Outcomes of Nursing Clinical Practice Guideline Development for Septic Shock in Medical Intensive Care Unit at Chiangrai Prachanukroh Hospital
Keywords:
การพัฒนาแนวทางการดูแล ผู้ป่วยช็อกจากการติดเชื้อในกระแสเลือด หอผู้ป่วยหนักอายุรกรรม, Nursing clinical practice guideline development, septic shock patients, intensive care unitAbstract
This Participate action research aimed to develop nursing clinical practice guideline (CNPG) for sepsis shock patients. Kemmis & McTaggart's action research design was used including 2 cycles.The results showed that the previous system had delayed detection and report signs and symptoms of septic shock to the physicians. Thus, patients had a high mortality rate (51.25%). These results led to the developing of nursing care guidelines for septic shock patients in the first six hours, MEWS or qSOFA were added into CNPG. The second cycle development included septic shock fast track. Finding: 1) Increased rate of admitted septic shock patients at medical ICU within 3 hours from 20 % to 82% 2) Sepsis detection increased from none to 97.6 %. 3) Septic shock patients survived without shock stage in six hours increased from 35.52 to 61.03. 4) The mortality rate decreased from 51.25% to 16.5%. 5) Overall satisfaction of care guideline development and utilization among head nurses and registered nurses was high
References
2. The Thai society of critical medicine.Critical care towards optimal perfection. Bangkok: The thai society of critical medicine; 2015.(in Thai)
3. Medical department of Chiang-rai prachanukoh hospital. Sepsis and septic shock medical guideline of Chiang rai prachanukoh hospital 2019. Chiang rai: prachanukoh hospital; 2019.(in Thai)
4. Capuzzo M, Rambaldi M, Pinelli G, Campesato M, Pigna A, Zanello M, et al. Hospital staff education on severe sepsis/septic shock and hospital mortality: An original hypothesis. Anesthesiology 2012; 12(28): 1-8.
5. Miller RR, Dong L, Nelson NC, Brown SM, Kuttler KG, Probst DR, et al. Multicenter implementation of a severe sepsis and septic shock treatment. Am.J. Respir 2013; 188: 77-82.
6. Nasuwan WN, Normkusol J, Thongjam R, Panaput T. Development of the nursing service system for patients with severe sepsis. Journal of Nursing and Health Care 2014; 32(2): 25-36. (in Thai)
7. Suranatchayanan P, Kenthongdee W, Kamonrat S. Nursing care system development for sepsis patients at Loei Hospital. Journal of Nursing and Health Care 2018; 36(1): 207-215. (in Thai)
8.Onswadipong P, Sungkard K, Kusumanaayuthya S, Rongrungruan Y. The effect of early goal directed nursing intervention on severity of organ failure in patients with sepsis syndrome. Journal of Nursing Science 2011; 29(2): 102-10.
9. Niyompruksa A, Chantara P, Yimyam P, Pakdevong N. System development in using clinical practice guideline in caring patients with sepsis syndrome. Journal of Nurses’ Association of Thailand North-Eastern Division 2013; 31(2): 14-24.
10. Kemmis S, McTaggart R. The action research planer 3rd ed. Victoria: Deakin University; 1988.
11. Suttichan K, Phithaksilp M, Prueksaritanond S, Jaidee W. Outcome of quick sequential (sepsis-related) organ failure assessment criteria compare with Chachoengsao’s sepsis screening criteria in patient with infection at Bangpakong hospital. BJM 2018; 5 (1):13-27. (inThai)
12. Sivayoham N, Rhodes A, Jaiganesh T, Van Zyl Smit N, Elkhodhair S, Krishnanandan S. Outcomes from implementing early goaldirected therapy for severe sepsis and septic shock: a 4-year observational cohort study. Eur J Emerg Med 2012;19:235–40.
13. Pornsirirat T, Naayutaya SK, Pinyopasakul P, Thongyu S. Factors predicting septic shock in septicaemic medical patients. Thai Journal of Nursing Council 2015; 30(1): 72-85. (in Thai)
14. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001;345:1368–77.
15. Finfer S, Chittock DR, Su SY, Blair D, Foster D, Dhingra V, et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med 2009; 360(13):1283-97.
16. Liu V, Morehouse JW, Soule J, Whippy A, Escobar GJ. Fluid volume, lactate values, and mortality in sepsis patients with intermediate lactate values. Annals American Thoracic Society 2012; 10: 466-73.
17. Jacob ST, Banura P, Baeten JM, Moore CC, Meya D, Nakiyingi L, et al. The impact of early monitored management on survival in hospitalized adult Ugandan patients with severe sepsis: A prospective intervention study. Critical Care Medicine 2012; 40(7): 2050-58.
18. Priponpalayoy B, Monaipong JS. The effect of participatory nursing supervision program of head nurses on professional nurses' performance in cancer hospitals. Thai Cancer Journal 2015; 2(35): 46-55.(in Thai)
19. Reaunsawang P, Limjareon K, Chathaisong P. The development of nursing supervision model based on knowledge management nursing section, Bamrasnaradura Infectious Diseases Institute. Journal of nursing division 2015; 2(42): 60-73.(in Thai)
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