Nursing Outcomes in the Management of Patients with Acute Appendicitis at Sichon Hospital, Nakhon Si Thammarat Province
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Abstract
This study aimed to examine nursing outcomes and Enhanced Recovery After Surgery (ERAS) nursing activities among patients undergoing appendectomy for acute appendicitis at Sichon Hospital, Nakhon Si Thammarat Province. A retrospective chart review was conducted on 193 patients selected through simple random sampling. Data were collected using a record form developed based on a comprehensive literature review. The instrument's content validity was verified by three experts, with the Item-Objective Congruence (IOC) index ranging from 0.67 to 1.00. Statistical analysis was performed using Fisher's exact tests.
Results: The majority of participants were male (52.8%) with an average age of 33.85± 20.07 years, primarily in the 15-30 age group (32.1%). Most were laborers or farmers (47.7%) and had no underlying diseases (79.8%). In term of nursing activities to promote rapid recovery, the most frequently implemented interventions were wound care (98.4%), discharge planning (97.9%), pain management (94.3%), and early ambulation (68.9%), while deep breathing and coughing exercises were the least frequent (2.1%). Regarding the nursing outcomes for patients following acute appendectomy, the majority of patients (94.3%) did not experience postoperative complications. The mean length of hospital stay (LOS) was 6.13 ±3.87 days, with 78.8% of patients discharged within 7 days. Notably, all patients (100%) were discharged with improved clinical status, and the 28-day unplanned readmission rate was remarkably low at 1.6% (98.4% without readmission). Correlation analysis revealed that early ambulation was significantly associated with a reduction in the length of hospital stay ($P < .05$). In contrast, other nursing activities did not show a statistically significant correlation with nursing outcomes across all dimensions.
Consequently, it is recommended to develop a systematic clinical nursing pathway for Enhanced Recovery After Surgery (ERAS) that prioritizes early ambulation over routine care. Such a targeted intervention aims to minimize variations in the length of hospital stay and further elevate nursing standards for improved patient outcomes.
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บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของ วิทยาลัยการสาธารณสุขสิรินธร จังหวัดยะลา
References
วรัมพร ศุภัทรกิจ. (2568). ความชุกและปัจจัยเสี่ยงที่มีผลต่อการเกิดโรคไส้ติ่งอักเสบแบบมีภาวะแทรกซ้อนในโรงพยาบาลเทพรัตน์นครราชสีมา. วารสารสมาคมศัลยแพทย์ทั่วไปแห่งประเทศไทยในพระบรมราชูปถัมภ์, 10(3), 148-161.
สดสวย ทองมหา และประภาพร จงใจภักดี. (2568). บทบาทพยาบาลในการส่งเสริมการฟื้นตัวเร็วหลังผ่าตัดกระดูกสันหลัง. วารสารพยาบาลทหารบก, 26(3), 10-18.
Al-Omran, M., & Al-Qasim, H. (2025). Laparoscopic appendectomy in acute appendicitis: analysis of independent risk factors associated with complications - a single-center retrospective study. Chirurgia, 38(4), 243-248.
Al-Ruwaili, S. R. H., Alrowauli, T. A., Al-Subaie, M. H., Al-Atawi, R. N. S., Al-Jumaili, A. M., Al-Anzi, E. A. A., ... & Alshammari, J. R. (2024). Effects of evidence‐based nursing on surgical site wound infection in post appendectomy patients. Journal of International Crisis and Risk Communication Research, 7(S9), 2724.
Chen, S. S., Gao, Y. M., Yao, X. F., Zhang, Q. Q., Yang, K. L., Xia, Q., & Ding, J. (2025). Effect of rapid rehabilitation surgical nursing on patients' gastrointestinal function recovery and sleep quality after laparoscopic appendectomy. World Journal of Gastrointestinal Surgery, 17(4), 102681.
Lapsekili, E., Deniz, A., & Celik, S. U. (2021). Factors associated with postoperative complications following appendectomy in elderly patients. Revista da Associacao Medica Brasileira (1992), 67(10), 1485–1490. https://doi.org/10.1590/1806-9282.20210672
Liu, F., Zhou, J., & Wu, X. L. (2024). Effects of evidence-based nursing on surgical site wound infection in patients undergoing acute appendicitis surgery: A meta-analysis. International wound journal, 21(3), e14539. https://doi.org/10.1111/iwj.14539 (Retraction published Int Wound J. 2025 Mar;22(3):e70286. doi: 10.1111/iwj.70286.
Nair, A., Al-Aamri, H. H. M., Ishaq, O. A., & Haque, P. W. (2022). Enhanced recovery after surgery pathways for patients undergoing laparoscopic appendectomy: A systematic review and meta-analysis. Journal of Acute Disease, 11(5), 173-180.
Podda, M., Di Saverio, S., Cillara, N., et al. (2022). Laparoscopic versus open appendectomy for complicated acute appendicitis: a systematic review and meta-analysis. Langenbeck's Archives of Surgery, 407(2), 527-542.
Salminen, P., Haijanen, J., Minneci, P. C., Davidson, G. H., Boermeester, M. A., Livingston, E., Andersson, R. E., Lee, K. H., & Flum, D. (2025). Appendicitis. Nature reviews. Disease primers, 11(1), 79. https://doi.org/10.1038/s41572-025-00659-6
Wang, Y., Shen, Q., & Wang, C. (2023). Efficacy of Rapid Rehabilitation Nursing in Postoperative Care in China: A Meta-Analysis. Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses, 48(5), 170–179. https://doi.org/10.1097/RNJ.0000000000000427
Wu, T., Yang, Y., Wu, Y., Lu, L., & Dong, S. (2021). Complications after appendectomy in patients with treated appendicitis: results from a retrospective study. Annals of Palliative Medicine, 10(12), 125462553-125412553.
Zamaray, B., De Boer, M. F. J., Popal, Z., Rijbroek, A., Bloemers, F. W., & Oosterling, S. J. (2023). AbcApp: incidence of intra-abdominal ABsCesses following laparoscopic vs. open APPendectomy in complicated appendicitis. Surgical Endoscopy, 37(3), 1694-1699.
Zhang, Q., Zhang, L. H., Wu, J. L., & Yang, F. Y. (2024). Effects of clinical nursing pathway on surgical site wound infection in patients undergoing acute appendicitis surgery: A meta-analysis. International wound journal, 21(4), e14600. https://doi.org/10.1111/iwj.14600 (Retraction published Int Wound J. 2025 Mar;22(3):e70281. doi: 10.1111/iwj.70281.
