The Development of Nursing Practice Guidelines for Stroke Patient in The Emergency Accident and Forensic Unit at Sawangweerawong Hospital

Abstract

         This research and development study aimed to develop nursing practice guidelines (NPGs) for patients with stroke and to evaluate the outcomes of their implementation. The participants consisted of 50 patients with stroke who received services at the emergency and forensic unit of Sawangweerawong Hospital. Purposive sampling was used to select participants, who were divided into two groups: an experimental group (n = 25) that received the stroke NPGs developed by the researcher and a comparison group (n = 25) that received the existing standard stroke NPGs. The research instruments included the stroke NPGs and a stroke patient screening record form. Data were analyzed using descriptive statistics, independent samples t–test, Chi-square test, and Risk Ratio (RR).
         The results revealed that the stroke NPGs developed by the researcher consisted of four components: 1) assessment and screening at the triage point, 2) nursing interventions and risk management, 3) pre-transfer nursing care before referral to a higher-capacity referral hospital, and 4) nursing care during patient transfer. The mean of door-to-refer time in the experimental group was significantly longer than that in the comparison group (M = 65.20, SD = 41.59 and M = 55.72, SD = 31.73, respectively; p = .009). However, the mean of door-to-refer time in the experimental group was significantly shorter than that in the comparison group (M = 25.68, SD = 2.75 and M = 42.12, SD = 11.62, respectively; p = .000). The probability of receiving recombinant tissue plasminogen activator (rt-PA) therapy was higher in the experimental group than in the comparison group (RR = 2.00, 95%CI = .80 - 5.02). However, the difference was not statistically significant (p = .108).