Evaluation of the Utilization of Nursing Practice Guidelines for Sepsis Management on Clinical Outcomes among Patients with Sepsis in Medical Units.

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Tarntana Wongtawee
Apinya Siripitayakunkit
Soontaree Jianvitayakij

Abstract

This quasi-experimental research aimed to evaluate the utilization of nursing practice guidelines for sepsis management on clinical outcomes among patients with sepsis. Donabedian’s model was used as a conceptual framework for the implementation of guidelines. The samples consisted of 32 patients with sepsis and 43 medical staff nurses who were recruited for this study from September 2019 to January 2020. The research instrument included the Nursing Practice Guidelines for Sepsis Management, the Personal Data Recording Form, the Nursing Care’ s Checklist Form, the Sequential Organ Failure Assessment (SOFA) Form, the Septic Shock Assessment Form, and the Feasibility of Nursing Practice Guidelines for Implementing in Medical Units Questionnaire. Descriptive statistics and Mann-Whitney U test were used to analyze the data. The results showed that the most common signs and symptoms of patients with sepsis were fever, SBP lower than 100 mmHg, tachypnea, and tachycardia, respectively. Almost all of the nurses practiced and followed the guidelines. However, some activities that did not completely adhere to the guidelines included recording of mean arterial pressure, giving broad-spectrum antibiotics within one hour, and monitoring of patients during the transfer, respectively. After using the guidelines, the level of SOFA decreased in 48 hours as compared to the baseline SOFA scores. Approximately 10% of sepsis patients turned to have septic shock and were transferred to the ICU within 6 hours. From this study, most nurses were satisfied with the guidelines and reported that it is feasible to manage the sepsis. However, the more specific guidelines that should be
developed include the protocol of early antibiotic administration within one hour, the training program for nurses to care for patients with sepsis, and practice guidelines in collaboration with the multidisciplinary team to improve the care quality in patients with sepsis.
Keywords: Nursing practice guidelines, Sepsis, Clinical outcomes, Severity of organ failure,Septic shock

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1.
Wongtawee ธ, Siripitayakunkit A, Jianvitayakij S. Evaluation of the Utilization of Nursing Practice Guidelines for Sepsis Management on Clinical Outcomes among Patients with Sepsis in Medical Units. Rama Nurs J [Internet]. 2021 Apr. 2 [cited 2022 May 24];26(2):155-71. Available from: https://he02.tci-thaijo.org/index.php/RNJ/article/view/241869
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บทความวิจัย

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