Development of Clinical Practice Guidelines for the Care of Patients with Chest Drainage Tubes to Prevent Dislodgement and Obstruction after Open-Heart Surgery: A Pilot Study
Keywords:
Chest drainage tube, Chest tube dislodgement, Chest tube obstruction, Open heart surgeryAbstract
Displacement and occlusion of chest drainage tubes are common problems in patients following open-heart surgery, leading to complications that affect the quality of nursing care. This study aimed to develop clinical practice guidelines for preventing dislodgement and obstruction of chest tubes, based on Soukup’s Evidence-Based Practice Model. The research process consisted of three phases: 1) Evidence-triggered phase, 2) Evidence-supported phase, and 3) Evidence-observed phase. Data collection tools included a chest tube displacement and occlusion incident record form and a nurse satisfaction questionnaire. The data were analyzed by descriptive statistics.
The resulting clinical practice guidelines for preventing dislodgement and obstruction of chest tubes included: 1) chest tube care; 2) care of the insertion site; 3) drainage system management; and 4) assessment of complications. The clinical practice guidelines were reviewed for quality by five experts. The content validity index (CVI) was 0.95. The result of pilot-testing the guidelines, with two post–open-heart surgery patients admitted to the cardiovascular thoracic intensive care unit at Khon Kaen Hospital, revealed that within 72 hours postoperatively, no incidence of chest tube displacement or occlusion were observed. The guidelines were also trialed with three nurses of the same unit, who reported a satisfaction level of 94%.
The findings indicate that implementing the guidelines is feasible, with adjustments made to reduce redundancy in nursing activities. However, further studies in similar settings are recommended before broader clinical application.
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