Development and Evaluation of Nursing Practice Guidelines to Prevent Shock in Patients with Septicemia at Makarak Hospital, Kanchanaburi Province

Abstract

This research and development aimed to develop and evaluate nursing practice guidelines to prevent shock in patients with Septicemia at Makarak Hospital, Kanchanaburi Province. The study comprised three phases: 1) development of nursing practice guidelines, 2) implementation of the guidelines, and 3) evaluation and dissemination. The sample consisted of two purposively selected groups: 1) 40 professional nurses, and 2) 44 patients with sepsis, equally divided into an experimental group (22 patients) and a control group (22 patients). The research instruments included the newly developed nursing practice guideline, a post-implementation outcome recording form, and an observation checklist for adherence to the guideline. The content validity and overall reliability of the instruments were 0.84 and 0.70, respectively. Data were collected between October 2023 and January 2024. Quantitative data were analyzed using descriptive statistics (percentage, mean, and standard deviation), paired t-tests to compare nursing performance before and after using the guideline, and percentage ratios to compare the incidence of shock and mortality rates.
The results indicated that after the implementation of the nursing practice guidelines, the nurses’ practice scores increased significantly (p<.05) rising from 143.24 to 147.56. Furthermore, the experimental group had lower percentages of both shock occurrence and mortality compared to the control group. In conclusion, the nursing practice guidelines developed in this study were effective in preventing and reducing mortality from Septic shock in patients with bloodstream infections.