Nursing practice for sepsis patients in the Medical Department, Chaopraya Abhaibhubejhr Hospital
Sepsis is an infectious condition that requires urgent assessment and appropriate nursing care to prevent septic shock and various complications. This study's objectives were to develop nursing care practices for sepsis patients in the Medical Department, Chaopraya Abhaibhubejhr Hospital, and examine their outcomes. The concept of participatory action was used to develop nursing practice guidelines for sepsis patients. A coaching technique was also applied to promote nursing practice. Subjects were 10 nurses in the coaching team, 65 nurses, and 366 sepsis patients. The study was divided into 4 phases; Phase 1: Situational Analysis, Phase 2: Development of nursing processes for sepsis patients, Phase 3: Promoting nursing practice, and Phase 4: Evaluation. The instruments used included nursing practice guidelines for sepsis patients and a coaching plan. Data were collected using a questionnaire assessing general characteristics, knowledge, an observation record form called ‘resuscitate: stop sepsis’, culture report, and hospital infectious surveillance form. Data were analyzed using descriptive statistics, paired t-test and chi-square.
Results show that nursing practice guideline for sepsis patients consists of various nursing activities including assessment and screening, nursing care in the 1st hour, the first 6 hours, 24-72 hours, and discharge plan. Outcomes of the development indicated that nurses had increased mean scores of knowledge and practice (p< 0.05). These improvements decreased re-shock and respiratory failure (p< 0.05). Development of nursing practice guidelines using participatory concepts led to nursing practice that was appropriate for this hospital’s context. Promoting practice through coaching can help increase knowledge and practice resulting in decreases in the severity of complications and mortality for sepsis patients.
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