Effectiveness of Clinical Practice Guideline Implementation for Caring of Patients with Aneurysmal Subarachnoid Hemorrhage Post Craniotomy with Clipping Aneurysm

Abstract

This research studied the implementation of clinical practice guidelines (CPG) for caring patients with aneurysmal subarachnoid hemorrhage post craniotomy
with clipping aneurysm. The CPG developed were implemented by 25 multidisciplinary teams of Prasat neurological Institute including 7 physicians, 15 nurses, 1 pharmacologist, 2 physical therapists. The CPG was examined for content validity and feasibility before implementing with 30 patients during July 2016 to August 2017. Data were collected using recording forms and questionnaires, including patients’ health status and satisfaction, multidisciplinary teams’ satisfaction toward the implementation, nurses’ knowledge in caring for patients. Data were analyzed by descriptive statistics. Results showed that the use of guidelines: patients had been observed and monitored for neurological symptoms continuously; patients were received information clearly by advanced practice nurse (APN). Nurses could observe and report for neurological changes to the medical team within one hour, resulting in 1 patient was treated promptly with preventable for postoperative adverse events. One patient had been prevented for unplanned surgical ICU admission. Patients and families’ satisfactions were reported at the high to highest level. Multidisciplinary team was satisfied with the implementation of the guidelines at the high to the highest levels. Nurses’ knowledge in caring for patients after craniotomy was increased from 86.67% to 99.33%. The implementation of the CPG results in better patients’ outcome and promoting the multidisciplinary team-working.