The Effectiveness of Implementing the Nurse Practice Guideline among Patients with Sepsis at Emergency Department, Naresuan University Hospital

Abstract

Sepsis is a serious condition that affects the patient. This condition was the factor which increased the mortality rate, length of hospital stay and cost of sepsis patient in Naresuan University Hospital. The purposes of this study were to develop a nursing practice guidelines and to examine the effectiveness of implementing the nursing practice guidelines among patients with sepsis at the Emergency Department, Naresuan University Hospital. Forty patients admitted to the emergency department before having the nursing practice guideline for patients were assessed and 40 other patients were evaluated after the introduction of the guideline. Research instruments consisted of a guideline of nursing practice for sepsis patients, a practice outcomes evaluation form and evaluation form for nursing practice guideline. Content validity between 0.60-1.00. Evaluation form for nursing practice guideline of which the reliability was 0.78. The data were analyzed using descriptive statistics, Chi-square and Independent t-test. The results of the study showed as follows: 1) The principle processes of nursing practice guideline for sepsis patients were screening and assessment, initial care, and continuing care. 2) The evaluation outcomes demonstrated statistically significant increases of detecting severe sepsis in time and survivals without shocking stage in six hours (p < .05) after the introduction of nursing practice guideline. The mortality rate demonstrated a statistically significant decrease and cost reduction for the admitted was also statistically significant (p < .05) by using the practice guideline. This study revealed that nursing practice guideline among patients with sepsis in the emergency department was an effectiveness tool for implementing in the Emergency Department at Naresuan University Hospital.