Development of a Clinical Nursing Practice Guideline for Patients with Non-ST segment Elevation Myocardial Infarction Loei Hospital

Abstract

This action research study aimed to develop and evaluate the effectiveness of a nursing practice guideline for patients with non-ST segment Elevation Myocardial Infarction (NSTEMI) in Loei hospital.               The framework for a guideline based on action research of Kemmis & McTaggart model. Participants were 1 Emergency department,1 Out Patients department, 6 medical wards, and 5 surgical wards, as 13 units at Loei Hospital.The study participants were 28 registered nurses and 100 patients with NSTEMI. The study was conducted from March 2020 to February 2021. The quantitative measurements consisted of a development needs questionnaire, a record of practice and results, and a satisfaction questionnaire. The qualitative measurements consisted of participant observation, focus group, and in-depth interview guidelines. There were 3 phases including 1) situation analysis 2) NSTEMI nursing practice guideline development, and 3) evaluation of nursing practice guideline implementation.The findings revealed that there were 3 categories of guidelines for nursing as follows: 1) screening;  2) safety care; and 3) surveillance according to the level of risk of severe incidence. The outcomes that nurses had more an average mean score in the high level of satisfaction of 4.54 (Mean=4.54, S.D.= 0.40). Patient outcomes were: the correct screening rate increased from 76.7 % to 96.7 %.Quality of patient care established guidelines that were ≥ 80%. No incidences  were found. In conclusion, this nursing practice guideline for patients with NSTEMI had positive outcomes for patients and was appropriated to use in Loei Hospital.