Development of a Nursing Model to Prevent Acute Pulmonary Embolism in Surgical Patients Undergoing Anesthesia

Abstract

Abstract: This research and development aimed to develop a Nursing Care Model for preventing acute pulmonary embolism in surgical patients undergoing anesthesia. There were 2 phases: 1) development of the Nursing Care Model; and 2) implementation and outcome evaluation. The sample comprised: 1) 61 healthcare personnel consisting of 33 healthcare team members and 28 nurse anesthesists; and 2) 58 patients undergoing surgical anesthesia divided into pre- and post-implementation of the model, 29 in each group. Research instruments included focus group interview guidelines, a handbook of the Nursing Care Model, and tools to assess the use and outcomes of the Nursing Care Model.  Qualitative data were analysed using content analysis, and quantitative data were analysed by descriptive statistics and paired t-test.  Findings showed that the Nursing Care Model consisted of 3 components: 1) Structure, comprising nursing management; 2) Process, comprising nursing guideline implementation, capacity buiding of the personnel, and supervision; and 3) Outcomes, comprising providers’ outcomes, clients’ outcomes, and organizational outcomes.  Implementation and outcome evaluation of the Nursing Care Model showed the following: 1) urse anesthesists had statistically significant higher scores on knowledge regarding acute pulmonary embolism (p<0.01); they agreed with the Nursing Care Model at a high level (x̅=4.25, SD=0.75); and their performances according the nursing guidelines were high (99.61%); 2) Patients’ satisfaction was at a high level  (x̅=4.40, SD=0.51); even though 6.89% of the patients with at high risk, there were no serious complications; and 3) All patients received screening for risk before the operations and were assessed for risk prevention during the operations. The Nursing Care Model can enhance nurses’ performance to ensure patients’ safety.