Construction of a quality evaluation index system for waterless surgical hand antisepsis in operating rooms
- 1epartment of Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
Abstract
ObjectiveTo develop and obtain expert consensus on a quality evaluation index system for waterless surgical hand antisepsis in operating rooms and to assign hierarchical weights to the finalized indicators.MethodsGuided by the Donabedian structure-process-outcome model, candidate indicators were generated through a structured literature review and semi-structured interviews. A three-round expert consultation was conducted: Rounds 1 and 2 were used to screen and refine indicators, and Round 3 was used for AHP-based pairwise weighting. Twenty-two eligible experts received the Round-1 questionnaire; 20 returned valid questionnaires and constituted the panel retained for Rounds 2 and 3, in which all 20 responded. Expert authority was assessed using Cr = (Ca + Cs)/2. In Round 3, individual expert authority coefficients were normalized to obtain expert-specific weights, and pairwise judgments were aggregated using a weighted geometric mean before AHP weight calculation and consistency testing.ResultsThe valid response rates were 90.9% (20/22), 100% (20/20), and 100% (20/20) in Rounds 1, 2, and 3, respectively. The panel mean expert authority coefficients (Cr) were 0.883, 0.895, and 0.900. Kendall's coefficients of concordance for the two indicator-screening rounds were 0.242 and 0.334, respectively (both P < 0.001), while coefficients of variation decreased from 0.07-0.20 to 0.05-0.18. The aggregated AHP group judgment matrices satisfied the predefined consistency criterion (CR < 0.10). The final system comprised three first-level, nine second-level, and 28 third-level indicators. The global weights of the first-level domains were structure 0.1762, process 0.4123, and outcome 0.4115.ConclusionThis study produced a consensus-based and hierarchically weighted quality evaluation index system for waterless surgical hand antisepsis. The framework may support standardized quality assessment and future quality-improvement work; however, the present study establishes expert consensus and relative priorities rather than clinical effectiveness, psychometric reliability, or causal effects. Multicenter clinical validation is required before broad implementation.
Related
- Evaluation of a mobile surgical air decontamination device in reducing airborne microbial load in the operating theatre of a tertiary care hospital.
- Applicator-Based Versus Bulk-Bottle Delivery of the Same Alcoholic Chlorhexidine: A Single-Center, Non-Randomized Pilot Micro-Costing Study of Two Surgical Skin-Antisepsis Workflows.
- From Person to Patient: Power, Control and the Construction of Vulnerability in the Operating Room.
- Virtual Operating Theatre Simulation: Development and Evaluation of a Web-Based Learning Tool for Medical Students
- The cognition of dynamic evaluation of operating room environmental quality among medical staff: a qualitative study
BibTeX
@article{yang2026construction,
title = {{Construction of a quality evaluation index system for waterless surgical hand antisepsis in operating rooms}},
author = {Songping Yang and Xi Yuan and Xuequn Yin and Wenjuan Zhou and Huixian Zhou and Li Miao and Guo Zhang and Xinmei Zhang},
journal = {Frontiers in Surgery},
year = {2026},
month = oct,
doi = {10.3389/fsurg.2026.1949101},
url = {https://doi.org/10.3389/fsurg.2026.1949101},
note = {CC BY},
}
RIS
TY - JOUR
TI - Construction of a quality evaluation index system for waterless surgical hand antisepsis in operating rooms
AU - Songping Yang
AU - Xi Yuan
AU - Xuequn Yin
AU - Wenjuan Zhou
AU - Huixian Zhou
AU - Li Miao
AU - Guo Zhang
AU - Xinmei Zhang
PY - 2026
DA - 2026/10/29
JO - Frontiers in Surgery
DO - 10.3389/fsurg.2026.1949101
UR - https://doi.org/10.3389/fsurg.2026.1949101
AB - ObjectiveTo develop and obtain expert consensus on a quality evaluation index system for waterless surgical hand antisepsis in operating rooms and to assign hierarchical weights to the finalized indicators.MethodsGuided by the Donabedian structure-process-outcome model, candidate indicators were generated through a structured literature review and semi-structured interviews. A three-round expert consultation was conducted: Rounds 1 and 2 were used to screen and refine indicators, and Round 3 was used for AHP-based pairwise weighting. Twenty-two eligible experts received the Round-1 questionnaire; 20 returned valid questionnaires and constituted the panel retained for Rounds 2 and 3, in which all 20 responded. Expert authority was assessed using Cr = (Ca + Cs)/2. In Round 3, individual expert authority coefficients were normalized to obtain expert-specific weights, and pairwise judgments were aggregated using a weighted geometric mean before AHP weight calculation and consistency testing.ResultsThe valid response rates were 90.9% (20/22), 100% (20/20), and 100% (20/20) in Rounds 1, 2, and 3, respectively. The panel mean expert authority coefficients (Cr) were 0.883, 0.895, and 0.900. Kendall's coefficients of concordance for the two indicator-screening rounds were 0.242 and 0.334, respectively (both P < 0.001), while coefficients of variation decreased from 0.07-0.20 to 0.05-0.18. The aggregated AHP group judgment matrices satisfied the predefined consistency criterion (CR < 0.10). The final system comprised three first-level, nine second-level, and 28 third-level indicators. The global weights of the first-level domains were structure 0.1762, process 0.4123, and outcome 0.4115.ConclusionThis study produced a consensus-based and hierarchically weighted quality evaluation index system for waterless surgical hand antisepsis. The framework may support standardized quality assessment and future quality-improvement work; however, the present study establishes expert consensus and relative priorities rather than clinical effectiveness, psychometric reliability, or causal effects. Multicenter clinical validation is required before broad implementation.
SN - 2296-875X
ER -