Effect of Nursing practice guideline On Neuroimmunology patients
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Abstract
Abstract
This research and development aimed to develop and evaluate the use of nursing practice guidelines for patients with neuroimmune disorders who received Therapeutic Plasma Exchange (TPE). The research consisted of 2 phases: (1) systematic search and development of the nursing practice guidelines; and (2) evaluation of the nursing practice guidelines usage. The sample consisted of 2 groups: (1) patients diagnosed with Neuromyelitis Optica Spectrum Disorders (NMOSD), Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), and Myasthenia Gravis (MG), divided into a control group of 26 patients and an experimental group of 20 patients; and (2) 10 professional nurses working in the neuroimmunology unit and the neurology intensive care unit. The research instrument was the nursing practice guidelines. The quality was examined using the Content Validity Index (CVI) by 5 experts, yielding a CVI value of 0.92. The data collection tools consisted of (1) a complication recording form with a CVI of .93 and an α of .72; (2) a clinical outcome assessment form with a CVI of 1.0 and an α of .81; and (3) a nurse satisfaction questionnaire with a CVI of .93 and an α of .75. Data were analyzed using descriptive statistics, Chi-square, paired t-test, and independent t-test.
The results revealed that the developed nursing practice guideline consisted of 3 nursing care phases: (1) nursing care before TPE (2) nursing care during TPE and (3) nursing care after TPE. The evaluation of the nursing practice guidelines usage found that the incidence of complications, including low blood pressure, hypocalcemia, and hypokalemia, was significantly lower in the experimental group than in the control group (p < .05). Comparison of clinical outcomes assessed via the Modified Rankin Scale (mRS) and Activities of Daily Living (ADL) revealed that the experimental group had significantly better rehabilitation than the control group (p < .05). Nurses reported a high level of satisfaction with the guidelines
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