Development nursing guidelines management for pain in patients open heart surgery at cardiothoracic surgery intensive care unit, Roi Et Hospital

Abstract

Purposes: To develop nursing practice guidelines (NPGs) for pain management in post-open heart surgery patients and evaluate the effectiveness of these NPGs in the Cardiothoracic ICU, Roi Et Hospital.

Study design: Research and Development (R&D) based on the Soukup framework.

Material and Methods: Conducted from October 2024 to June 2025. Subjects included 15 registered nurses and 30 post-cardiac surgery patients selected by purposive sampling. Instruments consisted of the developed NPGs, CPOT/NRS pain scales, and satisfaction questionnaires, validated by 3 experts. Data were analyzed using descriptive statistics and Wilcoxon Signed Rank Test.

Main finding: The developed NPGs included systematic pain assessment, pharmacological and non-pharmacological interventions, and standardized re-evaluation. Post-implementation results showed a significant decrease in patients’ pain scores at the .001 level, particularly at 72 hours post-surgery compared to 48 hours (improving from moderate to mild pain). Both patients and nurses reported the highest level of satisfaction with the NPGs (Mean = 4.78 and 4.70, respectively), specifically regarding the systematic assessment and feasibility of the guidelines.

Conclusion and recommendations: The NPGs provide a standardized and effective approach to reducing post-operative pain. Integrating these guidelines into routine clinical practice and promoting ongoing nursing training is recommended.