Development of clinical nursing practice guideline for Serious Mental Illness With High Risk to Violence Psychiatric and Drug Patients to community in Kaset Wisai Roiet Province

Abstract

Purposes: To study the situation, develop nursing practice guidelines and evaluate the implementation of nursing practice guidelines.

Study design : It is an action research by applying the concept of Kemmis and Mctaggart.

Materials and Methods : The sample group was divided into 3 groups according to the specified criteria, consisting of 1) 4 nurses in charge of work at Kaset Wisai Hospital. 2) 16 nurses responsible for work in sub-district health promotion hospitals and 3) 273 patients registered during January 2023 to April 2023. The instruments consisted of focus group discussion questions, questionnaires, and nursing practice guidelines. The content validity index was 0.80. Data were analyzed using percentages and content analysis.

Main findings :  It was found that there are no nursing practices that are specific to Kaset Wisai District. The co-developed nursing practice guidelines consisted of nursing care divided according to the overt aggression scale, with nurses in the sub-district health promoting hospital initially caring for patients with level 2 aggressive behavior, and nurses in the Kaset Wisai Hospital initially caring for patients with level 3 aggressive behavior. Nursing practice guidelines consist of 6 steps: 1) Assessment of the problem using a 10-dimension assessment form from Department of Mental Health, 2) Diagnosis of the problem from the 10-dimension assessment form, 3) Care planning using a Care Plan based on the 10-dimension problems, 4) conduct 4 home visits per month nursing operations, 5) evaluating nursing practice results, and 6) planning for continued care. The results after the implementation found that the number of patients seeking treatment as inpatients in the hospital decreased from 7.3 percent to 2.6 percent, and the evaluation of the quality of the implementation of the nursing practice guidelines by 20 nurses found that 100 percent of them were able to implement them.

Conclusion and recommendations : Has a quality and standard nursing practice guideline for psychiatric and drug addict patients at high risk of violence in the community and reduces hospitalization. Further experimental research should be conducted to demonstrate the effectiveness more clearly, including a much longer follow-up period.