The Development and Evaluation of Clinical Nursing Practice Guideline for Critically Ill Children with Extracorporeal Membrane Oxygenation
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Abstract
This study aimed to develop and evaluate clinical nursing practice guidelines for critically ill children receiving Extracorporeal Membrane Oxygenation (ECMO) to avoid complications and enable patients to receive treatment more quickly. Donabedian’s concept of service quality improvement was used and combined with relevant pathophysiology literature to guide the study. The development of evidence-based practice guidelines included 31 research and academic articles. Three stages were created using the following guidelines: 1) ECMO preimplantation nursing care, 2) nursing care while using the ECMO, and 3) post-ECMO nursing care. Three experts evaluated the validity and accuracy of the guidelines, which were then applied to eight critically ill pediatric patients using an ECMO machine. Seventy-five percent of cases required the veno-arterial (VA) ECMO. The average length of stay in the intensive care unit was 11.75 days. The most frequently encountered complication was bleeding. However, when nurses assessed and monitored patients closely, as per clinical nursing practice guidelines, they all were safe. Thrombosis in the pre-membrane circuit was the second complication. When nurses examined the pressure values at the pre-post membrane and checked for clots in the circuit at each turn,
they ensured that the patient was not in danger. From 32 nurses, the probability of following the guidelines was high to extremely high. Overall, nurses reported a high to a very high level of satisfaction with the guideline implementation. This study suggested that ECMO nurses should closely monitor the long-term implications of these clinical nursing practice guidelines for criticallyill pediatric patients receiving ECMO to ensure the feasibility and usefulness of the guidelines for patient safety.
Keywords: Clinical nursing practice guideline, Critical ill children, Extracorporeal membrane oxygenation (ECMO)
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บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในรามาธิบดีพยาบาลสาร ถือเป็นลิขสิทธิ์ของวารสาร หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่หรือเพื่อกระทำการใด ใด จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษรจากรามาธิบดีพยาบาลสารก่อนเท่านั้น
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