Effects of Clinical Nursing Practice Guidelines for Preventing Persistent Pulmonary Hypertension of the Newborn (PPHN) in High-risk Newborns at the Neonatal Intensive Care Unit of Sakon Nakhon Hospital

Abstract

          This quasi-experimental research aimed to study the effects of clinical nursing practice guidelines for preventing persistent pulmonary hypertension of the newborn (PPHN) in high-risk newborns including: 1) comparing the incidence of persistent pulmonary hypertension in high-risk newborns between the experimental and control groups, 2) comparing the day spent at the neonatal intensive care unit of high-risk newborns between the experimental and the control groups, 3) examining compliance of the professional nurses to the nursing practice guidelines, and 4) examining the satisfaction of professional nurses after using nursing practice guidelines. The sample was a total of 40 newborns at the neonatal intensive care unit. They were divided into a control group who received nursing care according to the original model, while the experimental group received nursing care according to nursing practices guidelines. There were 20 in each group, and 16 professional nurses working in the neonatal intensive care unit. The research instrument was a clinical nursing practice guidelines for preventing persistent pulmonary hypertension of the newborn in high-risk newborns. The tools used for collecting data consisted of a general information of high-risk newborns and professional nurses, as well as the nurses’ compliance and satisfaction assessment after using the guidelines. The data were analyzed by 1) analyzing personal data of both groups and the researchers analyzed data on compliance with professional nursing guidelines by distributing frequencies, percentages and comparing differences in personal data of the experimental and control groups using the Chi-square test, 2) comparing the incidence rate of persistent pulmonary hypertension and days spent in the neonatal intensive care unit between the experimental and the control groups using the Chi-square test and independent t-test, and 3) analyzing the satisfaction of professional nurses after using the developed guidelines of clinical nurses by using percentages, mean, and standard deviation.
          The results were as follows: 1) Infants in the experimental group had a lower incidence of persistent pulmonary hypertension (30%) than those in the control group (45%) with statistical significance at the .05 level. 2) Infants in the experimental group had a lower number of days spent in the neonatal intensive care unit (Mean = 9.05, SD = 3.50) than those in the control group (Mean = 15.10, SD = 7.17) with statistical significance at the .05 level. 3) Clinical nursing guidelines for preventing persistent pulmonary hypertension in high-risk newborns were developed in 3 phases. Professional nurses who took care for high-risk newborns followed these guidelines. Overall, the level of the clinical nursing practice guidelines was at a high level (88.63%). For phase 1, monitoring to prevent newborns in the high-risk group from developing persistent pulmonary hypertension was (81%), except for the early warning sign activity performed at a moderate level (75%). For phase 2, the score for caring for newborns with persistent pulmonary hypertension was (97.50%), and phase 3 caring for newborns with persistent pulmonary hypertension to prevent the development of complications was (86.22%). Lastly, 4) after using the developed clinical nursing guidelines, professional nurses were satisfied in all aspects at the highest level (Mean = 4.64, SD = 0.43).