The Development of Nursing Service for Safety of Coronary Artery Bypass Graft Patient In Operating Theatre Nursing Department
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Abstract
Abstract
This research and development study aimed to develop and evaluate a nursing service model to enhance patient safety in individuals undergoing coronary artery bypass graft (CABG) surgery. The study was guided by the Deming Cycle (Plan–Do–Check–Act: PDCA), and consisted of four phases: situation analysis, model development and pilot testing, full implementation, and evaluation. Purposive sampling was used to recruit 100 multidisciplinary healthcare personnel and 20 CABG patients. The research instruments included general information questionnaires for both staff and patients, the developed nursing service model, an observational checklist, a professional nurse opinion survey, and a patient satisfaction questionnaire. The content validity index (CVI) was 0.86, the inter-rater reliability for the observation checklist was 0.84, and the reliability coefficients for the instruments were 0.78, 0.82, and 0.80, respectively. Data were analyzed using descriptive statistics (frequency, percentage, mean) and the independent paired t-test.
The results showed that the developed nursing service model was structured into three phases: preoperative, intraoperative, and postoperative. Healthcare personnel demonstrated high adherence to the model (91.43% and 99.09%, respectively), with no reported cases of surgical site infections or retained surgical items. Patient satisfaction scores were high (Means = 46.30 and 54.50), and healthcare personnel satisfaction significantly increased from a moderate level (Mean = 21.16) to a high level (Mean = 31.96) (p < .001). In conclusion, the developed nursing service model effectively enhanced patient safety, reduced postoperative complications, and improved satisfaction among both patients and healthcare personnel.
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Reference
Shahjahan RD, Sharma S, Bhutta BS. Coronary Artery Disease. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024.
Lerdsin Hospital Quality Development Center. Infection prevention and control performance report 2021–2023. Bangkok: Lerdsin Hospital; 2023. Thai.
Needleman J, Buerhaus P, Pankratz VS, Leibson CL, Stevens SR, Harris M. Nurse staffing and inpatient hospital mortality. N Engl J Med. 2011 Mar 17;364(11):1037–45.
Barili F, Pacini D, Grossetti F, Di Bartolomeo R, Caputo M. Deep sternal wound infection after cardiac surgery: evidences and controversies. J Thorac Dis. 2020 Jul;12(7):3785–95.
Bryan CS, Yarbrough WM, Graeber GM. Preventing surgical site infections in cardiac surgery. J Thorac Cardiovasc Surg. 2019 May;157(5):1755–62.
Higgins R, Bakaeen F, Gillinov M, Johnston DR, Pettersson GB, Soltesz EG, et al. Prevention and management of surgical site infections in cardiac surgery: a scientific statement from the American Heart Association. Circulation. 2021 Nov 16;144(20):e376–94.
World Health Organization. Global guidelines for the prevention of surgical site infection. 2nd ed. Geneva: WHO; 2018.
Deming WE. PDCA cycle: a quality approach. Cambridge (MA): MIT; 1993.
Krejcie RV, Morgan DW. Determining sample size for research activities. Educ Psychol Meas. 1970;30(3): 607–10.
Melnyk BM, Fineout-Overholt E. Evidence-based practice in nursing and healthcare: a guide to best practice. 4th ed. Philadelphia: Wolters Kluwer; 2019.
Barili F, Pacini D, Grossetti F, Di Bartolomeo R, Caputo M. Deep sternal wound infection after cardiac surgery: evidences and controversies. J Thorac Dis. 2020 Jul;12(7):3785–95.
Bryan CS, Yarbrough WM, Graeber GM. Preventing surgical site infections in cardiac surgery. J Thorac Cardiovasc Surg. 2019 May;157(5):1755–62.
World Health Organization. Global guidelines for the prevention of surgical site infection. 2nd ed. Geneva: WHO; 2018.
Association of periOperative Registered Nurses (AORN). Guidelines for perioperative practice 2022. Denver : AORN; 2022.
Anderson DJ, Podgorny K, Berríos-Torres SI, Bratzler DW, Dellinger EP, Greene L, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014 Sep;35(S2): S66–88.
Uthumporn Sristaporn. Development of guidelines for preventing surgical site infections after cardiac surgery. J Vongchavalitkul Univ. 2019 Dec 30;32(2):30–9. Thai.
Miller A, Thompson R. Standardizing infection control measures in cardiac surgery units. Int J Nurs Stud. 2021;58:112–9.
Chen Y, Liu X, Zhang P. Effectiveness of a nurse-led intervention in preventing surgical site infections. Am J Infect Control. 2019 Jun;47(6):567–73.
Aringer M, Costenbader K, Daikh D, Brinks R, Mosca M, Ramsey-Goldman R, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Arthritis Rheumatol. 2019 Sep;71(9):1400–12.
Wattanatham S, Intrasuwan S. Effect of infection prevention guidelines in the intensive care unit after cardiac surgery. J Nurs Sci. 2021;39(2):112–25. Thai.
Sriboonruang W, Kongsom P. Development of a nursing service model for surgical patient safety. J Nurs Res. 2022;37(1):98–110. Thai.
Wilson M, Roberts J. The impact of educational programs on nurse adherence to infection prevention protocols. Nurse Educ Today. 2018;74:85–92.
Singh R, Kumar A. Patient satisfaction in post-operative cardiac care: a comparative analysis. Patient Exp J. 2021;8(4):310–8.
Johnson P, Lee H. Effectiveness of staff training in reducing hospital-acquired infections: a meta-analysis. J Clin Nurs. 2019 Jul;28(14–15):2500–12.
Brown K, Patel H, Carter J. Improving post-surgical care in coronary artery bypass patients. J Cardiovasc Nurs. 2020 May–Jun;35(3):245–51.
Green B, White C, Adams P. A systematic review of best practices for preventing post-operative infections in cardiovascular surgery. J Hosp Infect. 2020 Feb;104(2):123–35.
