The Development of Nursing Practice Guidelines for Preventing Severe Pneumonia Infection at Pathumrat Hospital, Roi Et Province

Abstract

Purposes: To investigate the current situation, develop nursing practice guidelines, and evaluate the effectiveness of the developed guidelines for preventing severe pneumonia infection at Pathumrat Hospital.

Study design: A four-phase Research and Development (R&D) study was conducted using qualitative and quantitative methods. The effectiveness of the developed nursing practice guidelines was evaluated using a one-group pretest–posttest design.

Materials and Methods: Participants included nursing personnel, clinical experts, 34 patients with pneumonia, and 11 nurses who implemented the guidelines. Research instruments consisted of interview guides, nursing practice guidelines, appropriateness and feasibility assessment forms, an effectiveness evaluation form, and clinical outcome records. The content validity index of the guidelines ranged from 0.66 to 1.00, and the reliability of the evaluation instrument demonstrated a Cronbach’s alpha coefficient of 0.82. Data were analyzed using descriptive statistics and paired t-test.

Main Findings: Risk factors associated with pneumonia infection were related to patient characteristics, healthcare accessibility, care processes, and organizational resources. The developed nursing practice guidelines consisted of four components: hand hygiene and personnel infection control, management of patients receiving high-flow nasal cannula (HFNC), patient positioning, and medical equipment decontamination. The guidelines were rated highly appropriate (Mean=4.21, SD.=0.50) and feasible (Mean=4.18, SD.=0.50). Following implementation, patients’ perceived effectiveness of care significantly improved (Mean diff. = 0.41, 95% CI: 0.27–0.55; p < .001). Clinical outcomes also improved, including reductions in body temperature, respiratory rate, and length of hospital stay, while oxygen saturation significantly increased. In addition, complication and mortality rates showed a declining trend. Nurses who implemented the guidelines demonstrated significantly higher perceived effectiveness scores after implementation (p < .001).

Conclusion and Recommendations: The developed nursing practice guidelines were appropriate, practical, and effective in improving the quality of care and clinical outcomes among patients with severe pneumonia in a community hospital setting. The guidelines should be adopted as a standard nursing practice and supported through continuous staff competency development.