ผลของแนวปฏิบัติการพยาบาลเพื่อป้องกันภาวะไตบาดเจ็บเฉียบพลัน ในผู้ป่วยวิกฤตอุบัติเหตุ โรงพยาบาลขอนแก่น Effects of Clinical Nursing Practice Guideline to Prevent Acute Kidney Injury among Critically Ill Trauma Patients in Khon Kaen Hospital

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อรทัย สืบกินร นงลักษณ์ เมธากาญจนศักดิ์

Abstract

Acute kidney injury (AKI) has been recognized as a serious medical problem in critically ill trauma patients. This two groups quasi-experimental study was conducted to evaluate effects of the clinical nursing practice guideline (CNPG) to prevent AKI among critically ill trauma patients in Khon Kaen Hospital. The subjects were critically ill trauma patients who were admitted to the Trauma Intensive Care Unit of the Khon Kaen Hospital. Eighty subjects were divided equally into two groups as the experimental group and the control group. The experimental group received the CNPG to prevent AKI for 72 hours, whilst the control group received usual standard nursing care (collected data from their medical records). The instruments in this research consisted of 1) The experimental instrument was the CNPG to prevent AKI among critically ill trauma patients. The CNPG was evaluated the quality by an expert panel and yielded an overall score of  91.67% of the AGREE II 2) The demographics data collection form included the risk factors associated with AKI assessment form and AKI monitoring form which were evaluated the quality by an expert panel and yielded a content validity index for scale (S-CVI) of 0.88 and yielded a Kappa of 1.0. Descriptive statistics were used to obtain frequency, percentage, means, standard deviation, median, min and max. The hypotheses were tested by using Z-test and relative risk (RR).


                The results of this study showed the proportion of AKI between two groups was statistically significant difference. The experimental group had 0.39 times the risk of AKI compared to the control group (RR=0.39, 95% Confidence Interval 0.18 to 0.83). The overall satisfaction score of volunteer nurses to CNPG was 4.00 level which was a high level. In conclusion, the CNPG can be used for prevent AKI in critically ill trauma patients in Khon Kaen Hospital.

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