Development of an Evaluation Indicator System for Discharge Preparation Services for First-Time Insulin Injection Patients Based on the Delphi Method

Objective: To establish a scientific, systematic, and operational assessment framework for discharge preparation services of patients initiating insulin therapy, providing a standardised tool for regulating and evaluating transitional care quality for this patient group. Methods: Based on the "structure-process-outcome” three-dimensional quality model , drawing on literature, and after two rounds of Delphi expert consultation, a preliminary Delphi-based indicator system was established for the evaluation of the nursing quality of discharge preparation services for patients with first-time insulin injections. Results: Both rounds of expert questionnaire responses achieved 100% valid return rates. Expert authority coefficients were 0.953 and 0.934, with Kendall’s W values of 0.101 and 0.096. Coefficients of variation ranged from 0.048 to 0.320 and 0.066 to 0.269 (all p < 0.05). The study ultimately established three primary indicators, ten secondary indicators, and thirty tertiary indicators. Conclusion: Grounded in the "structure-process-outcome” theoretical framework, this framework comprehensively covers service foundations, implementation processes, and health outcomes. It offers a practical reference for evaluating and continuously improving discharge preparation services for first-time insulin injection patients in clinical endocrinology settings, thereby supporting the enhancement of transitional care quality.