Development and Evaluation of Clinical Nursing Practice Guidelines Implementation for Hypovolemic Shock Management Among Critically Ill Patients
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Abstract
This implementation research aimed to develop and evaluate the clinical nursing practice guidelines (CNPGs) implementation for hypovolemic shock management among critically ill patients. The participants included: 1) all surgical critically ill patients (older than 18 years) who were admitted to the intensive care unit before and during the implementation of CNPGs (51 and 45 participants, respectively), and 2) 14 nursing personnel who utilized CNPGs. The implementation research process comprised two phases based on the framework proposed by the Australian National Health and Medical Research Council (NHMRC). The first was to develop CNPGs for hypovolemic shock management among critically ill patients, and the second was the use of CNPGs and to assess the CNPGs implementation process. Results showed that the CNPGs for hypovolemic shock management among critically ill patients comprised six categories: 1) protection of patient rights and ethics, 2) educating nurses about hypovolemic shock, 3) patient care for hypovolemic shock prevention, 4) management of patients with hypovolemic shock, 5) continuous care for patients, and 6) improvement of quality of care. The CNPGs were approved with good quality for all components by AGREE II (80.55-91.66%). Moreover, most of the nursing personnel strongly agreed on the feasibility of the CNPGs implementation covering the six categories at a high level (85.70-92.90%). All participants in the CNPGs implementation group were assessed showing that scores of , prevention, and shock management were higher than those in the before-CNPGs implementation group. The results of this study revealed that the developed CNPGs are appropriate for nurses to implement to improve the quality of hypovolemic shock management among critically ill patients.
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