Development of Nursing Care Model for Quality and Safety for Hepatocellular Carcinoma and Cholangiocarcinoma patients, underwent Endoscopic retrograde Cholangiopancreatography (ERCP) With Invasive Percutaneous Transhepatic Biliary Drainage

Abstract

Purposes : To study the situational problems, and to develop and evaluate the nursing care model for quality and safety for hepatocellular carcinoma and Cholangiocarcinoma patients, underwent endoscopic retrograde Cholangiopancreatography (ERCP) with invasive percutaneous transhepatic biliary drainage.

Study design : Research and Development.

Material and Methods : The sample comprised two participant groups: (1) 20 patients with liver cancer and cholangiocarcinoma who underwent endoscopic retrograde cholangiopancreatography (ERCP) combined with biliary drainage at Roi Et Hospital, and (2) 39 registered nurses with at least one year of work experience in the operating room. The research instruments consisted of intervention instruments specifically the nursing care model for patients with hepatobiliary cancer undergoing ERCP with biliary drainage at Roi Et Hospital and data collection instruments, comprising a demographic questionnaire, a satisfaction evaluation form, and a nursing activity checklist. Data were analyzed using descriptive statistics and the paired t-test. Statistical significance for all tests was set at p < .05.

Main finding : Nursing care for patients with hepatobiliary cancer is constrained by late-stage disease presentation and complex clinical complications, both of which hinder effective nursing management and patient self-care. This is further compounded by a shortage of specialized oncology and gastroenterology nurses. The developed nursing care model for patients with liver cancer and cholangiocarcinoma consists of three distinct phases: (1) pre-procedure nursing care for endoscopic retrograde cholangiopancreatography (ERCP), (2) intra-procedure nursing care during ERCP, and (3) post-procedure nursing care following ERCP. The evaluation outcomes demonstrated that nurses' satisfaction with the nursing care model for patients with liver cancer and cholangiocarcinoma showed a statistically significant difference between the pre- and post-development phases (p < .05). Similarly, performance of nursing activities based on the model exhibited a statistically significant difference following implementation (p < .05).

Conclusion and recommendations: The developed nursing care model provided a standardized, step-by-step clinical protocol for managing patients with hepatobiliary cancer undergoing ERCP with biliary drainage, achieving high satisfaction rates across both patients and nursing staff.