Development of a Clinical Nursing Practice Guideline for Mechanically Ventilated Patients with Acute Respiratory Distress Syndrome using Evidences-based Practice in the Intensive Care Unit, Yasothon Hospital
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Abstract
Acute respiratory distress syndrome (ARDS) refers to lung injury and associates with high mortality rate. Mechanical ventilation and supportive therapies are the keys basic treatment. However, using mechanical ventilation is associated with several physical complications. The purpose of this study was to develop a clinical nursing practice guideline (CNPG) for mechanically ventilated patients with ARDS using evidences-based practice. The study consisted of 4-steps: 1) evidence – triggered phase-searching for nursing problems related to ARDS patients using mechanical ventilation, 2) evidence - support phase-searching and selecting the research articles, 3) evidence - observe phase-developing the CNPG and 4) evidence - based phase- implementation of the CNPG. A sample of 51 patients was divided into 2 groups: 1) non-CNPG group consisted of 24 patients and 2) CNPG group consisted of the 27 patients. In addition, a sample of 25 professional nurses was recruited into the study. Data on clinical outcomes and opinions of the nurses were analyzed using descriptive statistics, independent t-test and relative risk statistics.
The findings revealed the non-CNPG group had the average age of 63.7 years and the mean APACHE II score was 17.83. The CNPG group had the average age of 64.2 years and the mean APACHE II score was18.16. The results of using the CNPG indicated that the incidence of hypoxemia, hypercapnia, barotrauma and APACHE II score of the CNPG group was lower than the non-CNPG group yielding statistical significance at the level of .05. The average length of stay in ICU of the CNPG group was also less than the non- CNPG groups. In addition, the professional nurses who did practice the CNPG stated that the CNPG was incredibly practical in real-life situations. They also affirmed that the CNPG was worthwhile to change the practices and their satisfaction towards using the CNPG was at a high level.
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References
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