The Development of Clinical Nursing Practice Guideline for patients with hip fracture due to osteoporosis and Total hip replacement in Lerdsin Hospital

Abstract

This action research aimed to development the Clinical Nursing Practice Guideline for patients with hip fracture due to osteoporosis and Total hip replacement in Lerdsin Hospital. The study consisted of 3 phases: (1) situation analysis (2) development and (3) evaluation. The research instruments included in-depth interview guidelines, focused group discussion guidelines, participatory observation guidelines form, a questionnaire on the nurses’ opinions towards safety culture in the hospital and a feasibility assessment of implementation the developed nursing practice guideline for patient with hip fracture due to osteoporosis and Total hip replacement. Data were analyzed using percentage, mean, standard deviation and content analysis.

 The results revealed that the developed clinical nursing practice guideline for patients with hip fracture due to osteoporosis and Total hip replacement consisted of building patient safety culture, providing a safe environment, risk management, and nursing innovations for patient safety. The outcomes composed of 4 facets (1) physiological health in which after using the development guideline, the patients had less postoperative complications than before using the developed guideline yielding a statistically significant of p < .05; (2) health perception found that the patient’s pain had reduced after received pain relief medication, and satisfied with health care at 84 per cent; (3) health functioning of the body reveled that the incidence of falls, dislocation of the hip joint and recurrent hip fractures were at zero percent  before and after development; and (4) family and care givers were satisfied  with nursing services at 82 percent. It was found that he possibility of implementing the developed guideline in general practice was feasible at a high level.