The Development of Clinical Nursing Practice with Evidence for Patients with Digital Replantation at the Men Orthopedic Ward I of Sunpasitthiprasong Hospital

Abstract

This study aimed to develop a nursing practice for patients with digital replantation at men orthopedic ward I of Sunpasitthipasong Hospital.  Following Soukup’s framework. There were four phases: 1) clinical problem, 2) evidence search, 3) drafting nursing practice guidelines, and 4) Implementing guidelines and summarizing results. Databases to search evidence about nursing practice guideline and digital replantation were the PubMed, Google scholar, and CINAHL between 2015 and 2017. Twenty-two studies for evidence were applied for the nursing practice for patients with digital replantation. There were three steps; pre – operation care, post – operation care, and discharge care. This nursing practice was proved by five experts, and applied with 11 registered nurses and 22 patients with hand replantation at orthopedic ward I of Sunpasitthipasong Hospital.  Findings showed 90 percentages of the registered nursing had good practice in pre – operation care and discharge care. For post – operation care, observation for finger in a few days was more concerned. For the patients, their hand problems were cut from sharp weapon. Successful rate for digital replantation was 82%. Complication was 18 percentage of hand ischemia. Means of patients who were admitted were seven days. Keeping accident finger at setting with right technique was more concerned. Although some was not comprehensive, the clinical nursing practice with evidence for patients with digital replantation was a basic and concrete practice to be safer for the patients.  The study suggests that this practice will be developed continuously and recommended for related parties and hospitals at 10^th regional health authority in the future