The Effect of Clinical Nursing Practice Guidelines on Delirium Prevention among Patients Undergoing Treatment in Cardiac Intensive Care Unit at Somdej Pranangchaosirikit Hospital
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Abstract
The purpose of this quasi-experimental research was to study the effect of clinical nursing practice guidelines on delirium prevention among patients undergoing treatment in the cardiac intensive care unit at Somdej Pranangchaosirikit hospital. The sample group consisted of 44 patients, divided into a control group and an experimental group with 22 patients per group who were matched by sex, age, and Modified Early Warning Score (MEWS). The control group received routine nursing care, while the experimental group followed a clinical nursing practice guideline for delirium prevention. The research tools included: (1) clinical nursing practice guidelines for delirium prevention, which were evaluated by 5 experts and had a content validity of 1; (2) personal information record form; and (3) Confusion Assessment Method of the ICU (CAM-ICU). Data were analyzed using descriptive statistics and Fisher’s exact test. The findings revealed that the acute delirium occurrences between experimental group and control group had no statistical significant difference (p = .412).
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References
Beary T. Delirium prevention: early recognition and treatment. Nursing and Residential Care 2013;15(8):547-51.
Ngamkala T, Malathum P, Krairit O. Incidence and risk factors of acute confusional state in hospitalized older patients. Rama Nurs J 2018;24(2):137-49. (in Thai).
Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet 2014;383(9920):911-22.
Marcantonio ER. Delirium in hospitalized older adults. N Engl J Med 2017;377(15):1456-66.
Laohatanakom S, Jaramillo WI. Development and evaluation clinical practice guidelines for prevention of delirium among critically Ill patients, medicine ward 3, Lampang hospital. Journal of Health Sciences and Pedagogy 2023;3(2):16-33. (in Thai).
Wichian K, Panpanit L. Development of a clinical nursing practice guideline for delirium prevention in older patients admitting in coronary care unit, Khon Kaen hospital. The Journal of Thailand Nursing and Midwifery Council 2012;23(2):26. (in Thai).
Boot R. Delirium: a review of the nurses role in the intensive care unit. Intensive Crit Care Nurs 2012;28(3):185-9.
Chutchawan, Natedao, Untaja P, Yuroong A. The nurses role in delirium management in older persons. Journal of The Royal Thai Army Nurses 2018;19(2):103-10. (in Thai).
Maldonado JR. Delirium in the acute care setting: characteristics, diagnosis and treatment. Crit Care Clin 2008;24(4):657-722.
Van RB, Elseviers MM, Schuurmans MJ, Shortridge-Baggett LM, Truijen S, Bossaert L. Risk factors for delirium in intensive care patients: a prospective cohort study. Crit Care 2009;13(3):R77.
Tabet N, Howard R. Prevention, diagnosis and treatment of delirium: staff educational approaches. Expert Rev Neurother 2006;6(5):741-51.
Bourne RS. Delirium and use of sedation agents in intensive care. Nurs Crit Care 2008;13(4):195-202.
Brummel NE, Girard TD. Preventing delirium in the intensive care unit. Crit Care Clin 2013;29(1):51-65.
Sirisawat M, Paprom W, Nudsuntae P, Kanapol Y. Effects of Clinical Nursing Practice Guidelines for preventing ventilator associated pneumonia in neonates neonatal intensive care unit Sakon Nakhon hospital. RTN Med J 2022;49(3):674-91. (in Thai).
Buckwalter KC, Cullen L, Hanrahan K, Kleiber C, McCarthy AM, Rakel B, et al. Iowa model of evidence-based practice: revisions and validation. Worldviews Evid Based Nurs 2017;14(3):175-82.
Suksiri M, Khuwatsamrit K, Kanogsunthornrat N. The development of clinical practice guideline for pain agitation and delirium management in critically ill surgical patients. Kuakarun Journal of Nursing 2020;27(1):116-28. (in Thai).
Krongyuth S. Managing of delirium in ICU patients. The Journal of Faculty of Nursing Burapha University 2015;23(4):1-15. (in Thai).
Mitchell ML, Kean S, Rattray JE, Hull AM, Davis C, Murfield JE, et al. A family intervention to reduce delirium in hospitalised ICU patients: a feasibility randomised controlled trial. Intensive Crit Care Nurs 2017;40:77-84.
Boettger S, Nuñez DG, Meyer R, Richter A, Fernandez SF, Rudiger A, et al. Delirium in the intensive care setting: a reevaluation of the validity of the CAM-ICU and ICDSC versus the DSM-IV-TR in determining a diagnosis of delirium as part of the daily clinical routine. Palliat Support Care 2017;15(6):675-83.
Rood PJT, Zegers M, Ramnarain D, Koopmans M, Klarenbeek T, Ewalds E, et al. The impact of nursing delirium preventive interventions in the ICU: a multicenter cluster-randomized controlled clinical trial. Am J Respir Crit Care Med 2021;204(6):682-91.
Hartrick CT, Kovan JP, Shapiro S. The numeric rating scale for clinical pain measurement: a ratio measure? Pain Pract 2003;3(4):310-6.
Khantejit K, Kasemkitwatana A, Chayaput A. Development of a clinical nursing practice guideline for prevention of acute delirium in elderly undergoing gastrointestinal surgery. Thai Journal of Nursing Council 2008;23(2):26-37. (in Thai).
Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. New York: Routledge; 1988. p. 473.
Naipat O. Power of the test. The Periodic of Behavioral Science 2001;7(1):1-19. (in Thai).
Lumyong T, Jitpanya C. Factors related to delirium in ICU patients with mechanical ventilators. Thai J Cardio-Thorac Nurs 2012;23(1):19-30. (in Thai).
Ngamsaeng P, Somrarnyart M, Tachaudomdach C, Chittawatanarat K. Effectiveness of implementing Clinical Practice Guidelines for delirium prevention and management in Critically Ill patients. Nursing Journal CMU 2023;50(4):56-76. (in Thai).