The development Clinical Nursing Practice Guideline for Hypertensive Disorder Pregnant for Ceasarean section undergoing General Anesthesia in Nakhonnayok Hospital
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Abstract
This research and development aimed to: (1) develop the clinical nursing practice guideline (CNPG) of general anesthesia management for cesarean delivery in patients with pregnancy induced hypertension; and (2) study the results of the guideline implementation in Nakhonnayok hospital. The samples were 14 nurse anesthetists and 20 patients with pregnancy induced hypertension who were delivered by cesarean section. Instruments included the patient record form, the audit practice form and the nurse’s opinion questionnaire. The study comprised of 3 phases. The first phase was to identify problems from relevant documents and from nurse anesthetists’ practice. The second phase was to develop CNPG based on the National Health and Medical Research Council (NHMRC), Australia. The developed CNPG was assessed for validity and usability by five experts (CVI=1). It was evaluated by using the Appraisal of Guideline Research and Evaluation (AGREE II) with the high quality of 92.17%. The final phase was to implement the revised CNPG into real practice and evaluate the outcomes. Descriptive statistics were used to analyze data. Results showed that: (1) the problems in general anesthesia management for cesarean delivery in patients with pregnancy induced hypertension included various practices of the nurse anesthetists, unclear CNPG, and 2 patients with complications; (2) the developed CNPG composed of 18 items within 3 phases: Pre- anesthetic (7 items), Peri– anesthetic (6 items), and Post- anesthetic phases (5 items); (3) the outcomes of CNPG implementation showed that patents had no complication. The developed CNPG was applicable to the clinical setting. All nurse anesthetists could follow the CNPG correctly in the peri-anesthetic and post-anesthetic phases. The developed CNPG could be used in patients within the similar contexts of this study.
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