Development and Evaluation of Clinical Nursing Practice Guideline to Prevent Undesirable Outcomes in Caring for Children with Tracheostomy Tube at Home
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Abstract
Taking care of children with tracheostomy tube at home is a difficult and complicated situation. Development and use of clinical nursing practice guideline could standardize the care, as well as prevent undesirable outcomes. This research aimed to: (1) develop clinical nursing practice guideline in caring for children with tracheostomy tube at home using evidence based practice; (2) assess the feasibility in implementing the guideline; and (3) evaluate the outcomes of clinical nursing practice guideline implementation. The samples were 29 nurses and case studies of caregiving for children with tracheostomy tube. Data collection tools developed by the researchers were: the feasibility assessment form and questionnaire on satisfaction of nurses using the guideline; and the case study recording form. Data were analyzed by descriptive statistics and content analysis. Results showed that: (1) the developed practice guideline was based on 80 evidences and consisted of 3 stages: before discharge; preparing for discharge; and after discharge. The guideline was examined be 3 experts. The content validity for the scale/average (S-CVI/Ave) was 0.99 and for S-CVI/UA was 0.98; (2) the feasibility of the guideline was reported at the high level (Mean = 61.2; SD = 6.59); and (3) the evaluation of the guideline implementation from 27.6% of nurses reported at high satisfaction level (Mean = 4.25; SD = 0.46). The undesirable outcome reported from the case study was the tracheostomy tube slipped off. However, the caregiver could manage the situation without being back to the hospital. The developed clinical nursing practice guideline could help caregiver in caring for the child with tracheostomy tube at home safely. The guideline should be further monitored and evaluated.
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