Nursing Outcomes after Using Bundle of Care for Pain Management in Patients with Severe Traumatic Brain Injury and Multiple Injury : ผลลัพธ์ทางการพยาบาลภายหลังใช้ชุดการดูแลเพื่อจัดการความปวด ในผู้ป่วยบาดเจ็บสมองรุนแรงและบาดเจ็บอวัยวะอื่นร่วม

บทคัดย่อ

          The research on nursing outcome aimed to assess the levels of pain, drowsiness and number of safety adverse incidences 24, 48 and 72 hours after using the care bundle for pain management developed by Pearkao et.al. The samples were 60 patients with severe traumatic brain injury and multiple injuries divided into 30 patients using this care bundle and 30 patients using the usual standard care reviewed from patients’ history records. Data were collected from September to October, 2018. The content validity index of the instrument was 0.89 and the reliability was 0.93.The general information was analyzed by the frequency, mean and standard deviation. The Chi-Square test and Independent t-test were applied to comparethe differences in nursing outcome between groups. A p-value < .05 was considered significant.

          The nursing outcome after 24, 48 and 72 hours showed that the mean score of pain in sample groups using the care bundle for pain management were 3.81 (SD = .505), 1.91 (SD = .548) and 0.91 (SD = 1.328), respectively. These scores were significantly lower than those in sample group using the usual standard care (p=.002, p =.009, p =.000, respectively). The mean score of drowsiness were 0.84 (SD = .552), 0.67 (SD = .471) and 0.67 (SD = .471), respectively. These scores were significantly lower than those in sample group using the usual standard care (p =.000, p =.000,p=.001, respectively). The nursing outcome in security aspect in the sample group using this care bundle was only on event; drainage tube dislocation whereas there were totally 20 events in sample group using the usual standard care.

          This research suggests that nurses should present and use this care bundle to continuously evaluate the patients leading to proper pain management.

          Keywords : patient with severe traumatic brain injury and multiple injuries, pain management, nursing outcomes