Clinical Practice Guideline Implementation in Colorectal Disease Patients undergoing Abdominal Surgery

Abstract

The study on the implementation of clinical practice guideline (CPG) in patients with colorectal disease undergone abdominal surgery was done by using the
CNPG developed based on the literature reviews. The samples were: 32 patients with colorectal diseases who undergone abdominal surgery; and 22 personnel including 5 surgeons, 15 nurses, and 2 practical nurses at a tertiary university hospital in Bangkok. Data were collected during November 2016 - March 2017. Research instruments developed by the researchers included: personal data interviewing form; clinical outcome record forms, patients’ satisfaction questionnaire, personnel satisfaction questionnaire, personnel adherence to CPG records, and perception of nurses’ ability to implement the CPG in caring for the patients. Data were analyzed using descriptive statistics and statistical testing. Results revealed that most of the patients had colorectal cancer. Patients’ outcomes: the implementation of the CPG resulting in length of hospital stay shortening for 2 days, having no incidence of urinary tract infection, and having no reoperation and no readmission within 28 days after discharge. However, infection rates at the surgical sites were not decreased. The patients were most satisfied with: surgeon’ courteous, surgeon’s performing physical examination, and nurse’ caring and helping manners. Personnel’s outcomes: They were satisfied with the CPG at high level and were 100 % adhered to the CPG. Most of nurses perceived their ability to care for the patients. Implementation of the CPG could improve outcomes of patients as well as personnel.