The development of a nursing care model for patients undergoing open heart surgery
Keywords:
nursing care model, nursing practice guideline, nurses’ competencies, open heart surgeryAbstract
This research and development aimed to 1) study the nursing care situation of patients undergoing open heart surgery, 2) develop a nursing care model for patients undergoing open heart surgery and 3) study the development outcomes, consisting of 3.1) nurse competency, 3.2) nurse satisfaction, 3.3) compliance with nursing guidelines, 3.4) complications after open heart surgery, and 3.5) satisfaction with nursing services. The study areas were Cardiothoracic Surgery Intensive Care Unit and Cardiothoracic Surgery ward, Khon Kaen Hospital.The samples were patients undergoing open heart surgery, registered nurses, and related interdisciplinary teams. The research was conducted between August 2022 and April 2023 and divided into 4 phases: 1) analyzing the problems and assessing the needs for the model development, 2) developing the model, 3) piloting and improving the model and 4) evaluating the effectiveness of the model. The model was piloted with 55 patients undergoing open heart surgery and 36 registered nurses. The collection tools were 1) medical record review form, 2) in-depth interview form, 3) group discussion question guideline, 4) nurses satisfaction questionnaire, 5) professional nurses competency assessment form, 6) the compliance of nursing practice guideline assessment form, 7) the data collection form for nursing outcomes, and 8) patient satisfaction assessment form. Analyze and compare the competencies of nurses before and after by using paired t-tests. In addition, comparing the results of the model development before and after the development were obtained by using Chi-square.
The results showed that the nursing care model for patients undergoing open heart surgery consisted of 1) the nursing practice guideline, 2) the development of nurses’ competencies, 3) the nursing supervision, and 4) EWS CVT KKH and CVT KKH Discharge Program. The development outcomes were as follows. 1) The complications and the delayed medical reports in the experimental group were significantly less than the control group (p < 0.05). In addition, the incidence of ICU readmission in 72 hours of the experimental group was less than the control group. The incidence of readmission after 28 days after discharge was not found. 2) The nurses’ competencies in caring for patients undergoing open heart surgery in the 6 aspects after competency development were significantly greater than before the development (p < 0.05). And 3) 81.90% of nurses were satisfied with the nursing care model and patient satisfaction was at high to the highest level. It can be concluded that the nursing care model produced good outcomes for patients, nurses and organizations. It can be the standardized practice guideline used in nursing care for patients undergoing open heart surgery.
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