Effectiveness of Clinical Nursing Practice Guidelines of Discharge Planning for Home Skin Traction in Elderly Patients with Hip Fracture in Phayao Hospital

Abstract

          This quasi-experimental research aimed to determine the effectiveness of following nursing guidelines of discharge planning in elderly patients with hip fracture who applied home skin traction. The research compared data collected from two groups of samples; pre- and  post- implementation of the nursing guidelines of discharge planning in elderly patients with   hip fracture who applied home skin traction. The samples were elderly patients with hip fracture of Orthopedics Ward, Phayao Hospital in 2017-2020. A total of 111 patients were divided into the experimental group 53 patient and the control group 58 patient. The sample size calculated using  Two-sample comparison of proportion. The power was set 80 alpha 0.05 two side test. Use the sample size of at least 58 patients in each group, but the experimental group had only 53 people. The data were analyzed and presented by using figures, percentage, mean, and standard deviation Furthermore, exact probability test (t-test) was used to compare data accordingly to its character. Additionally, multivariable logistic regression was used to analyze the effectiveness of the guidelines.

          The research showed that baseline characteristics was no statistically significant difference between the groups studied, except the body mass index. It was also found that patients given nursing care by following the newly developed nursing guidelines significantly healed better and faster.  The developed guidelines were also found to generate substantial higher scores on the activities of daily living scale and reduce the risk of developing pressure ulcers (p-value= .013, .004, <.001, and .004).

          From the multivariable logistic regression analysis, were also found that using the newly developed guidelines increased bone attachment (OR 4.18 95% CI 1.47 -11.89, p-value .013) generate substantial higher scores on the activities of daily living scale (OR 3.17 95% CI 3.09 -4.24, p-value < .001) and reduce the risk of developing pressure ulcers (OR .15 95% CI .51-.44, p-value= .004) and reduce the LOS  (.04 95%, CI .007-.033 ,p-value <.001) 

          Correspondingly, it was recommended that the newly developed nursing guidelines of discharge planning for home skin traction in elderly patients with hip fracture should follow when given care to patients with other kinds of illnesses or injuries, as well as shared to other departments.