Development of Clinical Nursing Practice Guidelines for Preventing Complications in Patients with Pulmonary Alveolar Proteinosis Undergoing General Anesthesia for Whole Lung Lavage
Abstract
This research and development project aimed to develop and study the feasibility of clinical nursing practice guidelines (CNPG) for preventing complications in patients with pulmonary alveolar proteinosis (PAP) undergoing general anesthesia for whole lung lavage (WLL) at Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand. The CNPGs were developed using the evidence-based practice model of Soukup, which has the following four steps: 1) Evidence-triggered phase, 2) Evidence-supported phase., 3) Evidence-observed phase, and 4) Evidence-based phase. The Phases 1 through 3 of the study were conducted from. There were 11 papers containing evidence best practices that were evaluated for reliability, and which were divided into eight level 4a papers, two level 4b papers, and one 4d paper. The participants for the pilot study were selected by purposive sampling according to specified qualifications and consisted of 45 nurse anesthetists to assess the feasibility of using the nursing practice guidelines, and two patients with PAP who underwent anesthesia for WLL. The research instruments consisted of 1) the CNPG and 2) a questionnaire on opinions toward the CNPG. The CNPGs were validated by three experts using the AGREE II (Appraisal of Guidelines for Research & Evaluation II) approach. Data were analyzed using descriptive statistics.
The results: revealed that 1) the CNPG consisted of 3 phases of nursing activities, including pre-anesthesia nursing, peri-anesthesia nursing, and post-anesthetic nursing; 2) the results of the expert's appraisal were 87.62% favorable; and 3) the feasibility study indicated that the CNPG had a good level of feasibility for being integrated into practice. Implementing nursing practice guidelines in a pilot study with patients found that nurse anesthetists could follow all the guidelines. A comparative study of the effectiveness of the CNPGs in relation to standard practices is recommended for the next research.
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