Development of a nursing-sensitive quality evaluation indicator system for perioperative care in breast reconstruction surgery: A Delphi study

Objective: The aim of this study is to develop a structured and quantifiable system of nursing-sensitive quality indicators (NSQIs) for evaluating perioperative care in breast reconstruction surgery. Methods: A mixed-methods study was conducted.First, a literature review and qualitative study were conducted to identify the potential NSQIs for perioperative care in breast reconstruction surgery.Subsequently, a two-round Delphi study with 15 experts was conducted to reach a consensus and establish the final version of NSQIs system.Results: The final NSQIs system for perioperative care in breast reconstruction surgery consisted of 3 first-level indicators (Structure, Process, and Outcome), 9 second-level indicators and 24 third-level indicators.The Structure level focuses on organizational resources, including human resources and environmental equipment; the Process level emphasizes nursing assessment and interventions (particularly flap monitoring and wound management); and the Outcome level evaluates patient satisfaction, clinical complications, and psychosocial function.Conclusions: This study developed objective and practical NSQIs for perioperative care in breast reconstruction surgery.The NSQIs system provided a quantifiable evaluation tool and a scientific basis for nursing management.The implementation of the NSQIs system is expected to standardize nursing practice and guide the continuous quality improvement of perioperative care for breast reconstruction J o u r n a l P r e -p r o o f patients.