Development of Nursing Practice Guideline for Lung Rehabilitation on Chest Trauma Patients with Chest Drainage

Abstract

Introduction: Chest trauma impairs lung compliance and ventilation efficiency, placing patients with chest drainage at high risk for acute respiratory complications, particularly atelectasis.

Research objectives: To develop and evaluate the feasibility of a nursing practice guideline (NPG) for lung rehabilitation in chest trauma patients with chest drainage.

Research methodology: This pilot implementation study research followed the NHMRC (1999) framework. The sample comprised five members of the multidisciplinary healthcare team, who participated in the guideline development process, 10 registered nurses, and 12 patients, selected via purposive sampling. Instruments were validated by 5 experts. The incentive spirometer was calibrated against a standard spirometer (error < ±3%). Data were analyzed using descriptive statistics.

Results: The NPG comprised four components: 1) lung function assessment, 2) promotion and monitoring of lung function, 3) pain management, and 4) patient education. Nurses rated the NPG highly feasible for clinical practice. Clinical outcomes showed that by Days 2 and 3, all patients achieved target inspiratory volumes (≥ 15 mL/kg), with no observed cases of atelectasis.

Conclusions: The evidence-based NPG is appropriate for clinical implementation, may enhance lung expansion and prevent respiratory complications.

Implications: This guideline should be continuously implemented for patients with chest trauma and chest drainage by promoting lung expansion, standardizing practice, and helping prevent respiratory complications.