The development of nursing practices for patients receiving Norepinephrine to prevent vascular complications, Kasetwisai Hospital

Abstract

This collaborative action research aimed to develop and evaluate nursing guidelines for patients receiving norepinephrine to prevent vascular complications at Kaset Wisai Hospital. The research participants consisted of 54 guideline developers and users, and 36 patients receiving peripheral intravenous norepinephrine. The research was conducted between March-August 2024. Research instruments included focus group discussion guides, clinical and incident record forms, assessment forms for nursing care activities for patients receiving norepinephrine, and professional nurse satisfaction surveys. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using content analysis.

The research resulted in clear and concrete nursing guidelines for patients receiving norepinephrine to prevent vascular complications, comprising five activity categories (K-A-S-A-T model): 1) Knowledge development of personnel (Knowledge), 2) Care of medication administration site (Active Caring), 3) Vein and site selection (Selection of Site), 4) Continuous monitoring (Awareness), and 5) Incident Management (Treatment). After implementing the developed guidelines, patient outcomes showed no incidents of phlebitis, with 4 cases (11.1%) of minor to moderate extravasation necrosis, all of which were treated until full recovery. Regarding nursing outcomes, professional nurses following the guidelines demonstrated complete and comprehensive implementation of all 5 activity categories at 95.4%. Additionally, professional nurses reported very high satisfaction with the guidelines. (  = 4.62, S.D. = 0.40) However, in long-term follow-up should be conducted to evaluate the effectiveness of the implemented guidelines and to apply them as a framework for nursing care involving other medications, aiming to prevent or reduce risks associated with nursing practices in the future.