Construction of a quality evaluation index system for nutrition nursing clinics based on the Donabedian model

Abstract

Objective To develop an evidence-based quality evaluation index system for Nutrition Nursing Clinics (NNCs) grounded in the Donabedian Structure-Process-Outcome model. Methods A preliminary indicator system was developed through a systematic literature review, expert panel discussions, and a national survey. Utilizing the Delphi method, 17 experts participated in two rounds of consultation. Questionnaires with a 100% effective response rate in both rounds were used to collect expert opinions on the importance of indicators. Indicators were screened based on an average importance score ≥3.5 and a coefficient of variation <0.25. The Analytic Hierarchy Process (AHP) was then applied to calculate the weights for the finalized indicators. Results The expert authority coefficients (Cr) for the two consultation rounds were 0.90 and 0.89, respectively, indicating high expert credibility. The Kendall's W coefficients for all levels of indicators were statistically significant (P < 0.01), demonstrating a good degree of coordination and convergence of expert opinions. Ultimately, a comprehensive quality evaluation index system for NNCs was established, comprising 3 first-level indicators, 16 second-level indicators, and 61 third-level indicators. Consistency Ratio (CR) values for all judgment matrices ranged from 0.0000 to 0.0904, confirming the logical consistency of the assigned weights. Conclusion This study developed a preliminary, consensus-based quality evaluation index system for NNCs, representing a foundational step toward standardized evaluation in this specialty.