Effectiveness of implementing Evidence-Based Nursing Practice for pediatric patients receiving heated humidified high-flow nasal cannula (HHHFNC)

Abstract

Abstract

Background: Children with lower tract respiratory infections require oxygen therapy to prevent tissue hypoxia and mitigate dyspnea. Heated humidified high flow nasal cannula (HHHFNC) has been reported to improve clinical outcomes by decreasing respiratory rate, heart rate, and dyspnea and increasing oxygen in the blood. However, HHHFNC oxygen therapy guideline has not been explicitly resulting in various and ineffective nursing care. Therefore, researchers applied was developed a nursing practice guideline based on evidence-based practice and implementing them to improve health outcomes among pediatric patients.

Objective: This research aimed to develop and implement the evidence-based nursing practice (EBNP) guidelines for pediatric patients receiving HHHFNC.

Material and methods: The sample comprised of 60 pediatric patients aged between 1 and 5 years old. Thirty participants were enrolled in the control group (receiving nursing standard care), and 30 were in the treatment group (receiving care as EBNP guidelines). Twenty-two healthcare providers took care of these 60 patients. The instruments included pediatric patient demographic, healthcare provider demographic, high flow scores and vital signs from patient records, parent satisfaction, and healthcare provider satisfaction. Three experts validated all tools. The EBNP was validated by experts, Content validity index (CVI) was 0.98. In addition, descriptive statistics, independent t-test, and Mann-Whitney tests were performed.

Result: The study results were as follows 1) the mean score of respiratory rates at the 1^st and 24^th hours were significantly different between before and after development of EBNP (p<.05) but at the 6^th and 12^th hours were not significantly different, 2) the mean score of oxygen saturation at 1^st, 6^th and 12^th hours were not significantly different between before and after the development of EBNP while at 24^th hour were significantly different (p<.001), 3) the mean score of high flow scores at 1^st and 24^th hours were not significantly different between before and after the development of EBNP while, at 6^th and 12^th hours were significantly different (p<.05), 4) the hospital length of stay and medical expenditure were not significantly different between before and after the development of EBNP, 5) Nursing problems had decreased in EBNP group, 6) healthcare provider reported a higher level of satisfaction with EBNP when compared to the standard care.

Conclusion: HHHFNC treatment can improve clinical outcomes in the 1^st hour, reduce respiratory rate, heart rate, high flow scores, and enhance healthcare provider satisfaction. EBNP is beneficial in its, clarification, applicability, feasibility, appropriateness, and time saving.