Perioperative multidisciplinary nursing model for endoscopic gastric submucosal dissection development and effect evaluation

Table 3 Inquiry results of the multidisciplinary team nursing quality index system for early gastric cancer patients during the perioperative period

Indicator	Importance (mean ± SD, points)	Coefficient of variation	Weight
1 Structural indicators	4.50 ± 0.55	0.12	0.1200
1.1 Human resource allocation	4.70 ± 0.45	0.10	0.0900
1.1.1 Nurse-to-patient ratio	4.60 ± 0.40	0.08	0.0080
1.1.2 Nurse skill level composition ratio	4.75 ± 0.30	0.06	0.0070
1.1.3 Presence of a multidisciplinary enhanced recovery after surgery (ERAS) team	4.90 ± 0.25	0.05	0.0120
1.1.4 Average nursing hours per 24 hours per hospitalized patient	4.70 ± 0.50	0.10	0.0030
1.2 Skill level and concept	4.75 ± 0.35	0.07	0.1100
1.2.1 Pass rate of nurse specialist skill training and assessment	4.85 ± 0.25	0.05	0.0230
1.2.2 Implementation rate of nurse training on ERAS concepts	4.80 ± 0.30	0.06	0.0230
1.3 Nursing protocols and procedures	4.70 ± 0.35	0.07	0.1200
1.3.1 Pass rate of training on perioperative gastric cancer nursing protocols	4.85 ± 0.25	0.05	0.0230
1.3.2 Pass rate of training on nasoenteric tube care protocols	4.80 ± 0.30	0.06	0.0070
1.3.3 Pass rate of training on abdominal drainage tube care protocols	4.75 ± 0.25	0.05	0.0070
1.3.4 Pass Rate of training on venous catheter maintenance procedures	4.70 ± 0.30	0.06	0.0070
1.4 Equipment	4.41 ± 0.25	0.13	0.0894
1.4.1 Ratio of monitors, mobile IV stands, walkers to beds	4.63 ± 0.25	0.14	0.0157
2 Process indicators	6.00	0.00	0.7332
2.1 Health education	4.65 ± 0.40	0.09	0.0690
2.1.1 Implementation rate of perioperative education on significance and methods of early postoperative ambulation	4.70 ± 0.40	0.09	0.0070
2.1.2 Mastery rate of postoperative oral nutritional solution preparation methods	4.60 ± 0.50	0.11	0.0030
2.1.3 Mastery rate of preoperative lung function exercise methods (for patients with underlying pulmonary diseases)	4.75 ± 0.35	0.07	0.0160
2.1.4 Implementation rate of discharge guidance	4.70 ± 0.40	0.09	0.0150
2.2 Psychological care	4.20 ± 0.60	0.14	0.0290
2.2.1 Screening rate for perioperative anxiety and depression	4.65 ± 0.650	0.11	0.0090
2.2.2 Intervention rate for perioperative anxiety and depression	4.60 ± 0.55	0.12	0.0060
2.3 Intraoperative temperature managemen	4.75 ± 0.35	0.07	0.1003
2.3.1 Implementation rate of intraoperative temperature management measures	4.85 ± 0.25	0.05	0.0402
2.3.2 Intraoperative normothermia achievement rate	4.80 ± 0.30	0.06	0.0402
2.4 Cooperation in tumor-free protective isolation techniques	6.00	0.00	0.3958
2.4.1 Implementation rate of supervision and cooperation in tumor-free protective isolation techniques	6.00	0.00	0.3958
2.5 Venous thromboembolism (VTE) management	4.65 ± 0.50	0.11	0.0440
2.5.1 VTE assessment rate	4.70 ± 0.40	0.09	0.0130
2.5.2 Implementation rate of VTE preventive measures	4.65 ± 0.45	0.10	0.0130
2.6 Pain management	4.55 ± 0.60	0.13	0.0320
2.6.1 Postoperative pain assessment rate	4.75 ± 0.35	0.07	0.0082
2.6.2 Mastery rate of patient- or family-controlled intravenous analgesia pump knowledge	4.60 ± 0.40	0.09	0.0020
2.6.3 Implementation rate of multimodal analgesia	4.70 ± 0.35	0.07	0.0082
2.7 Nutrition management	4.85 ± 0.25	0.05	0.2060
2.7.1 Preoperative nutrition assessment rate	4.80 ± 0.35	0.06	0.0252
2.7.2 Preoperative nutrition intervention rate	4.87 ± 0.35	0.07	0.0252
2.7.3 Implementation rate of postoperative early ONS1	4.93 ± 0.26	0.05	0.0772
2.8 Tube management	4.82 ± 0.35	0.07	0.1057
2.8.1 Venous catheter care compliance rate	4.82 ± 0.35	0.07	0.0182
2.8.2 Nasoenteric tube care compliance rate	4.75 ± 0.35	0.07	0.0200
2.8.3 Abdominal drainage tube care compliance rate	4.75 ± 0.35	0.07	0.0200
2.8.4 Implementation rate of urinary catheter removal on postoperative day 1 (for clinically stable patients)	4.55 ± 0.50	0.11	0.0070
2.9 Early ambulation	4.65 ± 0.59	0.09	0.0692
2.9.1 Completion rate of bedside activities on the day of surgery	4.75 ± 0.52	0.09	0.0216
2.9.2 Completion rate of ambulation on postoperative day 1	4.75 ± 0.35	0.09	0.0216
3 Outcome indicators	4.73 ± 0.46	0.07	0.2395
3.1 Adverse events	4.75 ± 0.35	0.09	0.2825
3.1.1 Incidence of stage 2 or above pressure injuries in hospitalized patients	4.80 ± 0.41	0.09	0.0117
3.1.2 Incidence of central venous catheter (CVC)-related bloodstream infections	4.87 ± 0.35	0.07	0.0187
3.1.3 Incidence of falls in hospitalized patients	4.73 ± 0.59	0.13	0.0041
3.1.4 Proportion of fall-related injuries in hospitalized patients	4.80 ± 0.56	0.12	0.0104
3.1.5 Incidence of deep vein thrombosis	4.84 ± 0.35	0.07	0.0166
3.1.6 Unplanned extubation rate	4.83 ± 0.56	0.12	0.0060
3.2 Complications	4.87 ± 0.35	0.07	0.4732
3.2.1 Incidence of aspiration during anesthesia recovery	4.84 ± 0.35	0.07	0.0852
3.2.2 Unplanned tube occlusion rate	4.83 ± 0.56	0.12	0.0281
3.3 Bowel function recovery	4.70 ± 0.45	0.10	0.1223
3.3.1 Bowel sound recovery rate within 12-24 hours postoperatively	4.87 ± 0.25	0.05	0.0291
3.4 Length of stay	4.70 ± 0.45	0.10	0.1223
3.4.1 Average length of stay for discharged patients	4.87 ± 0.26	0.05	0.0291

¹Oral nutritional supplements refer to the supplementation of deficiencies in the daily diet through the oral intake of special medical use (formula) foods in addition to the normal diet.

ERAS: Enhanced recovery after surgery; VTE: Venous thromboembolism; ONS: Oral nutritional supplements; CVC: Central venous catheter.