Effects of Using a Nursing Practice Guidelines for the Care of Acute Thrombotic or Ischemic Stroke Patients, Phrae Hospital.
Abstract
Background: Acute stroke is a critical condition in which the brain becomes ischemic, but the brain tissues do not become necrotic. Nurses play a key role in the care of stroke patients, particularly within the first 72 hours. If patients receive the right medical care in time based on evidence-based practice, patients tend to survive with rapid recovery.
Objective: To develop and study the effects of using a nursing practice guidelines for the care of acute thrombotic or ischemic stroke patients.
Study design: This action research with an interrupted time design used the evidence-based practice model of Soukup as the conceptual framework for the nursing practice guideline. The sample was 9 professional nurses in Medical Intensive Care Unit 2, 60 acute thrombotic or ischemic stroke patients receiving routine care only between March-May 2020 and 60 patients treated by using the nursing practice guidelines between June-August 2020. The data were analyzed by using descriptive statistics, paired t-test, exact McNemar test, exact probability test and rank sum test.
Results: The register nurses had higher scores for knowledge about the care of acute thrombotic or ischemic stroke patients, from 15.9 to 18.1 points (p <.001), and a high level of satisfaction in implementing the nursing practice guidelines at 88.9%.The patients in the group using of the nursing practice guidelines had a significantly lower complications than those in the non-using the nursing practice guidelines, pneumonia (13.3% vs 31.7%, p=0.028), urinary tract infection (13.3% vs 40.0%, p=0.002), and pressure ulcers (8.3% vs 31.7%, p= 0.002).
Conclusion: The nursing practice guidelines for the care of thrombotic or ischemic stroke patients during the acute phase is feasible for implementation and able to decreasing complications. Therefore, this guideline should be used on a continual basis.
Keywords: Acute thrombotic or ischemic stroke, nursing practice guideline, pneumonia, urinary tract infection, pressure sores
