Development of Clinical Nursing Practice Guideline for Pediatric Patient with Dengue Hemorrhagic Fever in Krabi Hospital

Abstract

          This research and development (R&D) study aimed to develop Clinical Nursing Practice Guidelines (CNPG) for pediatric patient with dengue hemorrhagic fever (DHF) in Krabi Hospital. The research’s framework was based on the nursing best practice’s evidences of Thailand Bureau of Nursing. The research was divided into 3 phases: 1) situational analysis, 2) developing the CNPG phase, and 3) evaluation phase. The samples were 280 pediatric patients with dengue hemorrhagic fever who were admitted to Krabi Hospital between January 1st, 2017 and june 30th, 2018. The research instruments were: 1) a medical record review form, 2) the developed CNPG, 3) DHF assessment form, and questionnaire about opinions towards using the CNPG. For each part, tools used for data collection included: 1) a scorecard indicator for monitoring each patient’s quality of care, a nursing practice assessment form, and nurse’s satisfaction questionnaires. Reliability of the tools was tested using Cronbach’s alpha coefficient yielding values of .86 and .89, respectively. Data were analyzed using mean, percentage, and content analysis. The results of this study revealed as follows.
          1. The CNPG for pediatric patient with dengue hemorrhagic fever consisted of: 1) zoning for Pediatric
patient with dengue hemorrhagic fever, 2) assessment of sign & symptom, 3) nursing care of 3 phase : fever-phase, critical ill or shock-phase, and recovery phase., 4) discharge plan and continuing care after discharge.
          2. The nursing outcomes of implementing the CNPG were : a) no mortality, pulmonary edema, DIC, ESRD and encephalitis, reducing prolong shock from 0.70% in 2015 to 0.23% in 2018, reducing length of stay,
increase continuing care after discharge, nurse’s satisfaction and nursing practice assessment to 100% All findings of this study suggest that the CNPG for pediatric patient with dengue hemorrhagic fever can be used for the safety of patients and preventing serious complications.