Development of Nursing Quality Indicators for High‐Flow Humidified Oxygen Therapy in Respiratory Medicine Wards

Background High‐flow humidified oxygen therapy is widely used in respiratory medicine wards, yet there is a lack of standardised nursing quality indicators to evaluate its effectiveness. Aim The aim of this study was to develop and validate a comprehensive nursing quality indicator system for high‐flow humidified oxygen therapy using a mixed‐methods approach, grounded in the Donabedian ‘Structure–Process–Outcome’ framework. Study Design From March to July 2023, based on a literature review and semi‐structured interviews, a nursing quality indicator system was constructed guided by the ‘Structure–Process–Outcome’ theory. A two‐round Delphi consultation involving 11 experts was conducted to refine the indicators. Results The expert panel demonstrated high engagement and authority, with judgement, familiarity and authority coefficients of 0.907, 0.893 and 0.900 in the first round, and 0.913, 0.907 and 0.910 in the second round, respectively. Kendall's coefficient of concordance was improved from 0.357 in the first round to 0.605 in the second round, indicating strong consensus. The finalised system included three first‐level, 11 second‐level and 31 third‐level indicators. Conclusions The Delphi method and analytic hierarchy process yielded a scientifically robust nursing quality indicator system for high‐flow humidified oxygen therapy. Relevance to Clinical Practice This system provides a practical reference for evaluating and improving nursing quality in respiratory medicine wards, ensuring better patient outcomes.