การพัฒนาแนวปฏิบัติการพยาบาลผู้ป่วยอุบัติเหตุและฉุกเฉินที่ได้รับบาดเจ็บไขสันหลัง

Duangjai Poolpholamnuay; Siriporn Chitsungnoen; Chattong Websoongnoen; Wasana  Yimnoun; Natchanicha  Sukpanphong; Panita  Khumprathom; Pantamon Suparee

Authors

Duangjai Poolpholamnuay Maharat Nakhon Ratchasima Hospital
Siriporn Chitsungnoen Maharat Nakhon Ratchasima Hospital
Chattong Websoongnoen Maharat Nakhon Ratchasima Hospital
Wasana Yimnoun Maharat Nakhon Ratchasima Hospital
Natchanicha Sukpanphong Maharat Nakhon Ratchasima Hospital
Panita Khumprathom Maharat Nakhon Ratchasima Hospital
Pantamon Suparee Maharat Nakhon Ratchasima Hospital

Keywords:

emergency and trauma nursing, spinal cord injury, nursing practice guideline

Abstract

This action research aimed to develop nursing practice guidelines for patients with traumatic spinal cord injury in the emergency department and to evaluate the effectiveness of the guidelines on nursing outcomes, as well as to examine nurses’ satisfaction with their implementation. The study sample consisted of 40 patients aged 18 years and older with traumatic spinal cord injury and 60 registered nurses working in an emergency department. The research instruments included the nursing practice guidelines, a guideline adherence assessment form, a nursing outcomes record form, and a nurse satisfaction questionnaire. Data were analyzed using descriptive statistics, independent t-tests, Chi-square tests, and Mann–Whitney U tests were used for comparisons.

The results showed that the developed nursing practice guidelines for patients with traumatic spinal cord injury in the emergency department was at an acceptable level, with quality scores in each domain ranging from 72.22% to 93.33%. When comparing nursing outcomes between the comparison group and the guideline implementation group, the incidences of autonomic dysreflexia, pneumonia, urinary tract infection, and pressure ulcers were not significantly different (p > .05). In addition, the length of stay in the emergency department was not significantly different between the two groups (p > .05). However, the length of hospital stay in the guideline implementation group was significantly shorter than in the comparison group. The median length of stay in the guideline implementation group was 17 days, compared with 52 days in the comparison group. Furthermore, nurses demonstrated a high level of adherence to the guidelines (93.01%) and their overall satisfaction with the guidelines was at the highest level. It is recommended that the nursing practice guidelines be periodically reviewed and updated based on evidence-based practice. In addition, the implementation of the guidelines should be expanded to other related units, and follow-up studies on patients’ self-care after discharge should be conducted to improve their quality of life.

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