THE DEVELOPMENT OF A CLINICAL NURSING PRACTICE GUIDELINE FOR PREVENTION OF INCREASED INTRACRANIAL PRESSURE IN PATIENTS WITH EXTERNAL VENTRICULAR DRAINAGE IN THE SURGICAL INTENSIVE CARE UNIT AT YASOTHON HOSPITAL

Abstract

This action research study employed Soukup's evidence-based nursing practice model to develop and evaluate the feasibility and implementation of nursing practice guidelines for preventing increased intracranial pressure in patients undergoing ventricular drainage surgery, as well as to assess professional nurses' satisfaction with the guidelines. The research was conducted in four phases: Phase 1 involved literature review and data collection to identify clinical problems through nursing practice experiences, medical record reviews, and knowledge sources. Phase 2 focused on developing nursing practice guidelines through evidence-based practice searches using the PICO framework Phase 3 consisted of pilot implementation of the nursing practice guidelines in the clinical unit. Phase 4 involved full implementation of the refined practice guidelines in the healthcare setting. In addition, analyzed using descriptive statistic: frequency, percentage, mean, and standard deviation.

The results of this study found that: 1) maintaining adequate cerebral blood flow control,2) maintaining adequate cerebrospinal fluid circulation, 3) monitoring warning signs of increased intracranial pressure, 4) maintaining adequate ventilation, and 5) observing abnormal symptoms following cerebrospinal fluid drainage catheter removal. All nurses successfully implemented the practice guidelines, with no incidents of increased intracranial pressure observed. Nurses demonstrated the highest level of satisfaction (M = 3.75, S.D. = 0.17). This study established practice guidelines that nursing personnel can implement uniformly, enhancing patient care quality and reducing the incidence of increased intracranial pressure.