中华灾害救援医学

目的 基于德尔菲法构建骨科护理人员灾害救护核心能力体系，并评价该体系在临床护理中的应用效果。方法 采用德尔菲法，邀请20名专家进行3轮专家咨询，构建骨科护理人员灾害救护核心能力指标体系。在此基础上，于2025年1月至2025年9月选取联勤保障部队第九〇四医院收治的40例骨折患者为研究对象，将2025年1月至4月收治的20例患者设为对照组（由接受传统培训的护理人员护理），2025年5月至9月收治的20例患者设为观察组（由接受基于核心能力体系培训的护理人员护理）。比较两组患者的疼痛程度、功能恢复情况、并发症发生率及护理满意度。结果 通过3轮德尔菲专家咨询，构建了包含6个一级指标、32个二级指标的骨科护理人员灾害救护核心能力体系。应用结果显示：干预后，观察组患者干预后1 d、3 d、7 d的VAS评分均低于对照组（P<0.05）；干预后2周、4周，观察组患者的关节活动度和肌肉力量均高于对照组（P<0.05）；观察组并发症总发生率为5.00%，低于对照组的30.00%(P<0.05)；观察组护理满意度为95.00%，高于对照组的65.00%(P<0.05)。结论 基于德尔菲法构建的骨科护理人员灾害救护核心能力体系具有较好的专家认可度，应用该体系培训护理人员有助于缓解患者疼痛、促进功能恢复、降低并发症发生率并提高护理满意度。

Objective To construct a core competency system for orthopedic nurses in disaster rescue using the Delphi method and evaluate its application effect in clinical nursing. Methods The Delphi method was adopted to conduct three rounds of expert consultation with 20 experts to establish the core competency index system for orthopedic nurses in disaster rescue. Based on this system, 40 fracture patients admitted to the 904 th Hospital of the Joint Logistics Support Force from January 2025 to September 2025 were selected as the study subjects. Twenty patients admitted from January to April 2025 were set as the control group(cared for by nurses receiving traditional training), and 20 patients admitted from May to September 2025 were set as the observation group(cared for by nurses receiving training based on the core competency system). Pain levels, functional recovery, complication rates, and nursing satisfaction were compared between the two groups. Results After three rounds of Delphi expert consultation, the core competency system for orthopedic nurses in disaster rescue was established, consisting of 6 primary indicators and 32 secondary indicators. Application results showed that after intervention, the VAS scores in the observation group were lower than those in the control group at 1 day, 3 days, and 7 days after intervention(P < 0.05). At 2 weeks and 4 weeks after intervention, the joint mobility and muscle strength in the observation group were higher than those in the control group(P < 0.05). The total complication rate in the observation group was 5.00%, which was lower than 30.00% in the control group(P < 0.05). The nursing satisfaction in the observation group was 95.00%, which was higher than 65.00% in the control group(P < 0.05). Conclusion The core competency system for orthopedic nurses in disaster rescue constructed based on the Delphi method has good expert recognition. Applying this system to train nurses can help alleviate patient pain, promote functional recovery, reduce complication rates, and improve nursing satisfaction.