ผลการใช้แนวปฏิบัติการพยาบาลทางคลินิกในการป้องกันภาวะไตบาดเจ็บเฉียบพลันในผู้ป่วยผ่าตัดหัวใจแบบเปิดที่ได้รับยาระงับความรู้สึกแบบทั่วไป

Ratchanee  Traiyawong; Nonglak  Petporkha; Voranut   Simadumrongchai; Supaporn  Chareongparu; Kanikar  Hemrungroj

Authors

Ratchanee Traiyawong Division of Nursing Research and Development, Department of Nursing Maharat Nakhon Ratchasima Hospital
Nonglak Petporkha Division of Anesthesiology Nursing, Department of Nursing Maharat Nakhon Ratchasima Hospital
Voranut Simadumrongchai Division of Anesthesiology Nursing, Department of Nursing Maharat Nakhon Ratchasima Hospital
Supaporn Chareongparu Division of Nursing Research and Development, Department of Nursing Maharat Nakhon Ratchasima Hospital
Kanikar Hemrungroj Division of Anesthesiology Nursing, Department of Nursing Maharat Nakhon Ratchasima Hospital

Keywords:

clinical nursing practice guideline, cardiac surgery– associated acute kidney injury, open heart surgery patients

Abstract

This research was quasi-experimental with a historical control group posttest. The objectives were to evaluate the effects of the clinical nursing practice guideline (CNPG) during surgery to prevent CS-AKI in patients undergoing open-heart surgery. The total participants were 20 anesthetist nurses and 68 patients who were undergoing open-heart surgery. The control group (n = 34), who were simple random sampled and retrospective data collected, received standard nursing care. Meanwhile, the experimental group (n = 34, purposive sampling) received nursing care followed by CNPG that was prospectively implemented and data collected. The instruments in this research consisted of 1) the CNPG during surgery to prevent CS-AKI in patients undergoing open-heart surgery and 2) the record form of adherence related to the CNPG procedure and satisfaction in using the CNPG. The content validity index was .88-1.00 and the reliabilities of each record form were 1.00, .88, and .83, respectively. Data analysis was performed using descriptive statistics and binary logistic regression.

The results of this study revealed that: 1) The proportion of CS-AKI between two groups had a statistically significant difference. The experimental group had a statistically significant chance of developing CS-AKI .27 times that of the control group. (Adjusted OR = .27, 95%CI = .08 - .92, p < .05). 2). The overall satisfaction score of volunteer nurses to CNPG was 97% and more than 92.50% adherence to the CNPG.

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