Development of a clinical nursing practice guideline for the care of acute stroke patients in the Department of Accident, Emergency, and Forensic Nursing, Mae Taeng Hospital, Chiang Mai Province
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Abstract
Background: Acute stroke is a medical emergency requiring timely treatment and patient referral.
Objectives: To develop and evaluate the outcomes of a nursing practice guideline for patients with acute stroke in the Accident, Emergency, and Forensic Nursing Department at Mae Taeng Hospital.
Methods: The research and development study followed Soukup's (2000) conceptual framework, which consisted of four steps: 1) problem analysis, 2) evidence-based research, 3) pilot testing, and 4) implementation of the nursing guideline. A purposive sample was selected, including 9 nurses and 26 patients. The research instruments included the development of a nursing practice guideline for patients with acute stroke. The data collection tools included 1) a focus group discussion guide for problem analysis, 2) a door-to-refer time recording form, 3) a general information recording form, and 4) a questionnaire on nurses' satisfaction with the nursing practice guideline.
Results: The nursing practice guideline consisted of 1) screening (minutes 1-5), 2) care according to the Stroke Fast Track protocol (minutes 6-10), and 3) preparation for referral to the central hospital (minutes 11-30). After implementing the nursing practice guidelines, it was found that the time patients received care according to the Stroke fast track protocol (M=8.15, SD=3.90) and the time from initial care to referral (M=29.31, SD=6.88) were significantly shorter than the standard criteria (p<.01). The time taken for patient screening (M=5.50, SD=3.36) showed no significant difference to the standard criteria. Nurses' overall satisfaction with the guideline was at the highest level (M=4.73, SD=0.41).
Conclusions: This clinical nursing practice guideline can help ensure patients receive prompt and more efficient care.
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บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวิทยาลัยพยาบาลบรมราชชนนี จังหวัดนนทบุรี
ข้อความที่ปรากฏในบทความแต่ละเรื่องในวารสารวิชาการเล่มนี้เป็นความคิดเห็นส่วนตัวของผู้เขียนแต่ละท่านไม่เกี่ยวข้องกับวิทยาลัยพยาบาลบรมราชชนนี จังหวัดนนทบุรี และคณาจารย์ท่านอื่น ในวิทยาลัยฯ แต่อย่างใด ความรับผิดชอบองค์ประกอบทั้งหมดของบทความแต่ละเรื่องเป็นของผู้เขียนแต่ละท่าน หากมีความผิดพลาดใด ๆ ผู้เขียนแต่ละท่านจะรับผิดชอบบทความของตนเองแต่ผู้เดียว
References
Feigin VL, Brainin M, Norrving B, Martins S, Sacco RL, Hacke W, et al. World Stroke Organization (WSO): Global stroke fact sheet 2022. Int J Stroke. 2022;17(1):18-29. doi: 10.1177/17474930211065917.
Division of Non-Communicable Diseases, Department of Disease Control, Ministry of Public Health. Number and mortality rate of 5 non-communicable diseases. [internet]. 2023 [cited 2023 Dec 1]; Available from: http://www.ddc.moph.go.th/dncd/news.php?news=39911. (in Thai).
Hollist M, Morgan L, Cabatbat R, Au K, Kirmani MF, Kirmani BF. Acute stroke management: overview and recent updates. Aging Dis. 2021;12(4):1000-9. doi: 10.14336/AD.2021.0311.
Grotta JC. Intravenous thrombolysis for acute ischemic stroke. Continuum (Minneap Minn). 2023;29(2):425-42. doi: 10.1212/CON.0000000000001207.
Wang X, You S, Sato S, Yang J, Carcel C, Zheng D, et al. Current status of intravenous tissue plasminogen activator dosage for acute ischaemic stroke: an updated systematic review. Stroke Vasc Neurol. 2018;3(1): 28-33. doi: 10.1136/svn-2017-000112.
Lorking N, Wood AD, Tiamkao S, Clark AB, Kongbunkiat K, Bettencourt-Silva JH, et al. Seasonality of stroke: winter admissions and mortality excess: a Thailand national stroke population database study. Clin Neurol Neurosurg. 2020;199:106261. doi: 10.1016/j.clineuro.2020.106261.
Boontongto S, Vibulchai N, Buthbankhow A. Development of fast-track service system for patients with stroke Wapipathum Hospital and service network. Mahasarakham Hospital Journal. 2017;14(3):100-13. (in Thai).
Medical Records, Mae Taeng Hospital. Statistics of access to emergency department 2018-2022. Chiang Mai: Medical Records, Mae Taeng Hospital; 2023. (in Thai).
Soukup SM. The center for advanced nursing practice evidenced based practice model: promoting the scholarship of practice. Nurs Clin North Am. 2000;35(2):301-9.
ECC Committee, Subcommittees and Task Forces of the American Heart Association. 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2005;112(24 Suppl):IV1-203. doi: 10.1161/CIRCULATIONAHA.105.166550.
Institute of Neurology, Department of Medical Services, Ministry of Public Health. Guidelines for stroke patient care for general nurses. Bangkok: Institute of Neurology; 2011. (in Thai).
Sritip P, Nantsupawat A, Thungjaroenkul P. Factors related to the intention to implement evidence-based practice by nurses in university hospitals. Journal of Nursing and Public Health Research. 2024;4(1): e265928. (in Thai).
The Joanna Briggs Institute. Joanna Briggs institute reviewers' manual: 2014 edition. [internet]. Adelaide: Joanna Briggs Institute; 2014. [cited 2023 Dec 1]. Available from: http://joannabriggs.org/assets/docs/sumari/ReviewersManual-2014.pdf.
Guo R, Berkshire SD, Fulton LV, Hermanson PM. Predicting intention to use evidence-based management among U.S. healthcare administrators: application of the theory of planned behavior and structural equation modeling. Int J Healthc Manag. 2019;12(1):25-32. doi: 10.1080/20479700. 2017.1336856.
