Construction of a nursing sensitive quality indicator evaluation system for sepsis care quality: A three-stage mixed-method Delphi study

Background Currently, there are no objective, scientific, and sensitive assessment frameworks for evaluating sepsis care quality management in China. This study aimed to address this gap by developing and validating nursing-sensitive quality indicators (NSQIs) tailored to sepsis management in Chinese clinical settings. Methods This mixed-methods investigation involved three phases. A systematic literature review (2014–2024) across four databases identified evidence regarding sepsis care quality. Subsequently, semi-structured interviews were conducted with 16 clinical experts from emergency departments (EDs) and intensive care units (ICUs) to examine their perspectives on NSQIs. Finally, a modified Delphi process engaged a multidisciplinary panel to refine and validate sepsis-specific NSQIs through a systematic consensus-building process. Result Two rounds of expert consultation were completed, with a 100% questionnaire return rate. Sixteen experts (10 nurses and six physicians) participated in the first and second rounds of the Delphi survey. The mean score of the expert authority coefficient for the two rounds was 0.96. The range of Kendall W values was 0.120–0.316 (P < 0.001). A comprehensive list of sensitive indicators for sepsis care quality was established, encompassing three primary, nine secondary, and 30 tertiary indicators. Conclusion The established NSQIs encompass three fundamental dimensions of sepsis care quality: importance, rationality, and operational feasibility. This two-round Delphi process achieved expert consensus, confirming the system’s alignment with clinical guidelines and feasibility. Clinical practice implications: This research provides a valuable framework for evaluating clinical care quality in sepsis management.