Development of a Clinical Nursing Practice Guideline for Stroke Patient Care at Home, Wichian Buri District, Phetchabun Province

Abstract

The effects of subacute stroke patients, nurses are essential in the care of stroke patients at home. Patients are more likely to be safe and without complications when they receive the appropriate nursing care based on evidence-based practice. The purposes of the research and development were as follow: 1) to investigate the challenges and needs of stroke patients, 2) to develop a clinical nursing practice guideline (CNPG) for stroke patient care in home setting, and 3) to examine the effect of a clinical nursing practice guideline for stroke patients care at home, in Wichian Buri District, Phetchabun Province.The sample categorized based on to the development process into four distinct stages: Stage 1- Evidence-triggered phase, the participants consisted of 15 registered nurses. Stage 2- Evidence-support phase, the samples consisted of 14 research papers that underwent a scoping review of the literature. Stage 3- Evidence-observed phase, the sample of 10 stroke patients and 10 caregivers who received care according to the CNPG. Stage 4- Evidence-based phase, the sample of 10 registered nurses who provided care using the developed CNPG. All samples were selected by purposive sampling. The research utilized several tools including  1) a brainstorming guideline, which aided in the analysis of data through conclusion and data synthesis, 2) the developed CNPG, 3) the Thai version assessment form of activity daily living, and deformities, and 4) a questionnaire to assess  on the readiness of caregivers for stroke care at home, and a questionnaire to assess nurse’s satisfaction toward the usage of the CNPG, The data were analyzed by using descriptive and non-parametric statistics.

The results revealed as follows: The subacute stroke patients faced a range of issues including physical, psychological, social, and economic domains. The CNPG for stroke patients receiving care at home addressing four key issues: (1) the patients’ inability to perform activities of daily living, (2) providing nursing care to prevent to complications resulting from limited mobility, (3) alleviating anxiety related to the illness, and (4) reducing the risk of recurrence. Following the evaluation of the CNPG, stroke patients showed a significant improvement in their activities of daily living score compared to before the CNPG testing. Additionally, caregivers shown a considerably greater level of readiness after the CNPG testing, and registered nurses expressed satisfaction with the CNPG.