ผลของโปรแกรมส่งเสริมการใช้แนวปฏิบัติทางคลินิกต่อการปฏิบัติของพยาบาลและการติดเชื้อในระบบทางเดินปัสสาวะที่สัมพันธ์กับการคาสายสวนปัสสาวะในหอผู้ป่วยวิกฤตอายุรกรรม Effects of Clinical Practice Guideline Use Promotion on Nurses, Practices and Catheter - Associated Urinary Tract Infections in Medical Intensive Care Unit

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ปัทมา วงษ์กียู้ วงเดือน สุวรรณคีรี ณิชกานต์ ทรงไทย

Abstract

The purpose of this                pretest-posttest quasi-experimental research was to study effects of the program to promote clinical practice guideline use on nurses, practices and catheter-associated urinary tract infections (CAUTI) in medical intensive care unit. The program was developed based on Roger's Theory of Innovation Diffusion. The study sample consisted of 2 groups including 18 nurses who were currently working at Medical Intensive Care Unit and 68 patients who retained a urinary catheter. The patient participants were divided into 2 groups before and after program implementation, 34 patients in each group. The study intervention was the program to promote the use of CAUTI prevention clinical practice guideline. The research instruments for data collection included the nurses’ practice observation form and CAUTI record form. The content validity was evaluated by the three experts that yielded the CVI of 0.94 for the nurses’ practice observation form. The reliability coefficients for observation form and urinary tract infection diagnosis were 0.96 and 1, respectively. The data were analyzed by descriptive statistics and McNemar test.


                Findings revealed that the nurses, clinical practice use to prevent CAUTI after program implementation (92.2 %) significantly higher than those before program implementation (83.3 %) at p<.05. The incidence of CAUTI decreased from 3.8 to 0 per 1,000 catheterized days after program implementation. This study indicates that program to promote clinical practice use based on Roger’s theory is helpful to improve the nurses’ use of  CAUTI prevention guideline and decrease CAUTI.

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