards, methods and processes for evidence-based evaluation and selection of essential medicine were established, and the evaluation tool was ascertained; and b) Disease and drug names, guidelines and searching processes for evaluation and selection of essential medicine were developed with standardized, systematic and transparent approaches. Conclusion a) Standards, methods and processes for searching, evaluating and recommending the best evidence are preliminarily established, through comparative analysis on the effectiveness, safety, cost-effectiveness and applicability of the candidate medicines for diagnosing, treating and preventing diseases in township health centers in China; b) Following the principle of “utilizing the best existing evidences and developing the urgently-needed but lacking evidence”, a good exploration was done for the localization, standardization and transparency of the standards, methods and processes of evidence-based evaluation and selection of essential medicine for pilot township health centers.
Objectives To establish the quality criteria for clinical nursing practice guidelines in China. Methods Two focus groups’ interviews for 26 clinical nursing experts and methodological experts from China were adopted to build the quality criteria for clinical nursing practice guidelines. Results The quality criteria for clinical nursing practice guidelines in China covered 5 domains and 15 items, which included scientificity/rigor, effectiveness/safety, economy, availability/feasibility, and conflict of interest. All items were from 0 to 5 scale and weighted 0.5 to 2 based on their contributions to the quality of guidelines. Conclusions The quality criteria for clinical nursing practice guidelines adopt the same framework with the quality criteria of guidelines in medical field and also integrate features of nursing. It provides the quality standard for Chinese clinical nursing practice guidelines.
ObjectivesTo evaluate the reliability and validity on quality criteria for clinical nursing practice guidelines.MethodsFive appraisers were included to assess two clinical nursing practice guidelines using the quality criteria for clinical nursing practice guidelines and AGREE Ⅱ. ICC and coefficient of consistency were adopted to assess the reliability and validity of the appraisal tools.ResultsICC for two guidelines of AIDS and infusion by the quality criteria for clinical nursing practice guidelines were 0.979 and 0.890. ICC for two guidelines of AIDS and infusion by AGREE Ⅱ were 0.957 and 0.887. The coefficient of consistency for guidelines of AIDS and infusion by the two appraisal tools were 0.880 and 0.886, both were highly consistent.ConclusionsThe quality criteria for clinical nursing practice guidelines has good reliability and validity and can be used as appraisal tool for quality evaluation of clinical nursing practice guidelines. It is strongly recommended that the users should understand the appraisal tool or should be trained to decrease the bias.
The purpose of this paper is to discuss the evaluation standard of rationality of medical examination from different perspectives, so as to provide theoretical evidence for medical department to establish the evaluation standard of the rationality of medical examination. By researching the relevant literature in the field of rational medical examination and combing the existing research results, this paper discusses the evaluation criteria of the rationality of medical examination from four dimensions: technology, ethics, law, and health economy. The following four suggestions are proposed for the current status of medical examination: construct clinical pathway management to avoid excessive medical examination; establish the internal supervision and evaluation mechanism to improve the professional quality of medical staff; improve medical examination-related policies, laws, and regulations, carry out specialized legislation; apply diagnosis-related group payment method, control the cost of medical examination.
Objective To explore the nursing quality standards of joint surgery based on “structure-process-outcome” three-dimensional quality evaluation model, and provide a reference for improving the quality of joint surgery nursing. Methods From March to July 2023, based on the “structure-process-outcome” three-dimensional quality structure model as the theoretical framework, combined with systematic literature review and semi-structured interviews, the quality standards of joint surgery specialist nursing were preliminarily formulated. The Delphi method was used for screening, demonstration, and correction, then the analytic hierarchy process was used to determine the weights. Results The recovery rates of the two rounds of expert letter consultation were 93.75% and 100.00%, respectively. The expert authority coefficients of both rounds were 0.95. The positive coefficients of experts in the two rounds were 0.93 and 1.00, respectively. The coefficients of variation after the second round of correspondence were 0-0.20. In the second round of correspondence inquiry, the Kendall harmony coefficients of primary standards, secondary standards and tertiary standards were 0.156, 0.115 and 0.285, respectively, with statistical significance (P<0.05). Finally, the quality standards of joint specialty nursing included 3 primary standards, 23 secondary standards and 99 tertiary standards. Conclusion The construction process of nursing quality standards of joint surgery specialty based on “structure-process-outcome” three-dimensional quality structure model is scientific and reliable, the index evaluation results are less volatile, and the opinions are concentrated, which can provide a basis for comprehensively, accurately and pertinently improving the quality of joint surgery specialty nursing.