The Development of Clinical Nursing Practice Guideline for the Patient with Thoracic Aortic Aneurysm
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Abstract
The purpose of this research and development is to develop and evaluate the result of using clinical nursing practice guidelines (CNPG) for thoracic aortic aneurysm patients. This study consisted of 1) a situation analysis based on the Donabedian model. 2) develop CNPG based on the Soukup model and 3) Implement and evaluate the use of guidelines. The study was conducted in the cardiovascular surgery intensive care unit and cardiovascular ward at Rajavithi Hospital from November 2022 - February 2023. A purposive sampling method was used to select samples, which were 1) 26 registered nurses, and 2) 40 thoracic aortic aneurysm patients compared to 20 allocated to a control group and 20 to an experimental group. The data were analyzed using descriptive statistics and t-tests. The result shows that:
1. CNPG compares 4 categories; 1) History taking and an initial assessment 2) management and pre-operation nursing care, 3) Preparation for operation, and 4) post-operation nursing care, discharge planning, and continuity of care.
2. The patient outcome of CNPG reveals that; the length of stay in an experimental group (M = 11.90, SD = 5.04), compared to a control group (M = 13.60, SD = 8.88), decreased but no significant difference (p = .46). Patients have been evaluated and closely monitored for preventable post-operative complications, resulting in 3 patients; acute renal failure, limb ischemia, and bowel ischemia, who were treated promptly and safely from complications. The nursing outcomes are nurses’ knowledge scores increased with statistical significance (t = -16.57, p < .001), gain more clinical skills in 20 persons (76.93%), and demonstrate firm agreement, appropriate, satisfied, and nursing outcomes with the use of CNPG at a high level (M = 4.50, 4.65, and 4.40; SD = .48, .56, and .45 respectively).
The recommendation of the study includes the following of the care process, the using CNPG should be continuously supervised to cover all categories and all issues.
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