Development of a clinical nursing practice guideline for patients with ST-elevation myocardial infarction in Intensive Care Unit, Pranangklao Hospital, Changwat Nonthaburi
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Abstract
Background: Patients with ST-elevation myocardial infarction (STEMI) undergoing coronary artery revascularization are at risk of complications from both the disease and the intervention.
Objectives: To evaluate current nursing practice, develop evidence-based nursing practice guidelines, and examine the outcomes of implementing these guidelines for STEMI patients.
Methods: This research and development study comprised three phases: 1) assessment of existing nursing practices, 2) development of evidence-based nursing guidelines, and 3) evaluation of the outcomes of guideline implementation. Participants included 15 nurses from medical intensive care units and 30 Killip class I and II STEMI patients undergoing primary coronary revascularization. Data were analyzed using descriptive statistics, Wilcoxon signed-rank test, t-test, and Fisher's exact test.
Results: 1) The nursing situation revealed that: (1) Patients experienced bleeding or hematoma at the procedure site, with hospital stays of 6-8 days, and (2) Nursing practice guidelines were not comprehensive in all dimensions, and discharge planning were discrepancy. 2) The developed practice guidelines were comprised of six phases. 3) After implementing the guidelines, it was found that nurses' knowledge increased significantly (p<0.05). bleeding and hematoma complications at the surgery site and hospital stay duration significantly decreased (p<0.05). Satisfaction levels were highest among both nurses and patients (=4.79, 4.61; SD=0.15, 0.39, respectively).
Conclusions: Clinical nursing practice guidelines from admission to discharge that adhere to standards may lead to improved outcomes in the care of patients with ST-elevation myocardial infarction (STEMI).
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บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวิทยาลัยพยาบาลบรมราชชนนี จังหวัดนนทบุรี
ข้อความที่ปรากฏในบทความแต่ละเรื่องในวารสารวิชาการเล่มนี้เป็นความคิดเห็นส่วนตัวของผู้เขียนแต่ละท่านไม่เกี่ยวข้องกับวิทยาลัยพยาบาลบรมราชชนนี จังหวัดนนทบุรี และคณาจารย์ท่านอื่น ในวิทยาลัยฯ แต่อย่างใด ความรับผิดชอบองค์ประกอบทั้งหมดของบทความแต่ละเรื่องเป็นของผู้เขียนแต่ละท่าน หากมีความผิดพลาดใด ๆ ผู้เขียนแต่ละท่านจะรับผิดชอบบทความของตนเองแต่ผู้เดียว
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