ผลของแนวปฏิบัติการพยาบาลในการป้องกันภาวะไตบาดเจ็บเฉียบพลัน ต่อผลลัพธ์ทางคลินิก ในผู้ป่วยวิกฤตศัลยกรรม Effect of Acute Kidney Injury Prevention Clinical Nursing Practice Guideline on Clinical Outcomes in Surgical Patients with Critical Illness

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นิษา ถนัดค้า นงลักษณ์ เมธากาญจนศักดิ์

Abstract

This study was a quasi-experimental research to study the effect of acute kidney injury prevention clinical nursing practice guideline (CNPG) on clinical outcomes in surgical patients with critical illness. Samples were 20 registered nurses and 56 patients in the surgical and emergency intensive care unit at Srinagarind Hospital, KhonKaen University. Subjects consisted of 28 critically ill patients receiving routine care, and 28 critically ill patients receiving care based on CNPG for acute kidney injury prevention by 20 registered nurses who implemented the CNPG. Research instruments included: 1) Acute kidney injury risk assessment tool for surgical patient, 2) Acute kidney injury recognition and monitoring tool for critically ill, 3) Fluid assessment tool for critically ill. Relative risk and t-test were calculated to compare effects of implementing the CNPG between two groups.


                The results of this study revealed that:


  1. The incidence of acute kidney injury in the experimental group was equal to 0.46 times compared with the control group (RR = 0.46, 95% Cl = 0.23-0.97, p = 0.02).

  2. Registered nurses had the highest level (= 28.35, SD = 1.87) of satisfaction in using the CNPG and had more than 75 percent adherence to the CNPG procedure

                This study reflects that the CNPG is effective for acute kidney injury prevention. The results showed that surgically critically patients in the experimental group were more likely to receive acute kidney injury risk assessment, acute kidney injury recognition and monitoring, and body fluid assessment.  In addition, nurses reported a high level of satisfaction in using the CNPG. However, the appropriateness of the guideline should be considered if applied in  other setting and to ensure the CNPG effectiveness.

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