Development of Nursing Practice Guidelines for Continuous Renal Replacement Therapy in Critically Ill Patients with Acute Kidney Injury in The Intensive Care Unit at Chiangrai prachanukroh hospital
Keywords:
Acute kidney injury, Continuous renal replacement therapy, Nursing guideline, Critical care, Patient outcomesAbstract
Acute kidney injury (AKI) is common among critically ill patients and is associated with high mortality, prolonged hospitalization, and increased treatment costs. Continuous renal replacement therapy (CRRT) is an important treatment option for this population, but its complexity requires standardized nursing guidelines to ensure safe and effective care. At Chiangrai Prachanukroh Hospital, no such guidelines were available, and complications were frequently observed. This study aimed to analyze nursing problems in CRRT care, develop evidence-based nursing practice guidelines, and evaluate their effectiveness in terms of nursing performance, nurse satisfaction, and patient outcomes. A research and development design were employed in four phases: situation analysis through interviews and record review, guideline development using evidence and the FASTHUG framework, pilot testing for feasibility, and evaluation with 90 nurses and 86 patients.
The results demonstrated a significant improvement in nursing practice scores (3.29±0.53 to 4.39±0.41, P<.001) and a high level of nurse satisfaction (4.48±0.54). Patient outcomes also improved, with longer filter life, fewer circuit clots, reduced thrombosis, shorter duration of mechanical ventilation and ICU stay, and significantly lower treatment costs.
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