Development of Clinical Supervision Model among Mechanically Ventilated Patients in Medical Intensive Care Unit, Hatyai Hospital
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Abstract
Abstract
This research and development aimed to develop and evaluate the use of a clinical supervision model of mechanically ventilated patients, medical intensive care unit. A sample consisted of 32 nurses working in the medical intensive care unit, divided in to 10 nurse-supervisors and 22 nurse-supervisees; and 580 mechanically ventilated patients, equally divided into 290 samples in before and 290 samples in after development group. There were 4 steps: (1) survey problems and development needs, (2) study of concept, theory, possibility, design, and method, (3) tryout and development, and (4) evaluation of using the model. The research tool was the clinical supervision model. Data collection tool consisted of the clinical supervision evaluation form of the nurse-supervisors, nursing practice competency assessment form of the mechanically ventilated patients, and nursing results record form; yielding Index of concordance (IOC) of 0.86, 0.87, and 0.88, respectively and Cronbach's alpha coefficient of 0.84, 0.86, and 0.85, respectively. Data were analyzed using mean, standard deviation, paired t-test and Mann-Whitney U test.
The results revealed that this clinical supervision model for mechanically ventilated patients consisted of (1) nursing practice guidelines for mechanically ventilated patients, (2) supervision manual, (3) coaching manual, and (4) nursing principles and ethics manual. The results on using the clinical supervision model for mechanically ventilated patients found that nurse-supervisors had significantly increased score on knowledge and clinical supervision skills (p < 0.001). Nursing practice for mechanically ventilated patients of the nurse-supervisees had significantly increased (p < .001). For patient outcomes, it was found that the rate of ventilator associated pneumonia significantly decreased (p < .001), the rate of unplanned extubation significantly decreased (p < .001), the rate of ventilator weaning significantly increased (p < .001, and the average duration of using mechanical ventilator significantly decreased (p < .001).
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