THE DEVELOPMENT OF CLINICAL NURSING PRACTICE GUIDELINE FOR INTRAHOSPITAL TRANSFER IN CRITICALLY ILL PATIENTS AT THE EMERGENCY NURSING DIVISION MAHARAT NAKHON RATCHASIMA HOSPITAL
Keywords:critical nursing practice guideline, intrahospital transfer in critically ill patients
This action research aimed to 1) develop clinical nursing practice guideline (CNPG) for intrahospital transfer in critically ill patients and 2) study the effect of CNPG for critically ill patients on caring outcomes. This study was carried out at the emergency nursing division of Maharat Nakhon Ratchasima hospital, during August 2018 to March 2020. The samples were 182 critically ill patients. Research instruments included 1) CNPG for intrahospital transfer record sheet, 2) participate observationchecklist, 3) the complications checklist and time record, 4) nurses’ satisfaction. The content validity index was verified by five experts at .88, .88, 1.00 and 1.00. Data was analyzed by using descriptive statistic,Fisher's exact test, independent t-test and content analysis.
A statistically significant level was set at .05. The results of this study revealed that:
- The content of CNPG for intrahospital transfer in critically ill patients comprised 3 phases: 1) the pre-transfer phase, including preparation of patients, equipment and personnel, 2) the during-transfer phase, including warning signs assessment in patients, and 3)the post-transfer phase, including recording and nursing communication by SBAR technique.
- The process evaluation showed that emergency nurses complied with CNPG at 96.12% and were satisfied with using the CNPG at 94.82%.
- Clinical outcome showed that 1) the adverse events of accidental extubation, hemodynamic instability, disconnection of intravenous fluid, loss of monitoring and loss of identify was significantly reduced, and 2) The average intrahospital transfer time was statistical significantly reduced at .05.
In conclusion, this study reflects that CNPG for intrahospital transfer in critically ill patients could develop knowledge, personnel competency, innovation and routine nursing practice with more effective for critically ill patients. Therefore, this CNPG could be continuously practiced.
Bergman, L. M., Pettersson, M. E., Chaboyer, W. P., Carlstrom, E. D., & Ringdal, M. L. (2017). Safety hazards during intrahospital transport: A prospective observational study. Critical Care Medicine, 45(10), 1043–1049.
Despoina, A. (2014). Intrahospital transport policies: The contribution of the nurse. Health Science Journal, 8(2), 166-178.
Emergency Care Institute New South Wales. (2016). Improving quality and safety in the ED. Retrieved from https://www.aci.health.nsw.gov.au
Holly, C., & Eileen, B. P. (2014). A systematic review on the transfer of information during nurse transitions in care. Journal of Clinical Nursing, 23(17), 2387–2395.
Jarden, R. J., & Quirke, S. (2010). Improving safety and documentation in intrahospital transport: Development of an intrahospital transport tool for critically ill patients. Intensive and Critical Care Nursing, 26(2), 101–107.
Jones, H. M., Zychowicz, M. E., Champagne, M., & Thornlow, D. K. (2016). Intrahospital transport of the critically ill adult: A standardized evaluation plan. Dimensions of Critical Care Nursing: DCCN, 35(3), 133–146.
Kaewmee, J., (2017). Efficiency improvement of patients’ transportation at the super tertiary hospital in southern thailand. Nursing Journal of the Ministry of Public Health, 27(special), 104-120.
Kemmis, S., & McTaggart, R. (2000). Participatory action research. In K. N. Denzin & S. Y. Lincoln (Eds.), Handbook of qualitative research (2nd ed.) (pp. 567–605). Thousand Oaks, CA: Sage.
Krongyuth, S. (2015). Managing of delirium in ICU patients. Journal of Faculty of Nursing Burapha University, 23(4), 1-15.
Maharat Nakhon Ratchasima Hospital. (2018). Statistical records. Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima.
Melnyk, B. M., & Fineout-Overholt, E. (2005). Evidence-based practice in nursing and healthcare:
A guide to best practice. Philadelphia: Lippincott Williams & Wilkins.
Ringdal, M., Chaboyer, W., & Warrén Stomberg, M. (2016). Intrahospital transports of critically ill patients: Critical care nurses’ perceptions. Nursing in Critical Care, 21(3), 178–184.
Shagana, J. A., Dhanraj, M., & Jain, A. R. (2018). Hypovolemic shock - a review. Drug Invention Today, 10(7), 4.
Soukup, S. M. (2000). The center for advanced nursing practice evidence-based practice model: Promoting the scholarship of practice. The Nursing Clinics of North America, 35(2), 301-309.
Wongnaikot, P., & Saensom, D. (2017). Development of an intrahospital transfer clinical nursing practice guideline for critically ill trauma patients. The National and International Graduate Research Conference 2016, Khon Kaen University, Khon Kaen.
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