Developing Guidelines for Caring Patients Using Norepinephrine to Prevent Phlebitis in Ranong Hospital

Abstract

Background: Norepinephrine is a high-alert drugs that can cause phlebitis.

Objective: To develop and evaluate the outcomes of implementing clinical care guidelines for patients receiving norepinephrine to prevent phlebitis at Ranong Hospital.

Methods: This research and development study included patients receiving norepinephrine in the female medical ward, male medical ward, and intensive care unit before and after the implementation of the guideline, from March 20 to July 5, 2024, and from March 20 to July 5, 2025, respectively, with 88 patients in each group. The research instruments included care guidelines for patients receiving norepinephrine to prevent phlebitis, norepinephrine prescription forms, dosage adjustment tables, phlebitis surveillance warning labels, and patient medical records. Data were analyzed using descriptive statistics and the chi-square test.

Results: The guidelines were developed through brainstorming sessions with the development team and clinical leadership in internal medicine. The guidelines and implementation tools were finalized collaboratively. After implementation, medication prescribing errors decreased from 100.0% to 54.0% (p-value < 0.05). Nurses’ compliance with recording nursing information increased from 26.4% to 77.0% (p-value < 0.05). However, the number of patients with phlebitis showed no statistically significant difference (p-value > 0.05).

Conclusion: The development of multidisciplinary, team-based care guidelines for patients receiving norepinephrine can reduce medication prescribing errors and improve nurses’ adherence to the guidelines.