The Effect of Knowledge Management Based Clinical Nursing Practice Guidelines on Prevention of Chemotherapy-Induced Neutropenia in Cancer Patients

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Pensri Rukwong
Kornkaew Sukwanichchareon
Chariya Rianwathi


     This study aimed to: 1) develop knowledge management based clinical nursing practice guidelines (CNPGs) for prevention of chemotherapy-induced neutropenia in cancer patients; 2) examine the effect of these CNPGs on incidence of infection, neutropenic sepsis, neutropenic septic shock, death related to neutropenic septic shock; and 3) investigate the compliance and personnel satisfaction with CNPGs. Action research design was employed. This study was conducted at the Cancer nursing department, Maharat Nakhon Ratchasima hospital, Thailand between June 2017 and May 2018. The key informants consisted of 32 registered nurses and 30 cancer patients. Data were collected using dialogues,
knowledge management activity record forms, participation observations, non-participation observations, questionnaires, and document analysis. Quantitative data were analyzed using descriptive statistics; qualitative data were analyzed using content analysis.
     Results revealed that the CNPGs were developed using knowledge management activities in research process based on the theory of unpleasant symptoms. The developed CNPGs consist of 4 dimensions: risk assessment for the neutropenic patient care plan design, nursing care according to the degree of risk of febrile neutropenia, discharge planning relevant to risk level of febrile neutropenia, and patient follow-up. A majority of nurses strongly agreed with these CNPGs. The results of CNPGs implementation showed that compliance with all 4 items of nursing practice guideline was completely 100%. The incidence of infection in neutropenic patient was 3.3%. Meanwhile, there were no incidences of neutropenic sepsis, neutropenic septic shock or death. In conclusion, these results suggest that these CNPGs would potentially be used to achieve
excellent nursing outcomes. The developed CNPGs should also be integrated to routine nursing care


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Rukwong, P., Sukwanichchareon, K., & Rianwathi, C. (2020). The Effect of Knowledge Management Based Clinical Nursing Practice Guidelines on Prevention of Chemotherapy-Induced Neutropenia in Cancer Patients. Journal of Health and Nursing Research (Journal of Boromarajonani College of Nursing, Bangkok), 36(2), 26-37. Retrieved from
Research articles


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