Effects of upper gastrointestinal bleeding care bundle on selected outcomes among surgical patients in the Tertiary Care Hospital

Authors

  • กาญจนา ขุ่มด้วง คณะพยาบาลศาสตร์ มหาวิทยาลัยขอนแก่น
  • Donwiwat Saensom

Keywords:

upper gastrointestinal bleeding, care bundle, selected outcomes

Abstract

This quasi-experimental research was conducted to study the effects of using the upper gastrointestinal bleeding care bundle (UGIB-CB) on selected outcomes among surgical patients. Study subjects were 146 UGIB patients admitted to the surgical department of a tertiary hospital. The comparison group consisted of 73 patients who were cared with the hospital routine while 73 patients of the experimental group received care with UGIB-CB. The study outcomes included clinical outcomes and human resource outcomes. Research instruments consisted of the UGIB-CB assessment form, nurse’s adherence to UGIB-CB form, and nurse’s satisfaction in using UGIB-CB form. Descriptive statistics were used to obtain frequencies, percentages, means and standard deviations.  Independent t-test, Chi-square and Relative risk were used to analyze the effects of UGIB-CB outcomes.

          The results showed that patients in the experimental group were 1.75 times more likely to receive esophagogastroduodenoscopy (EGD) on-time, compared to the comparison group (RR = 1.75, 95% CI 1.26-2.44). They also had higher average urine output in the first 24 hours (97.18 ml. for experimental and 82.53 ml. for comparison group, p .03).  Registered nurses who implemented the UGIB-CB reported a very high level of protocol adherence (95.89%) and expressed a high level of satisfaction in using the care bundle (82.93%).  Results from this study indicated that the UGIB-CB is feasible and effective in helping patients to have on-time EGD and achieving good clinical outcomes. 

References

Wongjitrat C, Wongchittarat N. Causes of upper gastrointestinal bleeding in hospitals, Her RoyalHighnessPrincessMahaChakriSirindhorn Medical center. Department of Internal Medicine Faculty of Medicine, Srinakharinwirot University 2013; 20: 46-52. (in Thai)

Iamcharoen T. Postpartum hemorrhage: The important role of nurses in prevention of postpartum hemorrhage: Significance of nurse’s roles in prevention. Private Higher Education Institute of Thailand under the Patronage of Her Royal Highest Princess Maha Chakri Sirindhorn Siam Borom Rajakarn 2017; 6: 146-57. (in Thai)

Viprakasit V. Approach to childhood anemia. J Hematol Transfus Med 2014; 24: 395-405.

Basile DP, Anderson MD, Sutton TA. Pathophysiology of acute kidney injury. Compr Physiol 2014; 2: 1303–53. doi:10.1002/cphy.c110041.

Medical Statistics, Khon Kaen ospital. Surgical patient statistics 2015-2017. Khon Kaen: Medical Record and Statistics Section, Khon Kaen hospital; 2017. (in Thai)

MRCP FFICM IASE, FRCA PKB, MRCP FRCA FFICM SI. Management of acute upper GI bleeding. BJA Education 2017;17(4):117-23. doi: 10.1093/bjaed/mkw054

Tang Y, Shen J, Zhang F, Zhou X, Tang Z, You T, et al. Scoring systems used to predict mortality in patients with acute upper gastrointestinal bleeding in ED. AM J EMERG MED 2018;36:27-32.

Abdelrahman M, Hornby S. Upper gastrointestinal haemorrhage. DOCME 2017;35:649-57.

Siau K, Chapman W, Sharma N, Tripathi D, Iqbal T, Bhala N. Management of acute upper gastrointestinal bleeding: An update for the general physician. J R Coll Physicians 2017; 47:218-30.

Chaikitchokamnuay R, Pathumannon C. The score for predicting the severity of gastrointestinal bleeding in 2014. J Public Health 2016;25:421-35.

Leone M, Asfar P, Radermacher P, Vincent J, Martin C. Optimizing mean arterial pressure in septic shock: A critical reappraisal of the literature. ‎Crit Care 2015;19(101):1-7. doi:10.1186/s13054-015-0794-z.

Jetsrisuphap A. Basic laboratory tests in hematology and factors that cause the results to be inaccurate. J Hematol Transfus Med 2016;26(2):91-5. (in Thai)

Ngamjarus C, Chongsuvivatwong V. N4 Studies: Sample size and power calculations for android. [dissertation]. The Royal Golden Jubilee: The Thailand Research Fund & Prince of Songkla University;2014. (in Thai)

The Joanna Briggs Institute. School of translational health scienceand. The joanna briggs institute 2014 annual report; 2014. Available from: https://onesearch.library.uwa. edu.au/discovery/fulldisplay?docid=alma 9931464502101&context=L&vid=61UWA_ INST:UWA&search_scope=MyInst_and_CI&tab=Everything&lang=en by linking through and searching for JBI20468

Srisamrit A, Panprasert S, Panmethit I. Development of Caring System for Patients with Upper Gastrointestinal Hemorrhage. JND 2014; 41(1): 36-55. (in Thai)

Li C, Yun D. Improvement effect of early goal-directed therapy on the prognosis in patients with septic shock. Chin Crit Care Med 2015;27(11):899-905.

Semler MW, Rice TW. Sepsis resuscitation: Fluid choice and dose. Clin Chest Med 2016; 37(2): 241-50. doi:10.1016/j.ccm.2016.01.007.

Suksathien S. Causes and factors predicting the occurrence of early gastrointestinal bleeding. MNRH 2019; 41:21-8.

Nuengnasuwan W, Nomkusol J, Thongjam R, Panaput T. Development of the nursing service system for patients with severe sepsis. J NAT-MED 2014; 32(2): 25-36. (in Thai)

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Published

2020-12-26

How to Cite

1.
ขุ่มด้วง ก, Saensom D. Effects of upper gastrointestinal bleeding care bundle on selected outcomes among surgical patients in the Tertiary Care Hospital. JNSH [Internet]. 2020 Dec. 26 [cited 2024 Mar. 29];43(4):72-83. Available from: https://he01.tci-thaijo.org/index.php/nah/article/view/243828

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Research Article