Development of Clinical Nursing Practice Guidelines to Promote Postoperative Bowel Movements among Emergency Abdominal Surgery Patients Undergoing General Anesthesia
Keywords:
clinical nursing practice guideline, emergency abdominal surgery, general anesthesiaAbstract
This study aimed to develop and evaluate clinical nursing practice guidelines (CNPGs) to promote postoperative bowel mobility in patients undergoing emergency abdominal surgery under general anesthesia, following Soukup’s evidence-based advanced nursing model. The study was conducted in three phases: 1) identifying clinical problems, 2) searching for evidence-based practices, and 3) implementing the guidelines. The sample was selected using purposive sampling and included 13 anesthetists and ward nurses and 10 emergency abdominal surgery patients who underwent general anesthesia. The research instruments consisted of (1) the developed CNPG, (2) a general information record, (3) a bowel function recovery assessment form, (4) a guideline quality assessment tool, and (5) a feasibility assessment tool for implementing the guidelines with content validity indexes (CVI) of .97, 1, 1, 1 and 1, respectively. Data were analyzed using descriptive statistics and One-Way Repeated Measures ANOVAs were used to compare the differences in mean scores of bowel function recovery at 24, 48, and 72 hours post-surgery.
The results showed that: 1) before implementing the CNPGs, 80.60% of patients experienced abdominal bloating and 8.96% had delayed bowel motility postoperatively; 2) the CNPG consisted of three phases of nursing care: (1) pre-anesthesia, (2) intra-anesthesia, and (3) post-anesthesia, with a CVI of .97 and Appraisal of Guideline for Research & Evaluation II (AGREE II) scores for all domains greater than 70%; 3) the trial implementation of the CNPG demonstrated statistically significant differences in mean bowel function recovery scores at 24, 48, and 72 hours postoperatively. Furthermore, the feasibility of implementing the CNPGs was rated at 100%, indicating a high potential for practical application. Therefore, the CNPGs should be adopted and should be evaluated for use with other types of abdominal surgery patients.
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