The Effect of Utilizing Clinical Nursing Practice Guideline for Prevention Incidence of Unplanned Extubation in Critically Ill Patients
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Abstract
The purposes of this research and development were to develop the practice guideline and investigate the effect of utilizing nursing practice guideline on the incidence rate of unplanned extubation (UE) in patients with ventilator. CURN model was used as a conceptual framework for the development. The samples were selected by purposive sampling and assigned into two groups; 1)The 33 registered nurses in intensive care unit, and 2) The 90 patients with ventilation in intensive care unit. The patients were divided into two groups, The 45 patients after development group from June to September 2020. The 45 patients before development group was selected from the medical records of the patients from May to August 2019. The instrument used was nursing practice guideline for prevention incidence of unplanned extubation. Data were collected from a record of basic data, the UE incidence record, nurses’ knowledge before and after development, and nurses’ opinion. Data were analyzed using descriptive statistics, Wilcoxon Signed Rank test, Fisher’s exact test and Mann-Whitney U test.
The result revealed that the test scores on nurses’ knowledge after development were significantly increase (p<.001). The nurses’s satisfaction was at a high level. The incidence rate of UE in the after-development group was significantly lower than that of the before development group (p < .05). Weaning times with ventilator in the after-development group was significantly lower than that of the before development group (p < .05). The day of ventilator in the after-development group was significantly lower than that of the before development group (p < .05). The study suggests that the nursing practice guideline should be applied in caring for the critically ill patients to prevent incidence of unplanned extubation. Further study should be conducted to clarify the effectiveness in other areas.
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References
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