Development of Nursing Model for patients using ventilators in Medical Department, Loei hospitals
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Abstract
Abstract
This research and development aimed to develop and examine the results of the nursing model for patients using ventilators. The sample was purposively selected and consisted of (1) 24 head nurses and professional nurses, and (2) 60 mechanically ventilated patients. There were 3 phases: (1) situation analysis, (2) model development, and (3) evaluation of the results. The research tools consisted of (1) recording form of the nurses’ general information, (2) recording form of the patients’ general information, (3) competency assessment of the nurses on nursing care for the patients using a ventilator, (4) a nursing practice guideline of the patients using a ventilator, (5) practice and results monitoring form, (6) the nurses’ practice ability questionnaire, (7) the nurses' satisfaction questionnaire, (8) participatory observation form, (9) guidelines for focus group meeting questions, and (10) in-depth interview question guidelines. The reliability of the instrument was checked by 5 experts. The Cronbach alphas of the instruments (3), (5), and (7) were equal to .80, .70, and .74, respectively. Quantitative data were analyzed using percentages and averages. Qualitative data were analyzed using content analysis.
The results revealed that the nursing model for patients using ventilators consisted of (1) clinical nursing practice guidelines for patients using ventilators, (2) nursing competency development, (3) a nursing process manual for the patients’ using ventilators, and (4) nursing supervision plan. The nurse’s outcomes found that after using the model, the nurses had significant higher competency on nursing care for patients using ventilators than before using the model (p = .001). The nurses were satisfied with the model at a high level by 95.8 percent and had ability to practice the guidelines. The patients’ outcomes revealed that the rate of unplanned extubation decreased from 9.5 to 0.0, the rate of ventilator-associated pneumonia decreased from 8.3 to 0.0 per 1000 ventilator days, the average duration of using mechanical ventilator decreased from 3.4 to 2.8 days, and the average length of stay in the unit decreased from 6.7 to 4.9 days, yielding statistical significance at .001
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