Development of Clinical Nursing Practice Guidelines for Patients Undergoing Hemodialysis

Abstract

Abstract

This action research aimed to develop and evaluate the clinical nursing practice guidelines for chronic kidney failure patients undergoing hemodialysis. The research participants consisted of 40 chronic kidney failure patients undergoing hemodialysis, 1 nephrologist, and 5 professional nurses. Data were collected using observation, interview, and focus group discussion. The 4 steps included (1) planning based on situation analysis and problems (2) taking action through meeting to explain, providing knowledge, and guidelines usage (3) observing the compliance with the clinical nursing guidelines, and (4) reflection included monitoring and evaluating the results of observation and interview as well as modification via 2 cycles of development. Data were analyzed using descriptive statistics, paired t-test and Wilcoxon test.

The results found that the clinical nursing practice guidelines for chronic kidney failure patients undergoing hemodialysis consisted of 3 phases: (1) before hemodialysis, (2) during hemodialysis, and (3) after hemodialysis.  After using the clinical nursing practice guidelines, the nurses’ average knowledge scores increased. and were able to follow the nursing guidelines at 87 percent. The patients’ complications after using the clinical nursing practice guidelines, in which consisted of (1) the incidence of hypotension during hemodialysis until receiving treatment and (2) high blood pressure before hemodialysis were significantly decreased than before using the clinical nursing practice guidelines (p < .01).