DEVELOPMENT OF EVIDENCE-BASED NURSING PRACTICE GUIDELINES FOR CARING OF PATIENTS WITH AMPHETAMINE-INDUCED PSYCHOTIC DISORDERS

Abstract

                Objective: This study aims to develop and evaluate the effectiveness of the clinical nursing practice guidelines (CNPGs) of caring for patients with amphetamine-induced psychotic disorders.

                Methods: The CNPGs were developed using the GRADE approach of GIN-McMaster as a conceptual framework. Purposive sampling was used to select participants, who were divided into three groups. Group 1 consisted of twenty healthcare professionals who developed the CNPGs, group 2 consisted of twelve healthcare professionals who implemented the CNPGs and group 3 consisted of thirty patients who were treated as part of the CNPGs implementation and admitted to amphetamine ward of Thanyarak Chiangmai Hospital from July to September 2021. The Clinical Nursing Practice Guidelines (CNPGs) for treating patients with amphetamine-induced psychotic disorders were one of the study tools. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and Brief Psychiatric Rating Scale (BPRS) served as the clinical outcome measures, and the patient satisfaction survey form, healthcare professional satisfaction survey form, and potential for CNPGs survey form served as the process outcome measures. The descriptive statistic, Paired sample t Test, and Wilcoxon Signed Ranks Test were used to analyze the data.

                Results: The CNPGs composed of 1) health assessment 2) nursing planning 3) implementation of nursing planning and 4) evaluation of nursing care. The developed CNPGs were approved by experts based on the AGREE-II criteria. The results found that the mean ASSIST scores before and after the implementation of the CNPGs differed statistical significantly at three months (MD = 18.48, p < .01). Also, there were statistically significant differences between the mean BPRS scores before and after implementation of the CNPGs at two weeks (MD = 3.03, p < .01), one month (MD = 3.76, p < .01), and three months (MD = 0.90, p < .05).  Additionally, the professional nurses who implemented the guidelines and the patients who were treated as part of the CNPGs implementation were satisfied with the CNPGs.

                Conclusion: The developed clinical nursing practice guidelines for patients with amphetamine-induced psychotic disorders were standardized and feasible to implement in clinical settings. Both professional nurses and the target patients were satisfied with the guidelines. Moreover, the clinical outcomes, including psychotic symptoms and amphetamine use among target patients were decreased.